PMID- 42951053 OWN - NLM STAT- Publisher LR - 20261028 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) DP - 2026 Oct 28 TI - Rationale for Early Discontinuation of Aspirin After Transcatheter Aortic Valve Implantation: Design of the SOLOTAVI Randomized Trial. PG - 107634 LID - S0002-8703(26)00296-6 [pii] LID - 10.1016/j.ahj.2026.107634 [doi] AB - BACKGROUND: Trans-aortic valve implantation (TAVI) has become the first line treatment of aortic stenosis, a condition predominantly affecting elderly patients. In absence of a specific indication for antithrombotic therapy, lifetime aspirin is recommended after TAVI while it may be discontinued 3 months after bioprosthetic surgical valve replacement. Primary prevention, using aspirin compared to placebo among elderly patients is associated with an increased risk of major bleeding and no reduction rates of thrombotic events. Hence, there is a gap of knowledge on whether aspirin should be continued >3 months after TAVI. STUDY DESIGN: SOLOTAVI is a multicenter, open label, blinded endpoint assessment, 1:1 randomized, non-inferiority trial comparing aspirin discontinuation 3 months after TAVI (experimental) to long-term therapy (control). Adult patients with successful transfemoral TAVI for symptomatic aortic stenosis and no indication or contraindication for long-term antithrombotic therapy will be enrolled. Randomization is stratified on center and valve type. The primary endpoint is the 12-month composite of all cause death, myocardial infarction, stroke, and non-procedure-related major or disabling bleeding. A hierarchical analysis is performed for the primary and 3 principal secondary endpoints. The sample size is computed for demonstrating the non-inferiority of the experimental strategy compared with the control strategy, with a conservative non-inferiority margin of 6.5%. A total of 1400 patients will be enrolled. CONCLUSIONS: The SOLOTAVI trial will assess the non-inferiority of a 3-month duration of aspirin compared to the long-term therapy after successful transfemoral TAVI in terms of thrombotic and bleeding events. NCT06518317 clinicaltrials.org. CI - Copyright (c) 2026. Published by Elsevier Inc. FAU - Beygui, Farzin AU - Beygui F AD - Cardiology Department, Centre Hospitalier Universitaire de Caen, & INSERM UMRS 1237, Caen, France. Electronic address: beygui-f@chu-caen.fr. FAU - Caussin, Christophe AU - Caussin C AD - Cardiology Department, Institut Medico-chirurgical Monsouris, Paris, France. FAU - Marliere, Stephanie AU - Marliere S AD - Cardiology Department, Centre Hospitalier Universitaire de Grenoble, Grenoble France. FAU - Bonnet, Guillaume AU - Bonnet G AD - Cardiology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France. FAU - Durand, Eric AU - Durand E AD - Cardiology Department, Centre Hospitalier Universitaire de Rouen & INSERM U1096 & Institut Alain Cribier, Rouen, France. FAU - Lhermusier, Thibaud AU - Lhermusier T AD - Cardiology Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France. FAU - Morelle, Jean-Francois AU - Morelle JF AD - Cardiology Department, Hopital Prive Saint Martin, Caen, France. FAU - Delepine, Stephane AU - Delepine S AD - Cardiology Department, Centre Hospitalier Universitaire de Angers, Angers, France. FAU - Souteyrand, Geraud AU - Souteyrand G AD - Cardiology Department, Centre Hospitalier Universitaire de Clermont Ferrand, Clermont Ferrand, France. FAU - Ghostine, Said AU - Ghostine S AD - Cardiology Department, Center Chirurgical Marie Lannelongue, Plessis-Robinson, France. FAU - Van Belle, Eric AU - Van Belle E AD - Cardiology Department, Centre Hospitalier Universitaire de Lille, Lille, France. FAU - Barthelemy, Olivier AU - Barthelemy O AD - Cardiology Department, Centre Hospitalier Universitaire Pitie-Salpetriere, AP-HP, Paris, France. FAU - Akodad, Mariama AU - Akodad M AD - Ramsay Sante, Institut Cardiovasculaire Paris Sud, Massy, France. FAU - Cayla, Guillaume AU - Cayla G AD - Cardiology Department, Centre Hospitalier Universitaire de Nimes, Nimes, France. FAU - Chamandi, Chekrallah AU - Chamandi C AD - Cardiology Department, Hopital Europeen Georges Pompidou, AP-HP, Paris, France. FAU - Chemouni, Frank AU - Chemouni F AD - Cardiology Department, Institut Medico-chirurgical Monsouris, Paris, France. FAU - Parienti, Jean-Jacques AU - Parienti JJ AD - Department of Clinical Research, Centre Hospitalier Universitaire de Caen, Caen, France. FAU - Bouleti, Claire AU - Bouleti C AD - University of Poitiers, Clinical Investigation Center Inserm 1402 & Cardiology Department, Centre Hospitalier Universitaire de Poitiers, Poitiers & FACT network, France. FAU - Eltchaninoff, Helene AU - Eltchaninoff H AD - Cardiology Department, Centre Hospitalier Universitaire de Rouen & INSERM U1096 & Institut Alain Cribier, Rouen, France. CN - SOLOTAVI Investigators LA - eng SI - ClinicalTrials.gov/NCT06518317 PT - Journal Article DEP - 20261028 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM OTO - NOTNLM OT - Trans-aortic valve implantation OT - aspirin OT - bleeding OT - outcome EDAT- 2026/10/28 23:27 MHDA- 2026/10/28 23:27 CRDT- 2026/10/28 20:33 PHST- 2026/08/30 00:00 [received] PHST- 2026/10/24 00:00 [revised] PHST- 2026/10/25 00:00 [accepted] PHST- 2026/10/28 23:27 [medline] PHST- 2026/10/28 23:27 [pubmed] PHST- 2026/10/28 20:33 [entrez] AID - S0002-8703(26)00296-6 [pii] AID - 10.1016/j.ahj.2026.107634 [doi] PST - aheadofprint SO - Am Heart J. 2026 Oct 28:107634. doi: 10.1016/j.ahj.2026.107634. PMID- 42941432 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261027 LR - 20261028 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 20 DP - 2026 Oct 14 TI - Early and Long-Term Results of 101 Consecutive Patients After Transcarotid Transcatheter Aortic Valve Implantation. LID - 10.3390/jcm15207917 [doi] LID - 7917 AB - Background/Objectives: Transcatheter aortic valve implantation through the common carotid artery (TC-TAVI) is one of the possible treatment options for patients with ineligible transfemoral approach. The aim of our study was to evaluate the efficacy and safety of patients treated with TC-TAVI in early and long-term follow-up. Methods: The study included patients with severe aortic stenosis treated with TC-TAVI. In-hospital outcomes, early, long-term follow-up were presented in accordance with the VARC-3 recommendations. Results: The analysis presented 101 patients. We observed high procedural success-97% (n = 98). The number of VARC-3 incidents: 3.96% major vascular complications; 0.99% myocardial infarction; 0.99% cardiac tamponade; 0.99% life-threatening bleeding; 3.96% cerebrovascular incidents. The NYHA class decreased significantly compared to the pre-procedure value (2 [1-2] vs. 3 [3-3]; p < 0.001). There was a significant improvement in postprocedural cerebral oximetry values compared to baseline on both the implanted and contralateral sides (67.5 [63-71]% vs. 70 [63.5-75]%; p < 0.05) and (67 [64-71]% vs. 71 [64-76]%; p < 0.05), respectively. The 30-day, 1-year, and 2-year survival rates were 94.1%, 80.2%, and 69.3%, respectively. In the univariate analysis, BAV (HR 4.54; 95% CI: 1.14-17.99; p = 0.03) and LVEF 14 minutes (>75th percentile), and determinants were assessed using Firth's penalised logistic regression. RESULTS: The device time was shorter with semi-rapid deployment (9.0 [interquartile range [IQR] 6.0-13.0] minutes vs 14.0 [IQR 11.0-16.0] minutes; p<0.001), while operation and procedure times were similar (p=0.13 and p=0.16, respectively). The mean recapture count was higher in the semi-rapid group (0.85+/-1.09 vs 0.53+/-0.70; p=0.08), and contrast volume was higher (32.0 [IQR 25.0-42.0] mL vs 25.0 [IQR 15.0-33.0] mL; p=0.008). Paravalvular leak >=mild (31.2% vs 32.1%; p=1.0) and in-hospital pacemaker implantation (2.1% vs 7.5%; p=0.37) did not differ significantly between the groups. In multivariable analysis, recapture predicted a prolonged device time (adjusted odds ratio [OR] 4.74, 95% confidence interval [CI]: 1.75-14.19; p=0.002), whereas the semi-rapid workflow predicted a reduced device time (adjusted OR 0.10, 95% CI: 0.01-0.66; p=0.015). CONCLUSIONS: Semi-rapid pacing-assisted Evolut FX deployment selectively reduced device time without compromising early in-hospital safety outcomes. Deployment efficiency represents a practical procedural target for workflow refinement in self-expanding TAVI. FAU - Doi, Shinichiro AU - Doi S AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Iwata, Hiroshi AU - Iwata H AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Sato, Eiichiro AU - Sato E AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Takahashi, Norihito AU - Takahashi N AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Kaneko, Tomohiro AU - Kaneko T AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Nozaki, Yui Okada AU - Nozaki YO AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Uchiyama, Daisuke AU - Uchiyama D AD - Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Okazaki, Shinya AU - Okazaki S AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Tabata, Minoru AU - Tabata M AD - Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Tang, Gilbert H L AU - Tang GHL AD - Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, USA. FAU - Minamino, Toru AU - Minamino T AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20261023 PL - France TA - AsiaIntervention JT - AsiaIntervention JID - 101697313 PMC - PMC13689742 COIS- S. Doi is a clinical proctor for Medtronic and Abbott; and a screening proctor for Edwards Lifesciences. T. Kaneko receives research grants from the Japanese Circulation Society; honoraria from Abbott; and belongs to an endowed department funded by ABeam Consulting. M. Tabata reports research funding from Medtronic. G.H.L. Tang has received speaker honoraria from and served as a physician proctor, consultant, advisory board member, TAVR publications committee member, RESTORE study steering and screening committee member, APOLLO trial screening committee member, and IMPACT MR steering committee member for Medtronic; has received speaker honoraria from and served as a physician proctor, consultant, advisory board member, ENVISION trial screening committee member, and TRILUMINATE trial anatomic eligibility and publications committee member for Abbott; and has served as an advisory board member for Boston Scientific, Anteris, Philips, Edwards Lifesciences, Peija Medical, and Shenqi Medical Technology. The other authors have no conflicts of interest to declare regarding this manuscript. EDAT- 2026/10/25 03:36 MHDA- 2026/10/25 03:37 PMCR- 2026/10/23 CRDT- 2026/10/24 11:43 PHST- 2026/03/27 00:00 [received] PHST- 2026/08/13 00:00 [accepted] PHST- 2026/10/25 03:37 [medline] PHST- 2026/10/25 03:36 [pubmed] PHST- 2026/10/24 11:43 [entrez] PHST- 2026/10/23 00:00 [pmc-release] AID - 10.4244/AIJ-D-26-00029 [doi] PST - epublish SO - AsiaIntervention. 2026 Oct 23;12(3):191-200. doi: 10.4244/AIJ-D-26-00029. eCollection 2026 Oct. PMID- 42923763 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261024 LR - 20261025 IS - 2491-0929 (Electronic) IS - 2426-3958 (Print) IS - 2426-3958 (Linking) VI - 12 IP - 3 DP - 2026 Oct TI - Dedicated versus off-label transcatheter devices for pure native aortic regurgitation via transfemoral access: a meta-analysis of contemporary outcomes. PG - 225-235 LID - 10.4244/AIJ-D-26-00011 [doi] AB - BACKGROUND: Pure native aortic regurgitation (PNAR) poses unique technical challenges for transcatheter aortic valve implantation (TAVI), including annular dilatation and absent calcification for anchoring. Whilst dedicated aortic regurgitation (AR) devices have been developed, their comparative performance against off-label devices specifically via transfemoral access - the contemporary standard approach - remains incompletely defined. AIMS: We aimed to compare the outcomes of dedicated versus off-label transcatheter devices for PNAR via transfemoral access in contemporary practice. METHODS: We systematically searched PubMed (MEDLINE) and Cochrane CENTRAL (January 2020-November 2025) for studies reporting transfemoral TAVI outcomes in PNAR. The primary outcome was 30-day mortality. Random-effects meta-analysis with meta-regression was performed. RESULTS: Twenty-four studies (2,956 patients) were included comprising 25 cohorts: 4 cohorts (537 patients) evaluated dedicated devices, and 21 cohorts (2,419 patients) assessed off-label devices. Overall, 30-day mortality was 3.3% (95% confidence interval [CI]: 2.3-4.8%). Dedicated devices showed a trend towards lower mortality (1.9% vs 4.1%, odds ratio [OR] 0.45, 95% CI: 0.20-1.00; p=0.051; risk ratio 0.40, 95% CI: 0.19-0.83). Dedicated devices achieved higher device success (95.8% vs 85.7%, OR 3.64; p=0.012), lower rates of residual AR >=moderate (0.6% vs 6.2%, OR 0.11; p=0.048), reduced valve embolisation (2.0% vs 7.3%, OR 0.26; p=0.048), and fewer reinterventions (2.0% vs 7.9%, OR 0.22; p=0.010). Permanent pacemaker implantation (20.8%), stroke (2.6%), and major bleeding (3.0%) were similar between groups. CONCLUSIONS: In contemporary transfemoral TAVI for PNAR, dedicated devices demonstrated superior procedural outcomes compared with off-label devices. These findings support the preferential use of dedicated devices in this population, though randomised trials are needed to establish definite treatment recommendations. FAU - Hon, Joshua J AU - Hon JJ AD - Faculty of Medicine, Imperial College London, London, United Kingdom. FAU - Egrilmezer, Archie AU - Egrilmezer A AD - Faculty of Medicine, Imperial College London, London, United Kingdom. FAU - Hon, Jimmy K F AU - Hon JKF AD - Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. LA - eng PT - Journal Article DEP - 20261023 PL - France TA - AsiaIntervention JT - AsiaIntervention JID - 101697313 PMC - PMC13689733 COIS- J.K.F. Hon reports reception of speaker honoraria from Edwards Lifesciences and Medtronic. The other authors have no conflicts of interest to declare. EDAT- 2026/10/25 03:36 MHDA- 2026/10/25 03:37 PMCR- 2026/10/23 CRDT- 2026/10/24 11:19 PHST- 2026/01/27 00:00 [received] PHST- 2026/04/21 00:00 [accepted] PHST- 2026/10/25 03:37 [medline] PHST- 2026/10/25 03:36 [pubmed] PHST- 2026/10/24 11:19 [entrez] PHST- 2026/10/23 00:00 [pmc-release] AID - 10.4244/AIJ-D-26-00011 [doi] PST - epublish SO - AsiaIntervention. 2026 Oct 23;12(3):225-235. doi: 10.4244/AIJ-D-26-00011. eCollection 2026 Oct. PMID- 42920634 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261024 LR - 20261025 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - Temporal changes in dilated ascending aorta after transfemoral TAVR: a comparative analysis of bicuspid and tricuspid aortic valves. PG - 1878963 LID - 10.3389/fcvm.2026.1878963 [doi] LID - 1878963 AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) addresses valvular obstruction but leaves concomitant ascending aortic dilatation untreated. Whether bicuspid aortic valve (BAV) morphology inherently accelerates post-TAVR aortic expansion compared with tricuspid aortic valves (TAV) remains uncertain. METHODS: This retrospective cohort study included 189 older adults (BAV, n = 87; TAV, n = 102) with severe aortic stenosis and ascending aortic dilatation (>/=4.5 cm) undergoing TAVR. Annualized aortic expansion rates were evaluated utilizing linear mixed-effects models derived from serial computed tomography angiography over a median 27.0-month follow-up. RESULTS: No ascending aortic dissection, rupture, or elective aortic interventions occurred during follow-up. The adjusted annualized expansion rate at the mid-ascending aorta was low and comparable between the BAV and TAV cohorts (0.43 vs. 0.39 mm/year; interaction P = 0.364). Progression rates at the distal ascending aorta and sinuses of Valsalva similarly demonstrated no significant morphological differences. No patient exhibited rapid progression (>5 mm/year). Although moderate or greater paravalvular leakage occurred exclusively in BAV patients (4.8% vs. 0.0%; P = 0.043), its overall incidence was low (2.2%); however, the extremely small number of cases precluded a definitive statistical assessment of its impact on longitudinal aortic expansion. CONCLUSIONS: In this selected cohort, dilated ascending aortas exhibited slow intermediate-term expansion following transfemoral TAVR utilizing self-expanding valves, with comparable rates between BAV and TAV morphologies. These findings suggest that conservative management of concomitant ascending aortic dilatation may be a reasonable strategy in older TAVR candidates during intermediate-term follow-up, provided that strict blood pressure control and rigorous imaging surveillance are maintained. CI - (c) 2026 Xu, Xu, Dai, Chen and Lin. FAU - Xu, Qichen AU - Xu Q AD - Department of Cardiovascular Surgery, Fujian Provincial Center for Cardiovascular Medicine, Union Hospital, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China. FAU - Xu, Zheng AU - Xu Z AD - Department of Cardiovascular Surgery, Fujian Provincial Center for Cardiovascular Medicine, Union Hospital, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China. FAU - Dai, Xiaofu AU - Dai X AD - Department of Cardiovascular Surgery, Fujian Provincial Center for Cardiovascular Medicine, Union Hospital, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China. FAU - Chen, Liangwan AU - Chen L AD - Department of Cardiovascular Surgery, Fujian Provincial Center for Cardiovascular Medicine, Union Hospital, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China. FAU - Lin, Zhiqin AU - Lin Z AD - Department of Cardiovascular Surgery, Fujian Provincial Center for Cardiovascular Medicine, Union Hospital, Fujian Medical University, Fuzhou, China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China. LA - eng PT - Journal Article DEP - 20261009 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13690726 OTO - NOTNLM OT - aortic remodeling OT - aortopathy OT - ascending aortic dilatation OT - bicuspid aortic valve OT - transcatheter aortic valve replacement COIS- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/10/24 05:35 MHDA- 2026/10/24 05:36 PMCR- 2026/10/09 CRDT- 2026/10/24 04:53 PHST- 2026/05/12 00:00 [received] PHST- 2026/09/25 00:00 [revised] PHST- 2026/09/28 00:00 [accepted] PHST- 2026/10/24 05:36 [medline] PHST- 2026/10/24 05:35 [pubmed] PHST- 2026/10/24 04:53 [entrez] PHST- 2026/10/09 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1878963 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Oct 9;13:1878963. doi: 10.3389/fcvm.2026.1878963. eCollection 2026. PMID- 42904374 OWN - NLM STAT- Publisher LR - 20261022 IS - 2149-2271 (Electronic) IS - 2149-2263 (Linking) DP - 2026 Oct 21 TI - Early and Mid-Term Mortality After Transcatheter Aortic Valve Implantation: Five-Year Experience from the KOSUTAVI Study. LID - 10.14744/AnatolJCardiol.2026.6567 [doi] AB - BACKGROUND: Although transcatheter aortic valve implantation (TAVI) outcomes are well-documented, predictors of mortality beyond conventional surgical risk scores and valve-related factors in real-world, high-risk cohorts require further elucidation. This study aimed to identify the key determinants of 30-day and 1-year mortality following TAVI, with a focus on both patient-specific and procedure-specific complications. METHODS: The KOSUTAVI study is a single-center, retrospective cohort analysis of 859 consecutive high-risk individuals with severe aortic stenosis undergoing TAVI between 2020 and 2025. Primary endpoints were 30-day and 1-year all-cause mortality. Multivariate Cox regression and Kaplan-Meier analyses were used to identify independent risk factors. RESULTS: Mean age was 78.7 +/- 6.5 years, and mean Society of Thoracic Surgeons score was 7.4 +/- 2.2. The 30-day and 1-year mortality rates were 6.5% (n = 56) and 12.4% (n = 107), respectively. The 5-year all-cause mortality rate was 26.3%. In multiple Cox's analysis, chronic renal failure (hazard ratio [HR] = 7.75, P = .008, 95% CI = 1.29-16.54), presentation with cardiogenic shock (HR = 5.83, P = .028, 95% CI = 1.19-15.41), major vascular injury (HR = 22.7, P = .019, 95% CI = 1.89-45.91), and cardiac tamponade (HR = 17.9, P = .012, 95% CI = 8.13-52.62) were independently associated with 30-day mortality. While these factors were all significant in univariate analysis for 1-year mortality, they did not retain independence in the multiple model. Valve type, access route, and sex were not associated with increased mortality. CONCLUSION: In a high-risk TAVI population, early mortality is predominantly driven by pre-existing renal dysfunction and acute procedural complications (shock, vascular injury, and tamponade), rather than valve-specific factors. These findings underscore the critical importance of optimizing renal function before the procedure and implementing advanced vascular protection strategies to improve early survival after TAVI. FAU - Zehir, Regayip AU - Zehir R AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Alizade, Elnur AU - Alizade E AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Usalp, Songul AU - Usalp S AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Emiroglu, Mehmet Yunus AU - Emiroglu MY AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Kargin, Ramazan AU - Kargin R AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Ozdemir, Nihal AU - Ozdemir N AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Kirma, Cevat AU - Kirma C AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Kaymaz, Cihangir AU - Kaymaz C AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Turkmen, Mehmet Muhsin AU - Turkmen MM AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Pala, Selcuk AU - Pala S AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Kulahcioglu, Seyhmus AU - Kulahcioglu S AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. FAU - Kirali, Mehmet Kaan AU - Kirali MK AD - Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialization Training and Research Hospital, University of Health Sciences, Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20261021 PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 SB - IM EDAT- 2026/10/22 17:33 MHDA- 2026/10/22 17:33 CRDT- 2026/10/22 15:56 PHST- 2026/10/22 17:33 [medline] PHST- 2026/10/22 17:33 [pubmed] PHST- 2026/10/22 15:56 [entrez] AID - 10.14744/AnatolJCardiol.2026.6567 [doi] PST - aheadofprint SO - Anatol J Cardiol. 2026 Oct 21. doi: 10.14744/AnatolJCardiol.2026.6567. PMID- 42897923 OWN - NLM STAT- Publisher LR - 20261020 IS - 2149-2271 (Electronic) IS - 2149-2263 (Linking) DP - 2026 Oct 19 TI - Ultrasound-Guided versus Fluoroscopy-Guided Femoral Access for Structural Heart Procedures: Outcomes From Transcatheter Aortic Valve Implantation and Left Atrial Appendage Closure. LID - 10.14744/AnatolJCardiol.2026.6536 [doi] AB - BACKGROUND: Transfemoral access is the default approach for transcatheter aortic valve implantation (TAVI) and left atrial appendage closure (LAAC). Although ultrasound (US)-guided femoral puncture improves first-pass success and reduces vascular complications in randomized trials, real-world data in contemporary structural heart interventions, including both arterial and venous large-sheath access, remain limited. The authors aimed to compare US-guided vs. conventional transfemoral access in patients undergoing TAVI and LAAC. METHODS: This single-center, retrospective cohort study included 165 consecutive patients undergoing transfemoral structural procedures between January 2022 and December 2024 (93: TAVI; 72: LAAC). Ultrasound guidance was used in 57 procedures (34.5%). Arterial and venous cohorts were analyzed separately. Primary outcomes were absolute hemoglobin decrease (DeltaHb) and access-site vascular complications (hematoma, pseudoaneurysm, and arteriovenous fistula). In the arterial cohort, 1 : 1 propensity score matching was performed to adjust for baseline differences. RESULTS: Hemoglobin decline was significantly smaller with US guidance in both venous (0.80 +/- 0.95 vs. 1.50 +/- 1.11 g/dL; P = .009) and arterial procedures (0.58 +/- 0.97 vs. 1.29 +/- 1.00 g/dL; P = .002). In the venous cohort, complication rates were numerically lower but not statistically different (3.8% vs. 17.4%; P = .143). In contrast, arterial complications were significantly reduced with US guidance. After propensity matching (31 patients per group), complications occurred in 3.2% vs. 29.0% [Absolute Risk Reduction(ARR) = 25.8%, Number Need to Treat (NNT) = 4, P = .013]. CONCLUSIONS: Ultrasound-guided transfemoral access was associated with reduced hemoglobin decline and fewer vascular complications, particularly in large-bore arterial procedures, supporting routine integration of real-time US guidance in structural interventions. FAU - Kivrak, Ahmet AU - Kivrak A AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Sezer, Can AU - Sezer C AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Canpolat, Ugur AU - Canpolat U AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Ates, Ahmet Hakan AU - Ates AH AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Cop, Selahattin AU - Cop S AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Coteli, Cem AU - Coteli C AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Yorgun, Hikmet AU - Yorgun H AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Sahiner, Mehmet Levent AU - Sahiner ML AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Kaya, Ergun Baris AU - Kaya EB AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Ozer, Necla AU - Ozer N AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. FAU - Aytemir, Kudret AU - Aytemir K AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye. LA - eng PT - Journal Article DEP - 20261019 PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 SB - IM EDAT- 2026/10/20 05:30 MHDA- 2026/10/20 05:30 CRDT- 2026/10/20 02:53 PHST- 2026/10/20 05:30 [medline] PHST- 2026/10/20 05:30 [pubmed] PHST- 2026/10/20 02:53 [entrez] AID - 10.14744/AnatolJCardiol.2026.6536 [doi] PST - aheadofprint SO - Anatol J Cardiol. 2026 Oct 19. doi: 10.14744/AnatolJCardiol.2026.6536. PMID- 42887713 OWN - NLM STAT- Publisher LR - 20261016 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) DP - 2026 Oct 16 TI - Transcarotid Access for Transcatheter Aortic Valve Replacement With the Evolut Self-Expanding Valve: Outcomes from a Real-World Registry. LID - S0003-4975(26)01031-3 [pii] LID - 10.1016/j.athoracsur.2026.09.055 [doi] AB - BACKGROUND: Transcarotid access for transcatheter aortic valve replacement (TAVR) is the most commonly used alternate access in the United States. Real-world evidence on transcarotid access using the Evolut self-expanding valve based on larger numbers of patients may help inform treatment optimization towards better outcomes. METHODS: The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry was queried for patients undergoing native TAVR using transcarotid access with an Evolut (January 2015-December 2024). In-hospital, 30-day, and 1-year outcomes are reported. RESULTS: We identified 2,105 patients (mean age 78.3+/-7.9 years) with mean Society of Thoracic Surgeons predicted risk of mortality 6.4+/-5.3. Most were high/extreme surgical risk (60.0%) with New York Heart Association class III/IV heart failure symptoms (66.8%) and mean baseline Kansas City Cardiomyopathy Questionnaire (KCCQ) Score 45.3+/-25.4. Implant success was 99.6% primarily using general anesthesia (95.8%) with median procedure time of 88.0 (Q1=68.0, Q3=115.0) minutes. Median length of stay was 2.0 (Q1=1.0, Q3=3.0) days; 89.0% were discharged to home. In-hospital, 30-day and 1-year all-cause mortality was 2.1%, 3.8% and 16.5%; stroke occurred in 3.1%, 3.8% and 5.1% of patients, respectively. At 30 days, major vascular complications (1.9%), valve related (0.4%) and non-valve related (10.9%) readmissions were low. The mean change in KCCQ score from baseline to 1-year was +30.5+/-27.1 points. CONCLUSIONS: Transcarotid TAVR with the Evolut TAV is an effective, safe approach for patients with unfavorable iliofemoral anatomy. Heart teams should become facile with this technique to provide optimal care across the anatomy spectrum. CI - Copyright (c) 2026. Published by Elsevier Inc. FAU - Allen, Keith B AU - Allen KB AD - St. Luke's Mid America Heart Institute, Kansas City, MO, United States. Electronic address: kallen2340@aol.com. FAU - Huded, Chetan AU - Huded C AD - St. Luke's Mid America Heart Institute, Kansas City, MO, United States. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York, NY and St. Francis Hospital, Roslyn, NY, United States. FAU - Reardon, Michael AU - Reardon M AD - Houston Methodist Debakey Heart & Vascular Center, Houston, TX, United States. FAU - Saxon, John AU - Saxon J AD - University Of Virginia, Charlottesville, VA, United States. FAU - Modine, Thomas AU - Modine T AD - Universite de Bordeaux, Bordeaux, France. FAU - Leroux, Lionel AU - Leroux L AD - Hopital Cardiologique du Haut-Leveque, Pessac, France. FAU - Paone, Gaetano AU - Paone G AD - Emory University Atlanta, Atlanta, GA, United States. FAU - Kemp, Clinton AU - Kemp C AD - Sentara Health, Norfolk, VA, United States. FAU - Eisenberg, Ruth AU - Eisenberg R AD - Structural Heart, Medtronic, Minneapolis, MN, United States. FAU - Grier, Elizabeth AU - Grier E AD - St. Luke's Mid America Heart Institute, Kansas City, MO, United States. FAU - Chhatriwalla, Adnan K AU - Chhatriwalla AK AD - St. Luke's Mid America Heart Institute, Kansas City, MO, United States. LA - eng PT - Journal Article DEP - 20261016 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM OTO - NOTNLM OT - TAVR OT - TVT Registry OT - Transcarotid OT - Transcatheter Aortic Valve Replacement OT - self-expanding EDAT- 2026/10/16 23:33 MHDA- 2026/10/16 23:33 CRDT- 2026/10/16 19:36 PHST- 2026/01/30 00:00 [received] PHST- 2026/06/03 00:00 [revised] PHST- 2026/09/14 00:00 [accepted] PHST- 2026/10/16 23:33 [medline] PHST- 2026/10/16 23:33 [pubmed] PHST- 2026/10/16 19:36 [entrez] AID - S0003-4975(26)01031-3 [pii] AID - 10.1016/j.athoracsur.2026.09.055 [doi] PST - aheadofprint SO - Ann Thorac Surg. 2026 Oct 16:S0003-4975(26)01031-3. doi: 10.1016/j.athoracsur.2026.09.055. PMID- 42876001 OWN - NLM STAT- Publisher LR - 20261015 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) DP - 2026 Oct 14 TI - Short-Term Complications of Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis (PROLONG-TAVR). LID - 10.1002/ccd.70944 [doi] AB - To estimate the cumulative incidence of short-term complications across different transcatheter heart valve (THV) prostheses used for transcatheter aortic valve replacement (TAVR). We performed a systematic review and meta-analysis in accordance with PRISMA and a prospectively registered PROSPERO protocol. Observational studies published from 2002 through May 2024 that included patients with severe aortic stenosis undergoing predominantly transfemoral TAVR and reported prosthesis-specific complications were eligible. Although the original protocol intended to evaluate both short- and long-term complications, long-term outcomes were too sparse and inconsistently reported for robust pooled analyses; therefore, the present analysis focuses on short-term complications. Pooled cumulative incidences were calculated using random-effects models. We included 242 studies comprising 181,187 patients. SAPIEN 3 had the lowest incidence of moderate-to-severe paravalvular leak (PVL) (1.04%, 95% CI 0.69-1.55) and stroke (1.87%, 95% CI 1.64-2.14), whereas ACURATE neo2 had the lowest incidence of permanent pacemaker implantation (PPI) (7.7%, 95% CI 5.82-10.11). Evolut PRO and SAPIEN 3 showed among the lowest rates of major vascular complications (3.56%, 95% CI 2.77-4.57 and 3.87%, 95% CI 3.22-4.66, respectively) and major or life-threatening bleeding (2.96%, 95% CI 2.09-4.17 and 4.8%, 95% CI 4.04-5.69, respectively). Short-term complications have decreased with newer-generation THV prostheses. PVL remains more frequent with self-expanding valves, whereas PPI is the most frequent complication and is generally less frequent with balloon-expandable valves and ACURATE neo2. Stroke rates have changed little across newer generations, and annular rupture, coronary artery obstruction, and valve embolization remain rare (< 1%). CI - (c) 2026 Wiley Periodicals LLC. FAU - Castillo-Perez, Mauricio AU - Castillo-Perez M AUID- ORCID: 0000-0003-1881-9471 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Leon-Gutierrez, Humberto De AU - Leon-Gutierrez H AUID- ORCID: 0000-0003-2426-8776 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Jerjes-Sanchez, Carlos AU - Jerjes-Sanchez C AUID- ORCID: 0000-0003-3222-7405 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. AD - Instituto de Cardiologia y Medicina Vascular, TecSalud, Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico. FAU - Royzman-Rivera, Lillian AU - Royzman-Rivera L AUID- ORCID: 0009-0006-9634-7130 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Paredes-Vazquez, Jose Gildardo AU - Paredes-Vazquez JG AUID- ORCID: 0000-0002-6895-8026 AD - Instituto de Cardiologia y Medicina Vascular, TecSalud, Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico. FAU - Jimenez-Franco, Vicente AU - Jimenez-Franco V AUID- ORCID: 0000-0003-4340-493X AD - Instituto de Cardiologia y Medicina Vascular, TecSalud, Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico. FAU - Gutierrez-Gallegos, Paola AU - Gutierrez-Gallegos P AUID- ORCID: 0000-0001-6586-1993 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Cabada-Garcia, Maria J AU - Cabada-Garcia MJ AUID- ORCID: 0009-0000-2846-100X AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Rodriguez-Rivera, Jahir AU - Rodriguez-Rivera J AUID- ORCID: 0000-0003-2748-4992 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Paredes-Gutierrez, Enrique AU - Paredes-Gutierrez E AUID- ORCID: 0009-0009-4846-8490 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Quevedo-Salazar, Renata AU - Quevedo-Salazar R AUID- ORCID: 0000-0002-6149-2243 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. FAU - Sanchez-Avila, Juan F AU - Sanchez-Avila JF AUID- ORCID: 0000-0002-4636-9028 AD - Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. AD - Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico. LA - eng PT - Journal Article PT - Review DEP - 20261014 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM OTO - NOTNLM OT - TAVR OT - complications OT - pacemaker implantation OT - paravalvular leak OT - stroke OT - transcatheter heart valve EDAT- 2026/10/15 07:18 MHDA- 2026/10/15 07:18 CRDT- 2026/10/15 01:14 PHST- 2026/09/09 00:00 [revised] PHST- 2025/12/11 00:00 [received] PHST- 2026/09/29 00:00 [accepted] PHST- 2026/10/15 07:18 [medline] PHST- 2026/10/15 07:18 [pubmed] PHST- 2026/10/15 01:14 [entrez] AID - 10.1002/ccd.70944 [doi] PST - aheadofprint SO - Catheter Cardiovasc Interv. 2026 Oct 14. doi: 10.1002/ccd.70944. PMID- 42875325 OWN - NLM STAT- Publisher LR - 20261014 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) DP - 2026 Oct 8 TI - Short-frame, self-expanding, fully recapturable transcatheter aortic valve replacement device in pure aortic regurgitation: Procedural performance and 30-day outcomes. LID - S1553-8389(26)00424-0 [pii] LID - 10.1016/j.carrev.2026.10.006 [doi] AB - BACKGROUND: Achieving stable anchoring and effective sealing remains the principal limitation of transcatheter aortic valve replacement (TAVR) in patients with pure native aortic regurgitation (PNAR). A short-frame, fully recapturable self-expanding valve may expand the procedural margin by enabling iterative repositioning and implantation depth optimisation in non-calcified anatomy. METHODS: We analysed 13 consecutive patients with symptomatic moderate-to-severe or severe PNAR who underwent transfemoral TAVR with the ScienCrown(R) (Lepu Medical, Beijing, China) system. The primary endpoint was technical success at exit from the procedure room according to VARC-3 criteria. Secondary endpoints included device success and early safety at 30 days. RESULTS: Technical success was achieved in all patients (13/13, 100%), and device success at 30 days was also achieved in all patients (13/13, 100%). The 30-day early safety endpoint was met in 12 patients (92.3%). The mean prosthesis size was 27.62 +/- 1.26 mm, with a mean prosthesis diameter oversizing relative to the average annular diameter of 12.90 +/- 3.54%; no balloon predilatation was performed. The mean number of deployment attempts was 1.62 +/- 0.77. All procedures were completed without valve embolisation/migration, coronary obstruction, second-valve implantation, or emergency surgery. One patient (7.69%) developed complete atrioventricular block on postoperative day 3 and underwent permanent pacemaker implantation; no additional pacemaker implantations occurred through 30 days. Predischarge diffusion-weighted magnetic resonance imaging demonstrated no new acute cerebral infarction. At 30 days, there were no deaths, strokes or transient ischaemic attacks, myocardial infarction, life-threatening/major bleeding, major vascular complications, endocarditis, or valve-related reinterventions. Mean transvalvular gradients were 7.67 +/- 5.20 mmHg, and all patients had improved or stable NYHA functional class with no moderate or severe residual aortic regurgitation. CONCLUSIONS: In this exploratory single-centre series, transfemoral TAVR using a short-frame, fully recapturable self-expanding valve achieved 100% technical success and favourable early safety and haemodynamic performance in selected patients with PNAR. Prospective multicentre studies with longer follow-up and appropriate comparator groups are warranted. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Yan, Hui AU - Yan H AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, 430000, China; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, 430000, China. FAU - Li, Yunyao AU - Li Y AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, 430000, China; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, 430000, China. FAU - Wan, Weiguo AU - Wan W AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. FAU - Liao, Haihan AU - Liao H AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. FAU - Cao, Sheng AU - Cao S AD - Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. FAU - Song, Hongning AU - Song H AD - Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. FAU - Zhou, Xiaoya AU - Zhou X AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, 430000, China; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, 430000, China. FAU - Jiang, Hong AU - Jiang H AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, 430000, China; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, 430000, China. FAU - Huang, Bing AU - Huang B AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, 430000, China; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei, 430000, China. Electronic address: binghuang@whu.edu.cn. LA - eng PT - Journal Article DEP - 20261008 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM OTO - NOTNLM OT - Implantation depth OT - Paravalvular leak OT - Pure aortic regurgitation OT - Recapture OT - Self-expanding valve OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/10/14 23:32 MHDA- 2026/10/14 23:32 CRDT- 2026/10/14 22:03 PHST- 2026/08/19 00:00 [received] PHST- 2026/09/29 00:00 [revised] PHST- 2026/10/01 00:00 [accepted] PHST- 2026/10/14 23:32 [medline] PHST- 2026/10/14 23:32 [pubmed] PHST- 2026/10/14 22:03 [entrez] AID - S1553-8389(26)00424-0 [pii] AID - 10.1016/j.carrev.2026.10.006 [doi] PST - aheadofprint SO - Cardiovasc Revasc Med. 2026 Oct 8:S1553-8389(26)00424-0. doi: 10.1016/j.carrev.2026.10.006. PMID- 42870852 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261014 LR - 20261015 IS - 2225-319X (Print) IS - 2304-1021 (Electronic) IS - 2225-319X (Linking) VI - 15 IP - 5 DP - 2026 Sep 30 TI - Surgery that looks like transcatheter aortic valve implantation: the transaxillary concept for minimally invasive aortic valve replacement in 1,848 consecutive patients. PG - 64 LID - 10.21037/acs-2026-0232-tdv [doi] LID - 64 AB - BACKGROUND: The transaxillary (TxA) approach for minimally invasive aortic valve replacement (MICS-AVR) is a sternum-sparing technique that combines surgical valve replacement with virtually no visible scarring. We report institutional outcomes of the first 1,848 consecutive TxA MICS-AVR procedures. METHODS: This retrospective single-center cohort included all consecutive patients undergoing isolated TxA MICS-AVR between January 2019 and June 2026. Patients with active endocarditis, redo surgery, or concomitant procedures were excluded. Primary endpoints were 30-day mortality and major adverse cardiac and cerebrovascular events (MACCEs). Univariable and multivariable logistic regression explored associations with adverse outcomes. RESULTS: Mean age was 67.7+/-8.1 years, Society of Thoracic Surgeons Predicted Risk of Operative Mortality (STS-PROM) 1.39%+/-2.90%, and European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) 1.65%+/-1.12%. TxA use among surgical treatments for isolated aortic valve disease rose from 18.8% in 2019 to 99.2% in 2025. Mean operative, cardiopulmonary bypass, and cross-clamp times were 132+/-34, 69+/-23, and 43+/-16 minutes. No intraoperative death occurred; 1.6% required conversion to sternotomy. Thirty-day mortality was 0.5%, and MACCE occurred in 1.6%, including stroke in 0.9% and myocardial infarction in 0.5%. In multivariable analysis, mortality associations were strongest for insulin-treated diabetes [odds ratio (OR) 8.56], left ventricular ejection fraction (LVEF) <40% (OR 8.45), and intraoperative transfusion (OR 17.86); corresponding MACCE associations included insulin-treated diabetes (OR 3.06), coronary artery disease (OR 2.46), peripheral arterial disease (OR 3.23), sternotomy conversion (OR 5.33), and transfusion (OR 5.49). These outcomes accompanied rapid institutional adoption of the technique, while operative efficiency remained favorable and the need for sternotomy conversion stayed low throughout the cohort. Given only 10 deaths and 30 MACCEs, multivariable findings should be considered exploratory and hypothesis-generating. CONCLUSIONS: Across 1,848 consecutive procedures, TxA MICS-AVR showed excellent reproducibility and safety. As long-term evidence increasingly supports surgical valve replacement in patients with extended life expectancy, TxA uniquely combines durable surgery with a cosmetic result comparable to transcatheter therapy, offering a scalable and strategically relevant platform for contemporary aortic valve care. CI - (c) AME Publishing Company. FAU - Arzt, Sebastian AU - Arzt S AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Alexiou, Konstantin AU - Alexiou K AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Taghizadeh-Waghefi, Ali AU - Taghizadeh-Waghefi A AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Petrov, Asen AU - Petrov A AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Matschke, Klaus AU - Matschke K AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Kappert, Utz AU - Kappert U AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Wilbring, Manuel AU - Wilbring M AUID- ORCID: 0000-0002-3382-1142 AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. LA - eng PT - Journal Article DEP - 20260929 PL - China TA - Ann Cardiothorac Surg JT - Annals of cardiothoracic surgery JID - 101605877 PMC - PMC13657892 OTO - NOTNLM OT - Minimally invasive cardiac surgery OT - aortic valve replacement (AVR) OT - transaxillary access (TxA access) COIS- Conflicts of Interest: The authors have no conflicts of interest to declare. EDAT- 2026/10/14 11:34 MHDA- 2026/10/14 11:35 PMCR- 2026/09/30 CRDT- 2026/10/14 05:20 PHST- 2026/06/24 00:00 [received] PHST- 2026/09/08 00:00 [accepted] PHST- 2026/10/14 11:35 [medline] PHST- 2026/10/14 11:34 [pubmed] PHST- 2026/10/14 05:20 [entrez] PHST- 2026/09/30 00:00 [pmc-release] AID - acs-15-5-64 [pii] AID - 10.21037/acs-2026-0232-tdv [doi] PST - ppublish SO - Ann Cardiothorac Surg. 2026 Sep 30;15(5):64. doi: 10.21037/acs-2026-0232-tdv. Epub 2026 Sep 29. PMID- 42857632 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261010 LR - 20261012 IS - 2950-6050 (Electronic) IS - 2950-6050 (Linking) VI - 12 DP - 2026 Dec TI - Enhanced recovery after surgery turnkey order set for periprocedural care of the patient undergoing transcatheter aortic valve replacement. PG - 100146 LID - 10.1016/j.xjse.2026.100146 [doi] LID - 100146 AB - OBJECTIVE: Transcatheter aortic valve replacement is now a leading treatment for severe symptomatic aortic stenosis across the risk spectrum. The choice between transcatheter and surgical aortic valve replacement remains a shared decision, particularly for patients aged 65 to 80 years. Despite extensive device-level randomized evidence and procedural standardization, periprocedural care pathways remain variable across programs. This turnkey order set integrates contemporary guidelines and consensus documents into a practical order set for the periprocedural care of patients undergoing transcatheter aortic valve replacement. METHODS: Subject matter experts translated existing peer-reviewed society guidelines, expert consensus documents, and randomized trial evidence, identified through a structured PICO-framed (population, intervention, comparator, outcome) literature review, into a sample turnkey order set. Orders derived from consistent Class I or IIa (or equivalent) recommendations across referenced documents appear in the order set in bold type. Orders that were inconsistently Class I or IIa, Class IIb, or supported by peer-reviewed evidence appear in italic type. RESULTS: Preprocedural care centers on interdisciplinary Heart Team evaluation, frailty and cognition assessment, baseline conduction risk stratification, anemia and iron deficiency screening, structured antithrombotic and endocrine medication management, and weight-based antibiotic prophylaxis. Intraprocedural care prioritizes ultrasound-guided femoral access, procedural sedation when feasible, normothermia, contrast minimization, and balanced procedural anticoagulation. Postprocedural care emphasizes telemetry-guided conduction monitoring, single antiplatelet therapy in patients without an indication for oral anticoagulation, oral anticoagulation alone in those with an existing indication, and early mobilization. Standardized discharge criteria target next-day discharge in appropriately selected transfemoral patients. CONCLUSIONS: Comprehensive periprocedural pathways for transcatheter aortic valve replacement have been demonstrated to shorten length of stay without compromising safety. This turnkey order set translates contemporary guideline recommendations into actionable orders to facilitate standardized adoption of best practices across programs. The composite pathway has not been prospectively validated. CI - (c) 2026 The Author(s). FAU - Engelman, Daniel T AU - Engelman DT AD - Heart and Vascular Program, Baystate Health, University of Massachusetts Chan Medical School-Baystate, Springfield, Mass. FAU - Ailawadi, Gorav AU - Ailawadi G AD - Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich. FAU - Russo, Mark J AU - Russo MJ AD - Division of Cardiac Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ. FAU - Allen, Keith B AU - Allen KB AD - Department of Cardiovascular and Thoracic Surgery, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Mo. FAU - Shah, Pinak B AU - Shah PB AD - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. FAU - Szerlip, Molly AU - Szerlip M AD - Baylor Scott & White, The Heart Hospital, Plano, Tex. FAU - Chhatriwalla, Adnan K AU - Chhatriwalla AK AD - Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Mo. FAU - Wieruszewski, Patrick M AU - Wieruszewski PM AD - Department of Pharmacy and Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minn. FAU - Chatterjee, Subhasis AU - Chatterjee S AD - Department of Surgery, Baylor College of Medicine and Texas Heart Institute, Houston, Tex. CN - ERAS Cardiac Working Group * CN - ERAS Cardiac Working Group LA - eng PT - Journal Article DEP - 20260831 PL - United States TA - JTCVS Struct Endovasc JT - JTCVS structural and endovascular JID - 9918991787106676 PMC - PMC13651565 OTO - NOTNLM OT - aortic stenosis OT - enhanced recovery after surgery OT - next-day discharge OT - periprocedural care OT - transcatheter aortic valve replacement OT - turnkey order set COIS- D.T.E. reports membership on a Data and Safety Monitoring Board for Edwards Lifesciences; membership on Steering Committees for Alexion and Chugai; and membership on Advisory Boards for Medela, Arthrex, AtriCure, Pharmacosmos, and Roivios. G.A. reports serving as a consultant for Abbott, Arthrex, Anteris, Edwards, Medtronic, JenaValve, EnableCV, Cultiv8, and Philips. M.J.R. reports serving as a consultant for Edwards Lifesciences, Abbott, and JenaValve. K.B.A. reports research grants, proctoring, and consulting from Edwards, Medtronic, and Abbott, with all payments made to the institution and none personally; research grants from Boston Scientific paid to the institution; and consulting for PiCardia. P.B.S. reports educational grants from Edwards Lifesciences, Abbott, and Medtronic. M.S. reports serving as a speaker and consultant for Edwards Lifesciences; membership on a Steering Committee for Medtronic; membership on a Steering Committee and an Advisory Board and serving as a proctor for Abbott; and membership on an Advisory Board and serving as a speaker for Boston Scientific. A.K.C. reports a research grant from Boston Scientific; serving on the Speakers Bureau and as a consultant for Abbott Vascular, Edwards Lifesciences, and Medtronic; and membership on Clinical Events Committees for Abiomed and Medtronic. P.M.W. reports consulting for Wolters Kluwer UpToDate and research funding from ZOLL Foundation. S.C. reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. FIR - Gregory, Alexander J IR - Gregory AJ FIR - Arora, Rakesh C IR - Arora RC FIR - Salenger, Rawn IR - Salenger R FIR - Grant, Michael C IR - Grant MC FIR - Rea, Amanda IR - Rea A FIR - Morton-Bailey, Vicki IR - Morton-Bailey V FIR - Crisafi, Cheryl IR - Crisafi C FIR - Lobdell, Kevin W IR - Lobdell KW FIR - Reddy, V Seenu IR - Reddy VS FIR - Gunaydin, Serdar IR - Gunaydin S FIR - Stoppe, Christian IR - Stoppe C EDAT- 2026/10/11 05:07 MHDA- 2026/10/11 05:08 PMCR- 2026/08/31 CRDT- 2026/10/10 16:44 PHST- 2026/06/24 00:00 [received] PHST- 2026/08/05 00:00 [revised] PHST- 2026/08/22 00:00 [accepted] PHST- 2026/10/11 05:08 [medline] PHST- 2026/10/11 05:07 [pubmed] PHST- 2026/10/10 16:44 [entrez] PHST- 2026/08/31 00:00 [pmc-release] AID - S2950-6050(26)00051-3 [pii] AID - 100146 [pii] AID - 10.1016/j.xjse.2026.100146 [doi] PST - epublish SO - JTCVS Struct Endovasc. 2026 Aug 31;12:100146. doi: 10.1016/j.xjse.2026.100146. eCollection 2026 Dec. PMID- 42825221 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261002 LR - 20261003 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 18 IP - 9 DP - 2026 Sep TI - Age-Related Excessive Tortuosity of the Right Brachiocephalic Artery in Patients Being Evaluated for Transcatheter Aortic Valve Replacement (TAVR): Potential to Affect Alternate Access. PG - e115579 LID - 10.7759/cureus.115579 [doi] LID - e115579 AB - Background We hypothesized age-related excessive tortuosity of the right brachiocephalic artery (RBCA) in patients undergoing transcatheter aortic valve replacement (TAVR) evaluation. Methods This single-center, retrospective, cross-sectional study evaluated 100 consecutive patients aged >/=70 undergoing TAVR workup. Contrast-enhanced computed tomography (CT) angiography of the chest, abdomen, and pelvis was performed, and three-dimensional volume-rendered reconstructions were generated. Tortuosity of the RBCA was quantified based on the number and degree of angulations (>/=45 degrees or >/=90 degrees ). Results Of the 100 patients, the mean age was 80.6 years, there were 53 females, 37 diabetics, and 99 hypertensives, the mean low-density lipoprotein (LDL) was 81.8 mg/dL, the mean ejection fraction was 57.1%, and the mean of the mean aortic valve gradients was 33.6 mmHg. About 88% of the patients had a varying combination of at least up to two angulations >/=45 degrees and/or >/=90 degrees , while 47% had at least two angulations >/=90 degrees . Conclusions Incidence of excessive tortuosity of the RBCA in the elderly being evaluated for TAVR is indeed very high; 88% of the patients had a varying combination of at least up to two angulations >/=45 degrees and/or >/=90 degrees , while 47% had at least two angulations >/=90 degrees (normal in young healthy subjects being no angulations at all >/=45 degrees and/or >/=90 degrees ). This excessive RBCA tortuosity may affect the ease and success of procedures performed using the right axillary approach, particularly for TAVR alternate access (percutaneous axillary (PercAx)). Larger studies are needed to corroborate our findings not only in patients with aortic stenosis being evaluated for TAVR but also in this age group in general, since such excessive RBCA tortuosity may, to some degree, explain the increased incidence of radial-to-femoral conversion with advancing age. CI - Copyright (c) 2026, Girgis et al. FAU - Girgis, Kyrillos AU - Girgis K AD - Cardiology, Newark Beth Israel Medical Center, Newark, USA. FAU - Gupta, Prashant K AU - Gupta PK AD - Radiology, Newark Beth Israel Medical Center, Newark, USA. FAU - Retcho, Danielle AU - Retcho D AD - Cardiology, Newark Beth Israel Medical Center, Newark, USA. FAU - Dele, Divine AU - Dele D AD - Internal Medicine, Newark Beth Israel Medical Center, Newark, USA. FAU - Gupta, Aarti AU - Gupta A AD - Internal Medicine, Newark Beth Israel Medical Center, Newark, USA. FAU - Tayal, Rajiv AU - Tayal R AD - Cardiology, The Valley Hospital, Paramus, USA. FAU - Sethi, Nishant AU - Sethi N AD - Cardiology, Commonwealth Health Physician Network, Scranton, USA. FAU - Salemi, Arash AU - Salemi A AD - Cardiothoracic Surgery, Robert Wood Johnson Barnabas (RWJBarnabas) Health, West Orange, USA. FAU - Waxman, Sergio AU - Waxman S AD - Cardiology, Newark Beth Israel Medical Center, Newark, USA. FAU - Wasty, Najam AU - Wasty N AD - Cardiology, Newark Beth Israel Medical Center, Newark, USA. LA - eng PT - Journal Article DEP - 20260901 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC13629739 OTO - NOTNLM OT - alternate access for tavr OT - brachiocephalic artery OT - tavr OT - tortuosity OT - vascular access COIS- Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Newark Beth Israel Medical Center Institutional Review Board issued approval 2026.06. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. EDAT- 2026/10/02 13:37 MHDA- 2026/10/02 13:38 PMCR- 2026/09/01 CRDT- 2026/10/02 07:22 PHST- 2026/08/31 00:00 [accepted] PHST- 2026/10/02 13:38 [medline] PHST- 2026/10/02 13:37 [pubmed] PHST- 2026/10/02 07:22 [entrez] PHST- 2026/09/01 00:00 [pmc-release] AID - 10.7759/cureus.115579 [doi] PST - epublish SO - Cureus. 2026 Sep 1;18(9):e115579. doi: 10.7759/cureus.115579. eCollection 2026 Sep. PMID- 42821072 OWN - NLM STAT- Publisher LR - 20261001 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) DP - 2026 Oct 1 TI - Peripheral vessel tortuosity index and prognosis in patients undergoing transcatheter aortic valve implantation. LID - 10.1007/s00392-026-03035-w [doi] AB - BACKGROUND AND AIMS: The peripheral vessel tortuosity index (TI) was proposed to discriminate procedural success in patients undergoing transcatheter endovascular aortic replacement but not in those undergoing transcatheter aortic valve implantation (TAVI). We aimed to investigate the TI and its prognostic relevance in patients undergoing transfemoral (Tf) TAVI. METHODS: Retrospective, observational single-center study, including patients undergoing Tf-TAVI from April 2011 to January 2023 at the TUM University Hospital, German Heart Centre, and available computed tomography angiography (CTA). Peripheral vessel measurements were performed using dedicated software (3mensio, Pie Medical). TI was determined dividing true central lumen vessel length from centerline reconstruction and direct distance from the aorto-iliac bifurcation to the epigastric artery. TI was dichotomized based on severity according to EVAR guidelines, where a TI of 1.5 is considered discriminatory for nonsevere tortuosity [< 1.5 for low TI (LTI)] and > 1.5 for high TI (HTI)]. Valve Academic Research Consortium 3 definitions were applied to describe procedural and follow-up outcomes. Mortality at 6-month follow-up was evaluated. RESULTS: We included 2002 patients. Overall age was 81 years [77, 85], 45.2% were female, EuroScore II was 4.22 [2.39, 7.60]. Age (p < 0.001), female sex (p < 0.001), diabetes (p < 0.001), peripheral artery disease (p = 0.002), myocardial infarction (p = 0.013), and creatinine (p = 0.001) were associated with tortuosity. Adjusted 6-month analysis showed that TI > 1.50 was associated with increased mortality [hazard ratio (HR) 1.679, 95% CI (1.098-2.567), p = 0.017]. CONCLUSIONS: TI > 1.50 may determine a higher-risk population in patients undergoing Tf-TAVI. Further study is required to validate our findings. CI - (c) 2026. The Author(s). FAU - Alvarez-Covarrubias, Hector A AU - Alvarez-Covarrubias HA AUID- ORCID: 0000-0003-0505-9530 AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. alvarez@dhm.mhn.de. AD - Departamento de Cardiologia, Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Cd. de Mexico, Mexico. alvarez@dhm.mhn.de. FAU - Jurisic, Martin AU - Jurisic M AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Seguchi, Masaru AU - Seguchi M AD - Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. FAU - Salzmann, Charlotte AU - Salzmann C AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Hug, Karsten AU - Hug K AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Hubner, Judith AU - Hubner J AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Starnecker, Fabian AU - Starnecker F AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Syryca, Finn AU - Syryca F AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Haug, Ferdinand AU - Haug F AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Rheude, Tobias AU - Rheude T AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. FAU - Mayr, N Patrick AU - Mayr NP AD - Institut Fur Anasthesiologie, TUM Klinikum Deutsches Herzzetrum, Munich, Germany. FAU - Cassese, Salvatore AU - Cassese S AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Joner, Michael AU - Joner M AD - Department of Cardiology, TUM Klinikum Deutsches Herzzentrum, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. LA - eng PT - Journal Article DEP - 20261001 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM OTO - NOTNLM OT - Percutaneous transluminal angioplasty OT - Peripheral artery disease OT - Tortuosity index OT - Transcatheter aortic valve implantation OT - Transfemoral access COIS- Declarations. Conflict of interest: Hector A. Alvarez-Covarrubias received lecture fees from SIS Medical AG, Translumina, LifeTech, and Edward Lifesciences, not related to the current work. Masaru Seguchi received lecture fees from Novartis Pharma, Amgen, Nipro, Biotronik, Dai-ichi Sankyo, Kowa, and Kaneka Medics, not related to the current work. Dr. Rheude received speaker fees from AstraZeneca, Boston Scientific, Edwards Lifesciences, SIS Medical AG, Terumo, and Translumina and travel support from Abbott, Boehringer Ingelheim, Edwards Lifesciences, LifeTech, and SIS Medical AG, outside the submitted work. Erion Xhepa reports lecture fees from Astra Zeneca, Boston Scientific, and SIS Medical and financial support from Abbott Vascular, not related to the current work. Michael Joner reports personal fees from Abbott, Alchimedics S.A.S., Astra Zeneca, Biotronik, Medtronic, Recor, Shockwave, TriCares, and Veryan, grants and personal fees from Boston Scientific, Cardiac Dimensions, and Edwards, grant from Infraredx outside the submitted work. The rest of the authors have no conflicts of interest to declare. EDAT- 2026/10/01 23:30 MHDA- 2026/10/01 23:30 CRDT- 2026/10/01 18:53 PHST- 2026/06/17 00:00 [received] PHST- 2026/09/19 00:00 [accepted] PHST- 2026/10/01 23:30 [medline] PHST- 2026/10/01 23:30 [pubmed] PHST- 2026/10/01 18:53 [entrez] AID - 10.1007/s00392-026-03035-w [pii] AID - 10.1007/s00392-026-03035-w [doi] PST - aheadofprint SO - Clin Res Cardiol. 2026 Oct 1. doi: 10.1007/s00392-026-03035-w. PMID- 42814485 OWN - NLM STAT- Publisher LR - 20260930 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) DP - 2026 Sep 28 TI - SAFE-SEAL: a bail-out technique for percutaneous femoral closure after failed hybrid closure. LID - 10.25270/jic/26.00137 [doi] AB - OBJECTIVES: Failure of the plug-based component during hybrid suture- and plug-based femoral closure may result in persistent bleeding when guidewire access is lost, leaving limited percutaneous bailout options. The authors describe a novel percutaneous bailout strategy designed to achieve hemostasis in this high-risk scenario. METHODS: The first clinical application of the SAFE-SEAL (Suture-Assisted Femoral Emergency SEALing) technique was performed in a patient undergoing transfemoral transcatheter aortic valve implantation. Following failure of the plug-based closure component and persistent bleeding despite balloon tamponade, a bioresorbable extravascular sealant was advanced over retained suture limbs from a previously deployed suture-based closure device and positioned at the arterial wall using a knot pusher. RESULTS: Complete hemostasis was achieved without additional vascular access or endovascular intervention, as confirmed angiographically. No residual bleeding or flow limitation was observed. CONCLUSIONS: The SAFE-SEAL technique may represent a practical and reproducible bailout option for femoral access-site bleeding after hybrid closure failure, warranting further evaluation in additional cases. FAU - Angelillis, Marco AU - Angelillis M AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. Email: angelillismarco@gmail.com. FAU - Misuraca, Leonardo AU - Misuraca L AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - Calabria, Paolo AU - Calabria P AD - Ospedale Misericordia, Grosseto, Italy. FAU - Giannini, Cristina AU - Giannini C AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - Spontoni, Paolo AU - Spontoni P AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - Stazzoni, Laura AU - Stazzoni L AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - Sticchi, Alessandro AU - Sticchi A AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - Costa, Giulia AU - Costa G AD - S.D. Laboratorio di Emodinamica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - De Carlo, Marco AU - De Carlo M AD - Department of Cardiology, University of Pisa. LA - eng PT - Journal Article DEP - 20260928 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM OTO - NOTNLM OT - femoral access complications OT - large-bore access OT - transcatheter aortic valve implantation OT - vascular closure devices EDAT- 2026/09/30 17:32 MHDA- 2026/09/30 17:32 CRDT- 2026/09/30 11:55 PHST- 2026/09/30 17:32 [medline] PHST- 2026/09/30 17:32 [pubmed] PHST- 2026/09/30 11:55 [entrez] AID - 10.25270/jic/26.00137 [doi] PST - aheadofprint SO - J Invasive Cardiol. 2026 Sep 28. doi: 10.25270/jic/26.00137. PMID- 42805726 OWN - NLM STAT- In-Process LR - 20260928 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 19 IP - 18 DP - 2026 Sep 28 TI - Transfemoral TAVR With a 35-mm Myval Valve in an Extremely Large Aortic Annulus Using Intentional Undersizing. PG - 2525-2528 LID - S1936-8798(26)02172-2 [pii] LID - 10.1016/j.jcin.2026.06.036 [doi] FAU - Magyari, Balazs AU - Magyari B AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. Electronic address: magyari.balazs@pte.hu. FAU - Kittka, Balint AU - Kittka B AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. FAU - Gojak, Ilona AU - Gojak I AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. FAU - Horvath, Ivan AU - Horvath I AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM OTO - NOTNLM OT - bicuspid aortic valve OT - extensive valvular calcification OT - extra large aortic anulus OT - intentional undersizing OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/09/28 23:28 MHDA- 2026/09/28 23:28 CRDT- 2026/09/28 20:56 PHST- 2026/04/27 00:00 [received] PHST- 2026/06/09 00:00 [revised] PHST- 2026/06/17 00:00 [accepted] PHST- 2026/09/28 23:28 [medline] PHST- 2026/09/28 23:28 [pubmed] PHST- 2026/09/28 20:56 [entrez] AID - S1936-8798(26)02172-2 [pii] AID - 10.1016/j.jcin.2026.06.036 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2026 Sep 28;19(18):2525-2528. doi: 10.1016/j.jcin.2026.06.036. PMID- 42795954 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260926 LR - 20260929 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 18 DP - 2026 Sep 16 TI - Remimazolam Versus Dexmedetomidine for Monitored Anesthesia Care in Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation: A Randomized Clinical Trial. LID - 10.3390/jcm15187182 [doi] LID - 7182 AB - Background/Objectives: Monitored anesthesia care is increasingly used for transfemoral transcatheter aortic valve implantation (tf-TAVI), but the optimal sedative regimen remains uncertain. We compared remimazolam with dexmedetomidine during tf-TAVI. Methods: In this single-center randomized trial, 34 patients were assigned 1:1 to remimazolam or dexmedetomidine. Primary outcomes were the number of intraoperative hypotensive episodes, defined as mean arterial pressure <65 mmHg requiring vasopressor treatment, and cumulative phenylephrine and norepinephrine doses. Secondary outcomes included hemodynamic and physiological variables, regional cerebral oxygen saturation (rSO(2)), arterial blood gases, recovery time, surgeon requests for deeper sedation, and procedural outcomes. Longitudinal variables were analyzed using generalized estimating equations with Holm adjustment for time-specific comparisons. Results: No significant between-group differences were detected in intraoperative hypotensive episodes or cumulative phenylephrine and norepinephrine doses, and no significant group-by-time interactions were observed for blood pressure. Both left and right rSO(2) showed significant group-by-time interactions, with higher remimazolam values at selected time points after Holm adjustment. Arterial carbon dioxide tension was higher and arterial pH lower with remimazolam immediately before rapid ventricular pacing and at procedure completion. Recovery was faster with remimazolam (mean +/- standard deviation, 13.5 +/- 7.2 vs. 32.4 +/- 12.5 min; p < 0.001), and surgeon requests for deeper sedation were less frequent (11.8% vs. 76.5%; p < 0.001). Conclusions: Remimazolam was associated with faster recovery and fewer surgeon requests for deeper sedation; however, the trial was not designed or powered to establish equivalence for hypotensive episodes, vasopressor requirements or hemodynamic outcomes. FAU - Hyung, Sung-Woo AU - Hyung SW AUID- ORCID: 0000-0003-2251-8102 AD - Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea. FAU - Choi, Myokyung AU - Choi M AD - Department of Anesthesiology and Pain Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon 14647, Republic of Korea. FAU - Chung, Mee Young AU - Chung MY AD - Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea. FAU - Hwang, Wonjung AU - Hwang W AUID- ORCID: 0000-0003-2820-0322 AD - Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea. LA - eng GR - Hana Pharm (South Korea)/ PT - Journal Article DEP - 20260916 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13607414 OTO - NOTNLM OT - cerebral oxygen saturation OT - conscious sedation OT - dexmedetomidine OT - hemodynamics OT - monitored anesthesia care OT - remimazolam OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/09/26 05:35 MHDA- 2026/09/26 05:36 PMCR- 2026/09/16 CRDT- 2026/09/26 01:12 PHST- 2026/08/10 00:00 [received] PHST- 2026/09/10 00:00 [revised] PHST- 2026/09/13 00:00 [accepted] PHST- 2026/09/26 05:36 [medline] PHST- 2026/09/26 05:35 [pubmed] PHST- 2026/09/26 01:12 [entrez] PHST- 2026/09/16 00:00 [pmc-release] AID - jcm15187182 [pii] AID - jcm-15-07182 [pii] AID - 10.3390/jcm15187182 [doi] PST - epublish SO - J Clin Med. 2026 Sep 16;15(18):7182. doi: 10.3390/jcm15187182. PMID- 42795392 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260926 LR - 20260929 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 16 IP - 9 DP - 2026 Sep 14 TI - Enabling Transfemoral TAVI Through a Hostile Abdominal Aortic Anatomy and a Migrated Mesenteric Stent Fragment: Review of the Literature and a Case Presentation. LID - 10.3390/life16091527 [doi] LID - 1527 AB - Hostile abdominal aortic anatomy may limit transfemoral transcatheter aortic valve implantation (TAVI), even when the iliofemoral access vessels are suitable. The principal anatomical substrate is advanced atherosclerotic calcification, which may cause luminal stenosis, reduced arterial compliance, and an increased risk of vascular injury or embolization during large-bore device passage. Evidence regarding endovascular access facilitation is derived predominantly from iliofemoral interventions, whereas experience with direct modification of the abdominal aorta remains limited. This review examines balloon angioplasty, intravascular lithotripsy, and other endovascular strategies used to facilitate transfemoral TAVI in hostile iliofemoral and aortic anatomy, complemented by an illustrative case highlighting the additional challenge posed by intraluminal foreign material. Within this context, we present a 75-year-old high-risk patient with symptomatic severe aortic stenosis and significant coronary artery disease, in whom otherwise suitable iliofemoral access was complicated by focal calcific abdominal aortic stenosis and an asymptomatic impacted fragment of a fractured superior mesenteric artery stent following a previous intervention. A staged strategy comprising coronary revascularization, abdominal aortic balloon angioplasty with apposition of the fragment against the aortic wall, and subsequent balloon-expandable TAVI was successfully performed. This case underscores the importance of individualized, imaging-guided planning for complex transfemoral access. FAU - Parasca, Catalina-Andreea AU - Parasca CA AUID- ORCID: 0000-0001-9129-4363 AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiovascular Surgery, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Radulescu, Crina-Ioana AU - Radulescu CI AUID- ORCID: 0000-0002-9524-4029 AD - Department of Cardiovascular Surgery, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Platon, Pavel AU - Platon P AD - Department of Interventional Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Calin, Andreea AU - Calin A AUID- ORCID: 0000-0003-1103-8437 AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Bubenek-Turconi, Serban AU - Bubenek-Turconi S AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Anesthesiology and Intensive Care, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Popescu, Bogdan A AU - Popescu BA AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Iliescu, Vlad Anton AU - Iliescu VA AUID- ORCID: 0000-0001-9069-2722 AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiovascular Surgery, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. LA - eng PT - Journal Article PT - Review DEP - 20260914 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC13608134 OTO - NOTNLM OT - abdominal aortic stenosis OT - balloon angioplasty OT - hostile abdominal aorta OT - superior mesenteric artery stent fracture OT - transcatheter aortic valve implantation OT - transfemoral access OT - vascular access facilitation COIS- The authors declare no conflicts of interest. EDAT- 2026/09/26 05:35 MHDA- 2026/09/26 05:36 PMCR- 2026/09/14 CRDT- 2026/09/26 01:10 PHST- 2026/07/19 00:00 [received] PHST- 2026/09/10 00:00 [revised] PHST- 2026/09/11 00:00 [accepted] PHST- 2026/09/26 05:36 [medline] PHST- 2026/09/26 05:35 [pubmed] PHST- 2026/09/26 01:10 [entrez] PHST- 2026/09/14 00:00 [pmc-release] AID - life16091527 [pii] AID - life-16-01527 [pii] AID - 10.3390/life16091527 [doi] PST - epublish SO - Life (Basel). 2026 Sep 14;16(9):1527. doi: 10.3390/life16091527. PMID- 42795368 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260926 LR - 20260929 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 16 IP - 9 DP - 2026 Sep 9 TI - Rescue Transcatheter Aortic Valve Implantation for Severe Native Aortic Regurgitation in a Young Patient with Hypertrophic Obstructive Cardiomyopathy and Cardiogenic Shock: Review of the Literature and Case Presentation. LID - 10.3390/life16091503 [doi] LID - 1503 AB - Transcatheter aortic valve implantation (TAVI) for pure native aortic regurgitation (AR) remains technically challenging, primarily because absent annular calcification limits prosthesis anchoring. We reviewed contemporary evidence on TAVI for native AR, focusing on devices, procedural performance, complications, and outcomes. A comprehensive PubMed search identified 371 articles, of which 28 studies comprising 3282 patients met the inclusion criteria; notably, 64.3% were published from 2023 onward, reflecting the rapidly expanding evidence in this field. Conventional off-label devices were evaluated in 60.7% of studies and dedicated AR devices in 35.7%, while 3.6% directly compared both strategies. Technical/device success ranged from 72% to 100%, generally exceeding 85-90% in contemporary series, while 30-day mortality ranged from 0% to 23%. To illustrate the technical challenges and expand this evidence, we present a 24-year-old man with MYH7-associated hypertrophic obstructive cardiomyopathy and severe post-myectomy AR complicated by biventricular failure, cardiogenic shock, and multiorgan dysfunction. Given prohibitive surgical risk, rescue transfemoral TAVI was performed. Despite embolization of the first balloon-expandable prosthesis, a second valve was successfully implanted using an individualized anchoring strategy. At 1 year, the patient was in NYHA class I with biventricular recovery. TAVI represents an evolving alternative for carefully selected patients with severe native AR and prohibitive surgical risk. FAU - Parasca, Catalina Andreea AU - Parasca CA AUID- ORCID: 0000-0001-9129-4363 AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiovascular Surgery, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Deleanu, Dan AU - Deleanu D AD - Department of Interventional Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Platon, Pavel AU - Platon P AD - Department of Interventional Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Radulescu, Crina Ioana AU - Radulescu CI AUID- ORCID: 0000-0002-9524-4029 AD - Department of Cardiovascular Surgery, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Stefan, Mihai AU - Stefan M AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Anesthesiology and Intensive Care, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Jurcut, Ruxandra Oana AU - Jurcut RO AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Filipescu, Daniela Carmen AU - Filipescu DC AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Anesthesiology and Intensive Care, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. FAU - Iliescu, Vlad Anton AU - Iliescu VA AD - Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. AD - Department of Cardiovascular Surgery, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania. LA - eng PT - Journal Article PT - Review DEP - 20260909 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC13608786 OTO - NOTNLM OT - aortic regurgitation OT - cardiogenic shock OT - hypertrophic cardiomyopathy OT - septal myectomy OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/09/26 05:35 MHDA- 2026/09/26 05:36 PMCR- 2026/09/09 CRDT- 2026/09/26 01:10 PHST- 2026/07/31 00:00 [received] PHST- 2026/09/04 00:00 [revised] PHST- 2026/09/07 00:00 [accepted] PHST- 2026/09/26 05:36 [medline] PHST- 2026/09/26 05:35 [pubmed] PHST- 2026/09/26 01:10 [entrez] PHST- 2026/09/09 00:00 [pmc-release] AID - life16091503 [pii] AID - life-16-01503 [pii] AID - 10.3390/life16091503 [doi] PST - epublish SO - Life (Basel). 2026 Sep 9;16(9):1503. doi: 10.3390/life16091503. PMID- 42783431 OWN - NLM STAT- MEDLINE DCOM- 20260924 LR - 20260930 IS - 2076-3271 (Electronic) IS - 2076-3271 (Linking) VI - 14 IP - 5 DP - 2026 Sep 10 TI - Evolution of Aortic Valve Replacement Across Two Eras: Institutional Changes in Transcatheter and Surgical Practice and Outcomes. LID - 10.3390/medsci14050558 [doi] LID - 558 AB - Objectives: Conventionally, the gold standard for aortic valve disease has been surgical aortic valve replacement (SAVR). Advances in transcatheter aortic valve replacement (TAVR) have since produced marked improvements in both outcomes and procedural volume. We sought to characterize this evolution by comparing the earliest and most recent 100 procedures of each modality at a single high-volume institution. Methods: We retrospectively compared four cohorts of 100 consecutive isolated procedures: 100 TAVRs from 2012 (the earliest period of complete and verifiable registry capture) and 100 first-time SAVRs from a contemporaneous period (2011), each versus the 100 most recent procedures of the same modality (TAVR 2024; SAVR 2024-2025). The SAVR cohorts were limited to first-time, isolated replacement; the TAVR cohorts to native-valve procedures. The primary endpoint was the 30-day composite of death or stroke. Secondary endpoints included new permanent pacemaker implantation, paravalvular leak, vascular access route, anesthetic technique, and length of stay. Results: For TAVR, the 30-day composite of death or stroke fell from 10% to 1% (p = 0.010), with fewer in-hospital deaths (6% to 0%; p = 0.029) and less new dialysis (4% to 0%; p = 0.059). A paravalvular leak of at least mild severity fell from 27% to 3% (p < 0.001), with none as moderate or greater in either era. New pacemaker implantation decreased from 15% to 6% (p = 0.056). Within the same comparison, general anesthesia decreased from 100% to 23%, non-transfemoral access from 29% to 2%, median ICU stay from 43 to 0 h, and hospital stay from 6 to 1 day (all p < 0.001). SAVR outcomes remained similar (composite 2% to 0%, p = 0.497; pacemaker 1% to 0%; and paravalvular leak 0% to 4%), while prolonged ventilation (11% to 1%; p = 0.007) and hospital stay (8 to 5 days; p < 0.001) improved. The SAVR population became younger (74 to 64 years; p < 0.001), and isolated first-time surgery was markedly less frequent, requiring 18.9 versus 5.7 months to accrue 100 consecutive cases. Conclusions: In this two-era institutional comparison, recent-era TAVR outcomes were markedly better, while SAVR outcomes remained excellent in both eras within a recent population that was younger and in whom eligible isolated first-time surgery was less frequent. Because the eras differed substantially in patient risk profile, these unadjusted within-modality comparisons describe a real-world redistribution of aortic stenosis care between two increasingly complementary treatments rather than isolating the effect of any single procedural or technological factor. FAU - Nickles, Jack T AU - Nickles JT AUID- ORCID: 0009-0005-7399-8232 AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Tagliafierro, Marco AU - Tagliafierro M AUID- ORCID: 0009-0006-7585-7166 AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Moos, Ezra AU - Moos E AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Kaproth, Kenji AU - Kaproth K AUID- ORCID: 0009-0009-2661-2172 AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Anand, Sarab AU - Anand S AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Ge, Shirley AU - Ge S AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Fatehi Hassanabad, Ali AU - Fatehi Hassanabad A AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. FAU - Pirelli, Luigi AU - Pirelli L AD - Division of Cardiothoracic Surgery, Columbia University Medical Center, 177 Fort Washington Avenue, 7GN-435, New York, NY 10032, USA. LA - eng PT - Journal Article DEP - 20260910 PL - Switzerland TA - Med Sci (Basel) JT - Medical sciences (Basel, Switzerland) JID - 101629322 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/trends/adverse effects MH - Female MH - Male MH - Treatment Outcome MH - Aged, 80 and over MH - Retrospective Studies MH - *Aortic Valve/surgery MH - Aged MH - Length of Stay MH - *Aortic Valve Stenosis/surgery PMC - PMC13609362 OTO - NOTNLM OT - aortic stenosis OT - case-mix migration OT - clinical outcomes OT - minimalist TAVR pathway OT - surgical aortic valve replacement OT - temporal trends OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2026/09/24 23:52 MHDA- 2026/09/24 23:53 PMCR- 2026/09/10 CRDT- 2026/09/24 18:14 PHST- 2026/08/03 00:00 [received] PHST- 2026/08/26 00:00 [revised] PHST- 2026/09/01 00:00 [accepted] PHST- 2026/09/24 23:53 [medline] PHST- 2026/09/24 23:52 [pubmed] PHST- 2026/09/24 18:14 [entrez] PHST- 2026/09/10 00:00 [pmc-release] AID - medsci14050558 [pii] AID - medsci-14-00558 [pii] AID - 10.3390/medsci14050558 [doi] PST - epublish SO - Med Sci (Basel). 2026 Sep 10;14(5):558. doi: 10.3390/medsci14050558. PMID- 42783017 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260924 LR - 20260928 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 13 IP - 9 DP - 2026 Aug 24 TI - Valve-Preserving Repair of Very Late Type A Aortic Dissection Following Self-Expanding TAVI in an Octogenarian Patient: Case Report and Focused Narrative Review of the Literature. LID - 10.3390/jcdd13090410 [doi] LID - 410 AB - Introduction: Acute type A aortic dissection (ATAAD) is a rare but potentially catastrophic complication following transcatheter aortic valve implantation (TAVI). Most reported cases occur during or shortly after the procedure and are attributed to procedural aortic injury. Very late presentations occurring years after successful TAVI are exceptionally uncommon, and evidence regarding their optimal management remains limited. Case Presentation: An 86-year-old man presented with acute chest pain four years after transfemoral implantation of a self-expanding Evolut R 29-mm transcatheter heart valve. Transthoracic echocardiography revealed pericardial effusion with signs of impending cardiac tamponade. Computed tomography angiography confirmed Stanford type A acute aortic dissection involving the ascending aorta. Emergency surgical repair was performed through replacement of the ascending aorta and hemiarch using a vascular graft. The previously implanted transcatheter valve was preserved because it remained structurally intact and functionally normal. The postoperative course was uneventful, and the patient was discharged on postoperative day 9 with preserved prosthetic valve function (mean gradient 11 mmHg, peak velocity of 2.1 m/s, EOA 1.8 cm(2), EF 50%, TAPSE 18 mm and no evidence of paravalvular or intraprosthetic regurgitation). Discussion: To better contextualize this rare presentation, a focused review of the literature on delayed and late ATAAD after TAVI was performed. Only a limited number of cases were identified, highlighting the exceptional rarity of this complication. Reported management strategies included conservative treatment, endovascular interventions, and open surgical repair, with considerable heterogeneity in outcomes. Compared with previously published reports, the present case is notable for the exceptionally long interval between TAVI and dissection onset and for the successful valve-preserving surgical repair. These findings suggest that emergency surgery with preservation of a functioning transcatheter valve may be a feasible option in carefully selected patients. Conclusions: Very late ATAAD after TAVI is an exceptionally rare but life-threatening condition. This case demonstrates that valve-preserving surgical repair can be successfully performed even in selected octogenarian patients. As the population of long-term TAVI survivors continues to expand, awareness of late aortic complications, prompt diagnosis, and referral to specialized aortic centers remain essential for achieving favorable outcomes. FAU - Giovannico, Lorenzo AU - Giovannico L AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Fischetti, Giuseppe AU - Fischetti G AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Parigino, Domenico AU - Parigino D AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Savino, Luca AU - Savino L AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Leo, Claudia AU - Leo C AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Cristiano, Giuseppe AU - Cristiano G AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Scrascia, Giuseppe AU - Scrascia G AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Carrozzini, Massimiliano AU - Carrozzini M AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Padalino, Massimo AU - Padalino M AUID- ORCID: 0000-0002-7535-9670 AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. FAU - Bottio, Tomaso AU - Bottio T AUID- ORCID: 0000-0001-7299-2983 AD - Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy. LA - eng GR - PNRR-MCNT2-2023-12378350/Ministero della Salute/ PT - Journal Article DEP - 20260824 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC13607663 OTO - NOTNLM OT - acute type A aortic dissection OT - late TAVI complications OT - self-expanding transcatheter heart valve OT - transcatheter aortic valve implantation (TAVI) OT - valve-preserving aortic surgery COIS- The authors declare no conflicts of interest. EDAT- 2026/09/24 23:52 MHDA- 2026/09/24 23:53 PMCR- 2026/08/24 CRDT- 2026/09/24 18:11 PHST- 2026/06/22 00:00 [received] PHST- 2026/08/12 00:00 [revised] PHST- 2026/08/21 00:00 [accepted] PHST- 2026/09/24 23:53 [medline] PHST- 2026/09/24 23:52 [pubmed] PHST- 2026/09/24 18:11 [entrez] PHST- 2026/08/24 00:00 [pmc-release] AID - jcdd13090410 [pii] AID - jcdd-13-00410 [pii] AID - 10.3390/jcdd13090410 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2026 Aug 24;13(9):410. doi: 10.3390/jcdd13090410. PMID- 42774398 OWN - NLM STAT- MEDLINE DCOM- 20260923 LR - 20261016 IS - 1177-8881 (Electronic) IS - 1177-8881 (Linking) VI - 20 DP - 2026 TI - Impact of Cipepofol versus Propofol on Long-Term Cardiovascular Outcomes After TAVR: An Extended Follow-Up of a Randomized Trial. PG - 621481 LID - 10.2147/DDDT.S621481 [doi] LID - 621481 AB - BACKGROUND: Patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) under general anesthesia are particularly vulnerable to hemodynamic instability. General anesthesia remains a common approach and is necessary in selected patients, although conscious sedation is increasingly used. A previous randomized trial showed greater peri-induction hemodynamic stability with cipepofol than with propofol, but whether this translates into improved clinical outcomes is uncertain. METHODS: We conducted a post hoc, exploratory extended follow-up of a single-center randomized trial. Patients were randomly assigned to cipepofol or propofol. In-hospital analyses included 122 TAVR-treated participants (61 per group), whereas the 30-day and 1-year analyses included 118 participants with follow-up data in the full analysis set (59 per group). The primary endpoint was the 1-year composite of all-cause mortality, stroke, acute kidney injury, myocardial infarction, and new-onset atrial fibrillation (NOAF). For this exploratory analysis, the components were grouped based on their hypothesized association with periprocedural hemodynamic instability and were also reported separately. RESULTS: At 1 year, the primary composite endpoint occurred in 13/59 (22.0%) patients in the cipepofol group and 22/59 (37.3%) patients in the propofol group (hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.28 to 1.10; P = 0.093). NOAF, analyzed separately as an exploratory secondary endpoint, occurred less frequently with cipepofol than with propofol (7/59 [11.9%] vs 17/59 [28.8%]; HR 0.39; 95% CI 0.16 to 0.95; P = 0.037). At 30 days, the composite endpoint occurred in 9/59 (15.3%) and 14/59 (23.7%) patients, respectively (HR 0.63; 95% CI 0.27 to 1.45; P = 0.277). The in-hospital composite endpoints were 10/61 (16.4%) and 16/61 (26.2%), respectively (P = 0.185). CONCLUSION: In this exploratory extended follow-up, cipepofol did not significantly reduce the 1-year primary composite endpoint compared with propofol. The observed lower incidence of NOAF should be regarded as hypothesis-generating given the limited sample size, multiple comparisons, and intermittent rhythm surveillance. The applicability of these findings is limited to patients undergoing transfemoral TAVR under general anesthesia and does not extend to procedures performed under conscious sedation. CI - (c) 2026 Ni et al. FAU - Ni, Tingting AU - Ni T AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Lv, Yantian AU - Lv Y AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Zhou, Laiying AU - Zhou L AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Yu, Jing AU - Yu J AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Tao, Xincheng AU - Tao X AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Cao, Han AU - Cao H AUID- ORCID: 0009-0004-5686-7479 AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Yao, Yuanyuan AU - Yao Y AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. FAU - Yan, Min AU - Yan M AUID- ORCID: 0000-0002-1355-1261 AD - Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China. LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20260917 PL - New Zealand TA - Drug Des Devel Ther JT - Drug design, development and therapy JID - 101475745 RN - YI7VU623SF (Propofol) RN - 0 (Anesthetics, Intravenous) SB - IM MH - Humans MH - *Propofol/administration & dosage/adverse effects MH - Female MH - *Transcatheter Aortic Valve Replacement MH - Follow-Up Studies MH - Male MH - Aged, 80 and over MH - Aged MH - *Anesthetics, Intravenous/administration & dosage MH - Treatment Outcome MH - Time Factors PMC - PMC13594509 OTO - NOTNLM OT - cipepofol OT - general anesthesia OT - hemodynamic stability OT - new-onset atrial fibrillation OT - propofol OT - transcatheter aortic valve replacement COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/09/23 11:50 MHDA- 2026/09/23 11:51 PMCR- 2026/09/17 CRDT- 2026/09/23 06:14 PHST- 2026/05/01 00:00 [received] PHST- 2026/09/06 00:00 [accepted] PHST- 2026/09/23 11:51 [medline] PHST- 2026/09/23 11:50 [pubmed] PHST- 2026/09/23 06:14 [entrez] PHST- 2026/09/17 00:00 [pmc-release] AID - 621481 [pii] AID - 10.2147/DDDT.S621481 [doi] PST - epublish SO - Drug Des Devel Ther. 2026 Sep 17;20:621481. doi: 10.2147/DDDT.S621481. eCollection 2026. PMID- 42771703 OWN - NLM STAT- Publisher LR - 20260922 IS - 2149-2271 (Electronic) IS - 2149-2263 (Linking) DP - 2026 Sep 22 TI - Impact of Anesthetic Strategy and the Institutional Learning Curve on Outcomes After Transcatheter Aortic Valve Implantation. LID - 10.14744/AnatolJCardiol.2026.6573 [doi] AB - BACKGROUND: As transcatheter aortic valve implantation (TAVI) has become a standard treatment for severe aortic stenosis, the optimal anesthetic strategy remains debated. In addition to anesthesia choice, institutional experience may influence procedural efficiency and outcomes; however, their interplay remains unclear. This study aimed to evaluate the association between anesthetic strategy and outcomes after elective transfemoral TAVI and to assess whether these associations are modified by institutional experience. METHODS: In this retrospective observational study, consecutive patients undergoing elective transfemoral TAVI at a high-volume tertiary center between 2020 and 2025 were analyzed. To reduce selection bias, inverse probability weighting with double-robust outcome modeling was applied. The primary outcome was intensive care unit (ICU) stay duration, and in-hospital mortality was evaluated as a secondary outcome. Institutional experience was modeled as chronological case sequence, with an interaction term to assess effect modification. RESULTS: A total of 852 patients were included. After weighting, baseline characteristics were well balanced between conscious sedation (CS) and general anesthesia (GA) groups. General anesthesia utilization decreased from 71% in 2020 to 13% in 2025. Conscious sedation was associated with shorter ICU stay compared with GA (21.0 vs. 23.0 hours; P < .001). In adjusted analysis, GA remained independently associated with longer ICU stay (rate ratios = 1.46, P < .001, 95% CI: 1.28-1.66). Anesthetic strategy was not associated with in-hospital mortality (OR = 1.14, P = .667, 95% CI: 0.62-2.10), and no significant interaction with case sequence was observed. CONCLUSION: Conscious sedation was associated with shorter ICU stay, while no significant differences were observed in mortality outcomes. FAU - Balaban, Ismail AU - Balaban I AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkiye. FAU - Zanbak Mutlu, Ozgecan Piril AU - Zanbak Mutlu OP AD - Department of Anesthesiology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkiye. FAU - Kultursay, Barkin AU - Kultursay B AD - Department of Cardiology, Tunceli State Hospital, Tunceli, Turkiye. FAU - Mutlu, Deniz AU - Mutlu D AD - Department of Interventional Cardiology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. FAU - Tanyeri Uzel, Seda AU - Tanyeri Uzel S AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkiye. FAU - Karaduman, Ahmet AU - Karaduman A AD - Department of Cardiology, Emsey Hospital, Istanbul, Turkiye. FAU - Danisman, Nesri AU - Danisman N AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkiye. FAU - Kaya, Azmican AU - Kaya A AD - Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkiye. FAU - Girgin Dinc, Ebru AU - Girgin Dinc E AD - Department of Anesthesiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkiye. FAU - Oner, Esin AU - Oner E AD - Department of Anesthesiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20260922 PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 SB - IM EDAT- 2026/09/22 21:36 MHDA- 2026/09/22 21:36 CRDT- 2026/09/22 13:53 PHST- 2026/09/22 21:36 [medline] PHST- 2026/09/22 21:36 [pubmed] PHST- 2026/09/22 13:53 [entrez] AID - 10.14744/AnatolJCardiol.2026.6573 [doi] PST - aheadofprint SO - Anatol J Cardiol. 2026 Sep 22. doi: 10.14744/AnatolJCardiol.2026.6573. PMID- 42769951 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260922 LR - 20260923 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 5 IP - 9 DP - 2026 Sep TI - Transcatheter Aortic Valve Replacement in Patients With Symptomatic, Severe Aortic Regurgitation: 1-Year Outcomes of the J-Valve Transfemoral Early Feasibility Study. PG - 105509 LID - 10.1016/j.jscai.2026.105509 [doi] LID - 105509 AB - BACKGROUND: Clinically significant native aortic regurgitation (AR) increases with age. Surgical aortic valve replacement has been the only curative guideline-recommended therapy, while transcatheter options remain limited by anatomic constraints. METHODS: The J-Valve early feasibility study (NCT06034028) evaluated the safety and effectiveness of transfemoral J-Valve transcatheter heart valve implantation in patients with symptomatic, severe native AR. The prospective single-arm study enrolled 25 patients with symptomatic, severe, native AR deemed high risk for surgical aortic valve replacement at 8 centers. Clinical and echocardiographic assessments were performed at baseline, 30 days, 6 months, and 1 year with independent core laboratory and clinical events committee adjudication. The primary effectiveness end point was a non-hierarchical composite of all-cause mortality or disabling stroke at 30 days. RESULTS: Mean age was 80.6 +/- 4.3 years; 76% were male; 100% were New York Heart Association (NYHA) class II/III; mean Society of Thoracic Surgeons-Predicted Risk of Mortality (STS-PROM) score was 5.6 +/- 4.5%. Successful implantation occurred in 92% (23/25). The primary end point occurred in 2 patients (8.0%). All-cause mortality was 4.0% at 30 days and 1 year, with no cardiovascular-related deaths. Two strokes (1 disabling) (8.2%) and 2 new pacemaker implantations (10%) occurred within 30 days. At 1 year, none/trace AR was present in 95.5% (21/22) and mild AR in 4.5% (1/22), with a mean gradient of 5.5 +/- 1.7 mm Hg, and an effective orifice area of 2.48 +/- 0.53 cm(2). Reverse left ventricular (LV) remodeling was evident at 30 days with sustained reductions in LV end-diastolic and end-systolic volume indices to 1 year. NYHA class improved in 72.7% (16/22) of patients, with 95.5% (21/22) in NYHA class I/II at 1 year. CONCLUSIONS: This study demonstrates preliminary safety and effectiveness of the J-Valve in high-risk patients with severe AR, with favorable 1-year outcomes and stable hemodynamic performance. CI - (c) 2026 The Author(s). FAU - Kereiakes, Dean J AU - Kereiakes DJ AD - The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio. FAU - Latib, Azeem AU - Latib A AD - Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York. FAU - Garcia, Santiago AU - Garcia S AD - The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio. FAU - Rizik, David G AU - Rizik DG AD - Banner Health, Scottsdale, Arizona. FAU - Fail, Peter AU - Fail P AD - Cardiovascular Institute of the South, Houma, Los Angeles. FAU - Waksman, Ron AU - Waksman R AD - MedStar Washington Hospital Center, Washington, DC. FAU - Gafoor, Sameer A AU - Gafoor SA AD - Swedish Medical Group, Providence St. Joseph Health, Seattle, Washington. FAU - Goel, Sachin AU - Goel S AD - Houston Methodist Debakey Heart & Vascular Center, Houston, Texas. FAU - Iyer, Vijay AU - Iyer V AD - University at Buffalo/Gates Vascular Institute, Buffalo, New York. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York, New York. AD - St. Francis Hospital, Roslyn, New York. FAU - Cavalcante, Joao L AU - Cavalcante JL AD - Minneapolis Heart Institute, Minneapolis, Minnesota. FAU - Hahn, Rebecca T AU - Hahn RT AD - NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York. FAU - Li, Yunyi AU - Li Y AD - Edwards Lifesciences, Irvine, California. FAU - Kaneko, Tsuyoshi AU - Kaneko T AD - Washington University School of Medicine in St. Louis, St. Louis, Missouri. FAU - Reardon, Michael J AU - Reardon MJ AD - Houston Methodist Hospital, Houston, Texas. LA - eng PT - Journal Article DEP - 20260625 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC13591531 OTO - NOTNLM OT - aortic regurgitation OT - aortic valve disease OT - transcatheter aortic valve replacement EDAT- 2026/09/22 12:42 MHDA- 2026/09/22 12:43 PMCR- 2026/06/25 CRDT- 2026/09/22 06:40 PHST- 2026/05/06 00:00 [received] PHST- 2026/05/22 00:00 [revised] PHST- 2026/06/05 00:00 [accepted] PHST- 2026/09/22 12:43 [medline] PHST- 2026/09/22 12:42 [pubmed] PHST- 2026/09/22 06:40 [entrez] PHST- 2026/06/25 00:00 [pmc-release] AID - S2772-9303(26)01256-1 [pii] AID - 105509 [pii] AID - 10.1016/j.jscai.2026.105509 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2026 Jun 25;5(9):105509. doi: 10.1016/j.jscai.2026.105509. eCollection 2026 Sep. PMID- 42766874 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260921 LR - 20260923 IS - 2694-1902 (Electronic) IS - 2694-1902 (Linking) VI - 12 IP - 12 DP - 2026 Sep 21 TI - Hybrid revascularization for acute common carotid artery occlusion after transcarotid transcatheter aortic valve implantation: illustrative case. LID - CASE26527 [pii] LID - 10.3171/CASE26527 [doi] AB - BACKGROUND: Transcarotid transcatheter aortic valve implantation (TC-TAVI) is an alternative access route for patients in whom transfemoral TAVI is not suitable. Although carotid complications are uncommon, they may occur because of direct carotid manipulation. We report a rare case of acute common carotid artery occlusion after TC-TAVI treated with hybrid revascularization. OBSERVATIONS: A 94-year-old woman underwent TC-TAVI through the left common carotid artery because severe iliofemoral calcification precluded transfemoral access. After the procedure, delayed emergence from general anesthesia, aphasia, and right hemiparesis developed. MRI demonstrated scattered infarctions in the left middle cerebral artery territory, and CT angiography revealed left common carotid artery occlusion. The mechanism and extent of the lesion could not be adequately determined preoperatively. Potential etiologies included repair site stenosis, thrombotic occlusion, and carotid dissection. Therefore, hybrid surgery was selected. Direct inspection revealed localized posterior wall intimal injury associated with subintimal hematoma and thrombus formation. Thrombectomy and intimal resection achieved complete recanalization with neurological improvement. LESSONS: Acute common carotid artery occlusion is a rare but potentially devastating complication of TC-TAVI. Careful patient selection for transcarotid access is essential. When the mechanism and extent of carotid occlusion cannot be adequately defined preoperatively, hybrid surgery may provide definitive diagnosis and safe revascularization. https://thejns.org/doi/10.3171/CASE26527. FAU - Yamamoto, Ryo AU - Yamamoto R AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Takayanagi, Kai AU - Takayanagi K AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Choo, Jungsu AU - Choo J AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Tashiro, Hiroshi AU - Tashiro H AD - Department of Cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Ohno, Tsukasa AU - Ohno T AD - Department of Cardiovascular Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi, Japan. FAU - Nomura, Kotona AU - Nomura K AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Suzuki, Keita AU - Suzuki K AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Shiraishi, Daimon AU - Shiraishi D AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. FAU - Yamanouchi, Takashi AU - Yamanouchi T AD - Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi. LA - eng PT - Journal Article DEP - 20260921 PL - United States TA - J Neurosurg Case Lessons JT - Journal of neurosurgery. Case lessons JID - 9918227275606676 PMC - PMC13592281 OTO - NOTNLM OT - carotid artery dissection OT - carotid endarterectomy OT - endovascular treatment OT - hybrid surgery OT - thrombectomy OT - transcarotid TAVI EDAT- 2026/09/21 23:33 MHDA- 2026/09/21 23:34 PMCR- 2026/09/21 CRDT- 2026/09/21 17:53 PHST- 2026/06/30 00:00 [received] PHST- 2026/07/30 00:00 [accepted] PHST- 2026/09/21 23:34 [medline] PHST- 2026/09/21 23:33 [pubmed] PHST- 2026/09/21 17:53 [entrez] PHST- 2026/09/21 00:00 [pmc-release] AID - CASE26527 [pii] AID - 10.3171/CASE26527 [doi] PST - epublish SO - J Neurosurg Case Lessons. 2026 Sep 21;12(12):CASE26527. doi: 10.3171/CASE26527. Print 2026 Sep 21. PMID- 42765779 OWN - NLM STAT- MEDLINE DCOM- 20260921 LR - 20260921 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 27 IP - 9 DP - 2026 Sep 1 TI - Newer-generation balloon-expandable vs. self-expanding transcatheter aortic valves: a propensity score matched analysis. PG - 706-715 LID - 10.2459/JCM.0000000000001934 [doi] AB - AIMS: Balloon-expandable valve (BEV) and self-expanding valve (SEV) platforms have undergone significant technological advancements. This study aimed to compare postoperative outcomes in patients with severe aortic stenosis (AS) treated with transcatheter aortic valve implantation (TAVI) using newer-generation BEV and SEV devices. METHODS: We retrospectively analyzed all patients who underwent TAVI for severe native AS at a single center between January 2018 and December 2023. Exclusion criteria included emergency procedures, active endocarditis, prior aortic valve interventions, bicuspid valves, primary aortic regurgitation, non-transfemoral access, concomitant coronary procedures, and use of retracted valves. Bioprosthetic valve dysfunction (BVD) was assessed according to modified Valve Academic Research Consortium 3 (VARC-3) definitions. RESULTS: Propensity score matching was used to create 354 well balanced pairs. Periprocedural outcomes, including mortality, were comparable between the matched BEV and SEV groups. However, echocardiographic evaluation at discharge revealed significantly higher mean transvalvular gradients (P < 0.001) and peak velocities (P < 0.001) in the BEV group. During follow-up, the SEV group showed a significantly lower incidence of BVD [hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.45-0.91; P = 0.013], particularly regarding higher rates of severe prosthesis-patient mismatch (P = 0.001) and at least moderate structural valve deterioration (P = 0.006). No significant differences were observed in all-cause (HR: 1.18, 95% CI: 0.90-1.56, P = 0.235), or cardiac-related mortality (HR: 1.29, 95% CI: 0.91-1.83, P = 0.157). CONCLUSION: Among patients treated with newer-generation transcatheter valves, SEV demonstrated more favorable hemodynamic performance compared with BEV. However, short- and mid-term mortality rates remained similar between the two groups. Longer-term follow-up of randomized trials is needed to confirm these findings. CI - Copyright (c) 2026 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Baudo, Massimo AU - Baudo M AD - Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA. AD - Cardiovascular Research Institute Maastricht-CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands. FAU - Sicouri, Serge AU - Sicouri S AD - Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA. FAU - Magouliotis, Dimitrios E AU - Magouliotis DE AD - Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA. FAU - Hage, Fadi AU - Hage F AD - Department of Cardiac Surgery. FAU - Wissam, Rahi AU - Wissam R AD - Department of Internal Medicine. FAU - Goldman, Scott M AU - Goldman SM AD - Department of Cardiac Surgery. FAU - Gnall, Eric M AU - Gnall EM AD - Department of Interventional Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA. FAU - Gray, William A AU - Gray WA AD - Department of Interventional Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA. FAU - Gelsomino, Sandro AU - Gelsomino S AD - Cardiovascular Research Institute Maastricht-CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands. FAU - Ramlawi, Basel AU - Ramlawi B AD - Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA. AD - Department of Cardiac Surgery. LA - eng PT - Comparative Study PT - Journal Article DEP - 20260827 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - Humans MH - *Heart Valve Prosthesis MH - *Aortic Valve Stenosis/surgery/physiopathology/mortality/diagnostic imaging MH - Propensity Score MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects/mortality MH - Retrospective Studies MH - Prosthesis Design MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Aged, 80 and over MH - Treatment Outcome MH - Female MH - Male MH - Risk Factors MH - Aged MH - *Bioprosthesis MH - Time Factors MH - *Balloon Valvuloplasty/adverse effects MH - Severity of Illness Index MH - Risk Assessment OTO - NOTNLM OT - balloon-expandable valve OT - prosthesis-patient mismatch OT - self-expanding valve OT - transcatheter aortic valve implantation EDAT- 2026/09/21 11:44 MHDA- 2026/09/21 11:45 CRDT- 2026/09/21 09:25 PHST- 2026/05/18 00:00 [received] PHST- 2026/07/20 00:00 [accepted] PHST- 2026/09/21 11:45 [medline] PHST- 2026/09/21 11:44 [pubmed] PHST- 2026/09/21 09:25 [entrez] AID - 01244665-202609000-00006 [pii] AID - 10.2459/JCM.0000000000001934 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2026 Sep 1;27(9):706-715. doi: 10.2459/JCM.0000000000001934. Epub 2026 Aug 27. PMID- 42760240 OWN - NLM STAT- Publisher LR - 20260918 IS - 1532-8422 (Electronic) IS - 1053-0770 (Linking) DP - 2026 Aug 30 TI - Long-Term Survival of Patients Undergoing Transcatheter Aortic Valve Implantation Under General Anesthesia Versus Monitored Anesthesia Care. LID - S1053-0770(26)00862-1 [pii] LID - 10.1053/j.jvca.2026.08.158 [doi] AB - OBJECTIVES: This study aimed to evaluate the long-term survival of patients who underwent transcatheter aortic valve implantation (TAVI) by general anesthesia (GA) versus monitored anesthesia care (MAC). DESIGN: Retrospective (observational) study. SETTING: Single center. PARTICIPANTS: Between 2015 and 2024, a total of 1,390 patients with severe aortic valve stenosis underwent TAVI with GA or MAC. INTERVENTIONS: Transcatheter aortic valve implantation by the transfemoral approach. MEASUREMENTS AND MAIN RESULTS: GA was used in 508 patients and MAC in 882 patients. The 30-day mortality was 1.6% (8 patients) in GA versus 0.6% (5 patients) in MAC (p = 0.08). Kaplan-Meier analysis showed that survival at 1, 3, 5, and 7 years was 91.1%, 75.6%, 59.8%, and 40% in GA versus 93.2%, 75.5%, 63.2%, and 46.9% in MAC, respectively (p = 0.16). Multivariable analysis using a Cox proportional hazards model demonstrated that anesthetic management with GA versus MAC (adjusted for age, sex, coronary artery disease, previous percutaneous intervention, EuroSCORE II, postprocedural cerebral vascular accident, permanent pacemaker implantation, valve-in-valve TAVI, and TAVI period) did not significantly affect the long-term survival of patients after TAVI (hazard ratio, 0.94, 95% CI, 0.74-1.18; p = 0.58). CONCLUSIONS: Anesthetic management with GA or MAC did not affect the long-term survival of patients after TAVI. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Samanidis, George AU - Samanidis G AD - Department of Cardiac Surgery, Onassis Hospital, Athens, Greece. Electronic address: gsamanidis@yahoo.gr. FAU - Kanakis, Meletios AU - Kanakis M AD - Department of Pediatric and Congenital Heart Surgery, Onassis Hospital, Athens, Greece. FAU - Koziakas, Ilias G AU - Koziakas IG AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. FAU - Falara, Areti AU - Falara A AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. FAU - Nikoli, Eleni AU - Nikoli E AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. FAU - Griva, Panagiota AU - Griva P AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. FAU - Ftikos, Panagiotis AU - Ftikos P AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. FAU - Kosmas, Ilias AU - Kosmas I AD - Department of Intervention Cardiology, Onassis Hospital, Athens, Greece. FAU - Smyrli, Anna AU - Smyrli A AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. FAU - Balanika, Marina AU - Balanika M AD - Department of Anesthesiology, Onassis Hospital, Athens, Greece. LA - eng PT - Journal Article DEP - 20260830 PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 SB - IM OTO - NOTNLM OT - TAVI OT - general anesthesia OT - monitored anesthesia care OT - survival COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/09/18 23:36 MHDA- 2026/09/18 23:36 CRDT- 2026/09/18 21:59 PHST- 2026/02/04 00:00 [received] PHST- 2026/08/05 00:00 [revised] PHST- 2026/08/26 00:00 [accepted] PHST- 2026/09/18 23:36 [medline] PHST- 2026/09/18 23:36 [pubmed] PHST- 2026/09/18 21:59 [entrez] AID - S1053-0770(26)00862-1 [pii] AID - 10.1053/j.jvca.2026.08.158 [doi] PST - aheadofprint SO - J Cardiothorac Vasc Anesth. 2026 Aug 30:S1053-0770(26)00862-1. doi: 10.1053/j.jvca.2026.08.158. PMID- 42759034 OWN - NLM STAT- Publisher LR - 20260918 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) DP - 2026 Sep 14 TI - Totally percutaneous transfemoral transcatheter aortic valve replacement via synthetic vascular grafts: a single-center case series. LID - 10.25270/jic/26.00134 [doi] AB - OBJECTIVE: Transfemoral (TF) vascular access is the preferred route for transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis; however, patients with prior peripheral vascular surgery are often treated via alternative, more invasive access sites. The authors aimed to assess the feasibility of valve delivery via synthetic vascular grafts in patients with aortobifemoral bypass surgery. METHODS: The authors report 3 consecutive patients with peripheral vascular disease and a history of aortobifemoral bypass graft surgery who underwent TF-TAVR via direct puncture of the synthetic vascular grafts. Preprocedural computed tomography angiography (CTA) guided access site selection and vascular closure strategy in all cases. RESULTS: Prophylactic 0.014-inch safety wires were delivered to the primary access sites via a secondary access site in order to facilitate hemostasis and enable percutaneous vascular repair if necessary. Self-expanding and balloon-expandable valves were successfully delivered via synthetic grafts in all 3 procedures. A prophylactic occlusive balloon was inflated within the abdominal aorta in 1 case in order to prevent potential hemorrhage during sheath removal. Successful hemostasis was achieved in all patients, using a plug-based vascular closure device (VCD) in 1 patient and combined suture-mediated VCDs and plug-based closure devices in 2 patients. CONCLUSIONS: Percutaneous TF-TAVR with valve delivery via synthetic vascular grafts appears feasible in select patients. VCDs achieved access site hemostasis in all cases. Procedural planning based on CTA appears essential for selecting the optimal vascular access strategy. FAU - Sliman, Hussein AU - Sliman H AD - the Department of Cardiology, Carmel Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. FAU - Eitan, Amnon AU - Eitan A AD - the Department of Cardiology, Carmel Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. FAU - Hayeq, Hashem AU - Hayeq H AD - the Department of Vascular Surgery, Carmel Medical Center, Haifa, Israel. FAU - Shiran, Avinoam AU - Shiran A AD - the Department of Cardiology, Carmel Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel. FAU - Zissman, Keren AU - Zissman K AD - the Department of Cardiology, Carmel Medical Center, Haifa, Israel. FAU - Jaffe, Ronen AU - Jaffe R AD - the Department of Cardiology, Carmel Medical Center, Haifa, Israel; Technion-Israel Institute of Technology, Haifa, Israel; Email: jafferonen@gmail.com. LA - eng PT - Journal Article DEP - 20260914 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM OTO - NOTNLM OT - TAVR OT - peripheral vascular disease OT - transcatheter aortic valve replacement OT - transfemoral access approach EDAT- 2026/09/18 17:36 MHDA- 2026/09/18 17:36 CRDT- 2026/09/18 16:53 PHST- 2026/09/18 17:36 [medline] PHST- 2026/09/18 17:36 [pubmed] PHST- 2026/09/18 16:53 [entrez] AID - 10.25270/jic/26.00134 [doi] PST - aheadofprint SO - J Invasive Cardiol. 2026 Sep 14. doi: 10.25270/jic/26.00134. PMID- 42757819 OWN - NLM STAT- MEDLINE DCOM- 20260921 LR - 20260924 IS - 1651-2006 (Electronic) IS - 1401-7431 (Linking) VI - 60 IP - 1 DP - 2026 Dec TI - Transcatheter aortic valve implantation in patients with tricuspid, bicuspid and bioprosthetic valves: observations from COMPARE-TAVI 1. PG - 2704938 LID - 10.1080/14017431.2026.2704938 [doi] AB - Background. Transcatheter aortic valve implantation (TAVI) is most extensively documented for the treatment of aortic stenosis in patients with tricuspid valves. To compare the 30-day and 1-year outcomes after TAVI in patients with tricuspid, bicuspid and bioprosthetic valves who participated in the COMPARE-TAVI 1 trial. Methods. In COMPARE-TAVI 1, all-comer patients treated with transfemoral TAVI were randomized to treatment with one of two balloon-expandable valves. In this study, these patients were divided into three groups based on valve anatomy. 30-day and 1-year outcomes among patients with bicuspid and bioprosthetic valves (surgical or transcatheter) were compared with outcomes among patients with tricuspid valves. Results. Patients with tricuspid valves (N = 892, median 82 years) were slightly older than patients with bicuspid (N = 98, median 78 years) and bioprosthetic (N = 40, median 80 years) valves. Procedural outcomes were similar. There were no differences in death or bleeding at 30 days, nor in death, myocardial infarction, percutaneous revascularization, or endocarditis at 1 year. Stroke was more frequent among patients with bicuspid valves at 30 days (n = 7), while new pacemaker was less frequent among patients with bioprosthetic valves at 30 days (n = 0). The need for reoperation was more frequent among patients with bicuspid valves (n = 3). Conclusions. In this observational study performed within the COMPARE-TAVI 1 cohort, patients with tricuspid, bicuspid or bioprosthetic valves had similar outcomes. No patients with bioprosthetic valves had a new pacemaker within 30 days after TAVI. Clinical trial registration. ClinicalTrials.gov: NCT04443023. FAU - Thim, Troels AU - Thim T AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. FAU - Nissen, Henrik AU - Nissen H AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Freeman, Phillip AU - Freeman P AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Dahl, Jordi Sanchez AU - Dahl JS AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Christiansen, Evald Hoj AU - Christiansen EH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. FAU - Norsell, Michala AU - Norsell M AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Eftekhari, Ashkan AU - Eftekhari A AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Norgaard, Bjarne Linde AU - Norgaard BL AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Frederiksen, Christian Alcaraz AU - Frederiksen CA AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Vase, Henrik Olholm AU - Vase HO AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Ellert, Julia AU - Ellert J AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Ovrehus, Kristian Altern AU - Ovrehus KA AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Tang, Mariann AU - Tang M AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. FAU - Terkelsen, Christian Juhl AU - Terkelsen CJ AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. LA - eng SI - ClinicalTrials.gov/NCT04443023 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20260921 PL - England TA - Scand Cardiovasc J JT - Scandinavian cardiovascular journal : SCJ JID - 9708377 SB - IM MH - Humans MH - *Bioprosthesis MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Female MH - Prosthesis Design MH - Male MH - Aged MH - Time Factors MH - Aged, 80 and over MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology/abnormalities MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging/mortality MH - Risk Factors MH - *Tricuspid Valve/surgery/diagnostic imaging/physiopathology/abnormalities MH - Bicuspid Aortic Valve Disease MH - Postoperative Complications/etiology/mortality/therapy MH - *Heart Valve Diseases/surgery/physiopathology/diagnostic imaging/mortality MH - Recovery of Function OTO - NOTNLM OT - Aortic stenosis OT - TAVI OT - THV OT - ballon-expandable valves OT - bicuspid OT - bioprosthesis EDAT- 2026/09/18 12:26 MHDA- 2026/09/21 11:44 CRDT- 2026/09/18 09:17 PHST- 2026/09/21 11:44 [medline] PHST- 2026/09/18 12:26 [pubmed] PHST- 2026/09/18 09:17 [entrez] AID - 10.1080/14017431.2026.2704938 [doi] PST - ppublish SO - Scand Cardiovasc J. 2026 Dec;60(1):2704938. doi: 10.1080/14017431.2026.2704938. Epub 2026 Sep 21. PMID- 42745734 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260916 LR - 20260928 IS - 2604-7276 (Electronic) IS - 2604-7306 (Print) IS - 2604-7306 (Linking) VI - 8 IP - 2 DP - 2026 Apr-Jun TI - Transcatheter aortic valve implantation without immediate cardiac surgery backup. A single-center retrospective analysis. PG - 72-78 LID - 10.24875/RECICE.M25000549 [doi] AB - INTRODUCTION AND OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is traditionally performed with on-site cardiac surgery (CS) backup. However, procedural advances enabled TAVI to be performed safely without immediate CS backup. This study describes our single-center experience with TAVI performed in a center without on-site CS backup. METHODS: We conducted a retrospective analysis of the first 300 patients undergoing TAVI without on-site CS backup between 2020 and 2024. The primary endpoint was 30-day mortality. Secondary endpoints included procedural and in-hospital mortality, stroke, emergency cardiac surgery (ECS), vascular complications, major hemorrhage, and pacemaker implantation. Outcomes were compared with those from the Portuguese national TAVI registry. RESULTS: The cohort mean age was 82+/-5 years (54% women). The median STS risk score was 3.8 [IQR, 2.3-6.6], with 17% high-risk patients (STS > 8). Most procedures were elective (83%). Transfemoral access was used in 99% of cases, and self-expandable valves were implanted in 95%. The 30-day mortality rate was 3.7% (n = 11), while stroke occurred in 2.7% (n = 8). The procedural survival rate was 99% (n = 298). No cases of ECS occurred (n = 0), coronary obstruction, TAVI-in-TAVI deployment as a bailout, or valve embolization were reported. Pericardial tamponade occurred in 0.7% of cases (n = 2). Major hemorrhage and vascular complications occurred in 8%, and pacemaker implantation in 20%. The 1-year mortality rate was 12%, with 4% attributed to cardiovascular causes; among survivors, and 91% reported symptomatic improvement. There were no significant differences in outcomes vs the results from the TAVI national registry. CONCLUSIONS: TAVI was safely and effectively performed without on-site CS, including emergency and complex cases. The non-ECS rate and outcomes comparable to national benchmarks support the feasibility of TAVI in selected non-CS centers. In this context, expanding TAVI access may reduce waiting times and improve the management of severe aortic stenosis while maintaining high procedural quality. CI - Copyright: (c) 2026 Sociedad Espanola de Cardiologia. FAU - Rocha de Almeida, Antonio AU - Rocha de Almeida A AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Fernandes, Renato AU - Fernandes R AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Bento, Angela AU - Bento A AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Neves, David AU - Neves D AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Bras, Diogo AU - Bras D AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Mendes, Gustavo AU - Mendes G AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Rocha, Rita AU - Rocha R AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Paralta Figueiredo, Marta AU - Paralta Figueiredo M AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Viana, Rafael AU - Viana R AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Louro, Rita AU - Louro R AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Laranjeira Santos, Alvaro AU - Laranjeira Santos A AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. FAU - Patricio, Lino AU - Patricio L AD - Departamento de Cardiologia, Hospital Espirito Santo de Evora, Unidade Local de Saude Alentejo Central, Evora, Portugal. AD - C-TRAIL, Centro Academico Clinico do Alentejo, Evora, Portugal. LA - eng LA - spa PT - Journal Article DEP - 20251103 PL - Spain TA - REC Interv Cardiol JT - REC, interventional cardiology JID - 9919033203206676 CIN - REC Interv Cardiol. 2026 Mar 03;8(2):67-68. doi: 10.24875/RECICE.M25000562. PMID: 42746971 PMC - PMC13343812 OTO - NOTNLM OT - Cardiac surgery backup OT - Severe aortic stenosis OT - TAVI OT - Transcatheter aortic valve implantation COIS- CONFLICTS OF INTEREST: None declared. EDAT- 2026/09/16 05:36 MHDA- 2026/09/16 05:37 PMCR- 2025/11/03 CRDT- 2026/09/16 04:17 PHST- 2025/05/28 00:00 [received] PHST- 2025/10/03 00:00 [accepted] PHST- 2026/09/16 05:37 [medline] PHST- 2026/09/16 05:36 [pubmed] PHST- 2026/09/16 04:17 [entrez] PHST- 2025/11/03 00:00 [pmc-release] AID - recic-8-2-72 [pii] AID - 10.24875/RECICE.M25000549 [doi] PST - epublish SO - REC Interv Cardiol. 2025 Nov 3;8(2):72-78. doi: 10.24875/RECICE.M25000549. eCollection 2026 Apr-Jun. PMID- 42745728 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260916 LR - 20260917 IS - 2604-7276 (Electronic) IS - 2604-7306 (Print) IS - 2604-7306 (Linking) VI - 8 IP - 2 DP - 2026 Apr-Jun TI - How does major bleeding influence decision-making in patients eligible for transfemoral TAVI? A single-center experience. PG - 79-84 LID - 10.24875/RECICE.M25000548 [doi] AB - INTRODUCTION AND OBJECTIVES: To evaluate the impact of bleeding on the risk-benefit balance of coronary revascularization prior to transfemoral transcatheter aortic valve implantation (TF-TAVI). METHODS: We conducted a retrospective analysis of the patients who underwent TF-TAVI at our center between 2008 and 2018 to evalute the management of coronary artery disease (percutaneous revascularization vs no revascularization). Subsequently, the rate of major bleeding -defined according to the Bleeding Academic Research Consortium (BARC) criteria (type 3-5)- and major adverse cardiovascular events (MACE) was compared between the 2 groups over a mean 60-month follow-up period. RESULTS: A total of 379 patients were included. The overall rate of major bleeding was 21.4%, higher in revascularized patients but without reaching statistical significance. The rate of major bleeding between coronary angiography and TF-TAVI implantation was 5.5% and significantly higher in revascularized patients (12.0% vs 3.5%; P = .07). During the hospitalization for TF-TAVI and throughout follow-up, the rate of major bleeding was 6.1% and 9.6%, respectively, with no significant inter-group differences. There were no significant differences either in the 5-year rate of MACE. CONCLUSIONS: In our patient cohort, pre-TF-TAVI preoperative coronary revascularization was associated with an initially higher bleeding risk; however, no statistically significant differences were observed in major bleeding or MACE at the 5-year follow-up. These findings support the need to generate high-quality clinical evidence to demonstrate the net clinical benefit of coronary revascularization in this context. CI - Copyright: (c) 2026 Sociedad Espanola de Cardiologia. FAU - Vidau Getan, Carmen AU - Vidau Getan C AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Lopez Vazquez, Domingo AU - Lopez Vazquez D AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Flores Rios, Xacobe AU - Flores Rios X AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Souto Cainzos, Borja AU - Souto Cainzos B AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Rebollal Leal, Fernando AU - Rebollal Leal F AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Pinon Esteban, Pablo AU - Pinon Esteban P AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Aldama Lopez, Guillermo AU - Aldama Lopez G AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Salgado Fernandez, Jorge AU - Salgado Fernandez J AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Gonzalez Montes, Miguel AU - Gonzalez Montes M AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Gonzalez Barbeito, Gabriel AU - Gonzalez Barbeito G AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Calvino Santos, Ramon AU - Calvino Santos R AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. FAU - Vazquez Rodriguez, Jose Manuel AU - Vazquez Rodriguez JM AD - Unidad de Hemodinamica, Servicio de Cardiologia, Hospital Universitario A Coruna, A Coruna, Spain. LA - eng LA - spa PT - Journal Article DEP - 20251214 PL - Spain TA - REC Interv Cardiol JT - REC, interventional cardiology JID - 9919033203206676 PMC - PMC13343803 OTO - NOTNLM OT - Bleeding OT - Coronary revascularization OT - Transcatheter aortic valve implantation COIS- CONFLICTS OF INTEREST: None declared. EDAT- 2026/09/16 05:36 MHDA- 2026/09/16 05:37 PMCR- 2025/12/14 CRDT- 2026/09/16 04:15 PHST- 2025/05/06 00:00 [received] PHST- 2025/10/03 00:00 [accepted] PHST- 2026/09/16 05:37 [medline] PHST- 2026/09/16 05:36 [pubmed] PHST- 2026/09/16 04:15 [entrez] PHST- 2025/12/14 00:00 [pmc-release] AID - recic-8-2-79 [pii] AID - 10.24875/RECICE.M25000548 [doi] PST - epublish SO - REC Interv Cardiol. 2025 Dec 14;8(2):79-84. doi: 10.24875/RECICE.M25000548. eCollection 2026 Apr-Jun. PMID- 42739720 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260915 LR - 20260916 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 17 DP - 2026 Aug 29 TI - Cerebral Infarctions After Transcatheter Aortic Valve Replacement of Horizontal Aorta Versus Non-Horizontal Aorta. LID - 10.3390/jcm15176715 [doi] LID - 6715 AB - Background/Objectives: Horizontal aorta, characterized by a high aortic angle, represents a challenging anatomical feature during transcatheter aortic valve replacement (TAVR), but its association with cerebral ischemic injury remains unclear. This study investigated the association between horizontal aorta and diffusion-weighted magnetic resonance imaging (DW-MRI)-detected cerebral infarctions after TAVR. Methods: We retrospectively enrolled 411 consecutive patients with severe aortic stenosis undergoing transfemoral self-expanding TAVR between March 2017 and May 2022. Aortic angle was defined as the angle between the aortic annular plane and the horizontal plane on preprocedural computed tomography, and horizontal aorta was defined as an aortic angle > 60 degrees . Patients were categorized into horizontal aorta and non-horizontal aorta groups. The incidence, number, and volume of new DW-MRI lesions were compared between groups. Results: The median age was 74.0 years (interquartile range [IQR]: 69.0 to 79.0); 54.5% were male, and the median Society of Thoracic Surgeons score was 3.83% (IQR: 2.29 to 6.39). Horizontal aorta was present in 69 patients (16.8%). Procedural complications were infrequent and comparable between groups. Although the incidence of new cerebral infarctions was similar between groups (89.9% vs. 83.0%; p = 0.157), patients with horizontal aorta had more cerebral infarction lesions (median, 4.0 vs. 3.0; p = 0.031), larger total lesion volume (320.0 vs. 180.0 mm(3); p = 0.017), and larger lesion volume per infarction (70.0 vs. 51.7 mm(3); p = 0.036). Multivariable analysis identified horizontal aorta as an independent predictor of the number of post-TAVR cerebral infarctions. Conclusions: Horizontal aorta is relatively common among patients undergoing TAVR and is independently associated with a greater burden of DW-MRI-detected subclinical cerebral ischemic injury. FAU - Dai, Hanyi AU - Dai H AUID- ORCID: 0000-0002-7782-891X AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310009, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou 310009, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou 310053, China. FAU - Zhou, Dao AU - Zhou D AUID- ORCID: 0000-0001-7815-9490 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310009, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou 310009, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou 310053, China. FAU - Sheng, Wenjing AU - Sheng W AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310009, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou 310009, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou 310053, China. FAU - Zheng, Rongrong AU - Zheng R AD - Hangzhou Emergency Medical Center of Zhejiang Province, Hangzhou 310021, China. FAU - Chen, Jun AU - Chen J AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310009, China. FAU - Yidilisi, Abuduwufuer AU - Yidilisi A AUID- ORCID: 0000-0001-8733-3585 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. FAU - Liu, Xianbao AU - Liu X AUID- ORCID: 0000-0003-1556-9198 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310009, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou 310009, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou 310053, China. AD - Binjiang Institute, Zhejiang University, Hangzhou 310052, China. FAU - Wang, Lihan AU - Wang L AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310009, China. LA - eng GR - 2024ZD0527100/National Center for Chronic and Noncommunicable Disease Control and Prevention/ PT - Journal Article DEP - 20260829 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13566855 OTO - NOTNLM OT - aortic stenosis OT - cerebral ischemic infarctions OT - horizontal aorta OT - transcatheter aortic valve replacement COIS- The authors declare no conflict of interest. EDAT- 2026/09/15 05:36 MHDA- 2026/09/15 05:37 PMCR- 2026/08/29 CRDT- 2026/09/15 03:25 PHST- 2026/06/26 00:00 [received] PHST- 2026/07/20 00:00 [revised] PHST- 2026/08/27 00:00 [accepted] PHST- 2026/09/15 05:37 [medline] PHST- 2026/09/15 05:36 [pubmed] PHST- 2026/09/15 03:25 [entrez] PHST- 2026/08/29 00:00 [pmc-release] AID - jcm15176715 [pii] AID - jcm-15-06715 [pii] AID - 10.3390/jcm15176715 [doi] PST - epublish SO - J Clin Med. 2026 Aug 29;15(17):6715. doi: 10.3390/jcm15176715. PMID- 42739285 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260915 LR - 20260916 IS - 2075-4418 (Print) IS - 2075-4418 (Electronic) IS - 2075-4418 (Linking) VI - 16 IP - 17 DP - 2026 Sep 5 TI - Transaxillary Versus Transfemoral Access for Transcatheter Aortic Valve Implantation: A Propensity Score-Matched Comparison of Clinical Outcomes Using VARC-3 Endpoints. LID - 10.3390/diagnostics16172855 [doi] LID - 2855 AB - Background/Objectives: Transaxillary access (TAx) is an established alternative to transfemoral access (TF) for transcatheter aortic valve implantation (TAVI) in patients with unfavorable iliofemoral anatomy. While TAx-TAVI has been increasingly adopted at experienced centers, propensity score-matched comparative data with VARC-3 endpoint definitions are scarce, and most existing series originate from Western European cohorts. We aimed to address this gap by reporting outcomes from a propensity-matched TAx versus TF cohort using VARC-3 endpoints, contributing contemporary data from a high-volume Turkish center with established alternative access expertise. Methods: Among 2389 consecutive TAVI procedures screened between January 2016 and December 2024, 291 patients with complete data were included. After stratification by access route (TAx n = 51; TF n = 240) and exclusion of one TAx patient with missing covariates, 1:2 greedy nearest-neighbor propensity score matching was performed using nine covariates. The final cohort comprised 150 patients (50 TAx, 100 TF). All outcomes were defined per VARC-3 criteria. Results: All nine covariates achieved standardized mean differences <0.1 after matching. Technical success was comparable (TAx 94.0% vs. TF 96.0%; p = 0.686). The VARC-3 early safety event rate did not differ significantly (16.0% vs. 15.0%; p = 1.000); no equivalence can be inferred given the small event counts and wide confidence intervals. Any bleeding (VARC-3) was significantly lower in the TAx group (8.0% vs. 22.0%; OR 0.31, 95% CI 0.10-0.95; p = 0.039), confirmed by conditional logistic regression for the matched structure (OR 0.32 [0.10-0.97]; p = 0.043); this should be considered an exploratory finding. Thirty-day all-cause mortality (encompassing in-hospital deaths) (6.0% vs. 10.0%; p = 0.545), 1-year mortality (12.0% vs. 16.0%; p = 0.628), and Kaplan-Meier 1-year survival (88.0% vs. 84.0%; log-rank p = 0.510) did not differ significantly. ICU stay (median 2 [1-2] vs. 2 [1-3] days; p = 0.020) and hospital stay (median 5 [4-6] vs. 5 [4-6] days; p = 0.005) yielded statistically significant p-values; however, medians were identical in both comparisons, and significance was driven by outlier-prolonged admissions in the TF group rather than a meaningful difference in typical recovery duration. Conclusions: TAx-TAVI demonstrated comparable mortality, safety, and hemodynamic outcomes to TF-TAVI, with a significantly lower rate of bleeding complications. Axillary access represents a safe and effective alternative route in patients unsuitable for transfemoral TAVI. FAU - Erdogan, Kemal Esref AU - Erdogan KE AUID- ORCID: 0000-0002-2684-7256 AD - Department of Cardiovascular Surgery, Ankara Yildirim Beyazit University, School of Medicine and Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Uguz, Emrah AU - Uguz E AUID- ORCID: 0000-0002-2758-7644 AD - Department of Cardiovascular Surgery, Ankara Yildirim Beyazit University, School of Medicine and Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Erdol, Mehmet Akif AU - Erdol MA AD - Department of Cardiology University of Health Sciences, Faculty of Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Saglam, Muhammet Fethi AU - Saglam MF AUID- ORCID: 0000-0003-0744-0001 AD - Department of Cardiovascular Surgery, Ankara Yildirim Beyazit University, School of Medicine and Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Yucel, Murat AU - Yucel M AUID- ORCID: 0000-0002-9182-0690 AD - Department of Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Alili, Altay AU - Alili A AUID- ORCID: 0009-0005-8575-2555 AD - Department of Cardiovascular Surgery, Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Bayram, Huseyin AU - Bayram H AD - Department of Cardiology University of Health Sciences, Faculty of Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Yigitbasi, Mehmet Murat AU - Yigitbasi MM AUID- ORCID: 0000-0002-6049-9910 AD - Department of Cardiology, Ankara Yildirim Beyazit University, School of Medicine and Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Kardesler, Burak AU - Kardesler B AUID- ORCID: 0000-0003-4576-5798 AD - Department of Cardiology, Ankara Bilkent City Hospital, Ankara 06800, Turkiye. FAU - Kalkan, Kamuran AU - Kalkan K AUID- ORCID: 0000-0001-6204-316X AD - Department of Cardiology, Ankara Yildirim Beyazit University, School of Medicine and Ankara Bilkent City Hospital, Ankara 06800, Turkiye. LA - eng PT - Journal Article DEP - 20260905 PL - Switzerland TA - Diagnostics (Basel) JT - Diagnostics (Basel, Switzerland) JID - 101658402 PMC - PMC13564691 OTO - NOTNLM OT - VARC-3 OT - alternative access OT - bleeding complications OT - propensity score matching OT - transaxillary access OT - transcatheter aortic valve implantation OT - transfemoral access COIS- The authors declare no conflicts of interest. EDAT- 2026/09/15 05:36 MHDA- 2026/09/15 05:37 PMCR- 2026/09/05 CRDT- 2026/09/15 03:24 PHST- 2026/07/15 00:00 [received] PHST- 2026/08/23 00:00 [revised] PHST- 2026/09/01 00:00 [accepted] PHST- 2026/09/15 05:37 [medline] PHST- 2026/09/15 05:36 [pubmed] PHST- 2026/09/15 03:24 [entrez] PHST- 2026/09/05 00:00 [pmc-release] AID - diagnostics16172855 [pii] AID - diagnostics-16-02855 [pii] AID - 10.3390/diagnostics16172855 [doi] PST - epublish SO - Diagnostics (Basel). 2026 Sep 5;16(17):2855. doi: 10.3390/diagnostics16172855. PMID- 42733293 OWN - NLM STAT- Publisher LR - 20260914 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) DP - 2026 Sep 13 TI - Feasibility and Procedural Considerations of Balloon-Expandable TAVR in Patients With Prior Endovascular Aortic Stent Grafts. LID - 10.1002/ccd.70867 [doi] AB - OBJECTIVES: To evaluate the feasibility and short-term outcomes of transcatheter aortic valve replacement (TAVR) using balloon-expandable Sapien valves in patients with prior endovascular aortic stent grafts. METHODS: We conducted a single-center, retrospective study of 23 patients with prior endovascular aortic stent grafts who underwent TAVR between 2012 and 2025 using Sapien platform balloon-expandable valves. Descriptive statistics and univariate logistic regression analysis were used to characterize and identify outcomes of peri-procedural complications. RESULTS: Transfemoral access was used in 87% of cases, and valve deployment was successful in all patients without aortic injuries or graft-related complications during the procedural and up to 30-day post-procedure period. Median length of stay was 3 days, and there were no deaths up to 30-days. Post-procedural events were infrequent and included new-onset atrial fibrillation (n = 2), transient hemodialysis (n = 1), pleural effusion (n = 1), and stroke (n = 1). In exploratory analyses limited by the small number of events, older age (OR 1.27, 95% CI 1.04-1.71) and higher baseline mean aortic-valve gradient (OR 1.24, 95% CI 1.06-1.76) were associated with periprocedural events. CONCLUSIONS: The complications observed in our cohort are general outcomes associated with TAVR, instead of graft-associated outcomes. Balloon-expandable TAVR is technically safe and feasible in patients with prior endovascular aortic stent grafts when performed at experienced centers. CI - (c) 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Alhallak, Iad AU - Alhallak I AUID- ORCID: 0000-0001-9200-9587 AD - Department of Cardiovascular Disease, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Mills, Alexander AU - Mills A AD - Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Bequeaith, Beau AU - Bequeaith B AD - Department of Cardiovascular Disease, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Chan, Ken AU - Chan K AUID- ORCID: 0009-0009-4386-9076 AD - Department of Cardiovascular Disease, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Tanaka, Akiko AU - Tanaka A AD - Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Estrera, Anthony L AU - Estrera AL AD - Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Kar, Biswajit AU - Kar B AUID- ORCID: 0000-0002-4777-5466 AD - Department of Cardiovascular Disease, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Smalling, Richard AU - Smalling R AUID- ORCID: 0000-0002-3516-7789 AD - Department of Cardiovascular Disease, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. FAU - Dhoble, Abhijeet AU - Dhoble A AD - Department of Cardiovascular Disease, McGovern Medical School at UTHealth Houston, Houston, Texas, USA. LA - eng PT - Journal Article DEP - 20260913 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM OTO - NOTNLM OT - aortic stent grafts OT - balloon-expandable valve OT - transcatheter aortic valve replacement EDAT- 2026/09/14 05:35 MHDA- 2026/09/14 05:35 CRDT- 2026/09/14 02:35 PHST- 2026/08/01 00:00 [revised] PHST- 2025/12/08 00:00 [received] PHST- 2026/08/27 00:00 [accepted] PHST- 2026/09/14 05:35 [medline] PHST- 2026/09/14 05:35 [pubmed] PHST- 2026/09/14 02:35 [entrez] AID - 10.1002/ccd.70867 [doi] PST - aheadofprint SO - Catheter Cardiovasc Interv. 2026 Sep 13. doi: 10.1002/ccd.70867. PMID- 42724931 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260911 LR - 20260924 IS - 2049-0801 (Print) IS - 2049-0801 (Electronic) IS - 2049-0801 (Linking) VI - 88 IP - 9 DP - 2026 Sep TI - Mechanical complications of transcatheter aortic valve replacement: a review article. PG - 5766-5773 LID - 10.1097/MS9.0000000000004935 [doi] AB - Aortic stenosis (AS) represents a prevalent valvular heart disease, particularly affecting the elderly population, with substantial implications for morbidity and mortality. This review examines the epidemiology, pathophysiology, management strategies, complications, and future implications of AS and its treatment modalities, focusing primarily on transcatheter aortic valve replacement (TAVR). The prevalence of AS is rising as the population ages, with notable differences observed across various demographic groups and regions. Additionally, AS can also occur in younger adults, typically due to a bicuspid aortic valve, the most common congenital heart defect, which further contributes to the condition's growing clinical significance. Surgical aortic valve replacement (SAVR) has historically been the standard treatment for severe AS, but TAVR methods have emerged as a less invasive alternative, particularly for high-risk surgical candidates. SAVR has historically been the standard treatment for severe AS, but TAVR has undergone rapid evolution and widespread acceptance, with over 200 000 procedures performed globally. Various delivery routes for TAVR exist, each with its advantages and limitations, including transfemoral, subclavian, direct aortic, transapical, and transcarotid approaches. Complications associated with TAVR include vascular complications, stroke, conduction disturbances, coronary artery obstruction, acute kidney injury, infections, and others. Strategies for complication prevention and management are actively researched and implemented. The review also discusses future implications of TAVR, highlighting advancements in device technology, procedural techniques, patient selection criteria, and the expanding patient population eligible for TAVR. Despite challenges and complications, TAVR has revolutionized the treatment landscape for AS and offers hope for patients previously deemed unsuitable for surgery. CI - Copyright (c) 2026 The Author(s). Published by Wolters Kluwer Health, Inc. FAU - Osman Ahmed, Rudaina Ismail AU - Osman Ahmed RI AUID- ORCID: 0000-0002-8646-0045 AD - Department of Internal Medicine, Napata College, Khartoum, Sudan. FAU - Salah, Mazin AU - Salah M AD - Department of Physiology, Napata College, Khartoum, Sudan. FAU - Abua'Isha, Hasan AU - Abua'Isha H AD - Department of Medicine and Nephrology, University of Khartoum, Khartoum, Sudan. LA - eng PT - Journal Article DEP - 20260403 PL - England TA - Ann Med Surg (Lond) JT - Annals of medicine and surgery (2012) JID - 101616869 PMC - PMC13561257 OTO - NOTNLM OT - SAVR OT - TAVI OT - TAVR OT - aortic stenosis OT - complications OT - delivery routes COIS- The authors declare no conflicts of interest related to this work. EDAT- 2026/09/11 11:38 MHDA- 2026/09/11 11:39 PMCR- 2026/04/03 CRDT- 2026/09/11 10:56 PHST- 2024/10/22 00:00 [received] PHST- 2026/03/09 00:00 [accepted] PHST- 2026/09/11 11:39 [medline] PHST- 2026/09/11 11:38 [pubmed] PHST- 2026/09/11 10:56 [entrez] PHST- 2026/04/03 00:00 [pmc-release] AID - AMSU-D-24-02239 [pii] AID - 10.1097/MS9.0000000000004935 [doi] PST - epublish SO - Ann Med Surg (Lond). 2026 Apr 3;88(9):5766-5773. doi: 10.1097/MS9.0000000000004935. eCollection 2026 Sep. PMID- 42723709 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260911 LR - 20260912 IS - 2604-7276 (Electronic) IS - 2604-7306 (Print) IS - 2604-7306 (Linking) VI - 8 IP - 3 DP - 2026 Jul-Sep TI - Transfemoral TAVI in hostile access: experience with the paving and cracking technique. PG - 194-196 LID - 10.24875/RECICE.M26000567 [doi] FAU - Vazquez Perez, Rocio AU - Vazquez Perez R AD - Servicio de Angiologia y Cirugia Vascular, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Del Valle Fernandez, Raquel AU - Del Valle Fernandez R AD - Servicio de Cardiologia, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Alperi Garcia, Alberto AU - Alperi Garcia A AD - Servicio de Cardiologia, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Zanabili Al-Sibbai, Ahmad Amer AU - Zanabili Al-Sibbai AA AD - Servicio de Angiologia y Cirugia Vascular, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Alvarez Marcos, Francisco AU - Alvarez Marcos F AD - Servicio de Angiologia y Cirugia Vascular, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. AD - Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain. FAU - Alonso Perez, Manuel AU - Alonso Perez M AD - Servicio de Angiologia y Cirugia Vascular, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. AD - Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain. LA - eng LA - spa PT - Journal Article DEP - 20260303 PL - Spain TA - REC Interv Cardiol JT - REC, interventional cardiology JID - 9919033203206676 PMC - PMC13532090 COIS- CONFLICTS OF INTEREST: R. del Valle Fernandez has received honoraria for lectures and teaching activities from Medtronic and Merce V., as well as consultancy fees from Medtronic. A. A. Zanabili Al-Sibbai has received consultancy and educational honoraria from W. L. Gore & Associates, Shockwave Medical, and Medtronic. F. Alvarez Marcos has received consultancy and proctoring fees from Medtronic and Terumo Aortic. The remaining authors declare no conflicts of interest whatsoever. EDAT- 2026/09/11 11:38 MHDA- 2026/09/11 11:39 PMCR- 2026/03/03 CRDT- 2026/09/11 05:19 PHST- 2026/09/11 11:39 [medline] PHST- 2026/09/11 11:38 [pubmed] PHST- 2026/09/11 05:19 [entrez] PHST- 2026/03/03 00:00 [pmc-release] AID - recic-8-3-194 [pii] AID - 10.24875/RECICE.M26000567 [doi] PST - epublish SO - REC Interv Cardiol. 2026 Mar 3;8(3):194-196. doi: 10.24875/RECICE.M26000567. eCollection 2026 Jul-Sep. PMID- 42718777 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260910 LR - 20260911 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - Ultra-low-contrast transfemoral TAVI using the MyVal transcatheter heart valve: a prospective single-center feasibility and safety study. PG - 1878620 LID - 10.3389/fcvm.2026.1878620 [doi] LID - 1878620 AB - BACKGROUND: Acute kidney injury remains clinically relevant after transcatheter aortic valve implantation (TAVI), particularly in chronic kidney disease, and iodinated contrast is a modifiable procedural contributor. METHODS: We conducted a prospective single-center study of 50 patients undergoing transfemoral TAVI with an intraprocedural ultra-low-contrast strategy using the MyVal transcatheter heart valve. The primary feasibility endpoint was successful TAVI completion with total intraprocedural contrast volume /= 30 s during the index hospitalization. Independent predictors were identified by multivariable logistic regression; discrimination was assessed by the area under the receiver operating characteristic curve (AUC), compared using the DeLong test, and internally validated by bootstrapping. RESULTS: NOAF occurred in 44 patients (16.4%). The HATCH score was higher in the NOAF group (2.75 +/- 0.81 vs. 2.03 +/- 0.85; p < 0.001). On multivariable analysis, the HATCH score (adjusted odds ratio [OR] 2.69, 95% CI 1.75-4.13; p < 0.001) and aortic root angulation (adjusted OR 1.05 per degree, 95% CI 1.02-1.09; p = 0.002) were independent predictors of NOAF. The HATCH score yielded an AUC of 0.730 (95% CI 0.672-0.782), numerically higher than that of the CHA(2)DS(2)-VASc score (0.668, 95% CI 0.608-0.724), although the difference was not significant (p = 0.216); a HATCH score >/= 3 provided 63.6% sensitivity and 77.7% specificity. The optimism-corrected C-statistic was 0.761 with a calibration slope of 0.918. NOAF was associated with a higher rate of in-hospital stroke (15.9% vs. 3.6%; p = 0.005). CONCLUSIONS: The HATCH score independently predicted NOAF after transfemoral TAVI and performed at least as well as the CHA(2)DS(2)-VASc score; aortic root angulation was an additional independent correlate. As a simple, bedside tool, the HATCH score may aid pre-procedural risk stratification, pending external validation. CI - (c) 2026 Wiley Periodicals LLC. FAU - Tunca, Cagatay AU - Tunca C AUID- ORCID: 0000-0001-7111-8450 AD - Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkiye. FAU - Sengul, Reha Yasin AU - Sengul RY AUID- ORCID: 0009-0000-3450-1717 AD - Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkiye. FAU - Akpinar, Ahsen Ozge AU - Akpinar AO AUID- ORCID: 0009-0006-7585-8310 AD - Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkiye. FAU - Buyukbas, Fatih Cihat AU - Buyukbas FC AUID- ORCID: 0009-0001-3324-4883 AD - Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkiye. FAU - Ozkan, Mehmet Taha AU - Ozkan MT AUID- ORCID: 0000-0002-7977-1785 AD - Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkiye. FAU - Ozcan, Ozgur Ulas AU - Ozcan OU AUID- ORCID: 0000-0003-4566-3468 AD - Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkiye. FAU - Tanik, Veysel Ozan AU - Tanik VO AUID- ORCID: 0000-0002-7193-4324 AD - Department of Cardiology, Lokman Hekim University Akay Hospital, Ankara, Turkiye. FAU - Ozlek, Bulent AU - Ozlek B AUID- ORCID: 0000-0001-5429-1323 AD - Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkiye. LA - eng PT - Journal Article DEP - 20260908 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM OTO - NOTNLM OT - CHA2DS2-VASc score OT - HATCH score OT - new-onset atrial fibrillation OT - risk prediction OT - transcatheter aortic valve implantation EDAT- 2026/09/08 12:33 MHDA- 2026/09/08 12:33 CRDT- 2026/09/08 07:15 PHST- 2026/08/02 00:00 [revised] PHST- 2026/06/13 00:00 [received] PHST- 2026/08/26 00:00 [accepted] PHST- 2026/09/08 12:33 [medline] PHST- 2026/09/08 12:33 [pubmed] PHST- 2026/09/08 07:15 [entrez] AID - 10.1002/ccd.70845 [doi] PST - aheadofprint SO - Catheter Cardiovasc Interv. 2026 Sep 8. doi: 10.1002/ccd.70845. PMID- 42701186 OWN - NLM STAT- In-Process LR - 20260908 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 21 IP - 1 DP - 2026 Sep 5 TI - Correction: Outcome of transcarotid transcatheter aortic valve replacement with balloon expandable valve. LID - 10.1186/s13019-026-04681-x [doi] LID - 670 FAU - Nakai, Chikashi AU - Nakai C AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. seiginohirohorita@gmail.com. FAU - Azhagiri, Nikhil AU - Azhagiri N AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Liu, Junyi AU - Liu J AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Zuo, Mei Xing G AU - Zuo MXG AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Tarabichi, Saeed AU - Tarabichi S AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Danduch, Eduardo AU - Danduch E AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - DeLago, Augustion AU - DeLago A AD - Department of Cardiology, Capital Cardiology Associates, Albany, NY, USA. FAU - Samy, Sanjay AU - Samy S AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. LA - eng PT - Published Erratum DEP - 20260905 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM EFR - J Cardiothorac Surg. 2026 Apr 04;21(1):240. doi: 10.1186/s13019-026-03996-z. PMID: 41935336 PMC - PMC13545782 EDAT- 2026/09/06 05:40 MHDA- 2026/09/06 05:40 PMCR- 2026/09/05 CRDT- 2026/09/06 01:56 PHST- 2026/09/06 05:40 [medline] PHST- 2026/09/06 05:40 [pubmed] PHST- 2026/09/06 01:56 [entrez] PHST- 2026/09/05 00:00 [pmc-release] AID - 10.1186/s13019-026-04681-x [pii] AID - 4681 [pii] AID - 10.1186/s13019-026-04681-x [doi] PST - epublish SO - J Cardiothorac Surg. 2026 Sep 5;21(1):670. doi: 10.1186/s13019-026-04681-x. PMID- 42700173 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261007 LR - 20261013 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 10 Pt 1 DP - 2026 Oct TI - Temporal Trends and Outcomes in Low-Risk Patients Undergoing TAVI: Insights From the LAPLACE-TAVI Registry. PG - 2348-2358 LID - S2772-3747(26)00691-5 [pii] LID - 10.1016/j.jacasi.2026.07.039 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation is now indicated in low-risk patients following favorable outcomes in clinical trials and real-world registries. OBJECTIVES: The authors aimed to investigate temporal trends and long-term outcomes in this population. METHODS: Using a multicenter registry database (2010-2025), we stratified 5,691 patients by their Society of Thoracic Surgeons scores: low risk (<4%, n = 1,580 of 5,691 [27.8%]), intermediate risk (4% to 8%, n = 2,388 of 5,691 [42.0%]), and high risk (>8%, n = 1,723 of 5,691 [30.3%]). Low-risk patients were further classified according to clinical trial eligibility. The primary outcomes were crude 30-day and Kaplan-Meier-estimated 4-year all-cause mortalities. RESULTS: The annual procedure volume among low-risk patients did not show a sustained increase and declined after peaking in 2022. Low-risk patients were younger, predominantly male, had a higher body mass index (BMI), fewer comorbidities, and fewer procedural complications. They also demonstrated higher rates of elective procedure and transfemoral access. Thirty-day mortality and procedural complication rates remained consistently low among the low-risk cohort; furthermore, 4-year mortality was the lowest among trial-eligible low-risk patients (overall follow-up: 2.2 years). Clinical trial eligibility criteria (frailty [HR: 2.43; 95% CI: 1.43-4.14; P = 0.003] and renal dysfunction [HR: 3.00; 95% CI: 1.46-6.20; P = 0.010]), female sex (HR: 0.62; 95% CI: 0.44-0.89; P = 0.009), BMI (HR: 0.94 per kg/m(2); 95% CI: 0.90-0.98; P = 0.008), and albumin levels (HR: 0.52 per g/dL; 95% CI: 0.36-0.77; P = 0.001) were associated with all-cause mortality in low-risk patients. CONCLUSIONS: Despite the overall expansion of transcatheter aortic valve implantation, procedure volume among low-risk patients has not consistently increased. Clinical trial eligibility, female sex, BMI, and albumin levels may refine risk stratification in Society of Thoracic Surgeons-defined low-risk patients. (Outcomes of transcatheter aortic valve implantation in Japanese patients with aortic stenosis: LAPLACE-TAVI registry; UMIN000031133). CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Higuchi, Ryosuke AU - Higuchi R AD - Department of Cardiology, Sakakibara Heart Institute, Fuchu, Tokyo, Japan. Electronic address: rhiguchi@shi.heart.or.jp. FAU - Takamisawa, Itaru AU - Takamisawa I AD - Department of Cardiology, Sakakibara Heart Institute, Fuchu, Tokyo, Japan. FAU - Nanasato, Mamoru AU - Nanasato M AD - Department of Cardiology, Sakakibara Heart Institute, Fuchu, Tokyo, Japan. FAU - Doi, Shinichiro AU - Doi S AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Okazaki, Shinya AU - Okazaki S AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Tamura, Harutoshi AU - Tamura H AD - Department of Cardiology, Pulmonology and Nephrology, Yamagata University Hospital, Yamagata, Japan. FAU - Ishiyama, Masaki AU - Ishiyama M AD - Department of Cardiology, Mie University Hospital, Tsu, Mie, Japan. FAU - Yokoyama, Hiroaki AU - Yokoyama H AD - Department of Cardiology, Hirosaki University Graduate School of Medicine, Aomori, Japan. FAU - Fukutomi, Motoki AU - Fukutomi M AD - Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan. FAU - Takanashi, Shuichiro AU - Takanashi S AD - Department of Cardiac Surgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan. FAU - Saji, Mike AU - Saji M AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan. FAU - Isobe, Mitsuaki AU - Isobe M AD - Sakakibara Heart Institute, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20260905 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC13654435 OTO - NOTNLM OT - TAVI OT - eligibility OT - low-risk OT - trend OT - volume COIS- Funding Support and Author Disclosures Clinical proctor: Dr Takamisawa (Edwards Lifesciences, Medtronic, Abbott Medical), Dr Doi (Medtronic, Abbott Medical), Dr Saji (Medtronic); Screening proctor: Dr Higuchi (Edwards Lifesciences, Medtronic), Dr Doi (Edwards Lifesciences); Lecture fee: Dr Higuchi (Edwards Lifesciences, Medtronic, Abbott Medical), Dr Takamisawa (Edwards Lifesciences, Medtronic, Abbott Medical), Dr Nanasato (Abbott Medical), Dr Saji (Medtronic, Abbott Medical, Daiichi-Sankyo). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/09/06 01:18 MHDA- 2026/09/06 01:19 PMCR- 2026/09/05 CRDT- 2026/09/05 12:48 PHST- 2026/05/19 00:00 [received] PHST- 2026/07/26 00:00 [revised] PHST- 2026/07/28 00:00 [accepted] PHST- 2026/09/06 01:19 [medline] PHST- 2026/09/06 01:18 [pubmed] PHST- 2026/09/05 12:48 [entrez] PHST- 2026/09/05 00:00 [pmc-release] AID - S2772-3747(26)00691-5 [pii] AID - 10.1016/j.jacasi.2026.07.039 [doi] PST - ppublish SO - JACC Asia. 2026 Oct;6(10 Pt 1):2348-2358. doi: 10.1016/j.jacasi.2026.07.039. Epub 2026 Sep 5. PMID- 42692520 OWN - NLM STAT- MEDLINE DCOM- 20260903 LR - 20260909 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 16 IP - 9 DP - 2026 Sep 2 TI - Quality indicators for transcatheter aortic valve implantation in Ontario, Canada: a population-based study. PG - e123640 LID - 10.1136/bmjopen-2026-123640 [doi] LID - e123640 AB - OBJECTIVES: We examined the utility of quality indicators (QIs) for transcatheter aortic valve implantation (TAVI) in the assessment of TAVI care quality and variation in practice. DESIGN: We performed a retrospective population-level cohort study in Ontario, Canada, where all residents receive publicly funded universal medical care. We examined the association between QI attainment and outcomes using multivariable hierarchical logistic models. We used median ORs to understand if variation in clinical outcomes between hospitals was attributable to variation in QI attainment. SETTING: We used all-comer registry data from the provincial CorHealth registry in Ontario, with linkage to administrative datasets using unique patient encoded identifiers. PARTICIPANTS: TAVI recipients between 2018 and 2023 in Ontario, Canada. INTERVENTION: We derived a unique set of QIs from internationally agreed ones. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoint was a composite of all-cause mortality or rehospitalisation at 1 year from the date of TAVI. RESULTS: Data from 9748 TAVI procedures were included between 2018 and 2023. We identified five feasible QIs, the majority of which had high compliance and minimal variation; the lone exception was the performance of transfemoral TAVI without general anaesthesia (median 0.87; IQR 0.78-0.93). Adherence to QIs was associated with a reduction in the composite endpoint. The strongest association was observed with multidisciplinary heart team involvement (defined as the presence of an interventional cardiologist and a cardiac surgeon) in the TAVI procedure (OR 0.67, 95% CI 0.50 to 0.90, p=0.007), the performance of transfemoral TAVI without general anaesthesia (OR 0.80, 95% CI 0.71 to 0.91, p<0.0004) and the utilisation of the transfemoral access (OR 0.84, 95% CI 0.69 to 1.04, p=0.10). However, variation in clinical outcomes following TAVI between hospitals was not attributable to variation in QI attainment. Falsification analysis suggests substantial residual confounding. CONCLUSIONS: We developed a feasible set of QIs for TAVI and validated these QIs using routinely collected data from a large all-comer registry in Ontario. We have identified overall high quality of care for TAVI, but with some variation in practice, which in part is attributable to differences in patient factors. Our work suggests that QIs can inform quality improvement efforts by prompting future work into discretionary versus non-discretionary variation. CI - (c) Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Aktaa, Suleman AU - Aktaa S AUID- ORCID: 0009-0004-7900-2742 AD - Cardiology, St Paul's Hospital, Vancouver, British Columbia, Canada. FAU - Haldenby, Olivia AU - Haldenby O AD - Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. FAU - Qiu, Feng AU - Qiu F AD - Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. FAU - Ko, Dennis T AU - Ko DT AD - Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. FAU - Fremes, Stephen AU - Fremes S AUID- ORCID: 0000-0003-1723-3049 AD - Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. AD - Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. FAU - Sud, Maneesh AU - Sud M AD - Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. AD - Department of Medicine, University of Toronto, Toronto, Ontario, Canada. FAU - Lauck, Sandra B AU - Lauck SB AD - Cardiology, St Paul's Hospital, Vancouver, British Columbia, Canada. FAU - Mamas, Mamas A AU - Mamas MA AUID- ORCID: 0000-0001-9241-8890 AD - Institute for Science & Technology in Medicine, Keele University, Keele, UK. FAU - Blackman, Daniel J AU - Blackman DJ AD - Leeds General Infirmary, Leeds, UK. AD - Leeds Institute of Cardiovascular & Metabolic Medicine, University of Leeds, Leeds, UK. FAU - Webb, John G AU - Webb JG AD - Centre for Cardiovascular Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada. FAU - Wijeysundera, Harindra C AU - Wijeysundera HC AD - Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada harindra.wijeysundera@sunnybrook.ca. AD - Department of Medicine, University of Toronto, Toronto, Ontario, Canada. LA - eng PT - Journal Article DEP - 20260902 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/standards/mortality MH - Ontario/epidemiology MH - *Quality Indicators, Health Care MH - Retrospective Studies MH - Female MH - Aged, 80 and over MH - Male MH - Registries MH - Aged MH - *Aortic Valve Stenosis/surgery MH - Logistic Models MH - Patient Readmission/statistics & numerical data PMC - PMC13548211 OTO - NOTNLM OT - Audit OT - Quality Improvement OT - Quality in health care OT - Valvular heart disease COIS- Competing interests: None declared. EDAT- 2026/09/03 23:36 MHDA- 2026/09/03 23:37 PMCR- 2026/09/02 CRDT- 2026/09/03 20:43 PHST- 2026/09/03 23:37 [medline] PHST- 2026/09/03 23:36 [pubmed] PHST- 2026/09/03 20:43 [entrez] PHST- 2026/09/02 00:00 [pmc-release] AID - bmjopen-2026-123640 [pii] AID - 10.1136/bmjopen-2026-123640 [doi] PST - epublish SO - BMJ Open. 2026 Sep 2;16(9):e123640. doi: 10.1136/bmjopen-2026-123640. PMID- 42690435 OWN - NLM STAT- Publisher LR - 20260903 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) DP - 2026 Sep 3 TI - Routine versus selective use of a femoral protection wire in transfemoral TAVI: a single-centre analysis of vascular complications. LID - 10.1007/s00392-026-03015-0 [doi] AB - BACKGROUND: Transfemoral transcatheter aortic valve implantation (TAVI) is the treatment of choice for severe aortic stenosis in patients with elevated surgical risk. However, vascular complications remain a major source of morbidity and mortality. The protection wire technique was introduced to prevent major access-related complications, but its role in contemporary TAVI practice is uncertain. AIMS: To evaluate whether routine protection wire use reduces vascular complications in contemporary transfemoral TAVI. METHODS: We performed a retrospective, single-centre analysis of 1476 consecutive patients undergoing transfemoral TAVI between January 2020 and August 2023. Until November 2021, protection wire placement was standard-of-care (Group 1, n = 801); thereafter procedures were performed without routine protection wire use (Group 2, n = 675). Vascular complications were defined according to VARC-3 criteria. Multivariable logistic regression was used to identify independent predictors of minor and major vascular complications. RESULTS: The composite of minor and major vascular complications occurred more frequently in Group 1 than in Group 2 (18.6% vs. 10.8%, p < 0.001). In Group 1, 34.8% of access-related complications were associated with the protection wire access. Major vascular complications were numerically less frequent in Group 2 (2.5% vs. 4.2%). Omission of routine protection wire placement was independently associated with a lower risk (OR 0.52, 95% CI 0.38-0.72, p < 0.001). CONCLUSION: In contemporary transfemoral TAVI, routine protection wire use was not associated with reduced major vascular complications and was linked to a higher rate of minor access site injuries. These findings support a restrictive rather than routine use of protection wires in current practice. CI - (c) 2026. The Author(s). FAU - Rogmann, Marc Adrian AU - Rogmann MA AUID- ORCID: 0000-0003-2472-4161 AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. FAU - Klingemann, Victor AU - Klingemann V AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. FAU - Meertens, Max AU - Meertens M AUID- ORCID: 0000-0002-7746-8723 AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany. FAU - Ahoopai, Majid AU - Ahoopai M AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. FAU - Rommel, Karl-Philipp AU - Rommel KP AUID- ORCID: 0000-0002-2901-8138 AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. FAU - Lurz, Philipp AU - Lurz P AUID- ORCID: 0000-0002-5993-4487 AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. FAU - von Bardeleben, Ralph S AU - von Bardeleben RS AUID- ORCID: 0000-0002-1356-0037 AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. FAU - Geyer, Martin AU - Geyer M AUID- ORCID: 0000-0002-9935-8293 AD - Department for Cardiology, University Medical Centre of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany. martin.geyer@unimedizin-mainz.de. LA - eng PT - Journal Article DEP - 20260903 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM OTO - NOTNLM OT - Protection wire OT - TAVI OT - Vascular complications COIS- Declarations. Conflict of interest: M. Geyer has received honoraria from Edwards Lifesciences, Medtronic, and Abbott and has received proctoring fees from JenaValve Technology. K.P. Rommel has received consulting fees from Edwards Lifesciences, Adona Medical, Gradient Denervation, and ReCor Medical and has received payment or honoraria from ReCor Medical, Edwards Lifesciences, and Boehringer Ingelheim. P. Lurz has been a consultant to Abbott, Edwards Lifesciences, and Recor Medical and holds stock options in Innoventric. R.S. von Bardeleben has received speaker honoraria from Siemens, Philips, Abbott, and Edwards Lifesciences; he conducted trials (unpaid) for Abbott, Edwards Lifesciences, Medtronic, and Jenscare; and he received a fiduciary role on the board of directors of the Heart Valve Society USA (unpaid). M. Rogmann, V. Klingemann, M. Meertens, and M. Ahoopai have no relevant conflicts of interest to declare. EDAT- 2026/09/03 17:36 MHDA- 2026/09/03 17:36 CRDT- 2026/09/03 12:31 PHST- 2026/05/21 00:00 [received] PHST- 2026/08/19 00:00 [accepted] PHST- 2026/09/03 17:36 [medline] PHST- 2026/09/03 17:36 [pubmed] PHST- 2026/09/03 12:31 [entrez] AID - 10.1007/s00392-026-03015-0 [pii] AID - 10.1007/s00392-026-03015-0 [doi] PST - aheadofprint SO - Clin Res Cardiol. 2026 Sep 3. doi: 10.1007/s00392-026-03015-0. PMID- 42688026 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260903 LR - 20260904 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - Transsubclavian versus transfemoral TAVR with self-expanding valves. PG - 1901010 LID - 10.3389/fcvm.2026.1901010 [doi] LID - 1901010 AB - INTRODUCTION: Transsubclavian (TS) access has emerged as a rapidly growing alternative to the traditional transfemoral (TF) approach in patients with hostile iliofemoral access undergoing transcatheter aortic valve replacement (TAVR). The aim of this study was to investigate clinical outcomes following TS-TAVR and TF-TAVR in severe aortic valve stenosis treated with self-expanding devices. METHODS: We conducted a single-center retrospective analysis of consecutive patients undergoing TS- or TF-TAVR between August 2017 and May 2025 at our department. Clinical endpoints were reported according to the Valve Academic Research Consortium-3 (VARC 3) criteria. RESULTS: A total of 817 patients underwent TF-TAVR, while 75 patients underwent TS-TAVR. Patients undergoing TS-TAVR were more frequently men, presented with a higher Euro Score II, and carried a greater burden of atherosclerotic disease. Unadjusted data analysis showed a significant association between TS access and 30-day mortality [HR 2.64, 95% CI: 1.00-6.97, p = 0.05], stroke [HR 2.44, 95% CI: 1.19-5.01, p = 0.01], myocardial infarction [HR 4.31, 95% CI: 1.16-15.96, p = 0.03], major bleeding [HR 1.79, 95% CI: 1.17-2.73, p = 0.007], and cardiovascular hospitalization [HR 1.65, 95% CI: 1.02-2.65, p = 0.01]. After risk adjustment, the access site remained independently associated with stroke and major bleeding, while 30-day mortality and cardiovascular hospitalization lost statistical significance. CONCLUSION: Overall, TS-TAVR appears to be a feasible approach when TF-TAVR is not possible. Adjusted data revealed no statistically significant association with early mortality. However, the access site was significantly associated with stroke and major bleeding, findings likely attributable to the higher baseline risk of the subclavian cohort in our study. CI - (c) 2026 Baysal, Osipenko, Laengle, Steiner, Kahrovic, Werner, Bartko, Zimpfer, Andreas and Coti. FAU - Baysal, Funda AU - Baysal F AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Osipenko, Kira AU - Osipenko K AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Laengle, Severin AU - Laengle S AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Steiner, Irene AU - Steiner I AD - Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria. FAU - Kahrovic, Amila AU - Kahrovic A AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Werner, Paul AU - Werner P AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Bartko, Philipp AU - Bartko P AD - Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Zimpfer, Daniel AU - Zimpfer D AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Andreas, Martin AU - Andreas M AD - Department of Cardiac Surgery, Medical University of Graz, Graz, Austria. FAU - Coti, Iuliana AU - Coti I AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. LA - eng PT - Journal Article DEP - 20260819 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13533891 OTO - NOTNLM OT - alternative access OT - aortic stenosis OT - self-expandable prosthesis OT - transcatheter aortic valve replacement OT - transsubclavian TAVR COIS- MA reports receiving research grants and serving as proctor, speaker, and consultant for Edwards, Abbott, Medtronic, LSI, Zoll, Boston, and Abbvie. DZ reports receiving research grants and travel support, and serving as speaker and consultant for Abbott, Berlin Heart, Corcym, Edwards, and Medtronic. IC reports receiving research grants and serving as speaker for Edwards, Abbott, and Medtronic. PB reports receiving educational grants and serving as speaker for Abbott and Edwards. The remaining author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/09/03 12:09 MHDA- 2026/09/03 12:10 PMCR- 2026/08/19 CRDT- 2026/09/03 05:48 PHST- 2026/06/05 00:00 [received] PHST- 2026/07/21 00:00 [revised] PHST- 2026/07/31 00:00 [accepted] PHST- 2026/09/03 12:10 [medline] PHST- 2026/09/03 12:09 [pubmed] PHST- 2026/09/03 05:48 [entrez] PHST- 2026/08/19 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1901010 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Aug 19;13:1901010. doi: 10.3389/fcvm.2026.1901010. eCollection 2026. PMID- 42686459 OWN - NLM STAT- Publisher LR - 20260902 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) DP - 2026 Aug 21 TI - Outcomes of single versus double Perclose suture device use after transfemoral transcatheter procedures using large-bore arterial access: A meta-analysis and systematic review. LID - S1553-8389(26)00371-4 [pii] LID - 10.1016/j.carrev.2026.08.012 [doi] AB - BACKGROUND: In large-bore transfemoral procedures such as transcatheter aortic valve replacement and endovascular aneurysm repair, the comparative effectiveness of single (SP) versus the default double Perclose (DP) strategies for arterial closure remains uncertain. METHODS: We performed a systematic literature search in PubMed, Scopus, Web of Science, and the Cochrane Library from January 2014 to April 2026 to identify studies comparing SP and DP devices for large-bore transfemoral arterial access closure. Outcomes included device/technical success, need for unplanned surgical or catheter-based intervention, 30-day mortality, any vascular complication, major bleeding, arterial dissection, and arterial stenosis. Random-effects meta-analysis using inverse-variance weighting was performed, and heterogeneity was assessed using the I(2) statistic. RESULTS: We identified 14 studies published or available between 2015 and 2026, comprising 6487 patients before matching or adjustment (SP 3518; DP 2969). Post-matching adjusted cohorts comprised 5077 patients (SP 2691; DP 2386). Comparing SP with DP, device/technical success was similar (RR 1.02, 95% CI 1.00-1.03; P = 0.07), as was the need for unplanned surgical/catheter intervention (RR 0.77, 95% CI 0.54-1.09; P = 0.14). There were no significant differences in overall vascular complications (RR 0.78, 95% CI 0.59-1.04; P = 0.09), major bleeding (RR 0.83, 95% CI 0.51-1.36; P = 0.46), arterial stenosis (RR 0.81, 95% CI 0.55-1.20; P = 0.30), or 30-day mortality (RR 0.99, 95% CI 0.65-1.50; P = 0.96). However, SP was associated with a lower risk of arterial dissection (RR 0.32, 95% CI 0.15-0.70; P = 0.004). CONCLUSION: In large-bore transfemoral transcatheter procedures, a single Perclose strategy was associated with a lower risk of arterial dissection compared to double Perclose and no significant difference for other major outcomes and complications. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Thakurathi, Priyesh AU - Thakurathi P AD - Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. FAU - Lee, JuYong AU - Lee J AD - Division of Cardiology, University of Connecticut Health Center, Farmington, CT, USA. FAU - Nana, Michael G AU - Nana MG AD - Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA. FAU - Thapa, Shrija AU - Thapa S AD - Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. FAU - Kshetri, Rupesh AU - Kshetri R AD - Division of Cardiology, MercyOne North Iowa Medical Center, Mason City, IA, USA. FAU - Kim, Agnes S AU - Kim AS AD - Division of Cardiology, University of Connecticut Health Center, Farmington, CT, USA. FAU - McKay, Raymond G AU - McKay RG AD - Division of Cardiology, Hartford Hospital, Hartford, CT, USA. FAU - Dahal, Khagendra AU - Dahal K AD - Division of Cardiology, University of Connecticut Health Center, Farmington, CT, USA. Electronic address: kdahal@uchc.edu. LA - eng PT - Journal Article DEP - 20260821 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM OTO - NOTNLM OT - Arterial dissection OT - Device success OT - Endovascular aneurysm repair OT - Hemostasis OT - Preclose technique OT - Transcatheter aortic valve replacement OT - Transfemoral access OT - Vascular closure device COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/09/03 01:19 MHDA- 2026/09/03 01:19 CRDT- 2026/09/02 21:53 PHST- 2026/07/31 00:00 [received] PHST- 2026/08/06 00:00 [revised] PHST- 2026/08/19 00:00 [accepted] PHST- 2026/09/03 01:19 [medline] PHST- 2026/09/03 01:19 [pubmed] PHST- 2026/09/02 21:53 [entrez] AID - S1553-8389(26)00371-4 [pii] AID - 10.1016/j.carrev.2026.08.012 [doi] PST - aheadofprint SO - Cardiovasc Revasc Med. 2026 Aug 21:S1553-8389(26)00371-4. doi: 10.1016/j.carrev.2026.08.012. PMID- 42677962 OWN - NLM STAT- Publisher LR - 20260901 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) DP - 2026 Sep 1 TI - Comparison of Two Percutaneous Femoral Closure Strategies During Transcatheter Aortic Valve Implantation. LID - 10.1002/ccd.70840 [doi] AB - BACKGROUND: Percutaneous closure of femoral arterial access is a critical step in transcatheter aortic valve implantation (TAVI). A hybrid strategy combining a suture-based device (Perclose ProStyle) and a collagen-based device (Angio-Seal) has emerged as an alternative to the conventional double Perclose ProStyle technique. AIMS: The objective of the study is to compare femoral vascular complications between a hybrid strategy (1 Perclose ProStyle+ 1 Angio-Seal) and a non-hybrid strategy (2 Perclose ProStyle) in a large single-center experience. METHODS: This prospective, single-center, non-randomized study included 633 consecutive patients who underwent transfemoral TAVI at Timone University Hospital (Marseille, France) between November 2024 and March 2026. The choice of closure strategy was left to the operator's discretion. The primary endpoint was the occurrence of any femoral vascular complication (classified according to VARC-3 criteria). RESULTS: A total of 273 patients underwent hybrid closure, and 360 underwent non-hybrid closure. The overall rate of vascular complications was 4.9% (31/633), with no significant difference between groups (hybrid 4.8% vs. non-hybrid 5.0%; p = 1.000). There were no differences in major VARC-3 complications (2.2% vs. 1.9%, p = 1.000) or minor complications (2.6% vs. 3.1%, p = 0.899). In univariate analysis, preprocedural dual antiplatelet therapy was the main predictor of overall complications, hematoma, pseudoaneurysm, and minor VARC-3 complications. Dialysis was associated with major VARC-3 complications. CONCLUSION: The hybrid closure strategy (1 Perclose ProStyle + 1 Angio-Seal) demonstrates a vascular safety profile comparable to the conventional strategy (2 Perclose ProStyle) in transfemoral TAVI. Preprocedural antithrombotic therapy, rather than the closure device strategy, appears to be the main determinant of vascular complications. CI - (c) 2026 Wiley Periodicals LLC. FAU - Roussel, Thomas AU - Roussel T AUID- ORCID: 0009-0004-1063-0142 AD - Departement de cardiologie, CHU Timone, Marseille, France. FAU - Boyer, Jeremy AU - Boyer J AUID- ORCID: 0000-0002-6371-0363 AD - Departement de cardiologie, CHU Timone, Marseille, France. FAU - Polo, Julien AU - Polo J AUID- ORCID: 0000-0002-7478-2370 AD - Departement de cardiologie, CHU Timone, Marseille, France. FAU - Pichene, Hadrien AU - Pichene H AD - Departement de cardiologie, CHU Timone, Marseille, France. FAU - Rahmani, Sami AU - Rahmani S AD - Departement de cardiologie, CHU Timone, Marseille, France. FAU - Bassez, Clemence AU - Bassez C AD - Cardiology Department, CH Toulon, Toulon, France. FAU - Quillot, Marine AU - Quillot M AD - Service de cardiologie, Centre Hospitalier Henri Duffaut, Avignon, France. FAU - Dabry, Thibaut AU - Dabry T AD - Service de cardiologie, Centre hospitalier du Pays d'Aix, Aix-en-Provence, France. FAU - Vaillier, Antoine AU - Vaillier A AD - Centre Hospitalier D'Ajaccio, Ajaccio, France. FAU - Morera, Pierre AU - Morera P AD - Departement de Chirurgie Cardiaque, CHU Timone, Marseille, France. FAU - Jaussaud, Nicolas AU - Jaussaud N AD - Departement de Chirurgie Cardiaque, CHU Timone, Marseille, France. FAU - Deharo, Pierre AU - Deharo P AD - Departement de cardiologie, CHU Timone, Marseille, France. AD - Inserm, Inra, C2VN, Aix-Marseille universite, Marseille, France. FAU - Cuisset, Thomas AU - Cuisset T AUID- ORCID: 0000-0003-0493-5500 AD - Departement de cardiologie, CHU Timone, Marseille, France. AD - Inserm, Inra, C2VN, Aix-Marseille universite, Marseille, France. LA - eng PT - Journal Article DEP - 20260901 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM OTO - NOTNLM OT - Angio-Seal OT - Perclose ProStyle OT - TAVI OT - VARC-3 OT - percutaneous closure OT - vascular complications EDAT- 2026/09/01 11:39 MHDA- 2026/09/01 11:39 CRDT- 2026/09/01 07:03 PHST- 2026/07/10 00:00 [revised] PHST- 2026/04/15 00:00 [received] PHST- 2026/08/26 00:00 [accepted] PHST- 2026/09/01 11:39 [medline] PHST- 2026/09/01 11:39 [pubmed] PHST- 2026/09/01 07:03 [entrez] AID - 10.1002/ccd.70840 [doi] PST - aheadofprint SO - Catheter Cardiovasc Interv. 2026 Sep 1. doi: 10.1002/ccd.70840. PMID- 42676765 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260901 LR - 20260902 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - The association of cerebral embolic protection during transcatheter aortic valve replacement with periprocedural neurological outcomes. PG - 1881371 LID - 10.3389/fcvm.2026.1881371 [doi] LID - 1881371 AB - INTRODUCTION: Cerebral Embolic Protection Devices (CEPs) have been designed to minimize the risk of periprocedural stroke. The clinical significance of these devices, however, is still under debate. We aimed to compare periprocedural neurological outcomes and mortality in patients undergoing transfemoral transcatheter aortic valve replacement (TF-TAVR) with vs. without CEP. METHODS: A single-center retrospective analysis of 1,101 patients undergoing transfemoral TAVR from August 2017 to May 2025 was performed. CEPs were used routinely at our institution whenever anatomically feasible beginning with October 2019. The primary outcome was defined as the incidence of ischemic stroke occurring within 3 days postoperatively. Secondary endpoints included transient ischemic attack (TIA) and delirium within 3 days and short-term all-cause mortality. RESULTS: Overall, 809 underwent TF-TAVR with CEP, while 292 were treated without. The primary endpoint of clinical ischemic stroke occurred less frequently in the CEP group (1.4% vs. 4.1%), and the group difference revealed a significant result in a univariable Cox regression analysis (p = 0.007). No clinically relevant differences were observed in the incidence of TIA (0.5% vs. 0.7%, p = 0.71) and postprocedural delirium (1.6% vs. 2.4%, p = 0.39). The 30-day mortality rate was numerically higher in the control group, but the difference did not reach statistical significance (1.9% vs. 3.9%, p = 0.06). CONCLUSION: The use of neuroprotection during TAVR was associated with a lower observed hazard of early periprocedural ischemic stroke in this unadjusted retrospective cohort. CI - (c) 2026 Baysal, Osipenko, Laengle, Steiner, Kahrovic, Werner, Bartko, Zimpfer, Andreas and Coti. FAU - Baysal, Funda AU - Baysal F AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Osipenko, Kira AU - Osipenko K AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Laengle, Severin AU - Laengle S AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Steiner, Irene AU - Steiner I AD - Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria. FAU - Kahrovic, Amila AU - Kahrovic A AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Werner, Paul AU - Werner P AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Bartko, Philipp AU - Bartko P AD - Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Zimpfer, Daniel AU - Zimpfer D AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. FAU - Andreas, Martin AU - Andreas M AD - Department of Cardiac Surgery, Medical University of Graz, Graz, Austria. FAU - Coti, Iuliana AU - Coti I AD - Department of Cardiac and Thoracic Aortic Surgery, Medical University of Vienna, Vienna, Austria. LA - eng PT - Journal Article DEP - 20260817 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13527623 OTO - NOTNLM OT - cerebral embolic protection OT - delirium OT - ischemic stroke OT - transcatheter aortic valve implantation OT - transient ischemic attack COIS- MA: research grants/proctor/speaker/consultant (Edwards, Abbott, Medtronic, LSI, Zoll, Boston, Abbvie); DZ: research grants/travel support/speaker/consultant (Abbott, Berlin Heart, Corcym, Edwards, Medtronic); IC: research grants/speaker (Edwards, Abbott, Medtronic); PB: educational grants/speaker (Abbott, Edwards). The remaining author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/09/01 11:39 MHDA- 2026/09/01 11:40 PMCR- 2026/08/17 CRDT- 2026/09/01 05:46 PHST- 2026/05/14 00:00 [received] PHST- 2026/07/05 00:00 [revised] PHST- 2026/07/29 00:00 [accepted] PHST- 2026/09/01 11:40 [medline] PHST- 2026/09/01 11:39 [pubmed] PHST- 2026/09/01 05:46 [entrez] PHST- 2026/08/17 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1881371 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Aug 17;13:1881371. doi: 10.3389/fcvm.2026.1881371. eCollection 2026. PMID- 42675574 OWN - NLM STAT- Publisher LR - 20260901 IS - 1538-4683 (Electronic) IS - 1061-5377 (Linking) DP - 2026 Sep 1 TI - One-Year Outcomes of Myval Versus Contemporary Transcatheter Heart Valves in Severe Aortic Stenosis: A Systematic Review and Meta-Analysis. LID - 10.1097/CRD.0000000000001459 [doi] AB - The Myval and Myval Octacor transcatheter heart valves (THVs) are newer-generation balloon-expandable devices for transcatheter aortic valve implantation (TAVI) in severe aortic stenosis (AS), but comprehensive synthesis of 1-year outcomes incorporating recent randomized data remains limited. We searched PubMed/MEDLINE, Embase, and CENTRAL through June 2026 for randomized controlled trials and propensity-matched or adjusted observational studies comparing Myval/Myval Octacor with contemporary THVs in adults undergoing transfemoral TAVI for severe symptomatic AS. The primary outcome was 1-year all-cause mortality; secondary outcomes included cardiovascular death, stroke, new permanent pacemaker implantation (PPI), mean transvalvular gradient, effective orifice area, and moderate-to-severe aortic regurgitation. Random-effects meta-analyses generated pooled risk ratios (RRs) and mean differences with 95% confidence intervals. Five studies (2 randomized trials, 3 propensity-matched/adjusted cohorts; 2327 patients: 1107 Myval, 1220 contemporary THV recipients) were included. At 1 year, Myval showed comparable outcomes to contemporary THVs for all-cause mortality (RR 0.89, 0.66-1.21), cardiovascular death (RR 0.92, 0.55-1.55), and stroke (RR 1.41, 0.91-2.18), with similar new PPI rates (RR 0.82, 0.47-1.42). Among randomized trials, Myval had lower mean transvalvular gradients (MD -1.28 mm Hg, -1.73 to -0.82) and larger effective orifice area (mean difference +0.15 cm2, 0.09-0.20) than SAPIEN, with no significant difference in moderate-to-severe aortic regurgitation (RR 1.28, 0.19-8.71). Myval demonstrated comparable all-cause mortality, cardiovascular death, stroke, and PPI rates to contemporary THVs at 1 year, along with favorable hemodynamics versus SAPIEN, supporting Myval as an effective contemporary TAVI platform; longer-term studies are needed to confirm durability and clinical outcomes. CI - Copyright (c) 2026 Wolters Kluwer Health, LLC. All rights reserved. FAU - Al-Harbi, Faisal A AU - Al-Harbi FA AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Alanazi, Ahmad Khalaf AU - Alanazi AK AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Algoblan, Norah Abdullah AU - Algoblan NA AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Aldhafeeri, Sayer Samawi AU - Aldhafeeri SS AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Alrashoodi, Layan Bader AU - Alrashoodi LB AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Alamer, Mohammed Ahmad AU - Alamer MA AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Alquraishi, Ola Fozan AU - Alquraishi OF AD - Department of Medicine, College of Medicine, Qassim University, Onaizah, Saudi Arabia. FAU - Alresaini, Alhanouf Abdalmahsn AU - Alresaini AA AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Almutiq, Norah Mohammed AU - Almutiq NM AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Aljibreen, Mohammad Saad AU - Aljibreen MS AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Alwabili, Lamis Faisal AU - Alwabili LF AD - From the Department of Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia. FAU - Kolko, Naser AU - Kolko N AD - Department of Cardiology, Prince Sultan Cardiac Center, Qassim, Saudi Arabia. LA - eng PT - Journal Article DEP - 20260901 PL - United States TA - Cardiol Rev JT - Cardiology in review JID - 9304686 SB - IM OTO - NOTNLM OT - Myval OT - aortic stenosis OT - balloon-expandable valve OT - meta-analysis OT - transcatheter aortic valve implantation OT - transcatheter heart valve COIS- Disclosure: The authors declare no conflicts of interest. EDAT- 2026/09/01 05:41 MHDA- 2026/09/01 05:41 CRDT- 2026/09/01 00:14 PHST- 2026/09/01 05:41 [medline] PHST- 2026/09/01 05:41 [pubmed] PHST- 2026/09/01 00:14 [entrez] AID - 00045415-990000000-01000 [pii] AID - 10.1097/CRD.0000000000001459 [doi] PST - aheadofprint SO - Cardiol Rev. 2026 Sep 1. doi: 10.1097/CRD.0000000000001459. PMID- 42663370 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261029 LR - 20261029 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 10 Pt 2 DP - 2026 Oct TI - Sex-Specific Differences in Patient-Centered Outcomes After Transcatheter Aortic Valve Replacement. PG - 103175 LID - S2772-963X(26)00596-X [pii] LID - 10.1016/j.jacadv.2026.103175 [doi] AB - BACKGROUND: Sex-specific disparities in patient-reported outcomes among patients undergoing transcatheter aortic valve replacement (TAVR) are not fully investigated. OBJECTIVES: The objective of the study was to evaluate sex-based differences in clinical outcomes and health status following transfemoral TAVR in patients with symptomatic severe aortic stenosis. METHODS: Patients in the investigator-initiated, multicenter SCOPE I randomized trial were stratified by sex. Outcomes of interest included vital status and patient-reported disease-specific health status, with an integrated patient-centered outcome defined as being alive with good health status (Kansas City Cardiomyopathy Questionnaire overall summary score [KCCQ-OS] >/=75 without a decline of >10 points from baseline). RESULTS: Of the 732 patients who underwent TAVR, 692 (394 females and 298 males) were included. At baseline, female patients had a higher surgical risk and higher prevalence of advanced heart failure symptoms and frailty, whereas male patients had a greater comorbidity burden. Female patients had lower baseline KCCQ-OS, which persisted after TAVR, leading to a lower likelihood of achieving KCCQ-OS >/=75 at 1 year (64.4% vs 74.2%). In contrast, male patients had higher all-cause mortality throughout 3 years of follow-up (26.3% vs 19.5%). These contrasting patterns in patient-reported health status and survival resulted in no statistically significant difference in the proportion of patients who achieved the patient-centered outcome at 3 years (42.7% vs 46.1%). CONCLUSIONS: In this post hoc analysis of SCOPE I, there was no statistically significant difference in the likelihood of achieving the patient-centered outcome between male and female patients up to 3 years after TAVR, despite contrasting patterns in patient-reported health status and survival. (Safety and Efficacy of the Symetis ACURATE Neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis [SCOPE I]; NCT03011346). CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Heg, Dik AU - Heg D AD - Department of Clinical Research, University of Bern, Switzerland. FAU - Cozzi, Ottavia AU - Cozzi O AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Thiele, Holger AU - Thiele H AD - Department of Cardiology, Heart Center Leipzig at Leipzig University, Leipzig, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Justus-Liebig University of Giessen/Marburg, Giessen, Germany. FAU - Joner, Michael AU - Joner M AD - TUM University Hospital German Heart Center, Technical University of Munich, Munich, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart Centre Hamburg, Hamburg, Germany. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Prendergast, Bernard AU - Prendergast B AD - Department of Cardiology, St Thomas' Hospital & Cleveland Clinic London, United Kingdom. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. CN - SCOPE I Investigators LA - eng SI - ClinicalTrials.gov/NCT03011346 PT - Journal Article DEP - 20260828 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 OTO - NOTNLM OT - aortic stenosis OT - sex OT - transcatheter aortic valve replacement COIS- Funding support and author disclosures SCOPE I was an investigator-initiated trial funded by Boston Scientific, Marlborough, MA. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Dr Pilgrim reports research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, Medtronic, and ATSens; and speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr Windecker reports research, travel, or educational grants to the institution without personal remuneration from Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Farapulse Inc. Fumedica, Guerbet, Idorsia, Inari Medical, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medalliance, Medicure, Medtronic, Merck Sharp & Dohm, Miracor Medical, MonarQ, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech. Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave; he served as advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave with payments to the institution but no personal payments; and he is also a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Prendergast reports speaker fees from Edwards Lifesciences and Polares Medical; serves as a steering/executive committee group member for Valvosoft; and is a Partner and Board Member of CERC CRO. Dr Toggweiler serves as a consultant and proctor for Medtronic, Biosensors, Edwards Lifesciences, Boston Scientific, and Microport; as a proctor for Abbott Vascular; as a consultant for Medira, Shockwave, Teleflex, atHeart Medical, Cardiac Dimensions, Polares Medical, Amarin, Armira, and P + F; has received speaker honoraria from Sanofi, AstraZeneca, ReCor Medical, Daiichi Sankyo, and Bayer; has received institutional research grants from Medtronic, Edwards Lifesciences, Boston Scientific, Fumedica, Novartis, Boehringer Ingelheim, and Polares Medical; and holds equity in Hi-D Imaging. Dr Kim reports personal fees from Abbott, Anteris, Boston Scientific, Cardiawave, Edwards Lifesciences, HID Imaging, Jenavalve, Medtronic, Meril Life Sciences, and P & F; and received institutional grants from Boston Scientific. Dr Lanz reports speaker fees to the institution from Edwards Lifesciences and Abbott; and served as advisory board member for Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/08/28 11:50 MHDA- 2026/08/28 11:51 CRDT- 2026/08/28 07:56 PHST- 2026/04/01 00:00 [received] PHST- 2026/07/28 00:00 [revised] PHST- 2026/07/28 00:00 [accepted] PHST- 2026/08/28 11:51 [medline] PHST- 2026/08/28 11:50 [pubmed] PHST- 2026/08/28 07:56 [entrez] AID - S2772-963X(26)00596-X [pii] AID - 10.1016/j.jacadv.2026.103175 [doi] PST - ppublish SO - JACC Adv. 2026 Oct;5(10 Pt 2):103175. doi: 10.1016/j.jacadv.2026.103175. Epub 2026 Aug 28. PMID- 42657851 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260827 LR - 20260903 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 8 DP - 2026 Aug TI - Optimized Balloon-Expandable Transcatheter Aortic Valve Implantation and Clinical Outcomes. PG - 103037 LID - S2772-963X(26)00458-8 [pii] LID - 10.1016/j.jacadv.2026.103037 [doi] LID - 103037 AB - BACKGROUND: The expansion of transcatheter aortic valve replacement (TAVR) to younger patients with longer life expectancy requires procedural optimization to enhance long-term valve durability. OBJECTIVES: To evaluate the relationship between fluoroscopic determinants of optimal transcatheter heart valve (THV) implantation-coaxiality, implantation depth, and expansion-and clinical and valve-related outcomes. METHODS: In this cohort study, consecutive patients undergoing transfemoral TAVR with balloon-expandable prostheses (Sapien S3, Sapien S3 Ultra) between February 2014 and June 2022 were included. THV coaxiality, implantation depth, and expansion were assessed in the 3-cusp view following deployment using standardized protocols. Suboptimal implantation was defined as >/=1 unfavorable determinants (coaxiality >/=4.8 degrees , depth >/=6 mm, or underexpansion >/=20%). Outcomes included the modified early safety endpoint, moderate or severe hemodynamic valve deterioration, and stage 2 bioprosthetic valve failure. RESULTS: Among 1,032 patients (mean age 81 +/- 6 years, 35.1% female), suboptimal THV implantation occurred in 443 (42.9%) patients and was driven by noncoaxial deployment (n = 240, 23.3%), excessive implantation depth (n = 261, 25.3%), and underexpansion (n = 54, 5.2%). Suboptimal implantation was associated with a higher likelihood of the modified early safety endpoint at 30 days (43.3% vs 19.9%; adjusted odds ratio: 3.05; 95% CI: 2.30-4.04) and stage 2 bioprosthetic valve failure at 5 years (subHR: 4.40; 95% CI: 1.25-13.59). Patients with >/=2 determinants demonstrated higher rates of hemodynamic valve deterioration at 5 years (subHR: 3.48; 95% CI: 1.24-9.80). CONCLUSIONS: Optimal THV implantation was associated with improved early procedural safety and long-term THV durability in balloon-expandable TAVR. Systematic fluoroscopic assessment of optimized valve implantation may enhance patient outcomes. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Vitez, Luka AU - Vitez L AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Angellotti, Domenico AU - Angellotti D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Samim, Daryoush AU - Samim D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Ferro, Cyril AU - Ferro C AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Cozzi, Ottavia AU - Cozzi O AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Elamin, Nadir AU - Elamin N AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Bartkowiak, Joanna AU - Bartkowiak J AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Praz, Fabien AU - Praz F AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Reineke, David AU - Reineke D AD - Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Cardiology, Burgerspital Solothurn, Solothurn, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. LA - eng PT - Journal Article PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC13531613 OTO - NOTNLM OT - TAVR optimization OT - depth OT - implantation coaxiality OT - valve expansion COIS- Funding support and author disclosures Dr Elamin is a British Cardiac Interventional Society (BCIS) international structural fellow, and his fellowship is funded by Edwards Lifesciences through BCIS and not directly from Edwards Lifesciences. Dr Angellotti is supported by a research grant provided by the CardioPath PhD program. Dr Lanz has received speaker fees to the institution from Edwards Lifesciences and Abbott. Dr Samim received funding for an online course from Edwards Lifesciences. Dr Praz has received travel expenses from Edwards Lifesciences, Abbott Vascular, Medira, Siemens Healthineers, and InQB8 Medical Technologies, as well as a research grant to the institution from Abbott Vascular. Dr Windecker reports research, travel and/or educational grants to the institution from Abbott, Abiomed, Alnylam, Amicus Therapeutics, Amgen, Astra Zeneca, Bayer, B.Braun, Bioanalytica, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cordis Medical, CorFlow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Fumedica, GE Healthcare, Guerbet, IACULIS, Inari Medical, Janssen AI, Johnson & Johnson, Medalliance, Medtronic, MSD Merck Sharp & Dohme, Neovii Pharmaceutica, Neutromedics AG, Novartis, Novo Nordisk, OM Pharma, Optimapharm, Orchestra BioMed, Pfizer, Philips AG, Sanofi-Aventis, Servier, Shockwave Medical, Siemens Healthcare, Sinomed, SMT Sahajanand Medical Technologies, Vascular Medical, and V-Wave. Dr Windecker serves as advisory board member and/or member of the steering/executive group of trials funded by Abbott, Amgen, Abiomed, Edwards Lifesciences, EnCarda Inc., Medtronic, Novartis, and Sinomed with payments to the institution but no personal payments. He is also a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Pilgrim reports research, travel, or educational grant to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/08/27 12:36 MHDA- 2026/08/27 12:37 PMCR- 2026/08/26 CRDT- 2026/08/27 08:28 PHST- 2026/04/17 00:00 [received] PHST- 2026/06/09 00:00 [revised] PHST- 2026/06/11 00:00 [accepted] PHST- 2026/08/27 12:37 [medline] PHST- 2026/08/27 12:36 [pubmed] PHST- 2026/08/27 08:28 [entrez] PHST- 2026/08/26 00:00 [pmc-release] AID - S2772-963X(26)00458-8 [pii] AID - 103037 [pii] AID - 10.1016/j.jacadv.2026.103037 [doi] PST - ppublish SO - JACC Adv. 2026 Aug;5(8):103037. doi: 10.1016/j.jacadv.2026.103037. PMID- 42652710 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260827 LR - 20260829 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 16 DP - 2026 Aug 14 TI - Single-Access Transfemoral TAVI with a Balloon Expandable Valve: Age-Stratified Analysis of Clinical Outcomes. LID - 10.3390/jcm15166305 [doi] LID - 6305 AB - Background: Single-access transfemoral transcatheter aortic valve implantation (TAVI) reduces the need for multiple vascular access and therefore, the related risk of related complications. However, the impact of patient age on its clinical outcomes remains uncertain. Methods: This is a secondary analysis of previously reported propensity score matched study comparing clinical outcomes of single- versus dual-access transfemoral TAVI using SAPIEN-3-Ultra. We examined the relation between patient age, access strategy and outcomes-specifically, 30-day safety endpoint according to the Valve Academic Research Consortium 3 (VARC-3) and major adverse cardiovascular events (MACE), defined as death, permanent pacemaker, neurological or vascular complications-using logistic regression interaction analyses, and restricted cubic spline modelling. Results: A total of 204 patients (propensity score-matched cohort) were included in the study. The elderly group were more likely to have hypertension, peripheral vascular disease or stroke. The use of single access was comparable. The elderly cohort demonstrated a tendency toward longer fluoroscopy and procedural times compared with the non-elderly group. This pattern likely reflects the greater technical complexity and heightened procedural caution often associated with older patients, including more challenging vascular anatomy and the need for careful device handling. Although not statistically significant, these findings remain clinically meaningful and are consistent with the notion that procedures in elderly patients frequently require more meticulous planning and execution. There was a significant interaction between access strategy and age in reducing MACE, but not in VARC-3 safety outcomes. Single access was associated with a significant reduction in MACE (5.4% vs. 26.7%, p = 0.015) with comparable technical and safety outcomes when compared with elderly patients who underwent dual-access TAVI. Conclusions: Single-access TAVI was linked to favourable early outcomes, maintained procedural success, and suggested a possible age-dependent pattern in the occurrence of MACE. Our findings support the need for randomised studies to demonstrate superiority of single- versus dual-access TAVI, particularly in the elderly population. FAU - Saluja, Sushant AU - Saluja S AD - Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK. FAU - Omari, Muntaser AU - Omari M AUID- ORCID: 0009-0005-3011-9824 AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Abukhalaf, Omran AU - Abukhalaf O AUID- ORCID: 0000-0002-6035-8843 AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Stewart, Debbie AU - Stewart D AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Lamb, Sarah AU - Lamb S AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Cartlidge, Timothy AU - Cartlidge T AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Edwards, Richard AU - Edwards R AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Das, Rajiv AU - Das R AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Zaman, Azfar AU - Zaman A AUID- ORCID: 0000-0003-4891-8892 AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Farag, Mohamed AU - Farag M AUID- ORCID: 0000-0003-0811-7679 AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. FAU - Alkhalil, Mohammad AU - Alkhalil M AUID- ORCID: 0000-0002-3088-8878 AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK. AD - Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AE, UK. AD - Department of Cardiothoracic Services, Freeman Hospital, Freeman Road, Newcastle-upon-Tyne NE7 7DN, UK. LA - eng PT - Journal Article DEP - 20260814 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13513657 OTO - NOTNLM OT - MACE OT - VARC-3 OT - age OT - dual access OT - single access OT - transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2026/08/27 05:35 MHDA- 2026/08/27 05:36 PMCR- 2026/08/14 CRDT- 2026/08/27 01:06 PHST- 2026/07/22 00:00 [received] PHST- 2026/08/08 00:00 [revised] PHST- 2026/08/11 00:00 [accepted] PHST- 2026/08/27 05:36 [medline] PHST- 2026/08/27 05:35 [pubmed] PHST- 2026/08/27 01:06 [entrez] PHST- 2026/08/14 00:00 [pmc-release] AID - jcm15166305 [pii] AID - jcm-15-06305 [pii] AID - 10.3390/jcm15166305 [doi] PST - epublish SO - J Clin Med. 2026 Aug 14;15(16):6305. doi: 10.3390/jcm15166305. PMID- 42648860 OWN - NLM STAT- MEDLINE DCOM- 20260826 LR - 20260826 IS - 2211-7466 (Electronic) IS - 2211-7458 (Linking) VI - 15 IP - 4 DP - 2026 Oct TI - Alternative Access for Transcatheter Aortic Valve Replacement: A Comprehensive Updated Review. PG - 565-578 LID - S2211-7458(26)00046-5 [pii] LID - 10.1016/j.iccl.2026.06.001 [doi] AB - Transfemoral is the most widely used and remains the preferred approach to perform Transcatheter aortic valve replacement (TAVR) in the vast majority of patients because of its superior clinical outcome. However, alternative access remains necessary in patients with unfavorable iliofemoral anatomy and includes peripheral strategies such as transcarotid, transaxillary, and transcaval approaches. Transcaval access offers a feasible option for patients without suitable arterial access and has shown high procedural success in contemporary studies. We hereby provide a comprehensive review on alternative access for TAVR, discussing the relevant data, providing the pros and cons of each access route. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Qintar, Mohammed AU - Qintar M AD - Structural Heart Division, The Heart Hospital, Hamad Medical Corporation, Doha, Qatar; Michigan State University, East Lansing, MI, USA. Electronic address: mohammedqintar@gmail.com. FAU - Al-Termanini, Mohammad AU - Al-Termanini M AD - Structural Heart Division, The Heart Hospital, Hamad Medical Corporation, Doha, Qatar. FAU - Eng, Marvin H AU - Eng MH AD - Division of Cardiology, University of Nebraska Medical Center, Omaha, NE, USA. LA - eng PT - Journal Article PT - Review DEP - 20260722 PL - Netherlands TA - Interv Cardiol Clin JT - Interventional cardiology clinics JID - 101615153 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - *Aortic Valve/surgery MH - Femoral Artery MH - *Catheterization, Peripheral/methods MH - Axillary Artery MH - *Cardiac Catheterization/methods OTO - NOTNLM OT - Alternative access OT - Direct aortic OT - Direct apical OT - Femoral access OT - TAVR OT - Transaxillary OT - Transcarotid OT - Transcaval COIS- Disclosure EDAT- 2026/08/26 23:35 MHDA- 2026/08/26 23:36 CRDT- 2026/08/26 20:55 PHST- 2026/08/26 23:36 [medline] PHST- 2026/08/26 23:35 [pubmed] PHST- 2026/08/26 20:55 [entrez] AID - S2211-7458(26)00046-5 [pii] AID - 10.1016/j.iccl.2026.06.001 [doi] PST - ppublish SO - Interv Cardiol Clin. 2026 Oct;15(4):565-578. doi: 10.1016/j.iccl.2026.06.001. Epub 2026 Jul 22. PMID- 42646606 OWN - NLM STAT- MEDLINE DCOM- 20260826 LR - 20260828 IS - 2076-3271 (Electronic) IS - 2076-3271 (Linking) VI - 14 IP - 4 DP - 2026 Aug 11 TI - More than Fluid: AI-Derived Pleural Effusion Volume as a Marker of Cardiovascular Congestion in Transcatheter Aortic Valve Implantation. LID - 10.3390/medsci14040472 [doi] LID - 472 AB - Background/Objectives: Pleural effusions are frequently encountered on pre-procedural computed tomography (CT) scans in patients undergoing transcatheter aortic valve implantation (TAVI). While often regarded as a marker of congestion and advanced cardiovascular disease, their clinical and prognostic significance in contemporary TAVI populations remains poorly understood. This study investigated the relationship between AI-derived pleural effusion volume, cardiovascular dysfunction, and long-term mortality after TAVI. Methods: Consecutive patients undergoing transfemoral TAVI between 2016 and 2022 who had available pre-procedural CT imaging were retrospectively included. Pleural effusion volume was quantified using an artificial intelligence-based segmentation workflow and analyzed as categorical, continuous, log-transformed, and threshold-based variables. Associations with clinical and echocardiographic characteristics were evaluated using Spearman correlation analyses. Long-term mortality was assessed using Kaplan-Meier analysis, Cox proportional hazards regression, and restricted cubic spline models. Results: A total of 470 patients were included (median age 82 years, 50.9% male). Pleural effusion was present in 124 patients (26.38%), including 73 (15.53%) with small, 26 (5.53%) with moderate, and 25 (5.32%) with larger effusions. Increasing pleural effusion volume was associated with atrial fibrillation (AF) (rho = 0.189, p < 0.001), higher systolic pulmonary artery pressure (rho = 0.224, p < 0.001), lower tricuspid annular plane systolic excursion (rho = -0.236, p < 0.001), impaired right ventricular-pulmonary arterial coupling (rho = -0.267, p < 0.001), lower stroke volume index (rho = -0.229, p < 0.001), and reduced left ventricular ejection fraction (rho = -0.221, p < 0.001). Despite these associations, pleural effusion volume was not associated with long-term mortality in univariable analyses, multivariable Cox regression models, or restricted cubic spline analyses. In the fully adjusted model, log-transformed pleural effusion volume was not independently associated with mortality (HR 1.00, 95% CI 0.93-1.08; p = 0.976). Conclusions: AI-derived pleural effusion volume is associated with markers of cardiovascular congestion and adverse hemodynamic remodeling in patients undergoing TAVI. However, pleural effusion burden does not independently predict long-term mortality, suggesting that its value lies primarily in phenotyping cardiovascular disease severity rather than risk stratification. FAU - Schorghofer, Nikolaos AU - Schorghofer N AUID- ORCID: 0000-0002-1842-0578 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Clodi, Nikolaus AU - Clodi N AUID- ORCID: 0009-0003-3443-9943 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Hecke, Gretha AU - Hecke G AD - Division of Cardiology, Department of Internal Medicine II, Paracelsus Medical University of Salzburg, Mullner Hauptstrasse 48, 5020 Salzburg, Austria. FAU - Hammerer, Matthias AU - Hammerer M AD - Division of Cardiology, Department of Internal Medicine II, Paracelsus Medical University of Salzburg, Mullner Hauptstrasse 48, 5020 Salzburg, Austria. FAU - Kupferthaler, Alexander AU - Kupferthaler A AUID- ORCID: 0000-0002-3429-2203 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Scharinger, Bernhard AU - Scharinger B AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Hoppe, Uta C AU - Hoppe UC AD - Division of Cardiology, Department of Internal Medicine II, Paracelsus Medical University of Salzburg, Mullner Hauptstrasse 48, 5020 Salzburg, Austria. FAU - Hergan, Klaus AU - Hergan K AUID- ORCID: 0009-0005-6571-8296 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Boxhammer, Elke AU - Boxhammer E AUID- ORCID: 0000-0002-6589-3853 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. AD - Division of Cardiology, Department of Internal Medicine II, Paracelsus Medical University of Salzburg, Mullner Hauptstrasse 48, 5020 Salzburg, Austria. FAU - Knapitsch, Christoph AU - Knapitsch C AUID- ORCID: 0000-0002-0656-7038 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. LA - eng PT - Journal Article DEP - 20260811 PL - Switzerland TA - Med Sci (Basel) JT - Medical sciences (Basel, Switzerland) JID - 101629322 SB - IM MH - Humans MH - *Pleural Effusion/diagnostic imaging/physiopathology/etiology MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Male MH - Aged, 80 and over MH - Retrospective Studies MH - *Artificial Intelligence MH - Tomography, X-Ray Computed MH - Prognosis MH - Aged PMC - PMC13515112 OTO - NOTNLM OT - artificial intelligence OT - cardiovascular congestion OT - computed tomography OT - pleural effusion OT - right ventricular function OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/08/26 17:37 MHDA- 2026/08/26 17:38 PMCR- 2026/08/11 CRDT- 2026/08/26 11:31 PHST- 2026/07/12 00:00 [received] PHST- 2026/08/01 00:00 [revised] PHST- 2026/08/09 00:00 [accepted] PHST- 2026/08/26 17:38 [medline] PHST- 2026/08/26 17:37 [pubmed] PHST- 2026/08/26 11:31 [entrez] PHST- 2026/08/11 00:00 [pmc-release] AID - medsci14040472 [pii] AID - medsci-14-00472 [pii] AID - 10.3390/medsci14040472 [doi] PST - epublish SO - Med Sci (Basel). 2026 Aug 11;14(4):472. doi: 10.3390/medsci14040472. PMID- 42645865 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260826 LR - 20260828 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 13 IP - 8 DP - 2026 Aug 17 TI - Clinical Outcomes and Factors Associated with MACCE in Chinese Patients Undergoing Single-Hospitalization PCI and Transfemoral TAVR. LID - 10.3390/jcdd13080394 [doi] LID - 394 AB - BACKGROUND: The incidence and predictors of major adverse cardiovascular and cerebrovascular events (MACCE) in patients undergoing percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR) during the same hospitalization remain poorly characterized, particularly in Asian populations. METHODS: This single-center retrospective study included 164 consecutive patients who underwent PCI and transfemoral TAVR during the same hospitalization at Beijing Anzhen Hospital between June 2018 and October 2023. The primary objective was to evaluate the incidence of MACCE, and logistic regression analyses were used to identify its predictors. RESULTS: Among 164 patients, the mean age was 73.9 +/- 7.2 years, and 57.9% were male. Device success was 97.6% and procedural success was 89.6%. MACCE occurred in 28 patients (17.1%) within the index hospitalization or 30 days after discharge. Independent predictors of MACCE were lower baseline left ventricular ejection fraction (LVEF; OR = 0.955, 95% CI 0.920-0.992; p = 0.017) and mixed aortic stenosis and regurgitation (AS + AR; OR = 6.360, 95% CI 1.035-38.993; p = 0.038). CONCLUSIONS: A single-hospitalization PCI and TAVR strategy appeared feasible and was associated with acceptable short-term clinical outcomes in carefully selected Chinese candidates, with lower baseline LVEF and mixed AS and AR as independent predictors of MACCE. The observed clinical outcomes should be interpreted descriptively because of the lack of a contemporaneous comparator group; large-scale prospective studies are needed to further evaluate the safety and clinical benefit of this "one-stop" paradigm. FAU - Tan, Tong AU - Tan T AD - Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing 100029, China. FAU - Awakeri, Alimujiang AU - Awakeri A AUID- ORCID: 0009-0005-3178-4500 AD - Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing 100029, China. FAU - Cui, Hao AU - Cui H AD - Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing 100029, China. FAU - Zhu, Enjun AU - Zhu E AD - Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing 100029, China. FAU - Lai, Yongqiang AU - Lai Y AD - Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing 100029, China. LA - eng GR - KCA-2305/National Natural Science Foundation's Excellent Young Scientist Fund and the Excellent Young Scientist Program of Capital Medical University/ GR - 2024AZC1003/Beijing Anzhen Hospital High Level Research Funding/ GR - Z251100004625015/Beijing Municipal Science and Technology Project/ GR - L251020/Beijing Natural Science Foundation Project - Joint Fund/ GR - CX23YQA05/Chinese Institutes for Medical Research/ PT - Journal Article DEP - 20260817 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC13512949 OTO - NOTNLM OT - aortic stenosis OT - coronary artery disease OT - major adverse cardiovascular and cerebrovascular events OT - percutaneous coronary intervention OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2026/08/26 17:36 MHDA- 2026/08/26 17:37 PMCR- 2026/08/17 CRDT- 2026/08/26 11:28 PHST- 2026/05/03 00:00 [received] PHST- 2026/07/31 00:00 [revised] PHST- 2026/08/03 00:00 [accepted] PHST- 2026/08/26 17:37 [medline] PHST- 2026/08/26 17:36 [pubmed] PHST- 2026/08/26 11:28 [entrez] PHST- 2026/08/17 00:00 [pmc-release] AID - jcdd13080394 [pii] AID - jcdd-13-00394 [pii] AID - 10.3390/jcdd13080394 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2026 Aug 17;13(8):394. doi: 10.3390/jcdd13080394. PMID- 42642914 OWN - NLM STAT- MEDLINE DCOM- 20260929 LR - 20261001 IS - 1525-1594 (Electronic) IS - 0160-564X (Print) IS - 0160-564X (Linking) VI - 50 IP - 10 DP - 2026 Oct TI - Early Multicenter Outcomes of Dedicated Transcatheter Aortic Valve Replacement for Left Ventricular Assist Device-Associated Pure Aortic Regurgitation. PG - 1427-1433 LID - 10.1111/aor.70226 [doi] AB - BACKGROUND: Aortic regurgitation (AR) is a frequent and clinically relevant complication in patients with left ventricular assist devices (LVAD), impairing circulatory support and worsening outcomes. Surgical aortic valve replacement often carries prohibitive risk in this population, while conventional transcatheter aortic valve replacement (TAVR) is limited by the lack of annular calcification. The JenaValve Trilogy is the first transfemoral TAVR system with regulatory approval for AR. Evidence on its use in LVAD patients remains scarce. METHODS: We conducted a retrospective multicenter registry of LVAD recipients undergoing JenaValve Trilogy implantation for pure AR between 2020 and 2026 at five high-volume centers in Germany and the United States. Patient characteristics, procedural details, and outcomes were analyzed. The primary endpoint was device success according to Valve Academic Research Consortium-3 (VARC-3) criteria at 30 days. Secondary endpoints included peri-procedural complications, mortality, and device-related reinterventions at follow-up. RESULTS: Thirty patients (median age 66 years, 36.7% female, median LVAD support time: four years) were included. One patient did not meet criteria for technical success, and one experienced a fatal hemorrhagic stroke on postoperative day 2, rendering device success 93.3% (28/30). 30-day mortality was 3.3% (1/30). At a median follow-up of 273 days (IQR 30-491), survival was 93.3% (28/30). CONCLUSION: This first multicenter experience demonstrates that JenaValve Trilogy provides a feasible and safe treatment option for clinically significant AR in LVAD patients at prohibitive surgical risk, with high device success and favorable short-term outcomes. CI - (c) 2026 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. FAU - Hinkov, Hristian AU - Hinkov H AUID- ORCID: 0000-0002-9602-2794 AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin, Berlin, Germany. AD - Structural Heart Interventions Program (SHIP), Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany. FAU - Yousefzada, Sara AU - Yousefzada S AD - Department of General and Interventional Cardiology and Angiology, Heart and Diabetes Center NRW, Ruhr University, Bad Oeynhausen, Germany. FAU - Just, Isabell A AU - Just IA AUID- ORCID: 0000-0003-1141-9387 AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin, Berlin, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany. FAU - Klein, Christoph AU - Klein C AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin, Berlin, Germany. AD - Structural Heart Interventions Program (SHIP), Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. FAU - Potapov, Evgenij AU - Potapov E AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin, Berlin, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany. FAU - Garcia, Santiago AU - Garcia S AD - Division of Cardiology, The Christ Hospital Heart and Vascular Institute and the Carl and Edyth Lindner Center for Research and Education, Cincinnati, Ohio, USA. FAU - Patel, Dhairya AU - Patel D AUID- ORCID: 0009-0009-2260-3789 AD - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. FAU - Ranard, Lauren S AU - Ranard LS AUID- ORCID: 0000-0002-2305-156X AD - Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA. FAU - Goncharov, Arseniy AU - Goncharov A AD - Department of General and Interventional Cardiology and Angiology, Heart and Diabetes Center NRW, Ruhr University, Bad Oeynhausen, Germany. FAU - Kereiakes, Dean J AU - Kereiakes DJ AUID- ORCID: 0000-0003-1086-127X AD - Division of Cardiology, The Christ Hospital Heart and Vascular Institute and the Carl and Edyth Lindner Center for Research and Education, Cincinnati, Ohio, USA. FAU - Makkar, Raj R AU - Makkar RR AD - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. FAU - Vahl, Torsten P AU - Vahl TP AD - Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Department of General and Interventional Cardiology and Angiology, Heart and Diabetes Center NRW, Ruhr University, Bad Oeynhausen, Germany. FAU - Unbehaun, Axel AU - Unbehaun A AUID- ORCID: 0000-0003-2851-695X AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin, Berlin, Germany. AD - Structural Heart Interventions Program (SHIP), Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20260825 PL - United States TA - Artif Organs JT - Artificial organs JID - 7802778 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery MH - *Aortic Valve Insufficiency/surgery/etiology/mortality MH - Germany MH - *Heart-Assist Devices/adverse effects MH - *Postoperative Complications/etiology/mortality/surgery MH - Registries MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Treatment Outcome MH - United States PMC - PMC13622895 OTO - NOTNLM OT - JenaValve trilogy OT - aortic regurgitation OT - left ventricular assist device OT - transcatheter aortic valve replacement COIS- Isabell Just has received honoraria from AstraZeneca GmbH, Abbott GmbH, Abiomed Inc., and Biotest, unrelated to the submitted work. Christoph Klein is a proctor for JenaValve and has received speaker fees from Medtronic. Santiago Garcia is a consultant and proctor and has received institutional research grants from Edwards Lifesciences, Medtronic, Abbott Structural Heart, and Boston Scientific. Dean Kereiakes is a consultant to Edwards Lifesciences and J.C. Medical Inc. Lauren Ranard has received an institutional research grant from Boston Scientific and consulting fees from 4C Medical, InnovHeart, and Philips. Raj Makkar has received travel support from JenaValve. Torsten Vahl is reporting institutional funding to Columbia University Irving Medical Center from Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic, and he has received consulting fees from Abbott Vascular, Philips, and InnovHeart. Tanja Rudolph is a proctor and medical advisor for JenaValve. Axel Unbehaun is a proctor for Edwards Lifesciences, Medtronic, and JenaValve. All other authors have reported they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/08/26 05:36 MHDA- 2026/09/29 19:03 PMCR- 2026/09/29 CRDT- 2026/08/26 01:13 PHST- 2026/08/07 00:00 [revised] PHST- 2026/03/25 00:00 [received] PHST- 2026/08/12 00:00 [accepted] PHST- 2026/09/29 19:03 [medline] PHST- 2026/08/26 05:36 [pubmed] PHST- 2026/08/26 01:13 [entrez] PHST- 2026/09/29 00:00 [pmc-release] AID - AOR70226 [pii] AID - 10.1111/aor.70226 [doi] PST - ppublish SO - Artif Organs. 2026 Oct;50(10):1427-1433. doi: 10.1111/aor.70226. Epub 2026 Aug 25. PMID- 42631804 OWN - NLM STAT- Publisher LR - 20260822 IS - 1868-4297 (Electronic) IS - 1868-4297 (Linking) DP - 2026 Aug 22 TI - Transcarotid transcatheter aortic valve implantation in a patient with vascular ring due to double aortic arch. LID - 10.1007/s12928-026-01334-7 [doi] FAU - Nakata, Yuki AU - Nakata Y AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Domoto, Satoru AU - Domoto S AUID- ORCID: 0000-0001-9811-1523 AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-0054, Japan. domoto.satoru@twmu.ac.jp. FAU - Sudo, Shinya AU - Sudo S AD - Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan. FAU - Nagao, Michinobu AU - Nagao M AD - Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan. FAU - Niinami, Hiroshi AU - Niinami H AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-0054, Japan. FAU - Yamaguchi, Junichi AU - Yamaguchi J AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20260822 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 SB - IM OTO - NOTNLM OT - Alternative access OT - Double aortic arch OT - Transcarotid approach OT - Transcatheter aortic valve implantation OT - Vascular ring COIS- Declarations. Conflict of interest: Dr Domoto has served as a proctor for Edwards Lifesciences, Medtronic, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/08/22 22:41 MHDA- 2026/08/22 22:41 CRDT- 2026/08/22 11:08 PHST- 2026/06/07 00:00 [received] PHST- 2026/08/03 00:00 [accepted] PHST- 2026/08/22 22:41 [medline] PHST- 2026/08/22 22:41 [pubmed] PHST- 2026/08/22 11:08 [entrez] AID - 10.1007/s12928-026-01334-7 [pii] AID - 10.1007/s12928-026-01334-7 [doi] PST - aheadofprint SO - Cardiovasc Interv Ther. 2026 Aug 22. doi: 10.1007/s12928-026-01334-7. PMID- 42623266 OWN - NLM STAT- MEDLINE DCOM- 20260820 LR - 20261028 IS - 1527-1323 (Electronic) IS - 0271-5333 (Linking) VI - 46 IP - 9 DP - 2026 Sep TI - Challenging Anatomic and Pathologic Features for Transcatheter Aortic Valve Replacement Planning. PG - e250099 LID - 10.1148/rg.250099 [doi] AB - Segmentation and processing of CT datasets for transcatheter aortic valve replacement (TAVR) planning is now an essential part of the transcatheter heart valve team process. Output for TAVR planning includes geometric and pathologic findings of the aortic valve, root, and left ventricular outflow tract. In addition, access route selection requires assessment of the size and course of the access vessel and identification of any associated variant anatomic or pathologic conditions that could affect the procedure. Spurious or erroneous output from three-dimensional processing software can occur, especially with gradient-based segmentation algorithms. Identification and correction of these processing errors is imperative for accurate TAVR planning output. The authors review specific considerations for each anatomic region in which TAVR planning is needed and outline processing tips for providing high-quality planning output. ((c))RSNA, 2026 Supplemental material is available for this article. FAU - Hallett, Richard L AU - Hallett RL AUID- ORCID: 0000-0001-9442-6173 AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. AD - Department of Radiology, University of Arizona College of Medicine-Phoenix, Phoenix, Ariz. FAU - Hatch, Kimberly A AU - Hatch KA AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - Bratcher, Jodi A AU - Bratcher JA AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - Grooters, Lindsey R AU - Grooters LR AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - DeBellevue, Rayna L AU - DeBellevue RL AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - Miner Denzine, Linda AU - Miner Denzine L AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - Fedewa, Jason L AU - Fedewa JL AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - Walsh, Mark F AU - Walsh MF AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. FAU - Rybicki, Frank J AU - Rybicki FJ AUID- ORCID: 0000-0002-4669-5886 AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. AD - Department of Radiology, University of Arizona College of Medicine-Phoenix, Phoenix, Ariz. FAU - Morris, Michael F AU - Morris MF AUID- ORCID: 0000-0001-8076-0488 AD - 3D Visualization Laboratory, Department of Radiology, Banner University Medical Center-Phoenix, 1111 E McDowell Rd, Phoenix, AZ 85006. AD - Department of Radiology, University of Arizona College of Medicine-Phoenix, Phoenix, Ariz. LA - eng PT - Journal Article PT - Review PL - United States TA - Radiographics JT - Radiographics : a review publication of the Radiological Society of North America, Inc JID - 8302501 SB - IM MH - *Transcatheter Aortic Valve Replacement/methods MH - Humans MH - *Tomography, X-Ray Computed/methods MH - *Aortic Valve/diagnostic imaging/surgery/anatomy & histology/pathology MH - Imaging, Three-Dimensional MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/pathology MH - *Patient Care Planning EDAT- 2026/08/20 17:35 MHDA- 2026/08/20 17:36 CRDT- 2026/08/20 12:53 PHST- 2026/08/20 17:36 [medline] PHST- 2026/08/20 17:35 [pubmed] PHST- 2026/08/20 12:53 [entrez] AID - 10.1148/rg.250099 [doi] PST - ppublish SO - Radiographics. 2026 Sep;46(9):e250099. doi: 10.1148/rg.250099. PMID- 42613595 OWN - NLM STAT- MEDLINE DCOM- 20260819 LR - 20260822 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 26 IP - 1 DP - 2026 Aug 18 TI - Comparative outcomes of balloon-expandable versus self-expanding transcatheter aortic valves: insights from a large-scale German registry. LID - 10.1186/s12872-026-06462-9 [doi] LID - 723 AB - BACKGROUND: While transcatheter aortic valve replacement (TAVR) has become an established alternative to surgical aortic valve replacement (SAVR), the comparative outcomes of balloon-expandable (BE) and self-expanding (SE) valve technologies remain an area of ongoing investigation. METHODS: Using the German DESTATIS database, we analyzed 48,565 transfemoral TAVR procedures performed between 2021 and 2022. Outcomes were compared between BE (n = 23,412) and SE (n = 25,153) valves using a double/debiased machine learning estimator to account for potential confounding. Key endpoints included in-hospital mortality, major bleeding, stroke, acute kidney injury, mechanical ventilation > 48 h, postoperative delirium, permanent pacemaker implantation (PPI), length of hospital stay, and reimbursement. RESULTS: Descriptively, SE valves were associated with significantly lower in-hospital mortality (1.6% vs. 2.0%, p < 0.001) and major bleeding (1.4% vs. 2.1%, p < 0.001) but a higher risk of stroke (2.4% vs. 1.9%, p < 0.001). A trend towards higher risk of PPI was observed (p = 0.078). After adjustment, patients with SE valves are at lower risk for in-hospital mortality (RR 0.85, p = 0.049) and major bleeding (RR 0.78, p = 0.006), but had a higher risk of stroke (RR 1.35, p < 0.001) and permanent pacemaker implantation (RR 1.09, p = 0.028). Subgroup analysis indicated that older and high-risk patients, particularly those aged >/= 85 years, showed a stronger association with lower in-hospital mortality for SE valves, whereas younger patients exhibited a trend favouring BE valves. BE valves were also associated with a modestly higher reimbursement (euro209 per case, p = 0.004). CONCLUSION: In this large, real-world cohort, self-expanding valves were associated with lower in-hospital mortality and major bleeding but a higher risk of stroke and permanent pacemaker implantation compared with balloon-expandable valves. Because prosthesis choice in routine practice is highly individualized and driven by anatomical and procedural factors not captured in administrative data, these associations are hypothesis-generating and cannot support device-selection recommendations. CI - (c) 2026. The Author(s). FAU - Kaier, Klaus AU - Kaier K AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. klaus.kaier@gmail.com. AD - Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26, Freiburg, Germany. klaus.kaier@gmail.com. FAU - Hazard, Derek AU - Hazard D AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. AD - Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26, Freiburg, Germany. FAU - Czerny, Martin AU - Czerny M AD - Department of Cardiovascular Surgery, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, Freiburg, Germany. AD - , Freiburg, Germany. FAU - Rilinger, Jonathan AU - Rilinger J AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - Hilgendorf, Ingo AU - Hilgendorf I AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - Wolf, Dennis AU - Wolf D AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - Valina, Christian AU - Valina C AD - Department of Cardiology and Angiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20260818 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Humans MH - Registries MH - *Heart Valve Prosthesis/economics MH - Germany MH - Treatment Outcome MH - Aged, 80 and over MH - Risk Factors MH - Prosthesis Design MH - Hospital Mortality MH - Female MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality/economics MH - Time Factors MH - Risk Assessment MH - Databases, Factual MH - Male MH - Aged MH - *Balloon Valvuloplasty/mortality/adverse effects/instrumentation MH - Postoperative Complications/therapy/mortality PMC - PMC13488022 OTO - NOTNLM OT - Aortic stenosis OT - Balloon-expandable valve OT - Double/debiased machine learning OT - Real-world data OT - Self-expanding valve OT - Transcatheter aortic valve replacement COIS- Declarations. Ethics approval and consent to participate: When analyzing data from the German Federal Statistical Office (Destatis). Under the German Federal Statistics Act (Bundesstatistikgesetz, BStatG) and the corresponding Lander statistics regulations, the scientific use of these anonymized, aggregated official statistics does not require ethics-committee approval or individual patient consent, because researchers receive no individual-level identifiable data. No approval or consent was therefore required for this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2026/08/19 14:49 MHDA- 2026/08/19 14:50 PMCR- 2026/08/18 CRDT- 2026/08/19 00:14 PHST- 2026/06/01 00:00 [received] PHST- 2026/08/10 00:00 [accepted] PHST- 2026/08/19 14:50 [medline] PHST- 2026/08/19 14:49 [pubmed] PHST- 2026/08/19 00:14 [entrez] PHST- 2026/08/18 00:00 [pmc-release] AID - 10.1186/s12872-026-06462-9 [pii] AID - 6462 [pii] AID - 10.1186/s12872-026-06462-9 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2026 Aug 18;26(1):723. doi: 10.1186/s12872-026-06462-9. PMID- 42611572 OWN - NLM STAT- MEDLINE DCOM- 20261014 LR - 20261016 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 108 IP - 4 DP - 2026 Oct TI - Sheath-to-Artery Diameter Ratio: A Robust Predictor of Early Access-Site Adverse Events in Percutaneous Procedures. PG - 1622-1629 LID - 10.1002/ccd.70808 [doi] AB - BACKGROUND: Vascular access site complications (VASCs) remain an important source of morbidity following percutaneous interventions. Although the sheath-to-femoral artery ratio is a recognized risk factor in transcatheter aortic valve implantation (TAVI), its role across a broader range of femoral procedures is less well defined. OBJECTIVE: To evaluate the association between the sheath‑to‑artery diameter (SHAD) ratio and early VASCs in patients undergoing femoral percutaneous interventions with sheaths > 6 Fr. METHODS: A nested case-control study was performed within a retrospective cohort of 2660 consecutive patients. A total of 177 patients who developed VASCs within 7 days were identified and compared with 353 propensity score-matched controls without complications. The propensity score included age, sex, body mass index, hypertension, diabetes mellitus, peripheral artery disease, and prior femoral access. The SHAD ratio was calculated using pre‑procedural computed tomography angiography (CTA). Inter‑observer agreement for arterial diameter was excellent (intraclass correlation coefficient 0.94). Receiver operating characteristic analysis identified the optimal cutoff (Youden index), and multivariable logistic regression with backward stepwise selection was internally validated by bootstrap. Anatomical factors (calcification, tortuosity) were examined as potential confounders. RESULTS: After matching, all baseline characteristics were well balanced (standardized differences < 0.10). The SHAD ratio was significantly higher in patients with VASCs than in controls (1.26 vs. 0.75; p < 0.001). A SHAD ratio >/= 1.07 optimally predicted complications (AUC 0.83, 95% CI 0.80-0.87; sensitivity 82%; specificity 78%). In the final multivariable model, SHAD >/= 1.07 remained the strongest independent predictor (OR 6.71, 95% CI 3.87-11.64; p < 0.001). Dual femoral access (OR 2.95, 95% CI 1.65-5.28) and procedural urgency (OR 1.98, 95% CI 1.18-3.32) also increased risk. Ultrasound‑guided puncture (OR 0.15, 95% CI 0.08-0.28) and fluoroscopy‑guided access (OR 0.14, 95% CI 0.07-0.26) were strongly protective. Anterior wall calcification was associated with a higher complication risk in univariable analysis but did not remain significant after adjustment for SHAD. Bootstrap internal validation yielded an optimism‑corrected AUC of 0.91 (95% CI 0.89-0.93), indicating good discrimination. CONCLUSIONS: A SHAD ratio >/= 1.07 is a robust predictor of early VASCs across multiple large‑bore femoral interventions. Maintaining a sheath‑to‑artery relationship 47 mmHg, n = 35) showed significantly higher peak VO(2) than the Low DeltaPP group (19.8 vs. 15.6 mL/kg/min, p < 0.01). In multivariable linear regression models adjusted for age and sex, widened DeltaPP remained associated with higher exercise capacity (coefficient 0.55 per 10 mmHg; 95% confidence interval 0.06-1.04; p = 0.029). CONCLUSIONS: In this single-center retrospective cohort, greater exercise-induced DeltaPP was associated with higher peak VO(2) after TAVI. The physiological determinants and clinical utility of this association require prospective validation. CI - Copyright (c) 2026 Takizawa, Kobayashi, Tajima, Sakamoto, Hori and Nakayama. FAU - Takizawa, Kotaro AU - Takizawa K AD - Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan. FAU - Kobayashi, Daichi AU - Kobayashi D AD - Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan. FAU - Tajima, Shinya AU - Tajima S AD - Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan. FAU - Sakamoto, Junko AU - Sakamoto J AD - Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan. FAU - Hori, Kentaro AU - Hori K AD - Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan. FAU - Nakayama, Atsuko AU - Nakayama A AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20260803 PL - Switzerland TA - Front Physiol JT - Frontiers in physiology JID - 101549006 PMC - PMC13477880 OTO - NOTNLM OT - blood pressure response OT - cardiopulmonary exercise testing OT - elderly OT - exercise capacity OT - pulse pressure OT - transcatheter aortic valve implantation COIS- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/08/18 07:46 MHDA- 2026/08/18 07:47 PMCR- 2026/08/03 CRDT- 2026/08/18 04:20 PHST- 2026/05/31 00:00 [received] PHST- 2026/07/13 00:00 [revised] PHST- 2026/07/17 00:00 [accepted] PHST- 2026/08/18 07:47 [medline] PHST- 2026/08/18 07:46 [pubmed] PHST- 2026/08/18 04:20 [entrez] PHST- 2026/08/03 00:00 [pmc-release] AID - 10.3389/fphys.2026.1896349 [doi] PST - epublish SO - Front Physiol. 2026 Aug 3;17:1896349. doi: 10.3389/fphys.2026.1896349. eCollection 2026. PMID- 42605057 OWN - NLM STAT- MEDLINE DCOM- 20260904 LR - 20260906 IS - 2753-670X (Electronic) IS - 2753-670X (Linking) VI - 41 IP - 9 DP - 2026 Sep 3 TI - Safety and Efficacy of Transaortic Transcatheter Aortic Valve Implantation Via Right Mini-Thoracotomy. LID - 10.1093/icvts/ivag226 [doi] LID - ivag226 AB - OBJECTIVES: Transcatheter aortic valve implantation (TAVI) via the transfemoral (TF) approach is widely used. However, patients with unsuitable peripheral arterial anatomy require alternative transthoracic access. In such patients, the transaortic TAVR via right mini-thoracotomy (Rt-TAo) approach offers a less invasive option than conventional sternotomy. Therefore, this study aimed to evaluate the procedural and 2-year clinical outcomes of TF TAVI versus Rt-TAo TAVI. METHODS: Patients who underwent TAVI via the TF approach or the Rt-TAo approach between January 2012 and November 2023 were retrospectively reviewed. Baseline characteristics and clinical outcomes were compared, and propensity score matching was performed to adjust for baseline differences. The primary end-points were in-hospital mortality, stroke, other periprocedural morbidities, and postprocedural length of hospitalization. Secondary end-points included overall survival, freedom from cardiac-related death, and major adverse cardiac and cerebrovascular events (MACCE) at 2 years. RESULTS: A total of 767 consecutive patients were included in the analysis, of whom 694 underwent TF TAVI and 73 underwent Rt-TAo TAVI. Before matching, the Rt-TAo group had higher baseline prevalences of comorbidities and Society of Thoracic Surgeon risk scores. After matching, the Rt-TAo group had a longer procedural time, higher transfusion requirements, and longer lengths of intensive care unit and total hospital stays. However, the 2 groups had similar rates of periprocedural stroke, coronary obstruction, annular rupture, access-related complications, and in-hospital mortality. The 2 groups had similar 2-year rates of survival and freedom from MACCE. CONCLUSIONS: The Rt-TAo TAVI is a safe and feasible alternative for patients with unsuitable peripheral arterial access, demonstrating comparable 2-year outcomes to TF TAVI. CI - (c) The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Kawamoto, Naonori AU - Kawamoto N AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. FAU - Yamashita, Kizuku AU - Yamashita K AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. FAU - Suzuki, Kota AU - Suzuki K AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. FAU - Kakuta, Takashi AU - Kakuta T AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. FAU - Ikuta, Ayumi AU - Ikuta A AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. FAU - Kutuzawa, Rieko AU - Kutuzawa R AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. FAU - Fukushima, Satsuki AU - Fukushima S AUID- ORCID: 0000-0002-9481-8860 AD - Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 564-8565, Japan. LA - eng PT - Journal Article PL - England TA - Interdiscip Cardiovasc Thorac Surg JT - Interdisciplinary cardiovascular and thoracic surgery JID - 9918540787006676 SB - IM MH - Humans MH - *Thoracotomy/methods/adverse effects MH - Retrospective Studies MH - Female MH - Male MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects/mortality MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery/mortality MH - Postoperative Complications MH - Hospital Mortality MH - Risk Factors MH - *Aortic Valve/surgery PMC - PMC13541777 OTO - NOTNLM OT - propensity score-matched analysis OT - right mini-thoracotomy OT - transaortic transcatheter aortic valve implantation OT - transfemoral transcatheter aortic valve replacement COIS- The authors have no conflicts of interest to disclose. EDAT- 2026/08/17 05:38 MHDA- 2026/09/04 05:36 PMCR- 2026/08/14 CRDT- 2026/08/17 01:23 PHST- 2026/02/06 00:00 [received] PHST- 2026/06/08 00:00 [revised] PHST- 2026/08/02 00:00 [accepted] PHST- 2026/09/04 05:36 [medline] PHST- 2026/08/17 05:38 [pubmed] PHST- 2026/08/17 01:23 [entrez] PHST- 2026/08/14 00:00 [pmc-release] AID - 8762003 [pii] AID - ivag226 [pii] AID - 10.1093/icvts/ivag226 [doi] PST - ppublish SO - Interdiscip Cardiovasc Thorac Surg. 2026 Sep 3;41(9):ivag226. doi: 10.1093/icvts/ivag226. PMID- 42604222 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260816 LR - 20260817 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 10 IP - 8 DP - 2026 Aug TI - Complete Versus Incomplete Revascularization in Patients With Severe Aortic Stenosis Undergoing Complex, High-Risk PCI: Insights From the ASCoP Registry. PG - 100824 LID - 10.1016/j.shj.2026.100824 [doi] LID - 100824 AB - BACKGROUND: Complex coronary artery disease frequently coexists with severe aortic stenosis. The prognostic impact of complete revascularization (CR) versus incomplete revascularization (IR) in patients undergoing complex and/or high-risk indicated percutaneous coronary intervention (CHIP) and transcatheter aortic valve implantation (TAVI) remains unclear. METHODS: We analyzed 550 patients who underwent CHIP and transfemoral TAVI between 2013 and 2023 at 14 international centers. Patients were stratified by completeness of revascularization. The primary endpoint was a composite of all-cause death and unplanned cardiovascular (CV) hospitalization at 1 year. RESULTS: CR was achieved in 299 patients (54.4%). Patients with IR more frequently had three-vessel disease, bifurcation lesions, left main disease, and need for mechanical support. Balloon-expandable valves were more frequently implanted in the CR cohort. Short-term outcomes were similar in the two groups. At 1 year, the incidence of the primary endpoint did not differ significantly between CR and IR groups (20.1 vs. 27.3%, hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.49-1.07). CV rehospitalizations were significantly reduced in the CR group (14.8 vs. 22.8%, HR 0.61, 95% CI 0.38-0.97) even after multivariable adjustment and excluding hospitalizations for repeat revascularization. CONCLUSIONS: In patients undergoing CHIP and TAVI, CR was associated with a reduction in CV hospitalizations. Further studies are needed to confirm this finding. CI - (c) 2026 The Authors. FAU - Tartaglia, Francesco AU - Tartaglia F AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Division of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Division of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Munafo, Andrea R AU - Munafo AR AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. FAU - Regazzoli, Damiano AU - Regazzoli D AD - Division of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Esposito, Giuseppe AU - Esposito G AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. FAU - Soriano, Francesco AU - Soriano F AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. FAU - Arslani, Ketina AU - Arslani K AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. FAU - Brunner, Stephanie AU - Brunner S AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Verhemel, Sarah AU - Verhemel S AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Squillace, Mattia AU - Squillace M AD - Division of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy. FAU - Diez Gil, Jose Luis AU - Diez Gil JL AD - Department of Cardiology, Hospital Universitario y Politecnico La Fe, Valencia, Spain. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Mandurino-Mirizzi, Alessandro AU - Mandurino-Mirizzi A AD - Interventional Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Bauer, David AU - Bauer D AD - Department of Cardiology, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic. FAU - Codner, Pablo AU - Codner P AD - Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel. FAU - Piayda, Kerstin AU - Piayda K AD - Division of Cardiology, CardioVascular Center Frankfurt (CVC), Frankfurt, Germany. FAU - Porto, Italo AU - Porto I AD - Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy. FAU - Nava, Stefano AU - Nava S AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. FAU - Maurina, Matteo AU - Maurina M AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. FAU - Gitto, Mauro AU - Gitto M AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Division of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Sievert, Horst AU - Sievert H AD - Division of Cardiology, CardioVascular Center Frankfurt (CVC), Frankfurt, Germany. FAU - Kornowski, Ran AU - Kornowski R AD - Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel. FAU - Tousek, Petr AU - Tousek P AD - Department of Cardiology, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic. FAU - Mussardo, Marco AU - Mussardo M AD - Cardiology Department, Vito Fazzi Hospital, Lecce, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Division of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Sanz Sanchez, Jorge AU - Sanz Sanchez J AD - Department of Cardiology, Hospital Universitario y Politecnico La Fe, Valencia, Spain. FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Division of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Division of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Van Mieghem, Nicholas AU - Van Mieghem N AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Saia, Francesco AU - Saia F AD - Interventional Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Oreglia, Jacopo A AU - Oreglia JA AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Montalto, Claudio AU - Montalto C AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy. AD - School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. LA - eng PT - Journal Article DEP - 20260226 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC13476877 OTO - NOTNLM OT - Aortic stenosis (AS) OT - Complete revascularization (CR) OT - Complex and/or high-risk indicated procedure PCI (CHIP) OT - Percutaneous coronary intervention (PCI) OT - Transcatheter aortic valve implantation (TAVI) COIS- The authors report no conflict of interest. EDAT- 2026/08/16 05:35 MHDA- 2026/08/16 05:36 PMCR- 2026/02/26 CRDT- 2026/08/16 04:07 PHST- 2026/01/14 00:00 [received] PHST- 2026/02/09 00:00 [revised] PHST- 2026/02/09 00:00 [accepted] PHST- 2026/08/16 05:36 [medline] PHST- 2026/08/16 05:35 [pubmed] PHST- 2026/08/16 04:07 [entrez] PHST- 2026/02/26 00:00 [pmc-release] AID - S2474-8706(26)00033-3 [pii] AID - 100824 [pii] AID - 10.1016/j.shj.2026.100824 [doi] PST - epublish SO - Struct Heart. 2026 Feb 26;10(8):100824. doi: 10.1016/j.shj.2026.100824. eCollection 2026 Aug. PMID- 42600558 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260924 LR - 20260924 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 9 DP - 2026 Sep TI - Safety of Selective and Routine Femoral Access Angiography Post-Transcatheter Aortic Valve Implantation. PG - 103127 LID - S2772-963X(26)00548-X [pii] LID - 10.1016/j.jacadv.2026.103127 [doi] LID - 103127 AB - BACKGROUND: Postprocedural iliofemoral angiography is commonly used to detect access-site complications after transfemoral transcatheter aortic valve implantation (TF-TAVI). However, the clinical value of routine angiographic surveillance remains uncertain. AIMS: To compare vascular and access-site-related complications according to Vascular Academic Research Consortium-3 (VARC-3) criteria associated with routine and selective postprocedural iliofemoral angiography after TF-TAVI. METHODS: We retrospectively analyzed 1,147 TF-TAVI procedures at 2 sites of a single center with different institutional strategies for postprocedural angiographic assessment. One site routinely performed iliofemoral angiography after TAVI (n = 674), whereas the other applied a selective strategy based on procedural suspicion (n = 473). RESULTS: Vascular and access-site complications (VARC-3) were similar between strategies (selective 6.6% vs routine 8.0%; OR: 0.76; 95% CI: 0.48-1.19). Routine angiography detected more access-site bleedings (13.9% vs 5.2%; P < 0.001), without differences in hemoglobin drop, transfusion due to access-site bleeding, or bleeding-related death. Overall vascular reinterventions were comparable (4.2% vs 6.5%; P = 0.095), with more catheter-based interventions in the routine strategy and more surgical/thrombin-based interventions in the selective strategy. In adjusted and inverse probability of treatment weights-weighted analyses, bleeding complications remained lower with the selective strategy, whereas overall VARC-3 complications did not differ. After adjustment using the inverse probability of treatment weights model, the angiography strategy was not associated with acute kidney injury despite higher total contrast in the routine group. CONCLUSION: Routine angiography increases detection of minor vascular abnormalities, while selective angiography guided by clinical suspicion may provide comparable clinical outcomes. Routine postprocedural angiography may be unnecessary in many patients. Prospective randomized studies are needed to determine the optimal surveillance strategy. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - von Ehr, Alexander AU - von Ehr A AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany; Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Campus Virchow Klinikum, Berlin, Germany. FAU - Rilinger, Jonathan AU - Rilinger J AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Hazard, Derek AU - Hazard D AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Mafiz, Tasnim AU - Mafiz T AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Dinh, Bui Bao Khanh AU - Dinh BBK AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Oettinger, Vera AU - Oettinger V AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Mauhardt, Thomas AU - Mauhardt T AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Heger, Lukas A AU - Heger LA AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Olivier, Christoph B AU - Olivier CB AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Zientara, Alicja AU - Zientara A AD - Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Gottardi, Roman AU - Gottardi R AD - Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Czerny, Martin AU - Czerny M AD - Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Hilgendorf, Ingo AU - Hilgendorf I AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany; Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Campus Virchow Klinikum, Berlin, Germany. FAU - Zeymer, Uwe AU - Zeymer U AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Maier, Alexander AU - Maier A AD - Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Electronic address: alexander.maier@uniklinik-freiburg.de. LA - eng PT - Journal Article DEP - 20260814 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC13482200 OTO - NOTNLM OT - TAVI OT - VARC-3 OT - access site OT - bleeding OT - iliofemoral angiography OT - vascular complications COIS- Funding support and author disclosures Dr Maier was funded by the IMMediate Advanced Clinician Scientist-Program, Department of Medicine II, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, funded by the Bundesministerium fur Forschung, Technologie und Raumfahrt (BMFTR, Federal Ministry of Research, Technology and Space) - 01EO2103. Dr Heger was funded by the Berta-Ottenstein-Programme for Advanced Clinician Scientists, Faculty of Medicine, University of Freiburg. All other authors have reported that they have no relationships relevant to the contents of this study to disclose. EDAT- 2026/08/14 23:37 MHDA- 2026/08/14 23:38 PMCR- 2026/08/14 CRDT- 2026/08/14 18:11 PHST- 2026/04/29 00:00 [received] PHST- 2026/07/13 00:00 [revised] PHST- 2026/07/14 00:00 [accepted] PHST- 2026/08/14 23:38 [medline] PHST- 2026/08/14 23:37 [pubmed] PHST- 2026/08/14 18:11 [entrez] PHST- 2026/08/14 00:00 [pmc-release] AID - S2772-963X(26)00548-X [pii] AID - 103127 [pii] AID - 10.1016/j.jacadv.2026.103127 [doi] PST - ppublish SO - JACC Adv. 2026 Sep;5(9):103127. doi: 10.1016/j.jacadv.2026.103127. Epub 2026 Aug 14. PMID- 42570530 OWN - NLM STAT- MEDLINE DCOM- 20261029 LR - 20261029 IS - 1527-3288 (Electronic) IS - 0147-9563 (Linking) VI - 80 DP - 2026 Nov TI - Impact of CT incidental lung findings and pulmonary function on 3-year mortality after transcatheter aortic valve replacement (TAVR). PG - 102911 LID - S0147-9563(26)00195-0 [pii] LID - 10.1016/j.hrtlng.2026.102911 [doi] AB - BACKGROUND: Incidental pulmonary findings, particularly interstitial lung abnormalities (ILA) and emphysema are frequently observed in preprocedural computed tomography (CT) scans of patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). However, their prognostic significance remains unclear. OBJECTIVES: To evaluate the impact of incidental lung findings on 3-year all-cause mortality and pulmonary function in TAVR patients. METHODS: In this retrospective study, we analysed 572 patients who underwent transfemoral TAVR at the Heart Center Bonn between January 2018 and December 2021. All patients underwent preprocedural CT and comprehensive pulmonary function testing. Primary endpoint was 3-year all-cause mortality. RESULTS: Radiological evidence of ILA was present in 20.8%. ILA was significantly associated with increased 3-year mortality (57.6% vs. 36.4%; p < 0.001). In multivariable analysis, ILA remained an independent predictor of mortality (HR 1.59, 95% CI 1.17-2.19, p = 0.004), alongside FVC < 80% predicted. Stratified analysis revealed that the prognostic impact of reduced FVC was confined to patients with ILA (p = 0.015), whereas no significant association was observed in patients without ILA (p = 0.058). ILA patients demonstrated significantly impaired pulmonary function, with lower FVC (65.2 +/- 16.6% vs. 72.0 +/- 18.0%; p < 0.001), and decreased DLCO (47.4 +/- 21.1% vs. 55.9 +/- 21.1%; p = 0.019) compared to patients without ILA. CONCLUSION: Incidental ILA detected on preprocedural CT is a strong and independent predictor of 3-year mortality in TAVR patients. ILA was associated with a restrictive and diffusion-limited pulmonary function pattern, emphasizing the need of integration of pulmonary function tests to facilitate better follow-up and monitoring of interstitial lung disease progression. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Mousa Basha, Mustafa AU - Mousa Basha M AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. Electronic address: Mustafa.Basha@ukbonn.de. FAU - Hein, Louisa AU - Hein L AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Mohr, Sophia AU - Mohr S AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Al-Kassou, Baravan AU - Al-Kassou B AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Weber, Marcel AU - Weber M AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Beiert, Thomas AU - Beiert T AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Zimmer, Sebastian AU - Zimmer S AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Luetkens, Julian AU - Luetkens J AD - Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany. FAU - Kutting, Daniel AU - Kutting D AD - Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany. FAU - Bakhtiary, Farhad AU - Bakhtiary F AD - Heart Center Bonn, Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Skowasch, Dirk AU - Skowasch D AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Pizarro, Carmen AU - Pizarro C AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Shamekhi, Jasmin AU - Shamekhi J AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. LA - eng PT - Journal Article DEP - 20260808 PL - United States TA - Heart Lung JT - Heart & lung : the journal of critical care JID - 0330057 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/mortality/methods MH - Male MH - *Tomography, X-Ray Computed/methods MH - Retrospective Studies MH - *Incidental Findings MH - *Aortic Valve Stenosis/surgery/mortality MH - Aged, 80 and over MH - Respiratory Function Tests/methods MH - Prognosis MH - *Lung Diseases, Interstitial/diagnosis/physiopathology MH - Survival Rate/trends MH - Aged OTO - NOTNLM OT - Aortic stenosis OT - Computed tomography OT - Emphysema OT - Interstitial lung abnormalities OT - Pulmonary function test OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest Drs. G. Nickenig and S. Zimmer have received speaker honoraria from Abbott, Abiomed, Medtronic, Boston Scientific, and Edwards Lifesciences. The other authors report no conflicts of interest. EDAT- 2026/08/09 00:43 MHDA- 2026/10/29 23:28 CRDT- 2026/08/08 18:05 PHST- 2026/03/17 00:00 [received] PHST- 2026/06/08 00:00 [revised] PHST- 2026/08/03 00:00 [accepted] PHST- 2026/10/29 23:28 [medline] PHST- 2026/08/09 00:43 [pubmed] PHST- 2026/08/08 18:05 [entrez] AID - S0147-9563(26)00195-0 [pii] AID - 10.1016/j.hrtlng.2026.102911 [doi] PST - ppublish SO - Heart Lung. 2026 Nov;80:102911. doi: 10.1016/j.hrtlng.2026.102911. Epub 2026 Aug 8. PMID- 42567693 OWN - NLM STAT- Publisher LR - 20260807 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) DP - 2026 Aug 7 TI - Ascending aorta and pure aortic regurgitation transcatheter aortic valve replacement: insights from the National Transcatheter Valve Therapeutics Registry. LID - heartjnl-2025-327742 [pii] LID - 10.1136/heartjnl-2025-327742 [doi] AB - BACKGROUND: Data regarding the association between self-expandable transfemoral transcatheter aortic valve replacement (TF-TAVR) and pure native aortic regurgitation (PNAR) are limited. The authors described their initial experience with self-expandable TF-TAVR for the treatment of patients with PNAR from the NTCVR database in China. METHODS: This was a national registry-based, multicentre, retrospective cohort study. Patients with PNAR were enrolled from the NTCVR in China between January 2017 and December 2023. The primary endpoint event was all-cause mortality at 30 days. Logistic regression analysis and machine learning techniques were used to identify the risk factors associated with 30-day all-cause mortality of TF-TAVR in patients with PNAR. RESULTS: Total 890 patients with PNAR (mean age 73.2 years; 56.3% men) from 72 centres in China were enrolled in this study. The in-hospital and 30-day all-cause mortality were 2.0% and 2.7%, respectively. By multivariate logistic regression analysis, the diameter of the ascending aorta (OR, 1.103 (95% CI 1.005 to 1.212); p=0.039) and renal insufficiency (OR, 4.602 (95% CI 1.455 to 14.553); p=0.009) were associated with the 30-day all-cause mortality. Moreover, Shapley Additive explanations analysis for the machine learning model XGBoost also highlighted the diameter of the ascending aorta as the key predictor; patients with an ascending aorta greater than 41.6 mm had a significantly higher 30-day all-cause mortality rate (OR, 5.027 (95% CI 2.042 to 12.696); p=0.0004). Moreover, the NYHA class III/IV and annulus long diameter were predictors of technical success in multivariate analysis. CONCLUSION: In this large national registry-based observational and exploratory study, we identified the ascending aorta as the key predictor for PNAR patients who underwent self-expandable TF-TAVR. Patients with ascending aortic diameters greater than 41.6 mm may have a significantly higher 30-day all-cause mortality rate. CI - (c) Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Hong, Nanchao AU - Hong N AUID- ORCID: 0009-0008-2634-9346 AD - Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. FAU - Chen, Lili AU - Chen L AD - Huadong Hospital, Fudan University, Shanghai, China. FAU - Liu, Xian-Bao AU - Liu XB AD - Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. FAU - Wang, Jian'an AU - Wang J AUID- ORCID: 0000-0002-4583-3204 AD - Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. FAU - Zhou, Daxin AU - Zhou D AD - Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. FAU - Pan, Wenzhi AU - Pan W AD - Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, China pan.wenzhi@zs-hospital.sh.cn. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. FAU - Ge, Junbo AU - Ge J AUID- ORCID: 0000-0002-8765-4941 AD - Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. LA - eng PT - Journal Article DEP - 20260807 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 SB - IM OTO - NOTNLM OT - Aortic regurgitation OT - Transcatheter Aortic Valve Replacement COIS- Competing interests: JG is a member of the Editorial Board of Heart. The article was subject to the journal's standard procedures, with peer review handled independently of these Editorial Board members and their research groups. EDAT- 2026/08/08 00:37 MHDA- 2026/08/08 00:37 CRDT- 2026/08/07 21:22 PHST- 2025/12/29 00:00 [received] PHST- 2026/07/19 00:00 [accepted] PHST- 2026/08/08 00:37 [medline] PHST- 2026/08/08 00:37 [pubmed] PHST- 2026/08/07 21:22 [entrez] AID - heartjnl-2025-327742 [pii] AID - 10.1136/heartjnl-2025-327742 [doi] PST - aheadofprint SO - Heart. 2026 Aug 7:heartjnl-2025-327742. doi: 10.1136/heartjnl-2025-327742. PMID- 42527114 OWN - NLM STAT- Publisher LR - 20260729 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) DP - 2026 Jul 29 TI - Comparative environmental life cycle assessment between transfemoral transcatheter aortic valve implantation and isolated surgical aortic valve replacement. LID - heartjnl-2026-328011 [pii] LID - 10.1136/heartjnl-2026-328011 [doi] AB - BACKGROUND: Comparisons between transfemoral transcatheter aortic valve implantation (TF-TAVI) and surgical aortic valve replacement (SAVR) in severe aortic stenosis have demonstrated a consistent mortality benefit, lower 1 year costs and greater quality-adjusted life years in favour of TF-TAVI. However, the differences in the environmental impact of these two interventions have not yet been sufficiently investigated. The aim of the present study was to compare the intraprocedural environmental impact of these two procedures and to identify emission hotspots in order to mitigate their environmental impact. METHODS: In this prospective, observational, single-centre study, usage data were collected from 15 TF-TAVI and 15 SAVR procedures. All products, energy and water consumed during the procedures were identified and were used in a comprehensive comparative environmental life cycle assessment to quantify the intraprocedural environmental impact of these two interventions. RESULTS: Material use in SAVR amounted to 17.7 kg compared with 8.7 kg in TF-TAVI, consisting of 84% and 69% plastics, respectively. Electricity use in TF-TAVI was 52% less than in SAVR; in both interventions, energy consumption was dominated by the use of electronic devices. In SAVR, water consumption was 30 times higher than in TF-TAVI (5800 vs 194 L), mainly due to the heating cooling system of the cardiopulmonary bypass in SAVR. In all 10 calculated environmental impact categories, SAVR had a greater life-cycle impact. Its carbon footprint was 181.2 kg CO(2)-eq, compared with 68.6 kg CO(2)-eq per TF-TAVI. CONCLUSIONS: TF-TAVI outperformed SAVR in all environmental impact categories and had a carbon footprint of 38% that of SAVR. In TF-TAVI, 51% less material, 52% less energy and 97% less water were used. Despite these impressive results, there is still room for improvement in the environmental impact of TF-TAVI by using fewer disposable items, powering down idle imaging systems and introducing reusable/remanufactured valve delivery systems. CI - (c) Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Friedericy, Herman J AU - Friedericy HJ AD - Department of Anaesthesiology, Leiden University Medical Center, Leiden, The Netherlands h.j.friedericy@lumc.nl. FAU - Lustig, Maelle J AU - Lustig MJ AUID- ORCID: 0000-0002-0299-8121 AD - Department of Anaesthesiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - de Haes, Florine I AU - de Haes FI AD - Centre for Sustainable Healthcare, Amsterdam UMC Location AMC, Amsterdam, The Netherlands. FAU - van der Kley, Frank AU - van der Kley F AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - van Oers, Lauran F C M AU - van Oers LFCM AD - Institute of Environmental Sciences (CML), Leiden University, Leiden, The Netherlands. FAU - van der Eijk, Anne C AU - van der Eijk AC AD - Operating Room Department, Leiden University Medical Center, Leiden, The Netherlands. AD - Faculty of Biomedical Engineering, Delft University of Technology, Delft, The Netherlands. FAU - Jansen, Frank Willem AU - Jansen FW AD - Faculty of Biomedical Engineering, Delft University of Technology, Delft, The Netherlands. LA - eng PT - Journal Article DEP - 20260729 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 SB - IM OTO - NOTNLM OT - Global Burden of Disease OT - Heart Valve Prosthesis Implantation OT - Transcatheter Aortic Valve Replacement COIS- Competing interests: None declared. EDAT- 2026/07/30 00:38 MHDA- 2026/07/30 00:38 CRDT- 2026/07/29 21:43 PHST- 2026/02/12 00:00 [received] PHST- 2026/07/11 00:00 [accepted] PHST- 2026/07/30 00:38 [medline] PHST- 2026/07/30 00:38 [pubmed] PHST- 2026/07/29 21:43 [entrez] AID - heartjnl-2026-328011 [pii] AID - 10.1136/heartjnl-2026-328011 [doi] PST - aheadofprint SO - Heart. 2026 Jul 29:heartjnl-2026-328011. doi: 10.1136/heartjnl-2026-328011. PMID- 42520093 OWN - NLM STAT- MEDLINE DCOM- 20260729 LR - 20260813 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 21 IP - 7 DP - 2026 TI - De Ritis (AST/ALT) ratio as a predictor of early adverse outcomes following transcatheter aortic valve replacement. PG - e0354267 LID - 10.1371/journal.pone.0354267 [doi] LID - e0354267 AB - BACKGROUND: Simple biochemical markers that capture systemic stress could refine short-term risk stratification after TAVR. We evaluated whether an elevated AST/ALT ratio predicts early adverse outcomes following transfemoral TAVR. METHODS: We retrospectively analyzed 733 consecutive patients undergoing transfemoral TAVR. The exposure was the preprocedural AST/ALT ratio categorized as low (<1.4; n = 478) or high (>/=1.4; n = 255). Baseline characteristics were compared using t/Wilcoxon tests and chi(2)/Fisher's exact tests. Thirty-day endpoints included all-cause mortality, acute kidney injury (AKI), stroke, and new-onset atrial fibrillation (NOAF). Kaplan-Meier failure curves were compared by the log-rank test. Cox models estimated hazard ratios (HRs) with 95% CIs; candidate covariates were prespecified and further refined with LASSO (10-fold cross-validation). Model assumptions were checked with Schoenfeld residuals. RESULTS: High AST/ALT was associated with greater 30-day risk of AKI (adjusted HR 3.18, 95% CI 1.80-5.63), stroke (adjusted HR 2.73, 95% CI 1.31-5.69), and NOAF (adjusted HR 2.35, 95% CI 1.57-3.51). For mortality, the crude association was not statistically significant (HR 2.07, 95% CI 0.91-4.68; p = 0.082) and remained non-significant after adjustment (HR 1.74, 95% CI 0.75-4.04; p = 0.197). Additional adjusted associations included higher AKI risk with high-intensity statins (HR 3.51, 95% CI 1.75-7.06) and baseline complete right bundle-branch block (HR 3.77, 95% CI 1.49-9.57). CONCLUSIONS: An elevated preprocedural AST/ALT ratio independently identifies TAVR recipients at increased 30-day risk of AKI, stroke, and NOAF, but not mortality. Incorporating this inexpensive marker into routine assessment may help tailor periprocedural strategies and early surveillance after TAVR. CI - Copyright: (c) 2026 Abu Khadija et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. FAU - Abu Khadija, Haitham AU - Abu Khadija H AUID- ORCID: 0000-0002-2336-3125 AD - Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Alkrinawi, Jebrin AU - Alkrinawi J AD - Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Abdullah, Ali AU - Abdullah A AD - Institute of Gastroenterology and Liver Disease, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University, Jerusalem, Israel. AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Ayyad, Omar AU - Ayyad O AD - Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Barakat, Ammar AU - Barakat A AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Najjar, Salma AU - Najjar S AUID- ORCID: 0009-0000-9716-2951 AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Kogan, Alexander AU - Kogan A AD - Department of Cardiac Surgery, The Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel. AD - Gray Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv-Yafo, Israel. FAU - Sternik, Leonid AU - Sternik L AD - Department of Cardiac Surgery, The Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel. AD - Gray Faculty of Medical and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv-Yafo, Israel. FAU - Shehady, Alaa AU - Shehady A AUID- ORCID: 0009-0003-6427-0683 AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Masu'd, Mohammad AU - Masu'd M AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Najajra, Duha AU - Najajra D AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Alnees, Mohammad AU - Alnees M AUID- ORCID: 0000-0002-5577-8499 AD - Department of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. AD - Harvard Medical School, Postgraduate Medical Education, Global Clinical Scholar Research Training Program, Boston, Massachusetts, United States of America. LA - eng PT - Journal Article DEP - 20260728 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - EC 2.6.1.1 (Aspartate Aminotransferases) RN - EC 2.6.1.2 (Alanine Transaminase) RN - 0 (Biomarkers) SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - Male MH - Acute Kidney Injury/etiology MH - *Aspartate Aminotransferases/blood MH - *Alanine Transaminase/blood MH - Aged, 80 and over MH - Aged MH - Stroke/etiology MH - Biomarkers/blood MH - Atrial Fibrillation/etiology MH - *Aortic Valve Stenosis/surgery MH - Proportional Hazards Models MH - Risk Factors MH - Treatment Outcome MH - *Postoperative Complications/etiology MH - Kaplan-Meier Estimate PMC - PMC13411933 COIS- The authors have declared that no competing interests exist. EDAT- 2026/07/28 18:35 MHDA- 2026/07/29 18:38 PMCR- 2026/07/28 CRDT- 2026/07/28 13:54 PHST- 2025/11/04 00:00 [received] PHST- 2026/07/06 00:00 [accepted] PHST- 2026/07/29 18:38 [medline] PHST- 2026/07/28 18:35 [pubmed] PHST- 2026/07/28 13:54 [entrez] PHST- 2026/07/28 00:00 [pmc-release] AID - PONE-D-25-57703 [pii] AID - 10.1371/journal.pone.0354267 [doi] PST - epublish SO - PLoS One. 2026 Jul 28;21(7):e0354267. doi: 10.1371/journal.pone.0354267. eCollection 2026. PMID- 42516847 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260729 LR - 20260813 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 5 IP - 6 DP - 2026 Jun TI - Stroke Rates and Clinical Outcomes After Transcaval Transcatheter Aortic Valve Replacement With and Without Central Embolic Protection: A Single-Center Experience. PG - 105375 LID - 10.1016/j.jscai.2026.105375 [doi] LID - 105375 AB - BACKGROUND: Alternate access transcatheter aortic valve replacement (TAVR) is associated with higher stroke rates. However, the use of cerebral embolic protection (CEP) in alternative access TAVR is not well defined. We sought to describe the 30-day stroke incidence and clinical outcomes in patients undergoing transcaval TAVR with and without CEP. METHODS: We performed a single-center retrospective cohort study of 197 patients who underwent transcaval TAVR from 2014 to 2025. CEP, when anatomically feasible, was employed using the SENTINEL device (Boston Scientific) after its commercial availability in 2017. The primary outcome was 30-day stroke. Secondary outcomes included 30-day major adverse cardiac events (MACE-3 [defined as the composite of nonfatal myocardial infarction, stroke, and cardiac death]). RESULTS: Of 197 patients, 59 received CEP and 138 did not. Baseline characteristics, including prior stroke and transient ischemic attack, were similar between groups. Overall, 30-day stroke was rare (2.54%) and similar between CEP and non-CEP patients (1.69% vs 2.9%, P = .68). Numerically, more patients without CEP experienced a stroke. Secondary outcomes, including 30-day mortality, myocardial infarction, and composite MACE-3, were similarly low across groups. A shorter hospital stay was observed with CEP use. CONCLUSIONS: In the largest description of stroke rates in transcaval TAVR with and without CEP, 30-day stroke and MACE-3 events were similar with and without CEP use. A further study is warranted to describe the protective utility of CEP in high-risk TAVR cohorts. CI - (c) 2026 The Author(s). FAU - Andrews, Tyler AU - Andrews T AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Coombe, Victoria AU - Coombe V AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Patel, Ritik AU - Patel R AD - Wayne State University School of Medicine, Detroit, Michigan. FAU - Fram, Georgi AU - Fram G AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Jabri, Ahmad AU - Jabri A AD - Department of Cardiovascular Medicine, William Beaumont University Hospital, Royal Oak, Michigan. FAU - Lee, James AU - Lee J AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Dawdy, John AU - Dawdy J AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Zweig, Bryan AU - Zweig B AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Frisoli, Tiberio M AU - Frisoli TM AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Villablanca, Pedro AU - Villablanca P AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - O'Neill, Brian P AU - O'Neill BP AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. FAU - Gonzalez, Pedro Engel AU - Gonzalez PE AD - Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan. LA - eng PT - Journal Article DEP - 20260514 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC13404043 OTO - NOTNLM OT - alternative access transcatheter aortic valve replacement OT - cerebral embolic protection OT - stroke OT - transcaval transcatheter aortic valve replacement EDAT- 2026/07/28 06:37 MHDA- 2026/07/28 06:38 PMCR- 2026/05/14 CRDT- 2026/07/28 04:41 PHST- 2025/12/11 00:00 [received] PHST- 2026/03/24 00:00 [revised] PHST- 2026/03/26 00:00 [accepted] PHST- 2026/07/28 06:38 [medline] PHST- 2026/07/28 06:37 [pubmed] PHST- 2026/07/28 04:41 [entrez] PHST- 2026/05/14 00:00 [pmc-release] AID - S2772-9303(26)01122-1 [pii] AID - 105375 [pii] AID - 10.1016/j.jscai.2026.105375 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2026 May 14;5(6):105375. doi: 10.1016/j.jscai.2026.105375. eCollection 2026 Jun. PMID- 42513488 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260729 LR - 20260813 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 14 DP - 2026 Jul 16 TI - Transcatheter Versus Mechanical and Bioprosthetic Surgical Aortic Valve Replacement in Retrospective Patient Cohorts with Aortic Stenosis <75 Years. LID - 10.3390/jcm15145574 [doi] LID - 5574 AB - Background: Comparisons between transcatheter and surgical aortic valve replacement (TAVR or SAVR) in younger aortic stenosis (AS) patients are scarce. The aim of the study was to evaluate the 5-year outcomes of AS patients <75 years undergoing TAVR or SAVR. Methods: This was a single-center study that retrospectively included AS patients <75 years who underwent transfemoral TAVR or SAVR from a Chinese real-world database (2014-2023). The primary outcome was defined as the composite of all-cause death, stroke, and cardiovascular rehospitalization at 5 years post-procedure. Robust risk adjustment was performed using inverse probability weighting (IPTW), multilevel regression models, and competing-risk analysis. Sensitivity analyses included comparison between TAVR and mechanical or bioprosthetic SAVR separately in the overall cohort and patients with bicuspid aortic valve (BAV). Results: A total of 1646 patients undergoing TAVR (n = 808) or SAVR (n = 838) were finally included. At baseline, TAVR patients had an older age [(67.9 +/- 5.2) vs. (56.5 +/- 9.6) years, p < 0.001] and a higher surgical risk score [(3.1 +/- 1.5) vs. (2.1 +/- 1.0) %, p < 0.001] than SAVR patients, which was well balanced after IPTW. The 5-year adjusted risk of the primary outcome was similar (TAVR 45.9% vs. SAVR 43.4%, weighted hazard ratio, 1.00, 95% confidence interval, 0.64-1.54, p = 0.986), which stayed comparable between TAVR and mechanical or bioprosthetic SAVR separately. In BAV patients (n = 516), the risk of death was 8.3% in the TAVR group and 3.4% in the SAVR group (p = 0.349). The risk of bioprosthetic structural valve deterioration at 5 years was comparable between groups in the overall cohort (5.7% vs. 8.4%, p = 0.478) and BAV patients (7.8% vs. 13.2%, p = 0.345). Conclusions: In this retrospective study of patients aged <75 years, the risk-adjusted 5-year major clinical outcomes were statistically similar between TAVR and SAVR. However, given the inherent historical imbalances, these exploratory findings should be interpreted with caution, and dedicated prospective studies are still needed in younger and BAV populations. FAU - Wang, Xi AU - Wang X AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610044, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Zeng, Lijun AU - Zeng L AUID- ORCID: 0000-0002-6690-1114 AD - Department of General Internal Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China. AD - Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China. FAU - Ou, Yuanweixiang AU - Ou Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610044, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Zhang, Xueli AU - Zhang X AD - Health Care Big Data Center of Sichuan Province, Chengdu 610044, China. FAU - Peng, Yong AU - Peng Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610044, China. FAU - Wei, Xin AU - Wei X AUID- ORCID: 0000-0001-6975-8651 AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610044, China. FAU - Meng, Wei AU - Meng W AD - Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610044, China. FAU - Feng, Yuan AU - Feng Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610044, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - De Backer, Ole AU - De Backer O AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark. FAU - Chen, Mao AU - Chen M AUID- ORCID: 0009-0007-6008-7944 AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610044, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu 610041, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China. LA - eng GR - U23A20395, 82170375/National Natural Science Foundation of China/ GR - XZ202501ZY0120/Science and Technology Projects of Xizang Autonomous Region, China/ GR - ZYGD23021, 23HXFH009/West China Hospital of Sichuan University/ PT - Journal Article DEP - 20260716 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13412188 OTO - NOTNLM OT - China OT - aortic stenosis OT - bicuspid aortic valve OT - surgical aortic valve replacement OT - transcatheter aortic valve replacement COIS- Y. Feng and M. Chen are consultants for Microport, Venus MedTech, and Peijia Medical. O. De Backer has received institutional research grants and consulting fees from Abbott and Boston Scientific. All other authors have no conflicts of interest. EDAT- 2026/07/28 06:37 MHDA- 2026/07/28 06:38 PMCR- 2026/07/16 CRDT- 2026/07/28 01:15 PHST- 2026/06/16 00:00 [received] PHST- 2026/07/05 00:00 [revised] PHST- 2026/07/13 00:00 [accepted] PHST- 2026/07/28 06:38 [medline] PHST- 2026/07/28 06:37 [pubmed] PHST- 2026/07/28 01:15 [entrez] PHST- 2026/07/16 00:00 [pmc-release] AID - jcm15145574 [pii] AID - jcm-15-05574 [pii] AID - 10.3390/jcm15145574 [doi] PST - epublish SO - J Clin Med. 2026 Jul 16;15(14):5574. doi: 10.3390/jcm15145574. PMID- 42512908 OWN - NLM STAT- MEDLINE DCOM- 20260729 LR - 20260813 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 7 DP - 2026 Jul 16 TI - Comparison of Clinical Outcomes of Myval vs. Acurate Neo Valves in TAVR: A Single-Center Experience. LID - 10.3390/medicina62071366 [doi] LID - 1366 AB - Background and Objectives: Transcatheter aortic valve replacement (TAVR) has become an established treatment for severe symptomatic aortic stenosis, and continuous technological advances have led to the development of different transcatheter heart valve (THV) systems. This study aimed to compare the short- and mid-term clinical outcomes of the balloon-expandable Myval (Meril Life Sciences, India) and the self-expanding Acurate Neo (Boston Scientific, MA, USA) transcatheter heart valves during a mean follow-up of 18 months. Materials and Methods: This retrospective single-center study included consecutive patients who underwent transfemoral TAVR with either the Myval or Acurate Neo valve between January 2020 and September 2022. Demographic, clinical, laboratory, electrocardiographic, echocardiographic, procedural, and follow-up data were collected and compared. Clinical outcomes were evaluated according to the Valve Academic Research Consortium-3 (VARC-3) criteria. Results: A total of 147 patients were included (Myval, n = 116; Acurate Neo, n = 31). Predilatation was performed in all patients in the Acurate Neo group but in only 22 (18.9%) patients in the Myval group (p < 0.001). In-hospital mild paravalvular leak (PVL) was more frequent in the Acurate Neo group (38.7% vs. 20.6%; p = 0.038), whereas moderate or greater PVL did not differ between the groups. During a mean follow-up of 18 months (range, 10-32 months), mild PVL remained significantly more frequent in the Acurate Neo group (p = 0.028). No significant differences were observed between the two valve systems regarding mortality, permanent pacemaker implantation, or other major VARC-3 clinical outcomes. Conclusions: The Myval and Acurate Neo transcatheter heart valves demonstrated comparable short- and mid-term clinical outcomes in patients undergoing TAVR. Although mild PVL was more frequent with the Acurate Neo valve, mortality, permanent pacemaker implantation, and moderate or greater PVL were similar between the two valve systems, supporting the safety and effectiveness of both prostheses in the treatment of severe symptomatic aortic stenosis. FAU - Yerlikaya, Murat Gokhan AU - Yerlikaya MG AUID- ORCID: 0000-0003-1880-5280 AD - Department of Cardiology, Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, 61030 Trabzon, Turkey. FAU - Ozderya, Ahmet AU - Ozderya A AUID- ORCID: 0000-0002-4369-6146 AD - Department of Cardiology, Trabzon Kanuni Training and Research Hospital, 61250 Trabzon, Turkey. FAU - Konus, Ali Hakan AU - Konus AH AUID- ORCID: 0000-0001-7078-4021 AD - Department of Cardiology, Bingol State Hospital, 12000 Bingol, Turkey. FAU - Maz, Mehmet Ali AU - Maz MA AD - Department of Cardiology, Bayburt State Hospital, 69000 Bayburt, Turkey. FAU - Gulcebi, Fatih AU - Gulcebi F AUID- ORCID: 0009-0001-6314-9369 AD - Department of Cardiology, Trabzon Kanuni Training and Research Hospital, 61250 Trabzon, Turkey. FAU - Kul, Selim AU - Kul S AD - Department of Cardiology, Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, 61030 Trabzon, Turkey. FAU - Emre, Ender AU - Emre E AD - Department of Cardiology, Kocaeli City Hospital, 41060 Kocaeli, Turkey. FAU - Korkmaz, Levent AU - Korkmaz L AD - Department of Cardiology, Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, 61030 Trabzon, Turkey. FAU - Akyuz, Ali Riza AU - Akyuz AR AUID- ORCID: 0000-0003-3327-7850 AD - Department of Cardiology, Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, 61030 Trabzon, Turkey. LA - eng PT - Comparative Study PT - Journal Article DEP - 20260716 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation MH - Retrospective Studies MH - Male MH - Treatment Outcome MH - Female MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis/standards MH - Aged, 80 and over MH - Aged MH - *Prosthesis Design MH - Aortic Valve/surgery MH - India PMC - PMC13413943 OTO - NOTNLM OT - Acurate Neo OT - Myval OT - balloon-expandable valve OT - self-expanding valve OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2026/07/28 06:37 MHDA- 2026/07/29 18:38 PMCR- 2026/07/16 CRDT- 2026/07/28 01:13 PHST- 2026/06/04 00:00 [received] PHST- 2026/07/01 00:00 [revised] PHST- 2026/07/14 00:00 [accepted] PHST- 2026/07/29 18:38 [medline] PHST- 2026/07/28 06:37 [pubmed] PHST- 2026/07/28 01:13 [entrez] PHST- 2026/07/16 00:00 [pmc-release] AID - medicina62071366 [pii] AID - medicina-62-01366 [pii] AID - 10.3390/medicina62071366 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Jul 16;62(7):1366. doi: 10.3390/medicina62071366. PMID- 42512836 OWN - NLM STAT- MEDLINE DCOM- 20260729 LR - 20260813 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 7 DP - 2026 Jul 4 TI - The AS-PAD Score Predicts Significant Peripheral Artery Disease and Is Associated with Femoral Access-Site Closure Device Failure in Patients Undergoing TAVI. LID - 10.3390/medicina62071293 [doi] LID - 1293 AB - Background and Objectives: Patients with severe aortic stenosis (AS) frequently present with concomitant peripheral artery disease (PAD), which complicates transcatheter aortic valve implantation (TAVI) and increases the risk of vascular complications. Early identification of significant PAD may facilitate optimized procedural planning and risk stratification. This study aimed to develop and internally validate a clinical score for estimating the likelihood of significant PAD in patients with severe AS undergoing TAVI evaluation and to exploratorily assess its association with femoral access-site closure-device failure after TAVI. Materials and Methods: In this retrospective study, 138 patients with severe AS (124 undergoing TAVI) were evaluated. Logistic regression analyses identified independent predictors of significant PAD (>/=50% stenosis), which were incorporated into the AS-PAD Score. The Score integrates age >75 years, diabetes mellitus, BMI >/=25 kg/m(2), Lp(a) >50 mg/dL (105 nmol/L), and Fontaine clinical stage. Model performance was assessed using receiver operating characteristic (ROC) analysis and internally validated using bootstrap resampling and stratified five-fold cross-validation. Vascular complications were adjudicated according to VARC-3 criteria. Results: The AS-PAD Score demonstrated good discriminatory performance, with an AUROC of 0.804. Advanced age (OR 2.43, 95% CI:1.05-5.70; p = 0.039) and diabetes (OR 3.18, 95% CI:1.29-7.83; p = 0.012) were independently associated with significant PAD, while BMI >/=25 kg/m(2) showed an inverse association. Elevated Lp(a) (>50 mg/dL) remained independently associated with significant PAD. Internal validation using bootstrap resampling and stratified five-fold cross-validation demonstrated consistent model performance. Femoral access-site closure-device failure occurred more frequently among patients classified as intermediate or high risk by the AS-PAD Score compared with low-risk patients. Conclusions: The AS-PAD Score may serve as an adjunctive clinical tool for estimating the likelihood of significant PAD in patients with severe AS undergoing TAVI evaluation. Its association with femoral access-site closure-device failure should be interpreted as exploratory and hypothesis-generating. Further external validation is required to confirm its role alongside standard CT-based vascular assessment. FAU - Gohman, Uttban AU - Gohman U AUID- ORCID: 0009-0004-1093-981X AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Nashtar, Mohamad Amer AU - Nashtar MA AUID- ORCID: 0009-0009-1258-6356 AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Liedtke, Paula AU - Liedtke P AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. AD - Institute of Molecular Immunology, Ruhr University Bochum, 44801 Bochum, Germany. FAU - Azizy, Obayda AU - Azizy O AUID- ORCID: 0009-0002-9030-6603 AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Trippe, Jorn AU - Trippe J AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Strauch, Justus AU - Strauch J AD - Department of Cardiac and Thoracic Surgery, University Hospital Bergmannsheil, Ruhr University Bochum, 44789 Bochum, Germany. FAU - Janosi, Rolf Alexander AU - Janosi RA AUID- ORCID: 0000-0002-9966-6886 AD - Department of Cardiology, Angiology and Electrophysiology, Heart Center Duisburg, 47169 Duisburg, Germany. FAU - Iliakis, Panagiotis AU - Iliakis P AUID- ORCID: 0009-0004-5768-9125 AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. AD - First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece. FAU - Dimitriadis, Kyriakos AU - Dimitriadis K AD - First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece. FAU - Tsioufis, Konstantinos AU - Tsioufis K AUID- ORCID: 0000-0002-7636-6725 AD - First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece. FAU - Canbay, Ali AU - Canbay A AUID- ORCID: 0000-0001-6069-7899 AD - Division of Hepatology and Gastroenterology, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Schmitz, Ingo AU - Schmitz I AUID- ORCID: 0000-0002-5360-0419 AD - Institute of Molecular Immunology, Ruhr University Bochum, 44801 Bochum, Germany. FAU - Steinmetz, Martin AU - Steinmetz M AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Patsalis, Polykarpos Christos AU - Patsalis PC AD - Division of Cardiology, Angiology and Internal Emergency Medicine, Department of Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. AD - Department of Cardiology, Angiology and Electrophysiology, Heart Center Duisburg, 47169 Duisburg, Germany. LA - eng PT - Journal Article DEP - 20260704 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Retrospective Studies MH - *Peripheral Arterial Disease/complications/diagnosis MH - Male MH - *Aortic Valve Stenosis/surgery/complications MH - Aged, 80 and over MH - Aged MH - Femoral Artery/surgery MH - ROC Curve MH - Risk Factors MH - Logistic Models MH - Equipment Failure/statistics & numerical data MH - Risk Assessment/methods PMC - PMC13413594 OTO - NOTNLM OT - Lipoprotein(a) OT - aortic stenosis OT - diabetes mellitus OT - peripheral artery disease OT - transcatheter aortic valve implantation OT - vascular complications COIS- The authors declare no conflicts of interest. EDAT- 2026/07/28 06:37 MHDA- 2026/07/29 18:38 PMCR- 2026/07/04 CRDT- 2026/07/28 01:13 PHST- 2026/05/24 00:00 [received] PHST- 2026/06/28 00:00 [revised] PHST- 2026/07/02 00:00 [accepted] PHST- 2026/07/29 18:38 [medline] PHST- 2026/07/28 06:37 [pubmed] PHST- 2026/07/28 01:13 [entrez] PHST- 2026/07/04 00:00 [pmc-release] AID - medicina62071293 [pii] AID - medicina-62-01293 [pii] AID - 10.3390/medicina62071293 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Jul 4;62(7):1293. doi: 10.3390/medicina62071293. PMID- 42502342 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260726 LR - 20260813 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 5 IP - 7 DP - 2026 Jul TI - Hybrid Suture- and Plug-Based Closure Versus Dual Suture Devices in Transfemoral Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. PG - 105339 LID - 10.1016/j.jscai.2026.105339 [doi] LID - 105339 AB - BACKGROUND: Effective vascular closure is crucial in transfemoral transcatheter aortic valve replacement (TAVR) to minimize access-related complications. Although dual suture-based closure is widely used, a hybrid approach combining suture- and plug-based vascular closure devices (VCD) has gained increasing attention. This meta-analysis compared these 2 strategies in terms of vascular outcomes and procedural success. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched through January 2025 for studies comparing suture-plus-plug-based vs suture-based VCD in TAVR patients. Primary outcomes were major and minor vascular complications, bleeding events, VCD failure, and unplanned interventions. Risk ratios (RRs) with 95% CIs were calculated. RESULTS: Six studies involving 2308 patients were included. The suture-plus-plug-based approach significantly reduced major vascular complications (RR, 0.50; P = .001), minor vascular complications (RR, 0.58; P < .00001), and VCD failure (RR, 0.26; P < .00001) compared with suture-based closure alone. No significant differences were observed in major (P = .30) or minor bleeding (P = .47). Unplanned interventions were less frequent with the hybrid approach, but the difference was not statistically significant (RR, 0.68; P = .19). CONCLUSIONS: The combination of suture- and plug-based closure devices in transfemoral TAVR provides superior vascular outcomes and lower device failure rates without increasing bleeding risk. These findings support the hybrid approach as a safe and effective strategy, although further randomized controlled trials are warranted to confirm long-term outcomes. CI - (c) 2026 The Author(s). FAU - Moeez, Abdul AU - Moeez A AD - Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan. FAU - Shah, Syed Wajihullah AU - Shah SW AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Huma, Sundus AU - Huma S AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Salma Shabbar Banatwala, Umm E AU - Salma Shabbar Banatwala UE AD - Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan. FAU - Ali, Aizaz AU - Ali A AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Khattak, Lintha Zafar AU - Khattak LZ AD - Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan. FAU - Bacha, Zaryab AU - Bacha Z AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Khan, Afra AU - Khan A AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Shaid, Fazlina AU - Shaid F AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Azeem, Touba AU - Azeem T AD - Department of Medicine, Khyber Medical College, Peshawar, Pakistan. FAU - Razzaq, Sayyam AU - Razzaq S AD - Department of Medicine, Poonch Medical College, Rawalkot, Pakistan. FAU - Khan, Malik Waleed Zeb AU - Khan MWZ AD - Department of Internal Medicine, AdventHealth Orlando, Orlando, Florida. FAU - Ikram, Jibran AU - Ikram J AD - Cardiovascular Medicine, Department, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Ullah, Farid AU - Ullah F AD - Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan. FAU - Shaban, Mohammed AU - Shaban M AD - Cardiovascular Medicine, Department, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. LA - eng PT - Journal Article PT - Review DEP - 20260514 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC13400108 OTO - NOTNLM OT - aortic valve stenosis OT - postoperative hemorrhage OT - transcatheter aortic valve replacement OT - vascular closure devices EDAT- 2026/07/26 06:42 MHDA- 2026/07/26 06:43 PMCR- 2026/05/14 CRDT- 2026/07/26 04:04 PHST- 2025/09/15 00:00 [received] PHST- 2026/03/17 00:00 [revised] PHST- 2026/03/17 00:00 [accepted] PHST- 2026/07/26 06:43 [medline] PHST- 2026/07/26 06:42 [pubmed] PHST- 2026/07/26 04:04 [entrez] PHST- 2026/05/14 00:00 [pmc-release] AID - S2772-9303(26)01085-9 [pii] AID - 105339 [pii] AID - 10.1016/j.jscai.2026.105339 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2026 May 14;5(7):105339. doi: 10.1016/j.jscai.2026.105339. eCollection 2026 Jul. PMID- 42502146 OWN - NLM STAT- Publisher LR - 20260725 IS - 1573-742X (Electronic) IS - 0929-5305 (Linking) DP - 2026 Jul 25 TI - Early versus delayed oral anticoagulation initiation after transcatheter aortic valve replacement in patients with atrial fibrillation: a retrospective cohort study. LID - 10.1007/s11239-026-03382-5 [doi] AB - The optimal timing of oral anticoagulation (OAC) initiation after transcatheter aortic valve replacement (TAVR) in patients with atrial fibrillation remains uncertain. This study compared early (within 2 days) versus delayed (5-7 days) OAC initiation on clinical outcomes in this population. In this retrospective cohort study using the TriNetX US Collaborative Network (data through 2024), we identified patients aged >/= 18 years with atrial fibrillation or flutter undergoing TAVR via percutaneous femoral approach. Patients were categorized by OAC initiation timing post-TAVR. The index date was the TAVR procedure day; outcomes were assessed at 30 days, 90 days, and 1 year. Analyses used risk ratios (RRs), hazard ratios (HRs), Kaplan-Meier curves, and log-rank tests. After 1:1 propensity score matching, 3,372 patients remained in each cohort. Early OAC was associated with lower net adverse clinical events (NACE; all-cause mortality, stroke, arterial embolism or thrombosis, or major hemorrhage including transfusion) at 30 days (RR 0.754, 95% CI 0.683-0.832, p < 0.001), 90 days (RR 0.780, 95% CI 0.719-0.846, p < 0.001), and 1 year (RR 0.839, 95% CI 0.789-0.893, p < 0.001). All-cause mortality, major hemorrhage, and acute kidney injury were also significantly reduced with early OAC across all time points. Corresponding hazard ratios confirmed sustained benefit (30-day NACE HR 0.74, 95% CI 0.66-0.82; 1-year HR 0.79, 95% CI 0.73-0.85). Early OAC initiation within 2 days after TAVR was associated with lower NACE, mortality, hemorrhage, and acute kidney injury compared with initiation at 5-7 days in patients with atrial fibrillation. Prospective trials are warranted to confirm these findings. CI - (c) 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Khawar, Muneeb AU - Khawar M AD - King Edward Medical University, Lahore, Pakistan. FAU - Elnashar, Mohab AU - Elnashar M AD - University of Arkansas for Medical Sciences, Little Rock, AR, USA. FAU - Khawar, Mirza Muhammad Hadeed AU - Khawar MMH AD - Services Institute of Medical Sciences, Lahore, Pakistan. FAU - Malik, Mohammad Azeem AU - Malik MA AD - King Edward Medical University, Lahore, Pakistan. FAU - Ghuman, Shameer Iqbal AU - Ghuman SI AD - King Edward Medical University, Lahore, Pakistan. FAU - Muhammad, Awon AU - Muhammad A AD - King Edward Medical University, Lahore, Pakistan. FAU - Mubashir, Mohammad Maheer AU - Mubashir MM AD - King Edward Medical University, Lahore, Pakistan. FAU - Ghouri, Gul Sher AU - Ghouri GS AD - King Edward Medical University, Lahore, Pakistan. FAU - Shahid, Abdullah AU - Shahid A AD - Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan. shahidabdullah.1930@gmail.com. FAU - Das, Ashesh AU - Das A AD - Mayo Clinic, Rochester, USA. LA - eng PT - Journal Article DEP - 20260725 PL - Netherlands TA - J Thromb Thrombolysis JT - Journal of thrombosis and thrombolysis JID - 9502018 SB - IM OTO - NOTNLM OT - Anticoagulation timing OT - Atrial fibrillation OT - Net adverse clinical events OT - Oral anticoagulation OT - Propensity score matching OT - Transcatheter aortic valve replacement COIS- Declaratrions. Conflict of interest: The authors declare that they have no competing interests. Consent for publication: Not applicable Ethics approval and consent to participate: This study was exempt from institutional review board (IRB) approval and the requirement for informed consent because it utilized fully de-identified electronic health records in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (Section section sign 164.514). EDAT- 2026/07/26 00:42 MHDA- 2026/07/26 00:42 CRDT- 2026/07/25 23:16 PHST- 2026/04/18 00:00 [received] PHST- 2026/07/21 00:00 [accepted] PHST- 2026/07/26 00:42 [medline] PHST- 2026/07/26 00:42 [pubmed] PHST- 2026/07/25 23:16 [entrez] AID - 10.1007/s11239-026-03382-5 [pii] AID - 10.1007/s11239-026-03382-5 [doi] PST - aheadofprint SO - J Thromb Thrombolysis. 2026 Jul 25. doi: 10.1007/s11239-026-03382-5. PMID- 42500613 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260725 LR - 20260813 IS - 2950-6050 (Electronic) IS - 2950-6050 (Linking) VI - 11 DP - 2026 Sep TI - Hospital volume and efficiency in transcarotid transcatheter aortic valve replacement: Insights from a national database of 10,000+ cases. PG - 100123 LID - 10.1016/j.xjse.2026.100123 [doi] LID - 100123 AB - BACKGROUND: When transfemoral transcatheter aortic valve replacement (TAVR) is unsuitable, transcarotid TAVR offers a safe alternative. The relationship between hospital procedural volume and clinical outcomes remains unclear, and solidifying this relationship is key to establishing benchmarks and guiding high-quality care. METHODS: We retrospectively analyzed US academic centers in the Vizient Clinical Database, a national repository of tertiary and quaternary hospital data. All centers performing transcarotid TAVR in 2022 to 2024 were included. Patient demographics and outcomes were compared using the Kruskal-Wallis and chi(2) tests. Spearman rank correlation was used to assess hospital volume and outcome associations. RESULTS: Between 2022 and 2024, 118 academic hospitals performed 10,394 transcarotid TAVR procedures. Institutions were stratified by 3-year cumulative procedural volume: Q1, 15 to 47 cases (n = 87); Q2, 48 to 77 (n = 87); Q3, 78 to 111 (n = 90); and Q4, 112 to 312 (n = 90). High-volume centers treated older patients (71 years vs 69 years), a higher proportion of white patients (85.4% vs 64.5%), more Medicare beneficiaries (72.4% vs 62.8%), and patients with lower case complexity (Case Mix Index, 2.6 vs 3.5) (P < .0001 for all). Observed hospital length of stay (LOS) decreased across quartiles (7.5 to 4.9 days), and intensive care unit admission declined (70.7% to 42.5%) (all P < .0001). Observed mortality and mortality index did not differ significantly (all P > .05). Spearman correlation analysis showed weak associations between higher volume and shorter LOS or lower case complexity, with very weak and inconsistent correlations for mortality. CONCLUSIONS: Higher hospital transcarotid TAVR volume is associated with greater resource efficiency, likely attributable in part to lower patient complexity. Mortality and complication outcomes were roughly comparable between transcarotid and transfemoral TAVR, suggesting comparable short-term safety across institutions. CI - (c) 2026 The Author(s). FAU - Zacharias, Gloria AU - Zacharias G AD - Lewis Katz School of Medicine at Temple University, Philadelphia, Pa. FAU - Moynihan, Connor AU - Moynihan C AD - Lewis Katz School of Medicine at Temple University, Philadelphia, Pa. FAU - Yu, Daohai AU - Yu D AD - Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa. FAU - Lu, Xiaoning AU - Lu X AD - Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa. FAU - Patel, Karan AU - Patel K AD - Lewis Katz School of Medicine at Temple University, Philadelphia, Pa. FAU - Moser, William AU - Moser W AD - Division of Cardiovascular Surgery, Temple University Hospital, Philadelphia, Pa. FAU - Mokashi, Suyog AU - Mokashi S AD - Division of Cardiovascular Surgery, Temple University Hospital, Philadelphia, Pa. LA - eng PT - Journal Article DEP - 20260504 PL - United States TA - JTCVS Struct Endovasc JT - JTCVS structural and endovascular JID - 9918991787106676 PMC - PMC13396957 OTO - NOTNLM OT - ICU utilization OT - clinical outcomes OT - hospital volume OT - length of stay OT - resource optimization OT - transcarotid TAVR OT - transcatheter aortic valve replacement COIS- The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. EDAT- 2026/07/25 06:36 MHDA- 2026/07/25 06:37 PMCR- 2026/05/04 CRDT- 2026/07/25 05:05 PHST- 2026/02/02 00:00 [received] PHST- 2026/03/17 00:00 [revised] PHST- 2026/03/24 00:00 [accepted] PHST- 2026/07/25 06:37 [medline] PHST- 2026/07/25 06:36 [pubmed] PHST- 2026/07/25 05:05 [entrez] PHST- 2026/05/04 00:00 [pmc-release] AID - S2950-6050(26)00028-8 [pii] AID - 100123 [pii] AID - 10.1016/j.xjse.2026.100123 [doi] PST - epublish SO - JTCVS Struct Endovasc. 2026 May 4;11:100123. doi: 10.1016/j.xjse.2026.100123. eCollection 2026 Sep. PMID- 42494668 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260724 LR - 20260813 IS - 2050-0904 (Print) IS - 2050-0904 (Electronic) IS - 2050-0904 (Linking) VI - 14 IP - 8 DP - 2026 Aug TI - Microaxial Flow Pump Support as a Bridge to Transaxillary TAVI-In-TAVI in Cardiogenic Shock. PG - e73225 LID - 10.1002/ccr3.73225 [doi] LID - e73225 AB - A 79-year-old man presented with cardiogenic shock due to severe degeneration of a prior transcatheter aortic valve. Temporary mechanical circulatory support with a transvalvular microaxial flow pump was initiated, resulting in rapid stabilization. A staged transaxillary TAVI-in-TAVI procedure was subsequently performed with a favorable outcome. CI - (c) 2026 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd. FAU - Orlandi, Matteo AU - Orlandi M AUID- ORCID: 0009-0002-6617-1040 AD - Department of Experimental and Clinical Medicine University of Florence Florence Italy. FAU - Ciardetti, Niccolo AU - Ciardetti N AUID- ORCID: 0000-0003-4226-1084 AD - Division of Structural Interventional Cardiology, Cardiothoracovascular Department Careggi University Hospital Florence Italy. FAU - Biagiotti, Lucrezia AU - Biagiotti L AD - Department of Experimental and Clinical Medicine University of Florence Florence Italy. FAU - Crociani, Maria Federica AU - Crociani MF AUID- ORCID: 0009-0003-5503-3627 AD - Department of Experimental and Clinical Medicine University of Florence Florence Italy. FAU - Grandi, Giulio AU - Grandi G AUID- ORCID: 0009-0002-1117-106X AD - Department of Experimental and Clinical Medicine University of Florence Florence Italy. FAU - Stolcova, Miroslava AU - Stolcova M AD - Division of Structural Interventional Cardiology, Cardiothoracovascular Department Careggi University Hospital Florence Italy. FAU - Ristalli, Francesca AU - Ristalli F AD - Division of Structural Interventional Cardiology, Cardiothoracovascular Department Careggi University Hospital Florence Italy. FAU - Di Mario, Carlo AU - Di Mario C AD - Department of Experimental and Clinical Medicine University of Florence Florence Italy. AD - Division of Structural Interventional Cardiology, Cardiothoracovascular Department Careggi University Hospital Florence Italy. FAU - Mattesini, Alessio AU - Mattesini A AD - Division of Structural Interventional Cardiology, Cardiothoracovascular Department Careggi University Hospital Florence Italy. FAU - Meucci, Francesco AU - Meucci F AD - Division of Structural Interventional Cardiology, Cardiothoracovascular Department Careggi University Hospital Florence Italy. LA - eng PT - Journal Article DEP - 20260722 PL - England TA - Clin Case Rep JT - Clinical case reports JID - 101620385 PMC - PMC13392199 OTO - NOTNLM OT - bioprosthesis failure OT - cardiogenic shock OT - mechanical circulatory support OT - percutaneous coronary intervention OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2026/07/24 06:35 MHDA- 2026/07/24 06:36 PMCR- 2026/07/22 CRDT- 2026/07/24 04:57 PHST- 2026/05/19 00:00 [received] PHST- 2026/06/22 00:00 [revised] PHST- 2026/07/16 00:00 [accepted] PHST- 2026/07/24 06:36 [medline] PHST- 2026/07/24 06:35 [pubmed] PHST- 2026/07/24 04:57 [entrez] PHST- 2026/07/22 00:00 [pmc-release] AID - CCR373225 [pii] AID - 10.1002/ccr3.73225 [doi] PST - epublish SO - Clin Case Rep. 2026 Jul 22;14(8):e73225. doi: 10.1002/ccr3.73225. eCollection 2026 Aug. PMID- 42478941 OWN - NLM STAT- MEDLINE DCOM- 20261014 LR - 20261016 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 108 IP - 4 DP - 2026 Oct TI - Percutaneous Transaxillary Access for Large-Bore Cardiovascular Interventions: Evidence, Technique, and Complication Management. PG - 1186-1197 LID - 10.1002/ccd.70759 [doi] AB - Percutaneous transaxillary access is an established alternative to transfemoral large-bore arterial access for transcatheter structural heart interventions and mechanical circulatory support (MCS). Although useful for overcoming hostile iliofemoral anatomy and providing prolonged support and patient mobilization in case of MCS, the axillary/subclavian territory poses distinct technical and anatomical challenges that demand meticulous pre-procedural imaging, patient selection, accurate puncture under ultrasound and angiographic guidance, preservation of bailout access, and familiarity with suture-based and balloon-assisted closure strategies. This review provides a contemporary practical framework for percutaneous transaxillary access, summarizing the available clinical evidence, technical aspects of puncture and closure, complication management, and procedural tips to improve safety and reproducibility. CI - (c) 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Secco, Gioel Gabrio AU - Secco GG AD - Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. AD - Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy. FAU - Lombardi, Marco AU - Lombardi M AUID- ORCID: 0000-0002-4045-2859 AD - Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. FAU - Elia, Edoardo AU - Elia E AD - Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. FAU - Chiabrando, Juan Guido AU - Chiabrando JG AUID- ORCID: 0000-0002-2128-8280 AD - Interventional Cardiology Unit, UOSD Emodinamica, Ospedale Barone Romeo, Patti, Italy. FAU - Demarchi, Andrea AU - Demarchi A AD - Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. FAU - Vergallo, Rocco AU - Vergallo R AUID- ORCID: 0000-0001-5577-081X AD - Department of Internal Medicine and Medical Specialties (DIMI), Universita di Genova, Genova, Italy. AD - Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy. FAU - Audo, Andrea AU - Audo A AD - Division of Cardiac Surgery, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. FAU - Maj, Giulia AU - Maj G AUID- ORCID: 0000-0002-1928-0693 AD - Division of Cardiothoracic Intensive Care, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. FAU - Patti, Giuseppe AU - Patti G AUID- ORCID: 0000-0002-5404-3968 AD - Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy. AD - Division of Cardiology, Maggiore della Carita Hospital, Novara, Italy. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. LA - eng PT - Journal Article PT - Review DEP - 20260721 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Punctures MH - *Catheterization, Peripheral/adverse effects/instrumentation/methods MH - *Cardiac Catheterization/adverse effects/instrumentation/methods MH - Risk Factors MH - Treatment Outcome MH - *Axillary Artery/diagnostic imaging MH - *Hemostatic Techniques/adverse effects/instrumentation MH - *Hemorrhage/prevention & control/etiology MH - Vascular Closure Devices PMC - PMC13667324 OTO - NOTNLM OT - TAVR OT - large-bore arterial access OT - mechanical circulatory support OT - percutaneous transaxillary access OT - vascular closure COIS- G.G.S. has received speaker fees from Medtronic, Abbott, Biosensor, Meril, Johnson & Johson; he is proctor for Meril Medical and Biosensor. M.L. reports speaker fees from Philips and consultancy fees from Boston Scientific. R.V. is consultant for Abbott Vascular and Medtronic; received lecturing fees from Abbott Vascular, Abiomed, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Novartis, Novo Nordisk, Philips, and SIS Medical; and served as member of advisory boards for Amarin and Amgen. G.P. reports speaker and/or consultancy fees from Amgen, Sanofi, Novartis, Daiichi Sankyo, Amarin, Aurora BioPharma, Malesci, PIAM, Boehringer Ingelheim, Bayer, Pfizer/BMS, AstraZeneca, Biotronik, Terumo, Medtronic, Abbott, Edwards, Amicus, Novo Nordisk, and Chiesi. The other authors declare no conflicts of interest. EDAT- 2026/07/21 12:35 MHDA- 2026/10/14 18:14 PMCR- 2026/10/14 CRDT- 2026/07/21 09:53 PHST- 2026/06/28 00:00 [revised] PHST- 2026/04/08 00:00 [received] PHST- 2026/07/09 00:00 [accepted] PHST- 2026/10/14 18:14 [medline] PHST- 2026/07/21 12:35 [pubmed] PHST- 2026/07/21 09:53 [entrez] PHST- 2026/10/14 00:00 [pmc-release] AID - CCD70759 [pii] AID - 10.1002/ccd.70759 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Oct;108(4):1186-1197. doi: 10.1002/ccd.70759. Epub 2026 Jul 21. PMID- 42471102 OWN - NLM STAT- MEDLINE DCOM- 20260813 LR - 20260825 IS - 1535-6280 (Electronic) IS - 0146-2806 (Linking) VI - 51 IP - 10 DP - 2026 Oct TI - Predictive performance of the STS-PROM score for acute kidney injury following transfemoral transcatheter aortic valve implantation. PG - 103403 LID - S0146-2806(26)00145-3 [pii] LID - 10.1016/j.cpcardiol.2026.103403 [doi] AB - INTRODUCTION: The Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score is widely used to estimate procedural risk in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). However, its ability to predict acute kidney injury (AKI) after TAVI has not been well established. OBJECTIVES: To evaluate the predictive performance of the STS-PROM score for post-procedural AKI in patients with symptomatic severe AS undergoing transfemoral TAVI. METHODS: We conducted a retrospective observational cohort study including consecutive patients with symptomatic severe AS treated with transfemoral TAVI. The primary outcome was AKI after the procedure. The discriminative performance of the STS-PROM score was assessed using receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC). The optimal cutoff value was determined using the Youden index. RESULTS: 82 patients were included (mean age, 82.5+/-6.6 years; 56.8% women). The median STS-PROM score was 4.18 (interquartile range [IQR], 3.22-6.15). AKI occurred in 9 patients (11.0%). The STS-PROM score demonstrated acceptable discriminative performance for predicting AKI (AUC, 0.732; 95% confidence interval [CI], 0.566-0.898; P=0.034). The optimal cutoff value was 5.75, providing 72% sensitivity and 80% specificity. Of the 9 patients who developed AKI, 8 (88.9%) had an STS-PROM score >/=5.75, whereas only 1 (11.1%) had a score <5.75 (P=0.025). CONCLUSIONS: In patients with symptomatic severe AS undergoing transfemoral TAVI, the STS-PROM score showed acceptable performance for predicting post-procedural AKI. An STS-PROM score >/=5.75 identified patients at increased risk of AKI and may provide additional value for preprocedural risk stratification. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Iroulart, Juan M AU - Iroulart JM AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: juan.iroulart@hospitalitaliano.org.ar. FAU - Garmendia, Cristian M AU - Garmendia CM AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Corna, Giuliana AU - Corna G AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Denicolai, Martin AU - Denicolai M AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Miceli, Ana L AU - Miceli AL AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Scarponi, Camila M AU - Scarponi CM AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Pinel, Sebastian AU - Pinel S AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Seropian, Ignacio M AU - Seropian IM AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Pizarro, Rodolfo AU - Pizarro R AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Agatiello, Carla R AU - Agatiello CR AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. LA - eng PT - Journal Article PT - Observational Study DEP - 20260718 PL - Netherlands TA - Curr Probl Cardiol JT - Current problems in cardiology JID - 7701802 SB - IM MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Acute Kidney Injury/etiology/epidemiology/diagnosis MH - *Aortic Valve Stenosis/surgery MH - Femoral Artery MH - *Postoperative Complications/epidemiology MH - Predictive Value of Tests MH - Retrospective Studies MH - Risk Assessment/methods MH - Risk Factors MH - ROC Curve MH - Severity of Illness Index MH - *Transcatheter Aortic Valve Replacement/adverse effects OTO - NOTNLM OT - Acute kidney injury OT - Aortic valve stenosis OT - Risk assessment OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest Dr. Carla R. Agatiello reports speaker fees from Edwards Lifesciences, Boston Scientific and Meril Life Sciences outside the submitted work. Dr. Ignacio M. Seropian reports speaker fees from Edwards Lifesciences, Boston Scientific and Meril Life Sciences outside the submitted work. The remaining authors declare no competing interests. EDAT- 2026/07/19 04:00 MHDA- 2026/08/13 23:36 CRDT- 2026/07/18 19:11 PHST- 2026/07/08 00:00 [received] PHST- 2026/07/17 00:00 [accepted] PHST- 2026/08/13 23:36 [medline] PHST- 2026/07/19 04:00 [pubmed] PHST- 2026/07/18 19:11 [entrez] AID - S0146-2806(26)00145-3 [pii] AID - 10.1016/j.cpcardiol.2026.103403 [doi] PST - ppublish SO - Curr Probl Cardiol. 2026 Oct;51(10):103403. doi: 10.1016/j.cpcardiol.2026.103403. Epub 2026 Jul 18. PMID- 42462847 OWN - NLM STAT- Publisher LR - 20260813 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) DP - 2026 Jul 16 TI - The SALZBURG Score: A Simple Clinical Tool for Long-term Risk Stratification After Self-Expanding Transcatheter Aortic Valve Implantation. LID - S0828-282X(26)00689-6 [pii] LID - 10.1016/j.cjca.2026.07.008 [doi] AB - BACKGROUND: Long-term survival after transcatheter aortic valve implantation (TAVI) remains difficult to estimate, and established risk scores perform suboptimally in this setting. We aimed to develop and externally validate a simple bedside score for prediction of long-term mortality after transfemoral TAVI. METHODS: In this multicentre study, 585 consecutive patients who underwent transfemoral TAVI with self-expanding valve systems comprised the derivation cohort, whereas 117 patients formed an independent external validation cohort. Predictors of 3-year all-cause mortality were identified using least absolute shrinkage and selection operator-Cox regression and multivariable Cox modelling. Model performance was assessed using discrimination, calibration, decision curve analysis, and net reclassification improvement. RESULTS: Six routinely available variables-age > 80 years, male sex, estimated glomerular filtration rate < 60 mL/min, atrial fibrillation, anemia, and diabetes mellitus-were incorporated into the SALZBURG Score (0-11 points). In the derivation cohort, the score predicted 3-year mortality with an area under the curve of 0.66 (95% confidence interval, 0.61-0.71), which outperformed the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (0.56; P = 0.002), the Society of Thoracic Surgeons (STS) Score; 0.57; P = 0.005), and the Transcatheter Aortic Valve Replacement (TAVR)-Risk Score (0.62; P = 0.035), and showed discrimination similar to the TAVI(2)-SCORe (0.63; P = 0.166). Calibration was good across predefined risk groups, and risk reclassification improved compared with established surgical and TAVI-specific risk models. In the external validation cohort, discrimination remained stable (C-index, 0.62; 95% confidence interval, 0.54-0.69). CONCLUSIONS: The SALZBURG Score is a simple and externally validated bedside tool for estimating long-term mortality risk after transfemoral TAVI using routinely available clinical variables. Pending validation in larger contemporary TAVI cohorts, it might serve as a complementary tool to support individualized long-term risk assessment and multidisciplinary heart team discussions. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Boxhammer, Elke AU - Boxhammer E AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria. Electronic address: e.boxhammer@salk.at. FAU - Clodi, Nikolaus AU - Clodi N AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Rezar, Richard AU - Rezar R AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Dinges, Christian AU - Dinges C AD - Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Lichtenauer, Michael AU - Lichtenauer M AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Lamm, Gudrun AU - Lamm G AD - Department of Cardiology, University Hospital Sankt Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria. FAU - Reiter, Christian AU - Reiter C AD - Department of Cardiology, Kepler University Hospital, Medical Faculty of the Johannes Kepler University Linz, Linz, Austria. FAU - Kammler, Jurgen AU - Kammler J AD - Department of Cardiology, Kepler University Hospital, Medical Faculty of the Johannes Kepler University Linz, Linz, Austria. FAU - Kellermair, Jorg AU - Kellermair J AD - Department of Cardiology, Kepler University Hospital, Medical Faculty of the Johannes Kepler University Linz, Linz, Austria. FAU - Steinwender, Clemens AU - Steinwender C AD - Department of Cardiology, Kepler University Hospital, Medical Faculty of the Johannes Kepler University Linz, Linz, Austria. FAU - Kirnbauer, Michael AU - Kirnbauer M AD - Department of Anesthesiology, Perioperative Medicine and Critical Care Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Neuner, Matthias AU - Neuner M AD - Department of Anesthesiology, Perioperative Medicine and Critical Care Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Hammerer, Matthias AU - Hammerer M AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria. FAU - Hoppe, Uta C AU - Hoppe UC AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria. LA - eng PT - Journal Article DEP - 20260716 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - clinical prediction model OT - comorbidity burden OT - external validation OT - long-term mortality OT - risk stratification EDAT- 2026/07/17 00:42 MHDA- 2026/07/17 00:42 CRDT- 2026/07/16 19:11 PHST- 2026/04/27 00:00 [received] PHST- 2026/07/01 00:00 [revised] PHST- 2026/07/03 00:00 [accepted] PHST- 2026/07/17 00:42 [pubmed] PHST- 2026/07/17 00:42 [medline] PHST- 2026/07/16 19:11 [entrez] AID - S0828-282X(26)00689-6 [pii] AID - 10.1016/j.cjca.2026.07.008 [doi] PST - aheadofprint SO - Can J Cardiol. 2026 Jul 16:S0828-282X(26)00689-6. doi: 10.1016/j.cjca.2026.07.008. PMID- 42431661 OWN - NLM STAT- MEDLINE DCOM- 20260711 LR - 20260813 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 16 IP - 7 DP - 2026 Jul 10 TI - Transcatheter aortic valve implantation outcomes by patient age and sex in COMPARE-TAVI 1: a cohort study. PG - e121596 LID - 10.1136/bmjopen-2026-121596 [doi] LID - e121596 AB - OBJECTIVES: To explore the outcomes among patients treated with TAVI (transcatheter aortic valve implantation) in the COMPARE-TAVI 1 trial by age groups and sex. DESIGN: Cohort study. SETTING: Three Danish university hospitals. PARTICIPANTS: Patients treated with TAVI in the COMPARE-TAVI 1 trial (N=1030), 60 (5.8%), 337 (32.7%), 592 (57.5%) and 41 (4.0%) were in the four age groups, < 70, 70-79, 80-89 and 90+ years while 414 (40.2%) and 616 (59.8%) were of female and male sex. INTERVENTIONS: Transfemoral TAVI with balloon-expandable valves (Sapien or Myval) performed between June 2020 and November 2023. OUTCOME MEASURES: Post hoc analyses of trial secondary outcomes that include end-point committee-adjudicated outcomes. RESULTS: In the four age groups, 1-year mortality rates were 8.3%, 5.6%, 5.6% and 7.3% while it was 5.8% in both sexes. Across the four age groups, 1-year stroke rates were 6.7%, 1.8%, 3.2% and 4.9%, and 5.1% among females and 4.7% among males. In the four age groups, 1-year new pacemaker rates were 7.5%, 15%, 19% and 13% while it was 15% among females and 18% among males. Females had smaller annuli than males and their gradients were higher and the effective orifice area lower after TAVI but their frequency of prosthesis-patient mismatch was similar at 1 year. CONCLUSION: While comorbidity levels varied between groups, clinical outcomes were similar across age groups and between sexes. TRIAL REGISTRATION NUMBER: NCT04443023. CI - (c) Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Thim, Troels AU - Thim T AUID- ORCID: 0000-0002-1014-5559 AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark troels.thim@clin.au.dk. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. FAU - Nissen, Henrik AU - Nissen H AD - Department of Cardiology, Odense University Hospital, Odense, Region Syddanmark, Denmark. FAU - Freeman, Phillip AU - Freeman P AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Sanchez Dahl, Jordi AU - Sanchez Dahl J AD - Department of Cardiology, Odense University Hospital, Odense, Region Syddanmark, Denmark. AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. FAU - Christiansen, Evald Hoj AU - Christiansen EH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. FAU - Eftekhari, Ashkan AU - Eftekhari A AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Linde Norgaard, Bjarne AU - Linde Norgaard B AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Povlsen, Jonas Agerlund AU - Povlsen JA AUID- ORCID: 0000-0001-9655-0493 AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Poulsen, Steen Hvitfeldt AU - Poulsen SH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Jensen, Rebekka Vibjerg AU - Jensen RV AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. FAU - Ovrehus, Kristian Altern AU - Ovrehus KA AD - Department of Cardiology, Odense University Hospital, Odense, Region Syddanmark, Denmark. FAU - Terkelsen, Christian Juhl AU - Terkelsen CJ AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. AD - Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. LA - eng SI - ClinicalTrials.gov/NCT04443023 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20260710 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Age Factors MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery/mortality MH - Cohort Studies MH - Denmark/epidemiology MH - Heart Valve Prosthesis MH - Sex Factors MH - Stroke/epidemiology/etiology MH - *Transcatheter Aortic Valve Replacement/mortality/adverse effects/methods MH - Treatment Outcome PMC - PMC13358245 OTO - NOTNLM OT - Adult cardiology OT - Aged, 80 and over OT - Valvular heart disease COIS- Competing interests: TT: lecture fees from Terumo and Chiesi. BLN: Unrestricted research grants from the Novo Nordisk Fonden. EHC: institutional research grants from Abbott, proctor fees from Edwards Lifesciences, Meril Life Sciences, Boston Scientific and Abbott, lecture fees from Edwards Lifesciences, Meril Life Sciences, Boston Scientific and Abbott. CJT: proctor and lecture fees and research grants from Edwards, Terumo, Medtronic and Meril. AE: institutional grant from Novo Nordisk Foundation and Heart Foundation. SHP: lecture and advisory board fees from BridgeBio, Cytokinetics, Alnylam, Pfizer, Bayer, Novo Nordisk and AstraZeneca. Research support from Novo Nordisk. All other authors: none. EDAT- 2026/07/11 05:38 MHDA- 2026/07/12 00:55 PMCR- 2026/07/10 CRDT- 2026/07/10 20:54 PHST- 2026/07/12 00:55 [medline] PHST- 2026/07/11 05:38 [pubmed] PHST- 2026/07/10 20:54 [entrez] PHST- 2026/07/10 00:00 [pmc-release] AID - bmjopen-2026-121596 [pii] AID - 10.1136/bmjopen-2026-121596 [doi] PST - epublish SO - BMJ Open. 2026 Jul 10;16(7):e121596. doi: 10.1136/bmjopen-2026-121596. PMID- 42425724 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260912 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 13 IP - 2 DP - 2026 Jul 9 TI - Successful off-label use of vascular closure devices in fully percutaneous transaxillary aortic valve implantation. LID - 10.1136/openhrt-2026-004150 [doi] LID - e004150 AB - BACKGROUND: The axillary artery is an alternative access- site for transcatheter aortic valve implantation (TAVI) when femoral arteries are unfavourable. Simplified transaxillary-TAVI (TAx-TAVI) is performed completely percutaneously, using vascular closure device (VCD) techniques for arteriotomy closure. Concerns exist regarding major vascular complications with this technique. This registry-study describes off-label VCD use during simplified TAx-TAVI. METHODS: Consecutive severe aortic stenosis patients unsuitable for both surgery and transfemoral access were enrolled in our heart valve registry and underwent simplified TAx-TAVI using VCDs for arteriotomy closure. At the operator's discretion, closure was performed with a collagen-based plug (MANTA) or a suture-based system (double ProGlide). The primary endpoint was axillary access-related major vascular complications in hospital and at 30 days according to Valve Academic Research Consortium (VARC-3) definitions. Secondary endpoints included axillary access-site bleeding and all-cause mortality during hospitalisation to 30 days post-TAx-TAVI. RESULTS: From January 2022 to January 2024, 32 patients (mean age 77 years, 31.3% female) underwent simplified TAx-TAVI using VCDs. MANTA and ProGlide were each used in 50.0% of cases (n=16). Local anaesthesia with conscious sedation was used in 21.9% (n=7). Overall VARC-3 device success was 96.9% (31/32). VCD failure occurred in 25.0% (8/32) and was numerically more frequent with ProGlide (31.3%) than MANTA (18.8%). A covered stent was required for definitive axillary haemostasis in 12.5% (4/32). The 30-day axillary major vascular complication rate was 3.1% (1/32). No major bleeding complications occurred. All-cause 30-day mortality was 3.1% (1/32). New permanent pacemaker implantation occurred in 12.5% (4/32). At 30 days, New York Heart association (NYHA) class improved by at least one category in 68.8% (22/32). CONCLUSIONS: In these simplified TAx-TAVI cases, MANTA and ProGlide VCDs performed well in terms of vascular and bleeding complications. Simplified TAx-TAVI requires advanced access-site management skills, including covered stent use. We found VCDs approved for femoral use safe with axillary access. CI - (c) Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Lauten, Philipp AU - Lauten P AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany Philipp.lauten@zentralklinik.de. AD - University of Marburg, Marburg, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Department of Cardiac Surgery, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. FAU - Costello-Boerrigter, Lisa C AU - Costello-Boerrigter LC AUID- ORCID: 0000-0002-6534-1629 AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. FAU - Gobel, Bjorn AU - Gobel B AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. FAU - Albert, Christian AU - Albert C AD - Department of Nephrology, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. AD - University Clinic for Cardiology and Angiology, Otto von Guericke University Magdeburg, Magdeburg, Germany. FAU - Al Jassem, Mahmoud AU - Al Jassem M AD - Department of Cardiac Surgery, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. FAU - Gonzalez-Lopez, David AU - Gonzalez-Lopez D AD - Department of Cardiac Surgery, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. FAU - Schieffer, Bernhard AU - Schieffer B AD - Department of Cardiology, University of Marburg, Marburg, Germany. FAU - Lapp, Harald AU - Lapp H AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka Gmbh, Bad Berka, Germany. AD - University of Marburg, Marburg, Germany. LA - eng PT - Journal Article DEP - 20260709 PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Humans MH - Female MH - *Vascular Closure Devices MH - Registries MH - *Aortic Valve Stenosis/surgery/mortality MH - *Axillary Artery/surgery MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Male MH - Treatment Outcome MH - Aged MH - *Off-Label Use MH - Aged, 80 and over MH - *Hemostatic Techniques/instrumentation/adverse effects MH - Time Factors MH - *Aortic Valve/surgery PMC - PMC13358239 OTO - NOTNLM OT - Aortic Valve Stenosis OT - Peripheral Vascular Diseases OT - Transcatheter Aortic Valve Replacement COIS- Competing interests: PL received honoraria for lectures by Edwards Lifesciences and Medtronic. EDAT- 2026/07/10 00:37 MHDA- 2026/07/11 01:09 PMCR- 2026/07/09 CRDT- 2026/07/09 21:14 PHST- 2026/04/08 00:00 [received] PHST- 2026/05/30 00:00 [accepted] PHST- 2026/07/11 01:09 [medline] PHST- 2026/07/10 00:37 [pubmed] PHST- 2026/07/09 21:14 [entrez] PHST- 2026/07/09 00:00 [pmc-release] AID - openhrt-2026-004150 [pii] AID - 10.1136/openhrt-2026-004150 [doi] PST - epublish SO - Open Heart. 2026 Jul 9;13(2):e004150. doi: 10.1136/openhrt-2026-004150. PMID- 42416597 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260708 LR - 20260813 IS - 2153-8174 (Electronic) IS - 1530-6550 (Print) IS - 1530-6550 (Linking) VI - 27 IP - 6 DP - 2026 Jun TI - International Age and Use Criteria for Transcatheter and Surgical Aortic Valve Replacement. PG - 49368 LID - 10.31083/RCM49368 [doi] LID - 49368 AB - Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) have transformed the management of severe aortic stenosis across a wide range of patient risk profiles. As populations age and indications extend to lower-risk and younger patients, determining the appropriate role of age in selecting TAVR versus SAVR has become increasingly complex. Current guidelines emphasize individualized decision-making, yet age-based referral patterns remain common in clinical practice. This review examines how age thresholds are applied in contemporary guidance from the United States (US), Europe, and the Asia-Pacific region. Additionally, this review evaluates whether chronological age alone is a defensible basis for referral or treatment selection. This evidence-based narrative review queried PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) from January 1, 2013, through December 31, 2025, using the search terms: ("aortic stenosis" AND ("TAVR" OR "transcatheter aortic valve implantation (TAVI)" OR "SAVR")) AND ("age" OR "appropriateness"). English-language abstracts and full texts were screened in duplicate. Eligible studies included randomized controlled trials, national or continental registries, health economic simulations, and clinical practice guidelines that reported age-stratified outcomes or recommendations. Single-case reports, editorials, and animal studies were excluded. Of the 1628 titles screened, 87 full texts were reviewed, and 45 studies were retained. Across regions, guidelines converge on a core principle: age is informative but insufficient in isolation. U.S. guidance generally favors SAVR in patients younger than 65 years or those with a life expectancy greater than 20 years, and favors transfemoral TAVR in patients older than 80 years or with a life expectancy shorter than 10 years. European guidance typically favors SAVR in patients younger than 75 years and TAVR in those older than 75 years. Meanwhile, Asia-Pacific recommendations adopt a similarly individualized approach but place greater emphasis on bicuspid anatomy, rheumatic disease, local health system infrastructure, and cost. Recent data support a cautious approach in younger patients. In observational U.S. analyses of patients younger than 65 years, TAVR use increased substantially despite guideline preference for surgery, and TAVR was associated with higher long-term mortality or higher pacemaker and readmission burdens in selected cohorts. Contemporary randomized data suggest broadly similar outcomes between TAVR and SAVR in older or intermediate-age populations; however, uncertainty persists in younger low-risk patients, particularly those with bicuspid anatomy and long projected survival. Age-based cutoffs should be interpreted as decision anchors rather than rigid rules. The most defensible framework integrates age with life expectancy, valve durability, anatomy, frailty, comorbidity burden, coronary artery disease, feasibility of future valve-in-valve therapy, and patient preferences within a multidisciplinary heart team. Expansion of TAVR into younger populations should remain measured until more robust long-term durability and lifetime management data become available. CI - Copyright: (c) 2026 The Author(s). Published by IMR Press. FAU - Sharma, Rohit AU - Sharma R AUID- ORCID: 0000-0001-7043-7185 AD - Department of Medicine, Mass General Brigham-Salem Hospital, Salem, MA 01970, USA. FAU - Srivats, Sudarshan AU - Srivats S AUID- ORCID: 0009-0000-2487-7219 AD - Department of Hospital Medicine, Catholic Medical Center, Manchester, NH 03102, USA. FAU - Ata, Fateen AU - Ata F AUID- ORCID: 0000-0001-7121-8574 AD - Department of Medicine, Hamad Medical Corporation, 3050 Doha, Qatar. FAU - Shuhaiber, Jeffrey AU - Shuhaiber J AUID- ORCID: 0000-0003-2082-2637 AD - The Wellman Institute of Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. LA - eng PT - Journal Article PT - Review DEP - 20260629 PL - Singapore TA - Rev Cardiovasc Med JT - Reviews in cardiovascular medicine JID - 100960007 PMC - PMC13339240 OTO - NOTNLM OT - SAVR OT - TAVR OT - age-criteria OT - comparison OT - international COIS- The authors declare no conflicts of interest. EDAT- 2026/07/08 06:51 MHDA- 2026/07/08 06:52 PMCR- 2026/06/29 CRDT- 2026/07/08 04:44 PHST- 2025/12/23 00:00 [received] PHST- 2026/03/23 00:00 [revised] PHST- 2026/04/16 00:00 [accepted] PHST- 2026/07/08 06:52 [medline] PHST- 2026/07/08 06:51 [pubmed] PHST- 2026/07/08 04:44 [entrez] PHST- 2026/06/29 00:00 [pmc-release] AID - S1530-6550(26)02369-0 [pii] AID - 10.31083/RCM49368 [doi] PST - epublish SO - Rev Cardiovasc Med. 2026 Jun 29;27(6):49368. doi: 10.31083/RCM49368. eCollection 2026 Jun. PMID- 42395848 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260703 LR - 20260813 IS - 1671-5411 (Print) IS - 1671-5411 (Linking) VI - 23 IP - 5 DP - 2026 May 28 TI - Predictors of early cerebrovascular events after transcatheter aortic valve replacement: a systematic review and meta-analysis. PG - 309-316 LID - 10.26599/1671-5411.2026.05.007 [doi] AB - BACKGROUND: Early cerebrovascular events (CVEs) following transcatheter aortic valve replacement (TAVR) are severe complications, but effective methods for predicting and preventing these events have not been well established. A systematic review and meta-analysis were performed to identify significant predictors of early CVEs post-TAVR. METHODS: MEDLINE/Embase databases were searched for articles published between December 2015 and April 2023. Original studies evaluating predictors of CVEs within 30 days post-TAVR after adjusting for confounders were included. Two investigators independently extracted data following the PRISMA statement. Meta-analyses of multivariable data were performed using DerSimonian and Laird random-effects models, with results expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Robustness was assessed via Harbord's test, nonparametric trim-and-fill analysis, leave-one-out sensitivity analysis, the QUIPS quality assessment tools, meta-regression, and subgroup analyses. RESULTS: Among the 74 included studies, multivariate meta-analyses identified 11 predictors of early CVEs, including 9 patient-level predictors-a CHA(2)DS(2)-VASc >/= 5, no prior heart failure, diabetes, isolated aortic stenosis, carotid artery stenosis, peripheral artery disease, advanced age, New York Heart Association class >/= III, and significant left ventricular outflow tract calcification-and 2 procedure-level predictors: the absence of cerebral embolization protection and post-dilation. Additionally, 10 patient-level factors and 5 procedure-level factors were not associated with early CVEs, although significant heterogeneity was observed in most analyses. CONCLUSIONS: This study identified multiple patient-level and procedure-level factors associated or not associated with early CVEs after TAVR. These findings support the development of a comprehensive risk prediction model that can accommodate diverse patient populations and evolving procedural techniques, thereby enhancing clinical risk management strategies. CI - (c) 2026 JGC All rights reserved; www.jgc301.com. FAU - Zhang, Yi AU - Zhang Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. FAU - Zhang, Ying AU - Zhang Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. FAU - Yao, Yi-Jun AU - Yao YJ AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. FAU - Xiong, Tian-Yuan AU - Xiong TY AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. FAU - Chen, Mao AU - Chen M AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. LA - eng PT - Journal Article PL - China TA - J Geriatr Cardiol JT - Journal of geriatric cardiology : JGC JID - 101237881 PMC - PMC13324393 EDAT- 2026/07/03 10:11 MHDA- 2026/07/03 10:12 PMCR- 2026/05/28 CRDT- 2026/07/03 05:26 PHST- 2026/07/03 10:12 [medline] PHST- 2026/07/03 10:11 [pubmed] PHST- 2026/07/03 05:26 [entrez] PHST- 2026/05/28 00:00 [pmc-release] AID - jgc-23-5-309 [pii] AID - 10.26599/1671-5411.2026.05.007 [doi] PST - ppublish SO - J Geriatr Cardiol. 2026 May 28;23(5):309-316. doi: 10.26599/1671-5411.2026.05.007. PMID- 42387964 OWN - NLM STAT- MEDLINE DCOM- 20260901 LR - 20260903 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 108 IP - 3 DP - 2026 Sep TI - Same-Day Discharge After Transcatheter Aortic Valve Implantation: Who, When, and How? PG - 816-823 LID - 10.1002/ccd.70715 [doi] AB - The burden of severe aortic stenosis requiring treatment is growing due to ageing populations. This places increased demands on health resources due to the growing number of transcatheter aortic valve implantation (TAVI) procedures and hospital bed occupancy. There are several studies of same-day discharge (SDD) after coronary angioplasty demonstrating its safety, particularly in transfemoral cases. There has been significant evolution in techniques and technologies underpinning TAVI, which have reduced its risk profile over time. As a result, several observational studies have demonstrated that SDD after TAVI is safe and effective. Careful selection of low-risk patients and a minimalist TAVI approach, with appropriate post-procedure review and follow-up, are crucial for successful SDD after TAVI. However, there is a need for randomised trials to validate this practice. This article provides a state-of-the-art overview and guidance to safely and effectively implement a SDD-TAVI service to improve the healthcare system efficiency while enhancing patient satisfaction and recovery. CI - (c) 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Khan, Hilal AU - Khan H AUID- ORCID: 0000-0003-0412-2227 AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Stewart, Debbie AU - Stewart D AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Lamb, Sarah AU - Lamb S AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Das, Rajiv AU - Das R AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Edwards, Richard AU - Edwards R AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Cartlidge, Timothy AU - Cartlidge T AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Alkhalil, Mohammad AU - Alkhalil M AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Zaman, Azfar AU - Zaman A AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Farag, Mohamed AU - Farag M AUID- ORCID: 0000-0003-0811-7679 AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. AD - School of Health, Medicine and Life Sciences, University of Hertfordshire, Hertfordshire, UK. LA - eng PT - Journal Article PT - Review DEP - 20260701 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Aortic Valve Stenosis/physiopathology/surgery/diagnostic imaging MH - *Patient Discharge MH - Risk Factors MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Time Factors MH - Patient Selection MH - Risk Assessment MH - *Length of Stay MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - Recovery of Function MH - Severity of Illness Index MH - Clinical Decision-Making PMC - PMC13532481 OTO - NOTNLM OT - aortic stenosis OT - day-case TAVI OT - same-day discharge OT - transcatheter aortic valve implantation EDAT- 2026/07/02 06:40 MHDA- 2026/09/01 11:39 PMCR- 2026/09/01 CRDT- 2026/07/02 02:33 PHST- 2026/04/05 00:00 [revised] PHST- 2026/01/02 00:00 [received] PHST- 2026/06/16 00:00 [accepted] PHST- 2026/09/01 11:39 [medline] PHST- 2026/07/02 06:40 [pubmed] PHST- 2026/07/02 02:33 [entrez] PHST- 2026/09/01 00:00 [pmc-release] AID - CCD70715 [pii] AID - 10.1002/ccd.70715 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Sep;108(3):816-823. doi: 10.1002/ccd.70715. Epub 2026 Jul 1. PMID- 42382304 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260701 LR - 20260813 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 10 IP - 7 DP - 2026 Jul TI - Prognostic Utility of the Dicrotic Notch Index in Patients Undergoing Transcatheter Aortic Valve Replacement. PG - 100849 LID - 10.1016/j.shj.2026.100849 [doi] LID - 100849 AB - BACKGROUND: The dicrotic notch (DN) on the central aortic pressure waveform reflects aortic valve closure. We aimed to assess the clinical utility of the DN index (DNI) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). METHODS: In this retrospective study, we analyzed 569 patients with aortic stenosis who underwent TAVR between January 2019 and December 2020. Aortic waveform data were used to measure systolic, diastolic, and DN pressures, whereas DNI was calculated as (systolic pressure - DN)/pulse pressure. Pre-TAVR and post-TAVR hemodynamic parameters were compared, and survival analysis was performed using Cox regression with post-TAVR/pre-TAVR DNI ratio as an independent covariate. RESULTS: Compared to pre-TAVR, DN pressure (92.18 to 95.37, p < 0.001) and DNI (0.45 to 0.58, p < 0.001) significantly increased post TAVR. Higher baseline DNI was predicted by carotid disease, diabetes mellitus, and a higher ejection fraction at baseline. Post-TAVR to pre-TAVR DNI ratio cut point >1.19 is an independent predictor of event-free survival at 2 years. Patients with higher post-DNI/pre-DNI ratio had a significantly lower risk of all-cause mortality in adjusted analyses (hazard ratio: 0.53, 95% confidence interval [CI]: 0.34-0.82). CONCLUSIONS: More than 20% increase in DNI post-TAVR was associated with a lower long-term risk of all-cause mortality. Further studies are needed to understand the determinants of the increase in DNI and if this can be modulated by procedural modifications. CI - (c) 2026 The Authors. FAU - Iskandar, Odette AU - Iskandar O AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Ramu, Shivabalan Kathavaryan AU - Ramu SK AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Majeed-Saidan, Maryam AU - Majeed-Saidan M AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Spilias, Nikolos AU - Spilias N AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Layoun, Habib AU - Layoun H AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Yun, James AU - Yun J AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Reed, Grant AU - Reed G AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. LA - eng PT - Journal Article DEP - 20260411 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC13316582 OTO - NOTNLM OT - Aortic stenosis OT - Dicrotic notch index OT - Invasive hemodynamics OT - TAVR COIS- Shivabalan Kathavarayan Ramu reports support was provided by Cleveland Clinic. The other authors had no conflicts to declare. EDAT- 2026/07/01 06:35 MHDA- 2026/07/01 06:36 PMCR- 2026/04/11 CRDT- 2026/07/01 05:11 PHST- 2025/01/26 00:00 [received] PHST- 2025/10/29 00:00 [revised] PHST- 2026/03/03 00:00 [accepted] PHST- 2026/07/01 06:36 [medline] PHST- 2026/07/01 06:35 [pubmed] PHST- 2026/07/01 05:11 [entrez] PHST- 2026/04/11 00:00 [pmc-release] AID - S2474-8706(26)00058-8 [pii] AID - 100849 [pii] AID - 10.1016/j.shj.2026.100849 [doi] PST - epublish SO - Struct Heart. 2026 Apr 11;10(7):100849. doi: 10.1016/j.shj.2026.100849. eCollection 2026 Jul. PMID- 42382077 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260701 LR - 20260813 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 10 IP - 6 DP - 2026 Jun TI - Long-Term Outcomes of a Self-Expanding Transcatheter Heart Valve. PG - 100841 LID - 10.1016/j.shj.2026.100841 [doi] LID - 100841 AB - BACKGROUND: Data on long-term outcomes and durability of the ACURATE neo valve are limited. This study aimed to obtain long-term outcome and echocardiographic data among ACURATE neo recipients. METHODS: Consecutive patients undergoing transfemoral transcatheter aortic valve implantation for severe native aortic stenosis from 4 centers using the ACURATE neo valve between 2012 and 2018 (n = 961) were included. Exclusion criteria for the durability analysis were 30-day mortality, valve-in-valve implantation or surgical aortic valve replacement within 30 days, and lack of echocardiographic follow-up (FU) beyond 30 days, leaving 758 patients included in the durability cohort. Primary endpoints were the cumulative incidence of late bioprosthetic valve failure (BVF), structural valve deterioration (SVD), and Kaplan-Meier estimates of all-cause mortality. RESULTS: In the overall cohort (median age of 82 years, 61.3% females, median and maximum FU time of 5.0 and 11.3 years), estimates of all-cause mortality at 1, 5, and 8 years were 13.6, 43.1, and 67.3%, respectively. In the durability cohort, the cumulative incidence was 3.5% for moderate SVD, 2.1% for severe SVD, and 3.2% for BVF at 8 years. Paired FU echocardiography beyond 5 years (n = 243, median FU time of 6.4 years) showed mean aortic valve gradients and effective orifice area of 9 mmHg and 1.8 cm(2) post-transcatheter aortic valve implantation and 6 mmHg and 1.7 cm(2) at final FU echo. CONCLUSIONS: In this multicenter observational cohort treated with the ACURATE neo platform, 8-year survival was 32.7%, and the cumulative incidence of severe SVD (2.1%) and BVF (3.2%) was limited. These findings provide long-term durability estimates in an elderly, real-world population. CI - (c) 2026 The Author(s). FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany. AD - DZHK (German Centre for Cardiovascular Research), Giessen, Germany. FAU - Siqueira, Dimytri AU - Siqueira D AD - Department of Cardiology, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. FAU - Mollmann, Helge AU - Mollmann H AD - St. Johannes Hospital, Department of Cardiology, Dortmund, Germany. FAU - Dorr, Oliver AU - Dorr O AD - Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. AD - Cardioangiological Center Bethanien, Frankfurt, Germany. FAU - Renker, Matthias AU - Renker M AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany. AD - DZHK (German Centre for Cardiovascular Research), Giessen, Germany. FAU - Charitos, Efstratios AU - Charitos E AD - Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany. FAU - Brunner, Stephanie AU - Brunner S AD - Heart Center Lucerne, Department of Cardiology, Lucerne, Switzerland. FAU - Choi, Yeong-Hoon AU - Choi YH AD - Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany. FAU - Sossalla, Samuel AU - Sossalla S AD - Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany. AD - DZHK (German Centre for Cardiovascular Research), Giessen, Germany. FAU - Nef, Holger AU - Nef H AD - Department of Cardiology, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. AD - Heart Center, Segeberger Kliniken, Bad Segeberg, Germany. FAU - Walther, Thomas AU - Walther T AD - Johann-Wolfgang-Goethe Universitat, Department of Cardiac Surgery, Frankfurt, Germany. FAU - Abizaid, Alexandre AU - Abizaid A AD - Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. LA - eng PT - Journal Article DEP - 20260404 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC13316482 OTO - NOTNLM OT - Degeneration OT - Durability OT - Long-term outcome OT - Structural valve deterioration COIS- Won-Keun Kim reports receipt of proctor/speaker honoraria from Abbott, Anteris, Boston Scientific, Cardiawave, Edwards Lifesciences, HID Imaging, Jenavalve, Medtronic, Meril Life Sciences, and P & F. Helge Mollmann reports receipt of honoraria or consultation fees from Abbott, Biotronik, Boston Scientific, Edwards Lifesciences, Medtronic, and SMT. Matthias Renker reports receipt of proctor honoraria from Boston Scientific and Medtronic. Efstratios Charitos reports receipt of proctor honoraria from Boston Scientific. Yeong-Hoon Choi reports receipt of speaker/proctor fees from Edwards Lifesciences, Cytosorbents, and Getinge. Stefan Toggweiler reports receipt of honoraria from Medtronic, Boston Scientific, Biosensors, Edwards Lifesciences, Hi-D Imaging, Abbott Vascular, Medira, Shockwave, Teleflex, atHeart Medical, Cardiac Dimensions, Polares Medical, Amarin, Sanofi, AstraZeneca, ReCor Medical, Daiichi Sankyo, Bayer, and Armira; reports receipt of institutional research grants from Edwards Lifesciences, Abbott Vascular, Boston Scientific, Fumedica, Novartis, Boehringer Ingelheim, and Polares Medical; is the founder and owner of CardiaNova GmbH; holds equity in Hi-D Imaging; and has filed a patent application for a balloon catheter (10 2015 114 609.8). The other authors had no conflicts to declare. EDAT- 2026/07/01 10:11 MHDA- 2026/07/01 10:12 PMCR- 2026/04/04 CRDT- 2026/07/01 05:08 PHST- 2025/11/29 00:00 [received] PHST- 2026/02/08 00:00 [revised] PHST- 2026/02/23 00:00 [accepted] PHST- 2026/07/01 10:12 [medline] PHST- 2026/07/01 10:11 [pubmed] PHST- 2026/07/01 05:08 [entrez] PHST- 2026/04/04 00:00 [pmc-release] AID - S2474-8706(26)00050-3 [pii] AID - 100841 [pii] AID - 10.1016/j.shj.2026.100841 [doi] PST - epublish SO - Struct Heart. 2026 Apr 4;10(6):100841. doi: 10.1016/j.shj.2026.100841. eCollection 2026 Jun. PMID- 42372999 OWN - NLM STAT- MEDLINE DCOM- 20260904 LR - 20260904 IS - 1879-3649 (Electronic) IS - 1537-1891 (Linking) VI - 164 DP - 2026 Sep TI - Prediction of peri-procedural cerebrovascular accidents in patients with severe peripheral artery disease undergoing transcatheter aortic valve replacement. PG - 107674 LID - S1537-1891(26)00094-7 [pii] LID - 10.1016/j.vph.2026.107674 [doi] AB - OBJECTIVES: Several models have been evaluated for the prediction of transcatheter aortic valve replacement (TAVR)-related cerebrovascular accidents (CVA). The HOSTILE registry recently investigated TAVR outcomes in patients with severe peripheral artery disease (PAD), assessed using a multi-parameter score (HOSTILE score). Among patients treated with transfemoral access (TFA), higher HOSTILE score was associated with higher rates of CVA. We sought to assess the efficacy of different modalities of risk estimation for TAVR-related CVA prediction in a population with severe PAD. METHODS: The predictive ability of the risk assessment modalities was compared using the area under the receiving-operator characteristic (ROC) curve and Harrell's C-statistic. The pre-defined outcome was any CVA occurring within 30 days after TAVR. RESULTS: The study population consisted of 1707 patients, 518 (30.3%) treated via TFA and 1189 treated via transthoracic and trans-axillary routes. The CHA(2)DS(2)-VASc and the HOSTILE score showed fair performance only in the TFA cohort (AUC 0.68, 95% CI 0.53-0.83, and 0.68, 95% CI 0.55-0.81, respectively); values of CHA(2)DS(2)-VASc >5 and HOSTILE >6 exhibited the best discriminatory ability. The highest risk group (CHA(2)DS(2)-VASc >5 and HOSTILE >6) showed a five-fold higher incidence of CVA as compared to the other groups (incidence 6.7%; HR: 5.38, CI95%: 1.80-16.01; p = 0.003). CONCLUSIONS: In a population of patients with severe PAD treated with TAVR via TFA, the integration of a clinical score (CHA(2)DS(2)-VASc score) with a purely anatomical one (HOSTILE score) increased the discriminative ability towards 30-day CVA. Further analyses are needed in order to prospectively evaluate this strategy in different cohorts. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Costa, Giulia AU - Costa G AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Mazzola, Matteo AU - Mazzola M AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Sticchi, Alessandro AU - Sticchi A AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Italy. FAU - Bruno, Antonio Giulio AU - Bruno AG AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Renker, Matthias AU - Renker M AD - Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Iadanza, Alessandro AU - Iadanza A AD - UOSA Cardiologia Interventistica Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - Fineschi, Massimo AU - Fineschi M AD - UOSA Cardiologia Interventistica Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Romagnoli, Enrico AU - Romagnoli E AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Trani, Carlo AU - Trani C AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Adrichem, Rik AU - Adrichem R AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Netherlands. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Netherlands. FAU - Tomii, Daijiro AU - Tomii D AD - Inselspital, Bern University Hospital, University of Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Inselspital, Bern University Hospital, University of Bern, Switzerland. FAU - Aranzulla, Tiziana Claudia AU - Aranzulla TC AD - A.O. Mauriziano Umberto I Hospital, Turin, Italy. FAU - Musumeci, Giuseppe AU - Musumeci G AD - A.O. Mauriziano Umberto I Hospital, Turin, Italy. FAU - Adam, Matti AU - Adam M AD - University Hospital Cologne - Heart Center, Klinik III fur Innere Medizin - Kardiologie, Pneumologie und Internistische Intensivmedizin, Cologne, Germany. FAU - Meertens, Max M AU - Meertens MM AD - University Hospital Cologne - Heart Center, Klinik III fur Innere Medizin - Kardiologie, Pneumologie und Internistische Intensivmedizin, Cologne, Germany. FAU - Alvarez-Covarrubias, Hector Alfonso AU - Alvarez-Covarrubias HA AD - German Heart Centre Munich/Deutsches Herzzentrzum Munchen, Munich, Germany; Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Ciudad de Mexico, Mexico. FAU - Joner, Michael AU - Joner M AD - German Heart Centre Munich/Deutsches Herzzentrzum Munchen, Munich, Germany. FAU - Meucci, Francesco AU - Meucci F AD - University Hospital Careggi, Florence, Italy. FAU - Di Mario, Carlo AU - Di Mario C AD - University Hospital Careggi, Florence, Italy. FAU - Loretz, Lucca AU - Loretz L AD - Heart Center Lucerne, Cardiology, Luzerner, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Cardiology, Luzerner, Switzerland. FAU - Testa, Luca AU - Testa L AD - Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy. FAU - Berti, Sergio AU - Berti S AD - Unit of Diagnostic and Interventional Cardiology, C.N.R. Reg. Toscana G. Monasterio Foundation, Ospedale del Cuore, Massa, Italy. FAU - Ancona, Marco B AU - Ancona MB AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Montorfano, Matteo AU - Montorfano M AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Gmeiner, Jonas AU - Gmeiner J AD - Department of Medicine I, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany. FAU - Braun, Daniel AU - Braun D AD - Department of Medicine I, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany. FAU - Nerla, Roberto AU - Nerla R AD - Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, RA, Italy. FAU - Castriota, Fausto AU - Castriota F AD - Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, RA, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. FAU - Leone, Pier Pasquale AU - Leone PP AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Sudo, Mitsumasa AU - Sudo M AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn - Universitatsklinikum Bonn, Bonn, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn - Universitatsklinikum Bonn, Bonn, Germany. FAU - Piva, Tommaso AU - Piva T AD - Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I - GM Lancisi, Torette, Ancona, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States of America; Cardiovascular Research Foundation, NY, New York, United States of America. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States of America; Cardiovascular Research Foundation, NY, New York, United States of America. FAU - Vercellino, Matteo AU - Vercellino M AD - Cardiology Unit, Cardio-Thoraco Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genoa, Italy. FAU - Porto, Italo AU - Porto I AD - Cardiology Unit, Cardio-Thoraco Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genoa, Italy. FAU - Frumento, Paolo AU - Frumento P AD - Department of Political Sciences, University of Pisa, Pisa, Italy. FAU - Codner, Pablo AU - Codner P AD - Rabin Medical Center, Petah Tikva, Israel. FAU - Kornowski, Ran AU - Kornowski R AD - Rabin Medical Center, Petah Tikva, Israel. FAU - Bartorelli, Antonio L AU - Bartorelli AL AD - Unita Operativa di Cardiologia Interventistica Universitaria, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. FAU - Fraccaro, Chiara AU - Fraccaro C AD - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - De Carlo, Marco AU - De Carlo M AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. LA - eng PT - Comparative Study PT - Journal Article DEP - 20260629 PL - United States TA - Vascul Pharmacol JT - Vascular pharmacology JID - 101130615 SB - IM MH - Humans MH - *Peripheral Arterial Disease/diagnosis/complications/epidemiology/mortality/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Female MH - Risk Factors MH - Risk Assessment MH - Male MH - Severity of Illness Index MH - Aged, 80 and over MH - Registries MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/complications/mortality MH - Predictive Value of Tests MH - Aged MH - Time Factors MH - *Catheterization, Peripheral/adverse effects MH - *Stroke/diagnosis/epidemiology MH - *Decision Support Techniques OTO - NOTNLM OT - Cerebrovascular accidents OT - Peripheral artery disease OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Palmerini has received speaker fees from Edwards Lifesciences and Medtronic. Dr. Saia has received consulting and lecture fees from Abbott, Edwards Lifesciences, and Medtronic. Dr. Kim has received personal fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Meril Life Sciences, and Shockwave Medical. Dr. Burzotta has received speaker fees from Abiomed, Abbott, Medtronic, and Terumo. Dr. De Backer received institutional research grants and consulting fees from Abbott, Boston Scientific and Medtronic. Dr. Romagnoli has received speaker fees by Abbott Vascular, Abiomed, and Medtronic. Dr. Van Mieghem has received research grant support from Abbott Vascular, Biotronik, Boston Scientific, Medtronic, Edwards Lifesciences, Abiomed, PulseCath BV, and Daiichi Sankyo. Dr. Pilgrim has received research grants to his institution from Boston Scientific, Biotronik, and Edwards Lifesciences; and honoraria from Biotronik, Boston Scientific, Medtronic, Abbott, and HighLife SAS. Dr. Adam has received personal and proctoring fees from Abbott, Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic (during the conduct of the study). Dr. Di Mario has received research grants to his institution from Abbott, Amgen, Boston Scientific, Chiesi, Daiichi Sankyo, Edwards Lifesciences, and Volcano Philips. Dr. Toggweiler has served as a proctor/consultant for Medtronic, Edwards Lifesciences, Biosensors, Boston Scientific, and Abbott Vascular; has served consultant for Medira, AtHeart Medical, Veosource, Shockwave, Teleflex, and Polares Medical; has received institutional research grants from Biosensors, Boston Scientific, and Eumedica; and holds equity in Hi-D Imaging. Dr. Testa has received consulting fees from and served as a proctor Abbott, Boston Scientific, Medtronic, and Merrill. Dr. Berti has served as a proctor for Edwards Lifesciences, Abbott, and Boston Scientific. Dr. Ancona has received consultant fees from Abbott. Dr. Montorfano has received proctor fees from Abbott, Edwards Lifesciences, and Boston Scientific. Dr. Castriota has received proctoring fees from Abbott and Medtronic. Dr. Barbanti has served as a consultant for Medtronic, Edwards Lifesciences, and Boston Scientific. Dr. Tamburino has received speaker honoraria from Abbott and Medtronic. Dr. Nickenig has received lecture or advisory board honoraria from Abbott, Amarin, AstraZeneca, Bayer, Berlin Chemie, Biosensus, Biotronik, Bristol Myers Squibb, Boehringer Ingelheim, CardioValve, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Novartis, Pfizer, and Sanofi; owns stock options with Beren, Cardiovalve; has served in clinical trials with Abbott, AstraZeneca, Bayer, Berlin Chemie, Biosensus, Biotronik, Bristol Myers Squibb, Boehringer Ingelheim, CardioValve, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Novartis, Pfizer, and Sanofi; and has received research funding from the Deutsche Forschungsgemeinschaft, the Bundeministerium fur Bildung und Forschun, the European Union, Abbott, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Edwards Lifesciences, Medtronic, Novartis, and Pfizer. Dr. De Carlo has rceived speaker fees from Medtronic and Institutional grants from Boston Scientific, Edwards Lifesciences and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/06/30 00:31 MHDA- 2026/09/04 23:36 CRDT- 2026/06/29 19:31 PHST- 2026/01/08 00:00 [received] PHST- 2026/06/23 00:00 [revised] PHST- 2026/06/24 00:00 [accepted] PHST- 2026/09/04 23:36 [medline] PHST- 2026/06/30 00:31 [pubmed] PHST- 2026/06/29 19:31 [entrez] AID - S1537-1891(26)00094-7 [pii] AID - 10.1016/j.vph.2026.107674 [doi] PST - ppublish SO - Vascul Pharmacol. 2026 Sep;164:107674. doi: 10.1016/j.vph.2026.107674. Epub 2026 Jun 29. PMID- 42362006 OWN - NLM STAT- MEDLINE DCOM- 20260810 LR - 20260901 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 274 DP - 2026 Sep 1 TI - Balloon-Expandable Versus Self-Expanding Valves in Patients With Small Aortic Annuli Undergoing Transcatheter Aortic Valve Replacement. PG - 44-50 LID - S0002-9149(26)00415-7 [pii] LID - 10.1016/j.amjcard.2026.06.021 [doi] AB - Transcatheter aortic valve replacement (TAVR) is a widely accepted treatment option for patients with severe aortic valve stenosis. However, approximately one-third of patients undergoing TAVR present with a small aortic annulus, which is associated with impaired valve performance. The primary objective of this study was to evaluate 2-year mortality after transfemoral TAVR in patients with a small aortic annulus (valve size /=30 s during index hospitalization. A doubly robust inverse probability weighted logistic regression model was applied to reduce baseline imbalances and assess the association between SGLT2 inhibitor use and NOAF. Results: Overall, 169 patients received SGLT2 inhibitors, while 404 patients constituted the control group. NOAF occurred less frequently in the SGLT2 inhibitor group than in controls (11% vs. 19%, p = 0.041). In adjusted analysis, SGLT2 inhibitor use was independently associated with lower odds of NOAF (adjusted OR: 0.171, 95% CI: 0.076-0.381, p < 0.001). Older age and diabetes mellitus were associated with increased NOAF risk, whereas higher baseline left ventricular ejection fraction was associated with lower risk. Subgroup analysis indicated a possible interaction by diabetes status (P-interaction = 0.040), although this exploratory finding should be interpreted cautiously. Conclusions: SGLT2 inhibitor use was independently associated with lower odds of NOAF after TAVI. These findings should be interpreted as observational and hypothesis-generating and require confirmation in prospective randomized studies. FAU - Keten, Mustafa Ferhat AU - Keten MF AUID- ORCID: 0000-0003-2646-4981 AD - Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34925, Turkiye. FAU - Biyikli, Kadir AU - Biyikli K AD - Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34925, Turkiye. FAU - Kultursay, Barkin AU - Kultursay B AUID- ORCID: 0000-0002-1424-2209 AD - Department of Cardiology, Tunceli State Hospital, Tunceli 62000, Turkiye. FAU - Eminoglu, Halit AU - Eminoglu H AD - Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34925, Turkiye. FAU - Ceneli, Dogancan AU - Ceneli D AD - Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34925, Turkiye. FAU - Danisman, Nesri AU - Danisman N AD - Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34925, Turkiye. FAU - Kafkas, Cagri AU - Kafkas C AD - Department of Cardiology, University of Marmara, Istanbul 34854, Turkiye. FAU - Balaban, Ismail AU - Balaban I AUID- ORCID: 0000-0002-1866-349X AD - Department of Cardiology, Hamidiye School of Medicine, Kosuyolu Heart, Education and Research Institute, University of Health Sciences, Istanbul 34925, Turkiye. LA - eng PT - Journal Article DEP - 20260621 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13302004 OTO - NOTNLM OT - SGLT2 inhibitors OT - diabetes mellitus OT - inverse probability weighting OT - new-onset atrial fibrillation OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/06/26 16:10 MHDA- 2026/06/26 16:11 PMCR- 2026/06/21 CRDT- 2026/06/26 01:16 PHST- 2026/05/23 00:00 [received] PHST- 2026/06/11 00:00 [revised] PHST- 2026/06/18 00:00 [accepted] PHST- 2026/06/26 16:11 [medline] PHST- 2026/06/26 16:10 [pubmed] PHST- 2026/06/26 01:16 [entrez] PHST- 2026/06/21 00:00 [pmc-release] AID - jcm15124812 [pii] AID - jcm-15-04812 [pii] AID - 10.3390/jcm15124812 [doi] PST - epublish SO - J Clin Med. 2026 Jun 21;15(12):4812. doi: 10.3390/jcm15124812. PMID- 42350252 OWN - NLM STAT- Publisher LR - 20260625 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) DP - 2026 Jun 19 TI - Association between aortic wall thrombus and stroke among patients undergoing transfemoral aortic valve replacement. LID - S1553-8389(26)00276-9 [pii] LID - 10.1016/j.carrev.2026.06.011 [doi] AB - BACKGROUND: Stroke is a major adverse event following transfemoral transcatheter aortic valve replacement (TAVR), often attributed to embolization of debris from the aortic valve or aorta. This study evaluated the relationship between severe aortic wall thrombus (AWT) on pre-TAVR imaging and peri-procedural stroke in a single-center cohort. METHODS: Patients with peri-procedural stroke after transfemoral TAVR (January 2013-December 2023) were compared with a randomly selected stroke-free control group. Severe AWT on baseline CT was assessed using a validated segmental scoring system. Associations with stroke were examined using Firth penalized logistic regression, with a pre-specified multivariable model adjusting for severe aortic root calcification, pre-TAVR albumin, recent heart failure, and valve type. RESULTS: Fifty-six patients with peri-procedural stroke (mean age 82 +/- 8.6 years) and 92 controls (mean age 79 +/- 9.8 years) were included. Strokes occurred a median of 1.5 days (interquartile range, 0-4 days) following TAVR. Severe AWT was present in 21.4% of stroke patients versus 3.3% of controls, corresponding to a univariable odds ratio (OR) of 7.18 (95% CI 2.28-29.16, p < 0.001). In the multivariable Firth model, severe AWT remained independently associated with stroke (OR 8.98, 95% CI 2.01-49.55, p = 0.004). AWT most frequently involved the descending thoracic (43%) and abdominal aorta (54%), and less commonly the ascending aorta (9-16%). CONCLUSION: Severe AWT on pre-TAVR CT was independently associated with peri-procedural stroke in this single-center analysis. Given the retrospective design and temporal differences between groups, these hypothesis-generating findings warrant prospective validation. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Galo, Jason AU - Galo J AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Al-Qaraghuli, Abdullah AU - Al-Qaraghuli A AD - Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Haberman, Dan AU - Haberman D AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA; Heart Center, Kaplan Medical Center, Hebrew University, Rehovot, Jerusalem, Israel. FAU - Jena, Nihar AU - Jena N AD - Marshall University, Huntington, WV, USA. FAU - Abusnina, Waiel AU - Abusnina W AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Cellamare, Matteo AU - Cellamare M AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Offit, Michelle AU - Offit M AD - Department of Neurology, MedStar Georgetown University Hospital, USA. FAU - Zhang, Cheng AU - Zhang C AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Verma, Beni AU - Verma B AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Rubio, Pablo M AU - Rubio PM AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Ben-Dor, Itsik AU - Ben-Dor I AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Waksman, Ron AU - Waksman R AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Rogers, Toby AU - Rogers T AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: toby.rogers@medstar.net. LA - eng PT - Journal Article DEP - 20260619 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM OTO - NOTNLM OT - Aortic wall thrombus (AWT) OT - Computed tomography (CT) imaging OT - Stroke risk OT - Thromboembolic events OT - Transfemoral aortic valve replacement (TAVR) COIS- Declaration of competing interest RW - Advisory Board: Abbott Vascular, Boston Scientific, Medtronic, Philips IGT, NovelRad.; Consultant: Abbott Vascular, Append Medical, Biotronik, Boston Scientific, MedAlliance/Cordis, Medtronic, Philips IGT, Pi-Cardia Ltd. Transmural Systems Inc.; Institutional Grant Support: Biotronik, Medtronic, Philips IGT; Investor: Append Medical, Pi-Cardia Ltd., Transmural Systems Inc., Vantis, NovelRad. TR - Consulting: Edwards Lifesciences, Medtronic, Boston Scientific, Abbott, Anteris, and Transmural Systems; Advisory board: Medtronic, Boston Scientific; Equity interest: Transmural Systems; Intellectual property: co-inventor on patents, assigned to NIH, for transcatheter electrosurgery devices. EDAT- 2026/06/26 00:49 MHDA- 2026/06/26 00:49 CRDT- 2026/06/25 21:58 PHST- 2026/06/04 00:00 [received] PHST- 2026/06/17 00:00 [accepted] PHST- 2026/06/26 00:49 [medline] PHST- 2026/06/26 00:49 [pubmed] PHST- 2026/06/25 21:58 [entrez] AID - S1553-8389(26)00276-9 [pii] AID - 10.1016/j.carrev.2026.06.011 [doi] PST - aheadofprint SO - Cardiovasc Revasc Med. 2026 Jun 19:S1553-8389(26)00276-9. doi: 10.1016/j.carrev.2026.06.011. PMID- 42346446 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260625 LR - 20260813 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 13 IP - 6 DP - 2026 May 27 TI - Preliminary Outcome of Transcatheter Aortic Valve Implantation at Centers Without On-Site Cardiac Surgery. LID - 10.3390/jcdd13060226 [doi] LID - 226 AB - In many countries, patients' access to transcatheter aortic valve implantation (TAVI) is limited by reimbursement issues or delayed admission to heart valve centers, thus increasing the risk of adverse events in wait-listed patients. The TAVI AT HOME (TAH) is a single-arm, multicenter study aiming to evaluate the safety and efficacy of transfemoral TAVI performed at centers without on-site cardiac surgery by expert operators. The primary endpoint is 30-day all-cause mortality. This study focuses on the run-in phase of the registry, which was required by the ethics committee to perform an interim safety analysis. The outcome of 20 TAH patients enrolled at three Italian centers from May 2023 to May 2024 was compared to 41 TAVI cases included in the permanent local registry, matching the TAH inclusion/exclusion criteria. The two groups had similar baseline characteristics. Significantly more patients in the TAH group were deemed at prohibitive risk (85.0% vs. 56.1%; p = 0.026) but had similar surgical risk scores. A self-expanding device was used in most cases (60.7%). Technical success did not differ between groups (95.0% in the TAH vs. 85.4%, p = 0.409). No deaths at 30 days (primary endpoint) were observed. The 1-year survival rate did not differ between groups. After interim data analysis, the ethics committee authorized the completion of the TAH enrollment and extension to other centers. The TAH approach might represent an alternative model to allow timely access to TAVI without compromising safety and effectiveness. FAU - Dall'Ara, Gianni AU - Dall'Ara G AUID- ORCID: 0000-0003-1394-402X AD - Structural Cardiology Unit Forli-Cesena, Morgagni-Pierantoni Hospital, 47121 Forli, Italy. AD - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy. FAU - Compagnone, Miriam AU - Compagnone M AUID- ORCID: 0000-0002-3458-8717 AD - Structural Cardiology Unit Forli-Cesena, Morgagni-Pierantoni Hospital, 47121 Forli, Italy. FAU - Grotti, Simone AU - Grotti S AUID- ORCID: 0000-0002-7165-7355 AD - Structural Cardiology Unit Forli-Cesena, Morgagni-Pierantoni Hospital, 47121 Forli, Italy. FAU - Santarelli, Andrea AU - Santarelli A AUID- ORCID: 0000-0001-7575-6118 AD - Cardiology Unit, Bufalini Hospital, 47521 Cesena, Italy. FAU - Balducelli, Marco AU - Balducelli M AUID- ORCID: 0000-0002-1038-4023 AD - Cardiology Unit, Santa Maria delle Croci Hospital, 48121 Ravenna, Italy. FAU - Cavazza, Caterina AU - Cavazza C AD - Cardiology Unit, Infermi Hospital, 47923 Rimini, Italy. FAU - Savini, Carlo AU - Savini C AUID- ORCID: 0000-0003-4197-7486 AD - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy. AD - Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy. FAU - Moretti, Carolina AU - Moretti C AD - Cardiology Unit, Santa Maria delle Croci Hospital, 48121 Ravenna, Italy. FAU - Ottani, Filippo AU - Ottani F AD - Cardiology Unit, Infermi Hospital, 47923 Rimini, Italy. FAU - Rubboli, Andrea AU - Rubboli A AUID- ORCID: 0000-0001-8657-6235 AD - Cardiology Unit, Santa Maria delle Croci Hospital, 48121 Ravenna, Italy. FAU - Galvani, Marcello AU - Galvani M AUID- ORCID: 0000-0001-5897-667X AD - Cardiovascular Research Unit, Fondazione Cardiologica Sacco, 47121 Forli, Italy. FAU - Pizzi, Carmine AU - Pizzi C AUID- ORCID: 0000-0002-4048-675X AD - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy. AD - Cardiology Unit, Morgagni-Pierantoni Hospital, 47121 Forli, Italy. FAU - Tarantino, Fabio Felice AU - Tarantino FF AD - Structural Cardiology Unit Forli-Cesena, Morgagni-Pierantoni Hospital, 47121 Forli, Italy. LA - eng GR - no number/Eukon s.r.l./ GR - no number/Abbott/ GR - no number/Sintec (Italy)/ GR - no number/Medstep/ GR - no number/Lopez S.p.a./ PT - Journal Article DEP - 20260527 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC13302494 OTO - NOTNLM OT - cardiac surgery OT - complications OT - heart team OT - transcatheter aortic valve implantation OT - transcatheter aortic valve replacement COIS- The authors declare that this study received funding from Abbott S.r.l., Eukon S.r.l., Lopez S.p.a., Medstep S.r.l., and Sintec S.r.l. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. EDAT- 2026/06/25 12:38 MHDA- 2026/06/25 12:39 PMCR- 2026/05/27 CRDT- 2026/06/25 09:43 PHST- 2026/05/04 00:00 [received] PHST- 2026/05/23 00:00 [revised] PHST- 2026/05/25 00:00 [accepted] PHST- 2026/06/25 12:39 [medline] PHST- 2026/06/25 12:38 [pubmed] PHST- 2026/06/25 09:43 [entrez] PHST- 2026/05/27 00:00 [pmc-release] AID - jcdd13060226 [pii] AID - jcdd-13-00226 [pii] AID - 10.3390/jcdd13060226 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2026 May 27;13(6):226. doi: 10.3390/jcdd13060226. PMID- 42331424 OWN - NLM STAT- In-Process LR - 20260622 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 19 IP - 12 DP - 2026 Jun 22 TI - Transcarotid UNICORN Procedure to Facilitate Valve-in-Valve TAVR. PG - 1700-1702 LID - S1936-8798(26)01445-7 [pii] LID - 10.1016/j.jcin.2026.04.038 [doi] FAU - Barrow, Firas AU - Barrow F AD - Alexian Brothers Medical Center, Elk Grove Village, Illinois, USA. FAU - Polito, William AU - Polito W AD - Alexian Brothers Medical Center, Elk Grove Village, Illinois, USA. FAU - Khambhati, Jay AU - Khambhati J AD - University of Chicago, Chicago, Illinois, USA. FAU - Poon, Karl AU - Poon K AD - University of Queensland, The Prince Charles Hospital, Metro North Health, Brisbane, Australia; University of Queensland, Brisbane, Australia. FAU - Parma, Radoslaw AU - Parma R AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Tang, Gilbert H L AU - Tang GHL AD - Department of Cardiovascular Surgery and Medicine (Cardiology), Mount Sinai Health System, New York, New York, USA. FAU - Cheung-Chi Lam, Simon AU - Cheung-Chi Lam S AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China. FAU - Pop, Andrei AU - Pop A AD - Alexian Brothers Medical Center, Elk Grove Village, Illinois, USA. Electronic address: andrei.pop@ascension.org. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM COIS- Funding Support and Author Disclosures Dr Poon is a consultant for Anteris Technologies; and is a proctor and serves on the Speakers Bureau for Edwards Lifesciences and Abbott Laboratories. Dr Tang has received honoraria for speaking from Medtronic; has served as a physician proctor, a consultant, an advisory board member, a transcatheter aortic valve replacement publications committee member, an APOLLO trial screening committee member, and an IMPACT MR steering committee member for Medtronic; has received honoraria for speaking from Abbott Structural Heart; has served as a physician proctor, a consultant, an advisory board member, and a TRILUMINATE trial anatomical eligibility and publications committee member for Abbott Structural Heart; has served as an advisory board member for Boston Scientific and JenaValve; has served as a consultant and physician screening committee member for Shockwave Medical; and has served as a consultant for Philips, Edwards Lifesciences, Anteris Technologies, Peija Medical, and Shenqi Medical Technology. Dr Pop has served as a consultant for Edwards Lifesciences and Inari Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/06/23 00:34 MHDA- 2026/06/23 00:34 CRDT- 2026/06/22 20:53 PHST- 2026/03/10 00:00 [received] PHST- 2026/04/08 00:00 [revised] PHST- 2026/04/22 00:00 [accepted] PHST- 2026/06/23 00:34 [medline] PHST- 2026/06/23 00:34 [pubmed] PHST- 2026/06/22 20:53 [entrez] AID - S1936-8798(26)01445-7 [pii] AID - 10.1016/j.jcin.2026.04.038 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2026 Jun 22;19(12):1700-1702. doi: 10.1016/j.jcin.2026.04.038. PMID- 42313026 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260827 LR - 20260903 IS - 2666-0849 (Electronic) IS - 2666-0849 (Linking) VI - 31 IP - 34 DP - 2026 Aug 26 TI - Successful Bailout for Transcarotid Delivery Failure of Transcatheter Aortic Valve. PG - 108920 LID - S2666-0849(26)02079-6 [pii] LID - 10.1016/j.jaccas.2026.108920 [doi] LID - 108920 AB - CASE SUMMARY: Transcarotid-transcatheter aortic valve implantation (TC-TAVI) generally enables smooth transcatheter heart valve crossing given its proximity to the aortic annulus; however, severe anatomical constraints may still lead to delivery failure. We report a TC-TAVI case in which transcatheter heart valve passage across the aortic valve was initially unsuccessful because of aortic angulation and extensive leaflet calcification. This technical difficulty was effectively resolved using the buddy balloon technique, which enabled successful valve advancement. This case demonstrates that the superior pushability of the TC approach may not overcome extreme anatomical resistance, necessitating predilatation aggressively indicated for such challenging anatomies. TAKE-HOME MESSAGES: Pronounced aortic angulation and severe leaflet calcification can hinder transcatheter heart valve delivery, even during TC-TAVI, where easier valve crossing is typically anticipated. These anatomical factors remain significant predictors of delivery failure, irrespective of the vascular access route. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Miyamoto, Keisuke AU - Miyamoto K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Suenaga, Tomohiro AU - Suenaga T AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ishizu, Kenichi AU - Ishizu K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. Electronic address: k.ishizu.04ri@gmail.com. FAU - Shirai, Shinichi AU - Shirai S AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ando, Kenji AU - Ando K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. LA - eng PT - Journal Article DEP - 20260618 PL - Netherlands TA - JACC Case Rep JT - JACC. Case reports JID - 101757292 PMC - PMC13531075 OTO - NOTNLM OT - TC-TAVI OT - buddy balloon technique COIS- Funding Support and Author Disclosures Dr Ishizu is a proctor of intracardiac echocardiography-guided TAVI for Abbott Medical; and has served as the screening proctor for Edwards Lifesciences. Dr Shirai is a proctor of transfemoral TAVI for Edwards Lifesciences, Medtronic, and Abbott Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/06/18 12:33 MHDA- 2026/06/18 12:34 PMCR- 2026/06/18 CRDT- 2026/06/18 10:31 PHST- 2026/04/30 00:00 [received] PHST- 2026/05/21 00:00 [revised] PHST- 2026/05/22 00:00 [accepted] PHST- 2026/06/18 12:34 [medline] PHST- 2026/06/18 12:33 [pubmed] PHST- 2026/06/18 10:31 [entrez] PHST- 2026/06/18 00:00 [pmc-release] AID - S2666-0849(26)02079-6 [pii] AID - 108920 [pii] AID - 10.1016/j.jaccas.2026.108920 [doi] PST - ppublish SO - JACC Case Rep. 2026 Aug 26;31(34):108920. doi: 10.1016/j.jaccas.2026.108920. Epub 2026 Jun 18. PMID- 42306318 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260617 LR - 20260813 IS - 2950-6050 (Electronic) IS - 2950-6050 (Linking) VI - 9 DP - 2026 Mar TI - Outcome of cerebral embolic protection during transcatheter aortic valve replacement in high-risk patient for stroke. PG - 100094 LID - 10.1016/j.xjse.2025.100094 [doi] LID - 100094 AB - OBJECTIVES: The sentinel cerebral embolic protection device has been used as prophylaxis of stroke and transient ischemic attack during transcatheter aortic valve replacement. However, there are no absolute criteria guiding cerebral embolic protection device placement. This study aimed to evaluate the impact of cerebral embolic protection on postoperative cerebrovascular events in patients at high risk for stroke. METHODS: Between April 2021 and August 2023, 695 patients underwent transcatheter aortic valve replacement through a transfemoral approach. The cerebral embolic protection device was placed at the beginning of transcatheter aortic valve replacement procedure when 1 of the following criteria was met preoperatively: bicuspid aortic valve, valve-in-valve procedure, or calcium score in computed tomography greater than 1000. Of 695 patients with transcatheter aortic valve replacement, 636 met the criteria. The cerebral embolic protection device was placed in 55% of patients (350/636, cerebral embolic protection group) and not placed in 45% of patients (286/636, non-cerebral embolic protection group) because cerebral embolic protection was not feasible anatomically. A 1:1 propensity score matching was performed using the nearest neighbor method between cerebral embolic protection and non-cerebral embolic protection groups. RESULTS: A total of 245 pairs were matched in propensity score matching. After matching, postoperative stroke/transient ischemic attack occurred in 0.4% (1/245) in the cerebral embolic protection group and 2.9% (7/245) in the non-cerebral embolic protection group. A significant difference was noted in postoperative stroke/transient ischemic attack between the 2 groups (P = .03). Early mortality and other complications did not differ between the 2 groups. In postoperative follow-up, incidence of stroke/transient ischemic attack was similar in 30 days (2.0% vs 1.2%, P = .72) and 1 year (0.4% vs 1.2%, P = .62). There was no vascular complication at the cerebral embolic protection access site. CONCLUSIONS: Cerebral embolic protection during transcatheter aortic valve replacement might reduce postoperative cerebrovascular events in patients who are high risk for stroke in this patient cohort. CI - (c) 2025 The Author(s). FAU - Nakai, Chikashi AU - Nakai C AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - Liu, Junyi AU - Liu J AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - Azhagiri, Nikhil AU - Azhagiri N AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - Ku, Andrew AU - Ku A AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - Wu, Yuan Haw AU - Wu YH AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - Danduch, Eduardo AU - Danduch E AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - Tarabichi, Saeed AU - Tarabichi S AD - Department of Cardiothoracic Surgery, Albany Medical Center, Albany, NY. FAU - DeLago, Augustin AU - DeLago A AD - Department of Cardiology, Capital Cardiology Associates, Albany, NY. LA - eng PT - Journal Article DEP - 20251217 PL - United States TA - JTCVS Struct Endovasc JT - JTCVS structural and endovascular JID - 9918991787106676 PMC - PMC13244676 OTO - NOTNLM OT - cerebral embolic protection OT - stroke OT - transcatheter aortic valve replacement OT - transient ischemic attack COIS- The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. EDAT- 2026/06/17 06:32 MHDA- 2026/06/17 06:33 PMCR- 2025/12/17 CRDT- 2026/06/17 05:23 PHST- 2025/09/01 00:00 [received] PHST- 2025/11/24 00:00 [revised] PHST- 2025/12/07 00:00 [accepted] PHST- 2026/06/17 06:33 [medline] PHST- 2026/06/17 06:32 [pubmed] PHST- 2026/06/17 05:23 [entrez] PHST- 2025/12/17 00:00 [pmc-release] AID - S2950-6050(25)00053-1 [pii] AID - 100094 [pii] AID - 10.1016/j.xjse.2025.100094 [doi] PST - epublish SO - JTCVS Struct Endovasc. 2025 Dec 17;9:100094. doi: 10.1016/j.xjse.2025.100094. eCollection 2026 Mar. PMID- 42304467 OWN - NLM STAT- Publisher LR - 20260617 IS - 1754-9485 (Electronic) IS - 1754-9477 (Linking) DP - 2026 Jun 16 TI - Diagnostic Adequacy of Pre-TAVI CTA Compared With ICA and Its Prognostic Association With Coronary Artery Disease. LID - 10.1111/1754-9485.70134 [doi] AB - BACKGROUND: Previous studies have investigated the concordance between pre-TAVI coronary CT angiography (CTA) and invasive coronary angiography (ICA). PURPOSE: To evaluate the agreement between pre-TAVI coronary CTA and ICA and to determine the relationship between coronary artery disease and one-year survival: MATERIALS AND METHODS: Coronary CTA findings were compared with invasive coronary angiography in patients undergoing TAVI for severe aortic stenosis at our tertiary care center between November 2023 and November 2024, with 50% and 70% stenosis used as diagnostic cut-off values. RESULTS: Ninety-five patients who underwent both coronary CTA and invasive coronary angiography prior to TAVI were included. Obstructive CAD was defined as >/= 70% stenosis in the right coronary, left anterior descending, or circumflex artery, or >/= 50% stenosis in the left main coronary artery. CTA findings showed strong agreement with invasive coronary angiography across all coronary arteries. At the 70% stenosis threshold, CTA demonstrated high sensitivity and specificity, with excellent interobserver agreement. Obstructive CAD was present in 82.1% of patients, with single-, two-, and three-vessel disease observed in 15.8%, 18.9%, and 47.4%, respectively. Severe carotid artery stenosis (> 70%) was observed in a minority of patients. One-year survival was 93.7% and was not associated with the presence of CAD (p = 0.466). CONCLUSION: Pre-TAVI coronary CTA shows strong agreement with invasive coronary angiography for detecting obstructive coronary stenosis and represents a practical, noninvasive option for coronary assessment before TAVI. CI - (c) 2026 Royal Australian and New Zealand College of Radiologists. FAU - Kaya, Murat AU - Kaya M AUID- ORCID: 0000-0002-1251-1292 AD - Radiology Department, Gaziantep City Hospital, Gaziantep, Turkey. FAU - Konukoglu, Osman AU - Konukoglu O AUID- ORCID: 0000-0002-3353-0230 AD - Radiology Department, Gaziantep City Hospital, Gaziantep, Turkey. FAU - Arslan, Baris Can AU - Arslan BC AUID- ORCID: 0000-0002-4530-3166 AD - Radiology Department, Gaziantep City Hospital, Gaziantep, Turkey. FAU - Kaya, Fatima Merve AU - Kaya FM AUID- ORCID: 0009-0001-1902-7444 AD - Abdulkadir Yuksel State Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Gaziantep, Turkey. FAU - Kaya, Emin Erdem AU - Kaya EE AUID- ORCID: 0000-0002-0650-5435 AD - Cardiology Department, Gaziantep City Hospital, Gaziantep, Turkey. FAU - Poyraz, Fatih AU - Poyraz F AUID- ORCID: 0000-0002-5984-4553 AD - Cardiology Department, Gaziantep City Hospital, Gaziantep, Turkey. FAU - Baris, Veysel Ozgur AU - Baris VO AUID- ORCID: 0000-0002-3021-8612 AD - Cardiology Department, Gaziantep City Hospital, Gaziantep, Turkey. LA - eng PT - Journal Article DEP - 20260616 PL - Australia TA - J Med Imaging Radiat Oncol JT - Journal of medical imaging and radiation oncology JID - 101469340 SB - IM OTO - NOTNLM OT - TAVI OT - computed tomography angiography OT - coronary artery disease OT - invasive coronary angiography OT - survival EDAT- 2026/06/17 06:31 MHDA- 2026/06/17 06:31 CRDT- 2026/06/17 00:15 PHST- 2026/05/22 00:00 [revised] PHST- 2026/01/20 00:00 [received] PHST- 2026/06/08 00:00 [accepted] PHST- 2026/06/17 06:31 [medline] PHST- 2026/06/17 06:31 [pubmed] PHST- 2026/06/17 00:15 [entrez] AID - 10.1111/1754-9485.70134 [doi] PST - aheadofprint SO - J Med Imaging Radiat Oncol. 2026 Jun 16. doi: 10.1111/1754-9485.70134. PMID- 42303223 OWN - NLM STAT- MEDLINE DCOM- 20260930 LR - 20261001 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 88 IP - 4 DP - 2026 Oct TI - Comparative outcomes of balloon-expandable and self-expanding valves in transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 297-320 LID - S0914-5087(26)00115-2 [pii] LID - 10.1016/j.jjcc.2026.06.009 [doi] AB - BACKGROUND: Balloon-expandable valves (BEVs) and self-expanding valves (SEVs) are the two primary platforms for transcatheter aortic valve replacement (TAVR), differing in design, deployment, and hemodynamic performance. Comparative evidence on their clinical and procedural outcomes remains limited and inconsistent. METHODS: A systematic review and meta-analysis were conducted, searching PubMed, Scopus, Web of Science, and Cochrane Library up to July 2025 for studies comparing BEVs and SEVs in adults with severe aortic stenosis undergoing transfemoral TAVR. Outcomes included all-cause mortality, cardiovascular mortality, stroke, permanent pacemaker implantation, hemodynamic parameters, device success, and safety endpoints. Dichotomous and continuous outcomes were pooled as risk ratios (RR) and mean differences (MD) with corresponding 95% confidence intervals (CI) using a random-effects model. RESULTS: Fifty-three studies (n = 157,921) were included (6 randomized controlled trials, 12 prospective, and 35 retrospective cohorts). BEVs showed significant early survival benefits at 1 month (RR = 0.75, 95% CI 0.57-0.97, p = 0.03) and 6 months (RR = 0.33, 95%CI0.18-0.60, p < 0.001), with reduced cardiovascular mortality at 12 months (RR = 0.88, 95% CI 0.79-0.99, p = 0.03). Permanent pacemaker implantation rates were consistently lower with BEVs (e.g. RR = 0.75, 95% CI 0.64-0.88, p < 0.001 at 1 month). SEVs exhibited superior hemodynamics, with lower mean gradients (MD = -3.16 to -7.77 mmHg) and larger aortic valve areas (MD = +0.11 to +0.13 cm(2)). Long-term mortality and safety outcomes, including major bleeding, vascular complications, and myocardial infarction, were comparable. CONCLUSION: BEVs offer early survival and conduction preservation advantages, while SEVs provide superior hemodynamic performance. These findings highlight the importance of individualized valve selection based on patient-specific factors. Further randomized trials with extended follow-up are needed to evaluate long-term durability and outcomes in diverse patient populations. CI - Copyright (c) 2026 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. FAU - Hafez, Abdelrahman AU - Hafez A AD - Cardiovascular Medicine Department, Mayo Clinic, Phoenix, AZ, USA. FAU - Sobhy, Ahmed AU - Sobhy A AD - Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt. FAU - Elshahat, Ahmed AU - Elshahat A AD - Faculty of Medicine, Al-Azhar University, Cairo, Egypt. FAU - Bruce, Dara AU - Bruce D AD - Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: Dbruce3@tulane.edu. FAU - Saad, Omar Abdulrahman AU - Saad OA AD - Faculty of Medicine, Al-Azhar University, Cairo, Egypt. FAU - Ashour, Mennatullah AU - Ashour M AD - College of Human Medicine, Banha University, Banha, Egypt. FAU - Ali, Karim AU - Ali K AD - Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, USA. FAU - Shebl, Mohamed A AU - Shebl MA AD - Faculty of Medicine, Cairo University, Cairo, Egypt. FAU - Bolla, Anmolika K AU - Bolla AK AD - Meinig School of Biomedical Engineering, Cornell University, NY, USA. FAU - Usmani, Reyan AU - Usmani R AD - Syracuse University, College of Arts and Sciences, NY, USA. FAU - Aboudabash, Mahmoud AU - Aboudabash M AD - School of Medicine, New Giza University, Giza, Egypt. FAU - Arafa, Amr AU - Arafa A AD - Faculty of Medicine, Alexandria University, Alexendria, Egypt. FAU - Shehata, Shaimaa A AU - Shehata SA AD - Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. FAU - Abdellatif, Nouran AU - Abdellatif N AD - Gulf Medical University, Ajman, United Arab Emirates. FAU - Alagab, Abdalrahman AU - Alagab A AD - Faculty of Medicine, Tripoli University, Tripoli, Libya. FAU - Eldessouki, Ahmed AU - Eldessouki A AD - Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. FAU - Riccelli, Richie AU - Riccelli R AD - Christain Brothers Academy, NY, USA. FAU - Gir, Deepak AU - Gir D AD - St. Joseph's Medical Center, CA, USA. FAU - Elzewiei, Ghada Y A AU - Elzewiei GYA AD - Department of Medicine, Tobruk University, Tobruk, Libya. FAU - Toraih, Eman A AU - Toraih EA AD - Cardiovascular Perfusion Department, SUNY Upstate Medical University, Syracuse, NY, USA; Genetics Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. FAU - Aiash, Hani AU - Aiash H AD - Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; Cardiovascular Perfusion Department, SUNY Upstate Medical University, Syracuse, NY, USA. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20260617 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/mortality MH - *Heart Valve Prosthesis MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - *Prosthesis Design MH - Hemodynamics MH - *Aortic Valve/surgery OTO - NOTNLM OT - Balloon-expandable valve OT - Interventional cardiology OT - Self-expanding valve OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest The authors confirm no disclosures related to this research. EDAT- 2026/06/17 00:36 MHDA- 2026/09/30 23:29 CRDT- 2026/06/16 19:37 PHST- 2025/10/11 00:00 [received] PHST- 2026/06/08 00:00 [revised] PHST- 2026/06/09 00:00 [accepted] PHST- 2026/09/30 23:29 [medline] PHST- 2026/06/17 00:36 [pubmed] PHST- 2026/06/16 19:37 [entrez] AID - S0914-5087(26)00115-2 [pii] AID - 10.1016/j.jjcc.2026.06.009 [doi] PST - ppublish SO - J Cardiol. 2026 Oct;88(4):297-320. doi: 10.1016/j.jjcc.2026.06.009. Epub 2026 Jun 17. PMID- 42300821 OWN - NLM STAT- MEDLINE DCOM- 20260616 LR - 20260620 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 87 IP - 23 DP - 2026 Jun 16 TI - 10-Year Randomized Outcomes of Transcatheter or Surgical Aortic Valve Replacement in Intermediate-Risk Aortic Stenosis. PG - 3309-3321 LID - S0735-1097(26)06266-2 [pii] LID - 10.1016/j.jacc.2026.03.169 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an established alternative to surgical aortic valve replacement for symptomatic severe aortic stenosis, but long-term, comparative clinical outcomes and echocardiography data are lacking. OBJECTIVES: Our goal was to compare 10-year clinical and echocardiographic outcomes after balloon-expandable TAVR or surgery in intermediate-risk surgical patients in the PARTNER 2A randomized trial. METHODS: Between 2011 and 2013, patients with severe, symptomatic aortic stenosis at intermediate surgical risk were randomized at 57 centers to TAVR with the balloon-expandable SAPIEN XT system (Edwards Lifesciences) or to surgery. Randomization was stratified by anatomical suitability for transfemoral (TF) or transthoracic (transapical/transaortic [TA/TAo]) access. Ten-year outcomes were evaluated in the valve implant population and included all-cause mortality, aortic valve reintervention, and core laboratory-adjudicated echocardiographic outcomes. To obtain 10-year data, patient reconsent at 5 years was required, and vital status sweeps were implemented to improve data completeness for all-cause mortality. RESULTS: Among 1,910 randomized patients who received a valve, 974 underwent TAVR (TF: 749/974 [76.9%]) and 936 had surgery. Mean patient age was 81.6 years, 45.4% were women, and the mean Society of Thoracic Surgeons score was 5.8%. At 10 years, vital status was available for 881 of 974 patients (90.5%) and 838 of 936 patients (89.5%). All-cause 10-year mortality with vital status sweeps was 86.1% after TAVR and 82.8% after surgery (HR: 1.13; 95% CI: 1.02-1.25; P = 0.02). When stratified by access route, rates of all-cause mortality for TAVR and surgery in the TF group were similar (83.9% vs 82.1%, respectively; P = 0.27), whereas mortality was higher for TAVR in the TA/TAo group (93.2% vs 85.1%; P < 0.01; P for interaction = 0.03). Cumulative incidence rates of aortic valve reintervention at 10 years were 6.3% for TAVR and 1.6% for surgery (P < 0.001). Of the 24 TAVR and 35 surgical patients with available echocardiographic data at 10 years, mean gradients were 12.6 mm Hg and 12.7 mm Hg, respectively. CONCLUSIONS: At the 10-year follow-up, TAVR in intermediate-risk patients with the SAPIEN XT prosthesis compared with surgery was associated with lower survival rates, with differences predominantly observed in the TA/TAo access cohort. TAVR with the XT valve was also associated with significantly higher rates of aortic valve reintervention. (PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - XT Intermediate and High Risk [PII A]; NCT01314313). CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, Georgia, USA. Electronic address: Vinod.Thourani@piedmont.org. FAU - von Stein, Philipp AU - von Stein P AD - Cardiovascular Research Foundation, New York, New York, USA. FAU - Mack, Michael J AU - Mack MJ AD - The Heart Hospital Baylor Scott and White Plano, Plano, Texas, USA. FAU - Nazif, Tamim M AU - Nazif TM AD - Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. FAU - Babaliaros, Vasilis AU - Babaliaros V AD - Emory University Hospital, Atlanta, Georgia, USA. FAU - Alkhouli, Mohamad AU - Alkhouli M AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. FAU - Fischbein, Michael P AU - Fischbein MP AD - Stanford Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California, USA. FAU - Desai, Nimesh D AU - Desai ND AD - Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Satler, Lowell AU - Satler L AD - Section of Interventional Cardiology, Washington Hospital Center, Washington, DC, USA. FAU - Zidar, Frank J AU - Zidar FJ AD - Austin Heart, Austin, Texas, USA. FAU - Kodali, Susheel K AU - Kodali SK AD - Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. FAU - Kron, Irving L AU - Kron IL AD - Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA. FAU - Zajarias, Alan AU - Zajarias A AD - Cardiovascular Division, Washington University/Barnes Jewish Hospital, St Louis, Missouri, USA. FAU - Brinkman, William AU - Brinkman W AD - The Heart Hospital Baylor Scott and White Plano, Plano, Texas, USA. FAU - Kapadia, Samir AU - Kapadia S AD - Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Dewey, Todd M AU - Dewey TM AD - Medical City Dallas Hospital, Dallas, Texas, USA. FAU - Gossl, Mario AU - Gossl M AD - Valve Science Center, Allina Health Minneapolis Heart Institute, Minneapolis, Minnesota, USA. FAU - Bodenhamer, R Mark AU - Bodenhamer RM AD - University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA. FAU - Ma, Ying AU - Ma Y AD - Edwards Lifesciences, Irvine, California, USA. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York, New York, USA; St Francis Hospital and Heart Center, Roslyn, New York, USA. FAU - Sharma, Rahul AU - Sharma R AD - Division of Cardiovascular Medicine, Stanford Health Care, Stanford, California, USA. FAU - Pibarot, Philippe AU - Pibarot P AD - Quebec Heart & Lung Institute, Universite Laval, Quebec, Quebec, Canada. FAU - Hahn, Rebecca T AU - Hahn RT AD - Cardiovascular Research Foundation, New York, New York, USA; Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. FAU - Leon, Martin B AU - Leon MB AD - Cardiovascular Research Foundation, New York, New York, USA; Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars-Sinai Medical Center, Los Angeles, California, USA. CN - PARTNER 2 Investigators LA - eng SI - ClinicalTrials.gov/NCT01314313 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/diagnosis MH - Female MH - *Transcatheter Aortic Valve Replacement/methods/mortality MH - Treatment Outcome MH - Male MH - Aged, 80 and over MH - Follow-Up Studies MH - Echocardiography MH - Aged MH - Time Factors MH - *Heart Valve Prosthesis Implantation/methods MH - *Aortic Valve/surgery/diagnostic imaging MH - Risk Factors OTO - NOTNLM OT - 10-year outcomes OT - aortic stenosis OT - aortic valve replacement OT - intermediate risk OT - long-term outcomes OT - reintervention COIS- Funding Support and Author Disclosures The PARTNER 2 studies were funded by Edwards Lifesciences. Dr Thourani has received institutional grants from Abbott Vascular, Artivion, and Edwards Lifesciences; honoraria from Abbott Vascular, Artivion, Edwards Lifesciences, and JenaValve; steering committee member for Abbott Vascular and Edwards Lifesciences; and equity in DASI Simulations and Trisol Medical. Dr Mack is a trial co-principal investigator for Abbott and Edwards Lifesciences and a trial study chair for Medtronic. Dr Nazif has received consulting fees and honoraria for Edwards Lifesciences, Medtronic, and Boston Scientific. Dr Babaliaros has received consulting fees for Edwards Lifesciences and equity in transmural systems. Dr Desai has received consulting fees for Artivion, Edwards Lifesciences, Terumo Medical, and WL Gore. Dr Zidar is a consultant for Abbott, Edwards Lifesciences, and Medtronic. Dr Kodali has received consulting fees and honoraria from Shifamed, Phillips, Nyra Medical, Helix Valve Repair, Tioga Medical, Xdot, and Abbott Vascular and equity/stocks in Thubrikar Aortic Valve, Inc, Dura Biotech, Supira, MID, TriFlo, Adona, Tioga, Xdot, Moray Medical, Cardiomech, Reniva, Bonaparte, Relief Cardiovascular, V2V, Meacor, Akura, Nyra Medical, and Trajectory. Dr Zajarias is a consultant for Anteris Technologies, Edwards Lifesciences, and Medtronic. Dr Brinkman has received consulting fees for Artivion, Edwards Lifesciences, Terumo Medical, and WL Gore. Dr Ma is an employee of Edwards Lifesciences. Dr Cohen has received institutional research grants from Edwards Lifesciences, Abbott, Boston Scientific, Zoll Medical, Philips, Corvia, Corcinch, and Cathworks and consulting income from Edwards Lifesciences, Abbott, Boston Scientific, Medtronic, Zoll Medical, and Elixir Medical. Dr Sharma has received grant/research support from Edwards Lifesciences and Boston Scientific and consulting fees and honoraria from Abbott, Adona, Boston Scientific, Cathworks, Edwards Lifesciences, Egnite, Genesis, Medtronic, Opsens, Philips, Siemens, and Tioga. Dr Pibarot has received institutional funding from Edwards Lifesciences, Medtronic, Pi-Cardia, Cardiac Success, Boston Scientific, and Novartis for echocardiography core laboratory analyses and research studies in the field of valvular heart disease, for which he received no personal compensation. Dr Hahn has received speaker fees from Abbott Structural, Baylis Medical, Edwards Lifesciences, and Philips Healthcare and is Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored valve trials, for which she receives no direct industry compensation. Dr Leon has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and equity in Medinol, Mirus, and SoloPace. Dr Makkar has received research grants and travel support from Edwards, Medtronic, Abbott, Jena Valve, and Boston Scientific and scientific advisory board member and equity in i Cardio. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/06/16 13:49 MHDA- 2026/06/16 13:50 CRDT- 2026/06/16 09:11 PHST- 2026/01/02 00:00 [received] PHST- 2026/03/25 00:00 [revised] PHST- 2026/03/28 00:00 [accepted] PHST- 2026/06/16 13:50 [medline] PHST- 2026/06/16 13:49 [pubmed] PHST- 2026/06/16 09:11 [entrez] AID - S0735-1097(26)06266-2 [pii] AID - 10.1016/j.jacc.2026.03.169 [doi] PST - ppublish SO - J Am Coll Cardiol. 2026 Jun 16;87(23):3309-3321. doi: 10.1016/j.jacc.2026.03.169. PMID- 42300820 OWN - NLM STAT- MEDLINE DCOM- 20260616 LR - 20260620 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 87 IP - 23 DP - 2026 Jun 16 TI - 10-Year Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement or Surgery in Intermediate-Risk Patients. PG - 3296-3308 LID - S0735-1097(26)06267-4 [pii] LID - 10.1016/j.jacc.2026.03.170 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis. However, long-term outcomes data are lacking for TAVR, particularly with newer-generation transcatheter heart valves. OBJECTIVES: The purpose of this study was to compare 10-year outcomes of intermediate-risk patients who underwent TAVR with the third-generation, balloon-expandable SAPIEN 3 valve in the PARTNER 2 SAPIEN 3 Intermediate-risk Registry (P2S3i) with those who underwent surgery in the PARTNER 2A (P2A) randomized trial. METHODS: Intermediate-risk patients were enrolled in the P2A trial from 2011 through 2013 and in the P2S3i registry in 2014. These prospective, multicenter studies used the same eligibility criteria and stratified patients based on suitability for transfemoral or transthoracic (transapical/transaortic) access. Ten-year outcomes were evaluated, including all-cause mortality, aortic valve reintervention, and core laboratory-adjudicated echocardiographic outcomes. Patient reconsent was required at 5 years for extended 10-year follow-up, and vital status sweeps were implemented to improve data completeness for all-cause mortality. To account for potential baseline differences and reduce confounding, P2S3i TAVR patients were propensity score-matched 1:1 to P2A surgical patients. RESULTS: Among 2,005 patients who received a valve, 1,069 underwent TAVR in P2S3i and 936 underwent surgery in P2A. After propensity score matching (N = 783 patients in each group), baseline characteristics were similar between groups: mean age was approximately 82 years, 43% were female, and mean Society of Thoracic Surgeons score was 5.5%. At 10 years, all-cause mortality rate was 83.4% after TAVR and 82.3% after surgery, respectively (HR: 1.01 [95% CI: 0.91-1.13]; P = 0.82). Aortic valve reintervention rates adjusted for competing mortality were 2.0% for TAVR and 1.9% for surgery (P = 0.47). Among 32 TAVR and 30 surgical patients with available echocardiographic data at 10 years, mean gradients were 11.0 mm Hg and 12.6 mm Hg, respectively. CONCLUSIONS: At 10 years, TAVR with the SAPIEN 3 valve and surgery resulted in similar rates of mortality and aortic valve reintervention, and similar hemodynamics in intermediate-risk patients with symptomatic severe aortic stenosis. This analysis highlights challenges associated with extended long-term follow-up of clinical trials, including differential loss to follow-up and the competing risk of mortality in elderly populations. (PARTNER 2A Trial; NCT01314313; PARTNER 2 SAPIEN 3 Intermediate-Risk Registry; NCT03222128). CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Nazif, Tamim M AU - Nazif TM AD - Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. Electronic address: tmn31@cumc.columbia.edu. FAU - Simonato, Matheus AU - Simonato M AD - Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. Electronic address: https://twitter.com/msimonatomd. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars-Sinai Medical Center, Los Angeles, California, USA. FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, Georgia, USA. FAU - Desai, Nimesh D AU - Desai ND AD - University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Babaliaros, Vasilis AU - Babaliaros V AD - Emory University, Atlanta, Georgia, USA. FAU - Greason, Kevin AU - Greason K AD - Mayo Clinic, Rochester, Minnesota, USA. FAU - Rovin, Joshua AU - Rovin J AD - Morton Plant Hospital, Clearwater, Florida, USA. FAU - Waxman, Sergio AU - Waxman S AD - Newark Beth Israel Medical Center, Newark, New Jersey, USA. FAU - Davidson, Charles AU - Davidson C AD - Northwestern University, Evanston, Illinois, USA. FAU - Kereiakes, Dean J AU - Kereiakes DJ AD - The Christ Hospital and Lindner Research Center, Cincinnati, Ohio, USA. FAU - Gupta, Anuj AU - Gupta A AD - University of Maryland, Baltimore, Maryland, USA. FAU - Satler, Lowell AU - Satler L AD - Washington Hospital Center, Washington, District of Columbia, USA. FAU - Schwartz, Richard AU - Schwartz R AD - Winthrop University Hospital, Mineola, New York, USA. FAU - Kapadia, Samir AU - Kapadia S AD - Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Wong, S Chiu AU - Wong SC AD - Weill Cornell Medicine, New York, New York, USA. FAU - Smalling, Richard W AU - Smalling RW AD - University of Texas and Memorial Hermann Heart and Vascular Institute-TMC, Houston, Texas, USA. FAU - Ghani, Mohammad AU - Ghani M AD - Oklahoma Cardiovascular Research Group, Oklahoma City, Oklahoma, USA. FAU - Teirstein, Paul AU - Teirstein P AD - Scripps Clinic, La Jolla, California, USA. FAU - George, Isaac AU - George I AD - Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA. FAU - Potluri, Srinivasa AU - Potluri S AD - Baylor Scott and White The Heart Hospital Plano, Plano, Texas, USA. FAU - Szerlip, Molly AU - Szerlip M AD - Baylor Scott and White The Heart Hospital Plano, Plano, Texas, USA. FAU - Xu, Ke AU - Xu K AD - Edwards Lifesciences, Irvine, California, USA. FAU - Cohen, David J AU - Cohen DJ AD - St Francis Hospital, Roslyn, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Sharma, Rahul P AU - Sharma RP AD - Stanford University, Stanford, California, USA. FAU - Pibarot, Philippe AU - Pibarot P AD - Universite Laval, Quebec, Quebec, Canada. FAU - Hahn, Rebecca T AU - Hahn RT AD - Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Mack, Michael J AU - Mack MJ AD - Baylor Scott and White The Heart Hospital Plano, Plano, Texas, USA. FAU - Leon, Martin B AU - Leon MB AD - Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. CN - PARTNER 2 Investigators LA - eng SI - ClinicalTrials.gov/NCT03222128 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/mortality MH - Female MH - *Aortic Valve Stenosis/surgery/mortality/diagnosis MH - Male MH - Treatment Outcome MH - Registries MH - Prospective Studies MH - Aged, 80 and over MH - Follow-Up Studies MH - *Heart Valve Prosthesis MH - Risk Assessment MH - Aged MH - Time Factors MH - Risk Factors MH - Postoperative Complications MH - *Aortic Valve/surgery/diagnostic imaging OTO - NOTNLM OT - 10-year outcomes OT - PARTNER 2 trial OT - intermediate-risk OT - long-term outcomes OT - propensity score OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures The PARTNER 2 studies were funded by Edwards Lifesciences. Tamim M. Nazif has received consulting and honoraria from Edwards Lifesciences, Medtronic, and Boston Scientific. Dr Makkar has received research grants and travel support from Edwards, Medtronic, Abbott, Jena Valve, and Boston Scientific; and Scientific Advisory board and equity from iCardio. Dr Thourani has received institutional grants from Abbott Vascular, Cryolife, and Edwards Lifesciences; honoraria from Abbott Vascular, Cryolife, Edwards Lifesciences, and JenaValve; is a Steering Committee member for Abbott Vascular and Edwards Lifesciences; and has equity in DASI Simulations and Trisol Medical. Dr Desai has done consulting with Gore, Edwards Lifesciences, Terumo, and Artivion. Dr Babaliaros is a consultant for Edwards Lifesciences; and has equity in Transmural Systems. Dr Rovin is a consultant/advisory board member for Medtronic. Dr Waxman is a consultant for Baim Institute for Clinical Research, Cardiovascular Research Foundation - Clinical Trials Center, Insight Medical, Avania Clinical, and BioCardia Inc. Dr Davidson has received institutional grant/contract from Abbott Vascular; institutional grant/contract and uncompensated advisor from Edwards Lifesciences; and is a consultant for Philips. Dr Kereiakes is a Consultant for J.C. Medical and Edwards Lifesciences. Dr Wong has received institutional research grants from Edwards Lifesciences, Abbott Vascular, and Medtronic. Dr Smalling has received clinical trial support from Edwards Lifesciences. Dr Teirstein has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic; speaking and consulting fees from Boston Scientific, Edwards Lifesciences, and Medtronic; and equity in SoloPace. Dr George has received consultant honoraria from Zimmer Biomet, Atricure, Neosurgery, Neptune Medical, Abbvie, Johnson & Johnson, Durvena, Boston Scientific, Edwards Lifesciences, Medtronic, Encompass Medical, Summus Medical, Abbott SJM, BCI, Xeltis, Innocardiac, KIS Medical, Shockwave Medical, Retex Medical, and Mediscient AI. Dr Potluri has received consultant honoraria from Boston Scientific, Edwards, Terumo, Shockwave, and Philips. Dr Szerlip has been a Speaker/Consultant for Edwards Lifesciences, Abbott, and Boston Scientific; Advisory Board Member for Boston Scientific and Abbott; and Steering Committee Member for Medtronic. Ke Xu is an employee of Edwards Lifesciences. Dr Cohen has received institutional research grants from Edwards Lifesciences, Abbott, Boston Scientific, Zoll Medical, Philips, Corvia, Corcinch, and Cathworks; and consulting income from Edwards Lifesciences, Abbott, Boston Scientific, Medtronic, Zoll Medical, and Elixir Medical. Dr Sharma is a consultant for Edwards Lifesciences. Dr Pibarot has received institutional funding from Edwards Lifesciences, Medtronic, Pi-Cardia, Cardiac Success, Boston Scientific, and Novartis for echocardiography core laboratory analyses and research studies in the field of valvular heart disease, for which he received no personal compensation. Dr Hahn has received speaker fees from Abbott Structural, Baylis Medical, Edwards Lifesciences, and Philips Healthcare; and she is Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored valve trials, for which she receives no direct industry compensation. Dr Mack is a Trial Co-PI for Abbott and Edwards Lifesciences; and is a Trial Study Chair for Medtronic. Martin B. Leon has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic; and equity in Medinol, Mirus, and SoloPace. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/06/16 13:49 MHDA- 2026/06/16 13:50 CRDT- 2026/06/16 09:11 PHST- 2026/01/02 00:00 [received] PHST- 2026/03/25 00:00 [revised] PHST- 2026/03/28 00:00 [accepted] PHST- 2026/06/16 13:50 [medline] PHST- 2026/06/16 13:49 [pubmed] PHST- 2026/06/16 09:11 [entrez] AID - S0735-1097(26)06267-4 [pii] AID - 10.1016/j.jacc.2026.03.170 [doi] PST - ppublish SO - J Am Coll Cardiol. 2026 Jun 16;87(23):3296-3308. doi: 10.1016/j.jacc.2026.03.170. PMID- 42282060 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260612 LR - 20260813 IS - 2752-4191 (Electronic) IS - 2752-4191 (Linking) VI - 6 IP - 3 DP - 2026 May TI - Outcomes after inhospital, subacute, and elective TAVI in COMPARE-TAVI 1. PG - oeag083 LID - 10.1093/ehjopen/oeag083 [doi] LID - oeag083 AB - AIMS: We aimed to compare procedural, echocardiographic, and clinical outcomes within the first year after transcatheter aortic valve implantation (TAVI) among inhospital and subacute patients to elective patients in the COMPARE-TAVI 1 cohort. METHODS AND RESULTS: Among 1030 patients treated with TAVI, 927 (90%) had an elective procedure, 63 (6.1%) had a subacute procedure, and 40 (3.9%) had an inhospital procedure. Procedural characteristics and outcomes were comparable. Among elective, subacute, and inhospital patients, mortality at 30 days was 15 (1.6%), 0 (0%), and 0 (0%) and at 1 year 54 (5.8%), 4 (6.3%), and 2 (5.0%). Stroke at 30 days was 28 (3.0%), 0 (0%), and 3 (7.5%) and at 1 year 42 (4.5%), 5 (7.9%), and 3 (7.5%). New pacemaker at 30 days was 119 (14%), 12 (21%), and 6 (17%) and at 1 year 130 (16%), 14 (25%), and 7 (19%). Elective, subacute, and inhospital patients with LVEF /= 75 without a decline of >10 points from baseline). RESULTS: Of 739 patients enrolled in SCOPE I, 692 were included in the present analysis. Median baseline KCCQ-OS was 54.9 (39.6-71.9) distributed as follows: KCCQ-OS < 25-74 (10.7%), 25 to 49-222 (32.1%), 50 to 74-271 (39.2%), and >/= 75-125 (18.1%). At 3 years after TAVR, higher baseline KCCQ-OS was associated with a greater likelihood of being alive with good health status (KCCQ-OS 50-75 vs 0-25: adjusted odds ratio 2.25, 95% confidence interval [CI] 1.12-4.54; 75-100 vs 0-25: adjusted odds ratio 5.15, 95% CI 2.33-11.3). Restricted cubic spline modelling demonstrated an approximately linear relationship between baseline KCCQ-OS and all-cause mortality, and alive with good health status. CONCLUSIONS: In this post hoc analysis of SCOPE I, better baseline patient-reported health status was associated with a higher probability of being alive with good health status up to 3 years after TAVR. CLINICAL TRIAL REGISTRATION: https://www. CLINICALTRIALS: gov/study/NCT03011346. CI - Copyright (c) 2026 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Heg, Dik AU - Heg D AD - Department of Clinical Research, University of Bern, Bern, Switzerland. FAU - Thiele, Holger AU - Thiele H AD - Heart Centre Leipzig, Leipzig University, Leipzig, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, University of Giessen, Giessen, Germany. FAU - Joner, Michael AU - Joner M AD - German Heart Centre, Technical University of Munich, Munich, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Internal Medicine I, St.-Johannes-Hospital, Dortmund, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University of Koln, Koln, Germany. FAU - Thilo, Christian AU - Thilo C AD - Department of Internal Medicine I, RoMed Klinikum Rosenheim, Germany. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Prendergast, Bernard AU - Prendergast B AD - Department of Cardiology, St. Thomas' Hospital, Cleveland Clinic, London, UK. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. CN - SCOPE I Investigators LA - eng SI - ClinicalTrials.gov/NCT03011346 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20260526 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery/mortality MH - Female MH - Male MH - *Health Status MH - *Quality of Life MH - Aged, 80 and over MH - *Patient Reported Outcome Measures MH - Treatment Outcome MH - Aged MH - Prognosis COIS- Conflict of interest Dr Pilgrim reports research, travel or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, Medtronic and ATSens; speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr Windecker reports research, travel or educational grants to the institution without personal remuneration from Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Farapulse Inc. Fumedica, Guerbet, Idorsia, Inari Medical, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medalliance, Medicure, Medtronic, Merck Sharp & Dohm, Miracor Medical, MonarQ, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech. Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, V-Wave. Dr Windecker served as advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave with payments to the institution but no personal payments. He is also member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Prendergast reports speaker fees from Edwards Lifesciences and Polares Medical, serves as a steering/executive committee group member for Valvosoft, and is a Partner and Board Member of CERC CRO. Dr Toggweiler serves as a consultant and proctor for Medtronic, Biosensors, Edwards Lifesciences, Boston Scientific, Microport, as a proctor for Abbott Vascular, as a consultant for Medira, Shockwave, Teleflex, atHeart Medical, Cardiac Dimensions, Polares Medical, Amarin, Armira, P+F, has received speaker honoraria from Sanofi, AstraZeneca, ReCor Medical, Daiichi Sankyo, Bayer, has received institutional research grants from Medtronic, Edwards Lifesciences, Boston Scientific, Fumedica, Novartis, Boehringer Ingelheim, Polares Medical, and holds equity in Hi-D Imaging. Dr Kim reports receiving lecture fees from Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Meril Life Sciences, as well as institutional fees from Boston Scientific and Meril Life Sciences. He is also a proctor for Abbott Vascular, Boston Scientific, and Meril Life Sciences, as well as a consultant for HID Imaging and P&F. Dr Lanz reports speaker fees to the institution from Edwards Lifesciences and Abbott and served as advisory board member for Abbott. All other authors have no relationships to disclose that are relevant to the contents of this article. EDAT- 2026/05/28 00:29 MHDA- 2026/07/09 00:40 CRDT- 2026/05/27 19:36 PHST- 2026/01/07 00:00 [received] PHST- 2026/05/11 00:00 [revised] PHST- 2026/05/22 00:00 [accepted] PHST- 2026/07/09 00:40 [medline] PHST- 2026/05/28 00:29 [pubmed] PHST- 2026/05/27 19:36 [entrez] AID - S0002-8703(26)00157-2 [pii] AID - 10.1016/j.ahj.2026.107495 [doi] PST - ppublish SO - Am Heart J. 2026 Oct;300:107495. doi: 10.1016/j.ahj.2026.107495. Epub 2026 May 26. PMID- 42200635 OWN - NLM STAT- Publisher LR - 20260726 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 22 IP - 13 DP - 2026 May 20 TI - Clinical and haemodynamic outcomes with contemporary intra- and supra-annular self-expanding valves: the multicentre international HERA-TAVI registry. PG - e730-40 LID - EIJ-D-26-00390 [pii] LID - 10.4244/EIJ-D-26-00390 [doi] AB - BACKGROUND: Contemporary self-expanding transcatheter heart valves (THVs) differ in leaflet position and frame architecture. Comparative data between new-generation intra-annular (IA) and supra-annular (SA) platforms remain limited. AIMS: We sought to compare 30-day and 1-year clinical and haemodynamic outcomes between contemporary intra-annular and supra-annular self-expanding THVs in a large multicentre real-world cohort. METHODS: Consecutive patients undergoing transfemoral transcatheter aortic valve implantation with a Navitor/Navitor Vision (IA self-expanding valve [SEV]) or Evolut FX/FX+ (SA-SEV) between June 2021 and April 2025 were included. The primary endpoint was the composite of all-cause death, disabling stroke, or heart failure hospitalisation at 1 year. Propensity score matching (PSM) was performed to adjust for baseline differences. RESULTS: Among 2,607 patients (IA-SEV: 1,604; SA-SEV: 1,003), PSM yielded 892 well-balanced pairs. Valve Academic Research Consortium 3 device success was achieved in 91.1% of IA-SEV patients and 90.9% of SA-SEV patients (p=0.868). Permanent pacemaker implantation was more frequent with IA-SEVs (22.1% vs 16.3%; p=0.007), whereas major or life-threatening bleeding was more common with SA-SEVs (4.2% vs 2.6%; p<0.001). At 1 year, the primary endpoint occurred in 12.6% of IA-SEV patients and 11.3% of SA-SEV patients (p=0.422) with no difference between groups in the time-to-event analysis (hazard ratio [HR] 1.01, 95% confidence interval [CI]: 0.77-1.33; p=0.916). The mean transvalvular gradients and rates of moderate or severe paravalvular leak remained low and similar between the two groups at 1 year. Findings were consistent in the unmatched cohort (HR 1.02, 95% CI: 0.81-1.31; p=0.835). CONCLUSIONS: In this large real-world registry, contemporary IA-SEVs and SA-SEVs demonstrated overall similar clinical outcomes and sustained haemodynamic performance at 1-year follow-up, despite differences in procedure-related endpoints between the groups. FAU - Casenghi, Matteo AU - Casenghi M AD - Division of Cardiology, Sant'Andrea Hospital, Rome, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - De Biase, Chiara AU - De Biase C AD - Department of Cardiology, Clinique Pasteur, Toulouse, France. FAU - Paolisso, Pasquale AU - Paolisso P AD - Division of Cardiology, Sant'Andrea Hospital, Rome, Italy. AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. FAU - Gallinoro, Emanuele AU - Gallinoro E AD - Division of Cardiology, Sant'Andrea Hospital, Rome, Italy. FAU - Kobari, Yusuke AU - Kobari Y AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Khokhar, Arif AU - Khokhar A AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Adams, Alejandro Aruajo AU - Adams AA AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Testa, Luca AU - Testa L AD - Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Italy. FAU - Millin, Antonella AU - Millin A AD - Department of Cardiology, Clinique Pasteur, Toulouse, France. FAU - Giordano, Arturo AU - Giordano A AD - Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Corcione, Nicola AU - Corcione N AD - Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Vanderheyden, Marc AU - Vanderheyden M AD - Cardiovascular Center Aalst, AZORG, Aalst, Belgium. FAU - Corradetti, Sara AU - Corradetti S AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. AD - Cardiovascular Center Aalst, AZORG, Aalst, Belgium. FAU - Esposito, Giuseppe AU - Esposito G AD - Division of Interventional Cardiology, De Gasperis Cardio Center ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. FAU - Oreglia, Jacopo AU - Oreglia J AD - Division of Interventional Cardiology, De Gasperis Cardio Center ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. FAU - Montalto, Claudio AU - Montalto C AD - Division of Interventional Cardiology, De Gasperis Cardio Center ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Department of Medicine and Surgery, Kore University of Enna, Enna, Italy. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, AOU Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy. FAU - Cannata, Stefano AU - Cannata S AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies) - UPMC, Palermo, Italy. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies) - UPMC, Palermo, Italy. FAU - De Marco, Federico AU - De Marco F AD - Department of Interventional Cardiology, Centro Cardiologico Monzino IRCCS, Milan, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Department of Interventional Cardiology, Centro Cardiologico Monzino IRCCS, Milan, Italy. FAU - Ussia, Gian Paolo AU - Ussia GP AD - Research Unit of Translational and Experimental Cardiology, University Campus Bio-Medico, Rome, Italy. AD - Research Unit of Hemodynamics, UOC Emodinamica Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. FAU - Mangiacapra, Fabio AU - Mangiacapra F AD - Research Unit of Translational and Experimental Cardiology, University Campus Bio-Medico, Rome, Italy. AD - Research Unit of Hemodynamics, UOC Emodinamica Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. FAU - Toth, Gabor AU - Toth G AD - University Heart Center Graz, Medical University Graz, Graz, Austria. FAU - Di Lenarda, Francesca AU - Di Lenarda F AD - University Heart Center Graz, Medical University Graz, Graz, Austria. FAU - De Felice, Francesco AU - De Felice F AD - Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy. FAU - Cesario, Vincenzo AU - Cesario V AD - Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy. FAU - Nicolini, Elisa AU - Nicolini E FAU - Piva, Tommaso AU - Piva T AD - UOSD Emodinamica Interventistica, Strutturale e Pediatrica, AOU delle Marche, Torrette, Italy. FAU - Leone, Attilio AU - Leone A AD - Cardiology Unit, AORN San Giuseppe Moscati, Avellino, Italy. FAU - Berni, Andrea AU - Berni A AD - Division of Cardiology, Sant'Andrea Hospital, Rome, Italy. AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. FAU - Belmonte, Marta AU - Belmonte M AD - Division of Cardiology, Sant'Andrea Hospital, Rome, Italy. AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. FAU - Tchetche, Didier AU - Tchetche D AD - Department of Cardiology, Clinique Pasteur, Toulouse, France. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Bedogni, Francesco AU - Bedogni F AD - Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Italy. FAU - Barbato, Emanuele AU - Barbato E AD - Division of Cardiology, Sant'Andrea Hospital, Rome, Italy. AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. LA - eng PT - Journal Article DEP - 20260520 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM PMC - PMC13330125 COIS- D. Tchetche is a proctor for Edwards Lifesciences, Abbott, Medtronic, and Boston Scientific. C. De Biase is a consultant for Medtronic and Abbott. F. De Marco is a proctor and receives speaker fees from Medtronic and Abbott. A. Latib has served on the advisory board for Supira, Medtronic, Abbott, Boston Scientific, Edwards Lifesciences, Shifamed, NeoChord Inc, VDyne, Philips, Centerline Biomedical, VahatiCor, Advanced NanoTherapies, NuevoSono, Anteris, T45 Labs, Tioga, and Nyra Medical. The other authors have no conflicts of interest to declare. EDAT- 2026/05/27 12:35 MHDA- 2026/05/27 12:35 PMCR- 2027/07/06 CRDT- 2026/05/27 09:03 PHST- 2026/05/27 12:35 [medline] PHST- 2026/05/27 12:35 [pubmed] PHST- 2026/05/27 09:03 [entrez] PHST- 2027/07/06 00:00 [pmc-release] AID - EIJ-D-26-00390 [pii] AID - 10.4244/EIJ-D-26-00390 [doi] PST - aheadofprint SO - EuroIntervention. 2026 May 20;22(13):e730-40. doi: 10.4244/EIJ-D-26-00390. PMID- 42195097 OWN - NLM STAT- MEDLINE DCOM- 20260527 LR - 20260813 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 5 DP - 2026 Apr 28 TI - Valve-in-Valve TAVR in Surgical Stentless Aortic Bioprostheses, a Challenging Scenario. LID - 10.3390/medicina62050844 [doi] LID - 844 AB - Background and objectives: Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become an established treatment for failed surgical bioprostheses in patients at high surgical risk. However, procedures performed in degenerated stentless aortic valves remain particularly challenging because of the absence of a radiopaque frame, variable surgical implantation techniques, and a potentially increased risk of coronary obstruction. Evidence in this specific setting is limited. We conducted a systematic review of the literature to identify studies reporting ViV TAVI in degenerated stentless surgical bioprostheses. Materials and methods: Case reports and case series were included when patient-level or clearly identifiable data were available. Baseline characteristics, anatomical features, procedural strategies, and clinical outcomes were extracted and analyzed using a descriptive approach. A total of 54 studies were included, encompassing 294 ViV TAVI procedures performed in failed stentless aortic valves. Results: The mean patient age was 73.9 years, and the average STS-PROM score was 13.45%, reflecting a high-risk population. The most frequently treated prosthesis was the Medtronic Freestyle valve, and the predominant mechanism of failure was regurgitation. Transfemoral access represented the most common approach, while balloon-expandable and self-expanding transcatheter valves were used with similar frequency. Coronary protection strategies were adopted in a minority of procedures, whereas adjunctive procedural techniques such as pre- or post-dilation were relatively common. Device-related complications were mainly driven by coronary obstruction, while cardiac complications included myocardial infarction and unplanned coronary intervention. Overall, VARC-3 device success was achieved in the majority of procedures, with acceptable short-term mortality despite the complexity of the treated population. Conclusions: ViV TAVR in degenerated stentless bioprostheses appears feasible and generally effective but remains associated with specific procedural challenges, particularly related to coronary obstruction risk. Careful anatomical assessment and tailored procedural planning are essential, and larger contemporary studies are needed to better define optimal management strategies in this complex setting. FAU - Saltarocchi, Sara AU - Saltarocchi S AUID- ORCID: 0000-0002-5052-1205 AD - Department of General Surgery, Surgical Specialty and Anesthesiology "Paride Stefanini", Sapienza University of Rome, 00161 Rome, Italy. AD - Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, 85100 Potenza, Italy. FAU - D'Abramo, Mizar AU - D'Abramo M AUID- ORCID: 0000-0002-7310-7410 AD - Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, 00161 Rome, Italy. FAU - Chourda, Emmanouela AU - Chourda E AD - Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, 00161 Rome, Italy. FAU - De Orchi, Paolo AU - De Orchi P AD - Division of Cardiac Surgery, Azienda di Rilievo Nazionale e Alta Specializzazione "G. Brotzu", 09134 Cagliari, Italy. FAU - Spunticchia, Flaminia AU - Spunticchia F AD - Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, 00161 Rome, Italy. FAU - Totaro, Marco AU - Totaro M AD - Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, 00161 Rome, Italy. FAU - Vinciguerra, Mattia AU - Vinciguerra M AUID- ORCID: 0000-0001-5237-7342 AD - Department of Health and Life Sciences, European University of Rome, 00163 Rome, Italy. FAU - Romiti, Silvia AU - Romiti S AUID- ORCID: 0000-0002-9594-4033 AD - Department of Health and Life Sciences, European University of Rome, 00163 Rome, Italy. FAU - Giunti, Gabriele AU - Giunti G AD - Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, 85100 Potenza, Italy. FAU - Greco, Ernesto AU - Greco E AUID- ORCID: 0000-0003-3177-5303 AD - Department of Health and Life Sciences, European University of Rome, 00163 Rome, Italy. FAU - Miraldi, Fabio AU - Miraldi F AUID- ORCID: 0000-0002-2404-3369 AD - Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, 00161 Rome, Italy. LA - eng PT - Journal Article PT - Systematic Review DEP - 20260428 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation MH - *Bioprosthesis/adverse effects/standards MH - *Heart Valve Prosthesis/adverse effects/standards MH - *Aortic Valve/surgery MH - Aged MH - Female MH - Aged, 80 and over MH - Male MH - Prosthesis Failure MH - Aortic Valve Stenosis/surgery PMC - PMC13208222 OTO - NOTNLM OT - TAVR OT - bioprosthesis OT - coronary obstruction OT - stentless OT - valve-in-valve COIS- The authors declare no conflict of interest. EDAT- 2026/05/27 06:42 MHDA- 2026/05/27 06:43 PMCR- 2026/04/28 CRDT- 2026/05/27 01:12 PHST- 2026/03/12 00:00 [received] PHST- 2026/04/11 00:00 [revised] PHST- 2026/04/24 00:00 [accepted] PHST- 2026/05/27 06:43 [medline] PHST- 2026/05/27 06:42 [pubmed] PHST- 2026/05/27 01:12 [entrez] PHST- 2026/04/28 00:00 [pmc-release] AID - medicina62050844 [pii] AID - medicina-62-00844 [pii] AID - 10.3390/medicina62050844 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Apr 28;62(5):844. doi: 10.3390/medicina62050844. PMID- 42188059 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260526 LR - 20260813 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 13 IP - 5 DP - 2026 Apr 22 TI - Early Echocardiographic Changes Following Transcatheter Aortic Valve Implantation: A Comparative Analysis of Different Transcatheter Aortic Valve Systems. LID - 10.3390/jcdd13050173 [doi] LID - 173 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a viable alternative therapeutic approach for patients with severe aortic stenosis (AS), following technological innovations in transcatheter aortic valve systems and advances in clinical expertise, which aim to optimize valve hemodynamics. In this study, we aimed to compare early hemodynamic changes in different types of TAVI valves via two-dimensional echocardiography. METHODS: This retrospective observational study examined patients with severe AS who underwent transfemoral TAVI. Patients were classified according to expansion mechanism (self-expanding valves (SEVs) or balloon-expandable valves (BEVs)) and leaflet position relative to the annulus (supra-annular valves (SAVs) or intra-annular valves (IAVs)). The implanted prostheses were Edwards SAPIEN XT valves (ESV, Edwards Lifesciences, Irvine, CA, USA), Medtronic valves (Core Valve-MCV and Evolut R, Medtronic, Minneapolis, MN, USA), Portico valves (St. Jude Medical, Saint Paul, MN, USA), and Myval valves (Meril Life Sciences, Vapi, India). Baseline two-dimensional transthoracic echocardiography (TTE) datasets were compared with post-TAVI measures obtained before discharge. RESULTS: In total (n = 332), 275 (82.8%) patients were treated with SEVs, and 57 (17.2%) were treated with BEVs. In terms of leaflet position, 249 (75%) patients were treated with SAVs, and the remaining 83 (25%) patients were treated with IAVs. Transaortic gradients were comparable between patients treated with SEVs and BEVs. However, patients treated with IAVs exhibited significantly higher aortic maximum gradients (16 [13-21] mmHg vs. 14 [10-20] mmHg, p = 0.019) and mean gradients (9 [7-11] mmHg vs. 8 [5-10] mmHg, p = 0.014) compared to those receiving SAVs. Post-TAVI gradients were also compared based on each TAVI device. Although post-TAVI aortic maximum gradient was comparable among TAVI devices (p = 0.080), aortic mean gradient was significantly different among the valves (p = 0.006). Post hoc analyses demonstrated that the post-TAVI mean gradient was significantly lower in Medtronic CoreValve compared to the Myval (p = 0.013) and Portico (p = 0.030). No significant differences were observed in the frequency of perivalvular leak between the valve groups. CONCLUSIONS: We found that post-TAVI transaortic gradients of SEVs and BEVs were comparable; however, SAVs were associated with lower transaortic gradients than those of the IAVs. In addition, the frequency of >/=moderate PVL was comparable between the valve groups. FAU - Dursun, Huseyin AU - Dursun H AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Colluoglu, Tugce AU - Colluoglu T AUID- ORCID: 0000-0002-2227-6177 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Senturk, Bihter AU - Senturk B AUID- ORCID: 0000-0003-3568-4476 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Ozdamar, Hatice AU - Ozdamar H AD - Department of Cardiology, Tepecik Training and Research Hospital, Izmir 35020, Turkey. FAU - Oktay, Cisem AU - Oktay C AUID- ORCID: 0009-0003-7671-9740 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Uysal, Hacer AU - Uysal H AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Simsek, Husna Tugce AU - Simsek HT AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Tanriverdi, Zulkif AU - Tanriverdi Z AUID- ORCID: 0000-0002-1053-1417 AD - Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa 63300, Turkey. FAU - Kaya, Dayimi AU - Kaya D AUID- ORCID: 0000-0003-1364-7770 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. LA - eng PT - Journal Article DEP - 20260422 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC13206975 OTO - NOTNLM OT - TAVI valves OT - transcatheter aortic valve implantation OT - two-dimensional echocardiography OT - valve hemodynamics COIS- The authors declare no conflicts of interest. EDAT- 2026/05/26 17:41 MHDA- 2026/05/26 17:42 PMCR- 2026/04/22 CRDT- 2026/05/26 09:44 PHST- 2026/03/11 00:00 [received] PHST- 2026/04/09 00:00 [revised] PHST- 2026/04/15 00:00 [accepted] PHST- 2026/05/26 17:42 [medline] PHST- 2026/05/26 17:41 [pubmed] PHST- 2026/05/26 09:44 [entrez] PHST- 2026/04/22 00:00 [pmc-release] AID - jcdd13050173 [pii] AID - jcdd-13-00173 [pii] AID - 10.3390/jcdd13050173 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2026 Apr 22;13(5):173. doi: 10.3390/jcdd13050173. PMID- 42165481 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260521 LR - 20260813 IS - 2666-0849 (Electronic) IS - 2666-0849 (Linking) VI - 31 IP - 20 DP - 2026 May 20 TI - Intermittent Left Bundle Branch Block After Transcatheter Aortic Valve Replacement: Electrophysiological and Clinical Significance. PG - 107958 LID - S2666-0849(26)01117-4 [pii] LID - 10.1016/j.jaccas.2026.107958 [doi] LID - 107958 AB - CASE SUMMARY: An 87-year-old man with pre-existing first-degree atrioventricular block underwent transfemoral transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. Postprocedure, he developed worsening first-degree atrioventricular block and intermittent left bundle branch block with a paradoxical electrocardiographic pattern: Slightly longer PR intervals were associated with narrow QRS beats, whereas shorter PR intervals resulted in marked QRS widening. Electrophysiology study revealed advanced infra-Hisian conduction disease, with greater prolongation of the His-ventricular interval before narrow QRS beats, prompting permanent pacemaker implantation. TAKE-HOME MESSAGE: This case demonstrates that intermittent left bundle branch block after TAVR-particularly when associated with marked PR prolongation preceding apparent QRS narrowing-warrants careful evaluation, as it may mask high-risk trifascicular disease. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Cardinali, Francesco AU - Cardinali F AD - Cardiology and Arrhythmology Clinic, University Hospital "Azienda Ospedaliero-Universitaria delle Marche," Ancona, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy. FAU - Casella, Michela AU - Casella M AD - Cardiology and Arrhythmology Clinic, University Hospital "Azienda Ospedaliero-Universitaria delle Marche," Ancona, Italy; Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. FAU - Di Eusanio, Marco AU - Di Eusanio M AD - Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy; Cardiac Surgery Department, University Hospital "Azienda Ospedaliero-Universitaria delle Marche," Ancona, Italy. FAU - Dello Russo, Antonio AU - Dello Russo A AD - Cardiology and Arrhythmology Clinic, University Hospital "Azienda Ospedaliero-Universitaria delle Marche," Ancona, Italy; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy. FAU - Compagnucci, Paolo AU - Compagnucci P AD - Cardiology and Arrhythmology Clinic, University Hospital "Azienda Ospedaliero-Universitaria delle Marche," Ancona, Italy. Electronic address: paolocompagnucci1@gmail.com. LA - eng PT - Journal Article PL - Netherlands TA - JACC Case Rep JT - JACC. Case reports JID - 101757292 PMC - PMC13198071 OTO - NOTNLM OT - HV interval OT - TAVR OT - electrophysiology study OT - infra-Hisian disease OT - intermittent left bundle branch block OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Dello Russo is a consultant for Abbott Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/05/21 12:37 MHDA- 2026/05/21 12:38 PMCR- 2026/05/20 CRDT- 2026/05/21 08:28 PHST- 2026/01/21 00:00 [received] PHST- 2026/03/10 00:00 [revised] PHST- 2026/03/23 00:00 [accepted] PHST- 2026/05/21 12:38 [medline] PHST- 2026/05/21 12:37 [pubmed] PHST- 2026/05/21 08:28 [entrez] PHST- 2026/05/20 00:00 [pmc-release] AID - S2666-0849(26)01117-4 [pii] AID - 107958 [pii] AID - 10.1016/j.jaccas.2026.107958 [doi] PST - ppublish SO - JACC Case Rep. 2026 May 20;31(20):107958. doi: 10.1016/j.jaccas.2026.107958. PMID- 42162704 OWN - NLM STAT- In-Process LR - 20260908 IS - 1532-2165 (Electronic) IS - 1078-5884 (Linking) VI - 72 IP - 3 DP - 2026 Sep TI - A Multidisciplinary Approach for Safe Transfemoral Transcatheter Aortic Valve Implantation in Patients with High Risk Features for Access Complications. PG - 548-549 LID - S1078-5884(26)00492-2 [pii] LID - 10.1016/j.ejvs.2026.05.018 [doi] FAU - Smeets, Reinier R AU - Smeets RR AD - Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: rr.smeets@gmail.com. FAU - Prent, Anna AU - Prent A AD - Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. FAU - Maesen, Bart AU - Maesen B AD - Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. FAU - van 't Hof, Arnoud W J AU - van 't Hof AWJ AD - Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. FAU - Vriesendorp, Pieter A AU - Vriesendorp PA AD - Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. FAU - Mees, Barend M E AU - Mees BME AD - Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. LA - eng PT - Journal Article DEP - 20260519 PL - England TA - Eur J Vasc Endovasc Surg JT - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JID - 9512728 SB - IM OTO - NOTNLM OT - Multidisciplinary care team OT - Risk assessment OT - Transcatheter aortic valve replacement OT - Vascular access complications EDAT- 2026/05/21 05:33 MHDA- 2026/05/21 05:33 CRDT- 2026/05/20 23:55 PHST- 2026/02/09 00:00 [received] PHST- 2026/04/12 00:00 [revised] PHST- 2026/05/13 00:00 [accepted] PHST- 2026/05/21 05:33 [pubmed] PHST- 2026/05/21 05:33 [medline] PHST- 2026/05/20 23:55 [entrez] AID - S1078-5884(26)00492-2 [pii] AID - 10.1016/j.ejvs.2026.05.018 [doi] PST - ppublish SO - Eur J Vasc Endovasc Surg. 2026 Sep;72(3):548-549. doi: 10.1016/j.ejvs.2026.05.018. Epub 2026 May 19. PMID- 42140210 OWN - NLM STAT- Publisher LR - 20260515 IS - 1439-1902 (Electronic) IS - 0171-6425 (Linking) DP - 2026 May 15 TI - TAVR as a Viable Option for Patients with Pure Native Aortic Regurgitation. LID - 10.1055/a-2872-7708 [doi] AB - OBJECTIVE: Surgical aortic valve replacement (SAVR) is now considered the gold standard in the management of aortic regurgitation (AR). However, transcatheter aortic valve replacement (TAVR) is increasingly being used for the therapy of high-risk patients. The latest Chinese expert consensus states that TAVR can be used as one of the strategies for the treatment of pure AR, and no longer exists as an off-label option, providing a new way of thinking about the treatment of pure AR patients. METHODS: We comprehensively searched PUBMED, EMBASE, OVID, Web of Science, and Cochrane Library from the construction of the database to March 28, 2024, to obtain eligible clinical trial data for analysis. The study protocol was registered in PROSPERO (CRD42024529532). RESULTS: A total of 21 studies (5,978 patients) were included in the analysis. Device success rates ranged from 74 to 100%. Among these, 23 patients (0.35%) required implantation of a second valve. Thirty-five patients (0.59%) underwent intraoperative conversion to SAVR. The primary outcome-all-cause mortality within 30 days-was observed in 272 patients (4.6%). Secondary outcomes are summarized as follows: 120 patients (2.01%) experienced myocardial infarction within 30 days, and 110 patients (1.84%) experienced cerebrovascular events; major bleeding occurred in 384 patients (6.42%), while major vascular complications were lowest at 51 cases (0.85%). Four hundred two patients (6.72%) required permanent pacemaker implantation, and 266 patients (4.45%) experienced acute kidney injury. The incidence of moderate or severe postoperative AR was 61 cases (1.02%). CONCLUSION: AR could be an indication for transfemoral TAVR, which would benefit patients. CI - Thieme. All rights reserved. FAU - Feng, Jie AU - Feng J AD - Nanchang University, The Second Affiliated Hospital, Jiangxi Medical College, Department of Cardiology, China. FAU - Pi, Yanrong AU - Pi Y AD - Nanchang University, The Second Affiliated Hospital, Jiangxi Medical College, Department of Cardiology, China. FAU - Li, Kai AU - Li K AD - Nanchang University, The Second Affiliated Hospital, Jiangxi Medical College, Department of Cardiology, China. FAU - Han, Leilei AU - Han L AD - Nanchang University, The Second Affiliated Hospital, Jiangxi Medical College, Department of Cardiology, China. FAU - Liu, Yunman AU - Liu Y AD - Nanchang University, The Second Affiliated Hospital, Jiangxi Medical College, Department of Cardiology, China. FAU - Wu, Yanqing AU - Wu Y AUID- ORCID: 0000-0002-3042-271X AD - Nanchang University, The Second Affiliated Hospital, Jiangxi Medical College, Department of Cardiology, China. LA - eng GR - 2024ZD007/The Jiangxi Provincial Health Commission Science and Technology Innovation Key Project/ PT - Journal Article DEP - 20260515 PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 SB - IM COIS- The authors declare that they have no conflict of interest. EDAT- 2026/05/16 00:37 MHDA- 2026/05/16 00:37 CRDT- 2026/05/15 18:43 PHST- 2026/05/16 00:37 [medline] PHST- 2026/05/16 00:37 [pubmed] PHST- 2026/05/15 18:43 [entrez] AID - 10.1055/a-2872-7708 [doi] PST - aheadofprint SO - Thorac Cardiovasc Surg. 2026 May 15. doi: 10.1055/a-2872-7708. PMID- 42123194 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260513 LR - 20260813 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 9 DP - 2026 May 1 TI - Transfemoral Valve-in-Valve TAVI with MyVal for Failed Surgical Aortic Bioprostheses: Procedural Outcomes, Serial Hemodynamics, and Anatomy-Based Determinants of Residual Gradient. LID - 10.3390/jcm15093462 [doi] LID - 3462 AB - Background/Objectives: Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is an established treatment for failed surgical aortic bioprostheses, but dedicated data on the MyVal platform remain limited. We evaluated outcomes, hemodynamics, residual gradient, and an exploratory matched comparison with ACURATE neo2. Methods: This prospective, single-center cohort included consecutive patients with failed surgical aortic bioprostheses treated with MyVal ViV-TAVI between July 2022 and June 2025. Outcomes were reported according to VARC-3. Results: Sixty-eight patients were included (age 77 +/- 7 years; 51.5% women; EuroSCORE II 7.3 +/- 1.8%). Technical success was 100%, with no 30-day death, stroke, myocardial infarction, second-valve implantation, or emergency surgical conversion. Mean gradient decreased from 38.0 +/- 9.5 mmHg at baseline to 6.7 +/- 2.1 mmHg post-procedure and remained low at 1 year (8.1 +/- 2.5 mmHg; overall p < 0.001). AVA increased from 0.80 +/- 0.23 cm(2) to 1.98 +/- 0.19 cm(2) post-procedure and was 1.86 +/- 0.23 cm(2) at 1 year (overall p < 0.001). Smaller true internal diameter independently predicted elevated 1-year gradient (adjusted OR per 1-mm decrease 1.33, 95% CI 1.04-1.78; p = 0.028). In the exploratory matched comparison, safety and hemodynamic outcomes did not differ significantly between MyVal and ACURATE neo2. At a median follow-up of 12.8 months, all-cause mortality and heart failure hospitalization were each 4.4%. Conclusions: In this prospective single-center cohort, MyVal ViV-TAVI was associated with high procedural success and favorable 1-year hemodynamic outcomes, with residual gradient driven mainly by small surgical valve true internal diameter. FAU - Papadopoulos, Georgios E AU - Papadopoulos GE AUID- ORCID: 0000-0002-7155-9907 AD - Cardiology Department, Interbalkan Medical Center, 57001 Thessaloniki, Greece. FAU - Ninios, Ilias AU - Ninios I AUID- ORCID: 0000-0002-4444-3781 AD - Cardiology Department, Interbalkan Medical Center, 57001 Thessaloniki, Greece. FAU - Evangelou, Sotirios AU - Evangelou S AUID- ORCID: 0000-0002-3080-5729 AD - Cardiology Department, Interbalkan Medical Center, 57001 Thessaloniki, Greece. FAU - Ioannides, Andreas AU - Ioannides A AD - Cardiology Department, Interbalkan Medical Center, 57001 Thessaloniki, Greece. FAU - Nikitopoulos, Athinodoros AU - Nikitopoulos A AD - Cardiology Department, Interbalkan Medical Center, 57001 Thessaloniki, Greece. FAU - Ninios, Vlasis AU - Ninios V AUID- ORCID: 0000-0002-0390-7172 AD - Cardiology Department, Interbalkan Medical Center, 57001 Thessaloniki, Greece. LA - eng PT - Journal Article DEP - 20260501 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13163781 OTO - NOTNLM OT - ACURATE neo2 OT - MyVal OT - failed surgical bioprosthesis OT - hemodynamics OT - structural valve degeneration OT - transvalvular gradient OT - true internal diameter OT - valve-in-valve TAVI COIS- The authors declare no conflicts of interest. EDAT- 2026/05/13 06:31 MHDA- 2026/05/13 06:32 PMCR- 2026/05/01 CRDT- 2026/05/13 01:10 PHST- 2026/04/04 00:00 [received] PHST- 2026/04/20 00:00 [revised] PHST- 2026/04/28 00:00 [accepted] PHST- 2026/05/13 06:32 [medline] PHST- 2026/05/13 06:31 [pubmed] PHST- 2026/05/13 01:10 [entrez] PHST- 2026/05/01 00:00 [pmc-release] AID - jcm15093462 [pii] AID - jcm-15-03462 [pii] AID - 10.3390/jcm15093462 [doi] PST - epublish SO - J Clin Med. 2026 May 1;15(9):3462. doi: 10.3390/jcm15093462. PMID- 42118524 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260527 LR - 20260813 IS - 1568-5888 (Print) IS - 1876-6250 (Electronic) IS - 1568-5888 (Linking) VI - 34 IP - 6 DP - 2026 Jun TI - Dedicated versus non-dedicated transcatheter valves for pure native aortic regurgitation: a single-centre experience. PG - 206-215 LID - 10.1007/s12471-026-02048-4 [doi] AB - BACKGROUND: Aortic regurgitation (AR) is the third most common valvular heart disease in the Western world. Management of high-surgical-risk patients is challenging. The absence of calcifications in the aortic valve presents anchoring challenges for transcatheter aortic valve implantation (TAVI) in patients with severe native AR. The Trilogy device is a dedicated transcatheter heart valve for the treatment of AR and anchors by clipping onto the native aortic valve leaflets. Real-world data comparing dedicated vs. non-dedicated THVs remains scarce. METHODS: We evaluated 42 consecutive high- or prohibitive-surgical-risk patients with pure native AR who underwent transfemoral TAVI. Twenty-one patients received the Trilogy device, and 21 received non-dedicated transcatheter valves (THV). Co-primary endpoints were device success and early safety at 30 days. Secondary endpoints included valve embolisation, residual moderate-to-severe AR, new pacemaker implantation, mortality, and length of hospital stay. RESULTS: Device success was significantly higher with dedicated THVs (100% vs. 61.9%; p = 0.002). Early safety was comparable (71.4% vs. 61.9%; p = 0.513). There were 4 valve embolisations (9.5%) and two cardiovascular deaths (4.8%) in the non-dedicated group. Residual moderate-to-severe AR was absent in the dedicated cohort and occurred in 2 of 21 non-dedicated cases. Overall, new permanent pacemaker implantation occurred in 19%, with no significant difference between the 2 cohorts (p = 1.00). Median hospital stay was significantly shorter in the dedicated cohort (2 vs. 5 days; p = 0.015). CONCLUSION: TAVI with the Trilogy valve system had higher device success as compared to non-dedicated valves and should become the preferred transcatheter strategy for patients with severe native AR at high-operative risk. CI - (c) 2026. The Author(s). FAU - de Assis, Lucas Uchoa AU - de Assis LU AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Kostea, Antigone AU - Kostea A AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Mariani, Andrea AU - Mariani A AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. AD - Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. FAU - Mondellini, Giulio M AU - Mondellini GM AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - van den Dorpel, Mark M P AU - van den Dorpel MMP AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Kardys, Isabella AU - Kardys I AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Daemen, Joost AU - Daemen J AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Nuis, Rutger-Jan AU - Nuis RJ AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, The Netherlands. n.vanmieghem@erasmusmc.nl. LA - eng PT - Journal Article DEP - 20260512 PL - Netherlands TA - Neth Heart J JT - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation JID - 101095458 PMC - PMC13216396 OTO - NOTNLM OT - Aortic Valve Implantation OT - Aortic Valve Insufficiency OT - Heart Valve Prosthesis OT - Pacemaker OT - Transcatheter Aortic Valve Replacement OT - Treatment Outcome COIS- Conflict of interest: R.-J. Nuis: Research grant support from Vifor Pharma and Meril and consultancy fees from Edwards Lifesciences, Abbott, and Boston Scientific. J. Daemen: Institutional grant/research support from ACIST Medical, Abbott Vascular, Boston Scientific, Medtronic, Microport, Pie Medical, and ReCor Medical; and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST Medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, Medtronic, PulseCath, Pie Medical, ReCor Medical, Sanofi, and Siemens Health Care. N.M. Van Mieghem: Grant support/research contracts from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Daiichi Sankyo, AstraZeneca, and PulseCath BV; and consulting/speaker fees from Abbott Vascular, Boston Scientific Corporation, Medtronic, Daiichi Sankyo, PulseCath BV, JenaValve, and Amgen. L.U. de Assis, A. Kostea, A. Mariani, G.M. Mondellini, M.M. P. van den Dorpel and I. Kardys declare that they have no competing interests. EDAT- 2026/05/12 12:37 MHDA- 2026/05/12 12:38 PMCR- 2026/05/12 CRDT- 2026/05/12 11:22 PHST- 2026/01/08 00:00 [received] PHST- 2026/04/13 00:00 [accepted] PHST- 2026/05/12 12:38 [medline] PHST- 2026/05/12 12:37 [pubmed] PHST- 2026/05/12 11:22 [entrez] PHST- 2026/05/12 00:00 [pmc-release] AID - 10.1007/s12471-026-02048-4 [pii] AID - 2048 [pii] AID - 10.1007/s12471-026-02048-4 [doi] PST - ppublish SO - Neth Heart J. 2026 Jun;34(6):206-215. doi: 10.1007/s12471-026-02048-4. Epub 2026 May 12. PMID- 42109755 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260511 LR - 20260813 IS - 1671-5411 (Print) IS - 1671-5411 (Linking) VI - 23 IP - 3 DP - 2026 Mar 28 TI - Frailty as a predictor of delayed discharge and 12-month mortality following transcatheter aortic valve implantation. PG - 133-141 LID - 10.26599/1671-5411.2026.03.005 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is the principal treatment for aortic stenosis in older and high-risk patients. Whilst important in holistic decision making, frailty indices vary in ease of use, objectivity, and accuracy. We assess prognostic ability of the Clinical Frailty Scale (CFS) and Essential Frailty Toolset (EFT) in predicting delayed discharge and 1-year mortality following TAVI. METHODS: Prospective, single centre, observational cohort study of patients undergoing TAVI at a tertiary centre in the UK from 2020-2022. Clinical characteristics, CFS, and EFT were collected pre-procedurally. Primary outcomes were length of hospital stay following TAVI and mortality at 1- year post-procedure. Generalized regression with elastic net is used to assess the additive discriminative ability of frailty scores to predict outcomes. Stepwise regression is used to identify informative outcome predictors. RESULTS: One hundred and four patients were included with mean age 81.3 +/- 5.9 years, 47% female. Median post-procedural stay length was 2 days (IQR 2.75). Use of EFT and CFS resulted in a statistically significant prediction of survival at 1 year post TAVI (EFT: DeltaLogL of 2.68, ChiSq P = 0.021; RCFS DeltaLogL: 1.42, ChiSq P = 0.092) compared to predictive model using conventional clinical characteristics. EuroSCORE II and TAVI2SCORe were poor predictors of outcomes. CFS and access site (femoral vs. non-femoral) significantly improved prediction of delayed discharge. CONCLUSIONS: EFT informs decision making on survival 1-year post-TAVI, beyond conventional measures. Use of non-femoral access site and high CFS are the best predictors of delayed discharge. Surgical risk stratification scores poorly predict medium-term TAVI survival and delayed discharge. CI - (c) 2026 JGC All rights reserved; www.jgc301.com. FAU - Patel, Nirav AU - Patel N AD - School of Clinical Medicine, University of Cambridge, Cambridge UK. FAU - Brubert, Jacob AU - Brubert J AD - Department of Medicine, University of Cambridge, Cambridge, UK. FAU - Ballabio, Marco AU - Ballabio M AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - Teh, Wen Hui AU - Teh WH AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - Omoniyi, Oluwamayowa AU - Omoniyi O AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - D'Errico, Luigia AU - D'Errico L AD - Department of Radiology, Royal Papworth Hospital, Cambridge University Health Partners, Cambridge, UK. FAU - Evans, Nicholas AU - Evans N AD - Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK. FAU - Singh, Jayesh AU - Singh J AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - O'Sullivan, Michael AU - O'Sullivan M AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - Davies, Will AU - Davies W AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - Costopoulos, Charis AU - Costopoulos C AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. FAU - Costanzo, Pierluigi AU - Costanzo P AD - Department of Interventional Cardiology, Royal Papworth Hospital Royal Papworth NHS Foundation Trust, Cambridge UK. LA - eng PT - Journal Article PL - China TA - J Geriatr Cardiol JT - Journal of geriatric cardiology : JGC JID - 101237881 PMC - PMC13156545 COIS- None. EDAT- 2026/05/11 13:00 MHDA- 2026/05/11 13:01 PMCR- 2026/03/28 CRDT- 2026/05/11 06:38 PHST- 2026/05/11 13:01 [medline] PHST- 2026/05/11 13:00 [pubmed] PHST- 2026/05/11 06:38 [entrez] PHST- 2026/03/28 00:00 [pmc-release] AID - jgc-23-3-133 [pii] AID - 10.26599/1671-5411.2026.03.005 [doi] PST - ppublish SO - J Geriatr Cardiol. 2026 Mar 28;23(3):133-141. doi: 10.26599/1671-5411.2026.03.005. PMID- 42075545 OWN - NLM STAT- MEDLINE DCOM- 20260716 LR - 20260813 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 4 DP - 2026 Apr 1 TI - Computed Tomography Coronary Angiography as a Gatekeeper for Invasive Coronary Assessment Before Transcatheter Aortic Valve Implantation. LID - 10.3390/medicina62040673 [doi] LID - 673 AB - Transcatheter aortic valve implantation (TAVI) has become the predominant treatment strategy for severe aortic stenosis across all surgical risk categories. The coexistence of coronary artery disease (CAD) in 40-75% of TAVI candidates has traditionally mandated pre-procedural invasive coronary angiography (ICA). However, computed tomography coronary angiography (CTCA), which is already integral to TAVI planning for annular sizing and access route evaluation, offers the potential to assess coronary anatomy simultaneously. Accumulating evidence demonstrates that CTCA possesses excellent sensitivity (90-97%) and high negative predictive value (94-99%) for excluding significant proximal CAD, potentially serving as a reliable gatekeeper to avoid unnecessary ICA in a substantial proportion of patients. This approach is particularly attractive given the questionable benefit of routine pre-emptive coronary revascularization in stable TAVI candidates, as demonstrated by the ACTIVATION and NOTION-3 trials. This review synthesizes the current evidence on the diagnostic performance of CTCA, clinical outcomes with CT-guided strategies, technical considerations and limitations, and the evolving paradigm of coronary assessment in the contemporary TAVI era. We propose a practical algorithm integrating CTCA as a first-line screening tool, reserving ICA for patients with suspected significant proximal disease, thereby optimizing resource utilization while maintaining patient safety. FAU - Apostolos, Anastasios AU - Apostolos A AUID- ORCID: 0000-0003-2616-7952 AD - Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London UB9 6JH, UK. FAU - Ktenopoulos, Nikolaos AU - Ktenopoulos N AUID- ORCID: 0000-0002-0995-7015 AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Theodoropoulou, Theoni AU - Theodoropoulou T AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Vlachakis, Panayotis AU - Vlachakis P AUID- ORCID: 0000-0003-0736-4942 AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Karakasis, Paschalis AU - Karakasis P AUID- ORCID: 0000-0002-3561-5713 AD - Second Department of Cardiology, "Hippokration" General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece. FAU - Milaras, Nikias AU - Milaras N AUID- ORCID: 0000-0001-7312-0976 AD - Department of Cardiology, "Hippokration" General Hospital, 11527 Athens, Greece. FAU - Iliakis, Panagiotis AU - Iliakis P AUID- ORCID: 0009-0004-5768-9125 AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. AD - Department of Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Knappschaft Kliniken University Hospital Bochum, Ruhr University Bochum, 44892 Bochum, Germany. FAU - Synetos, Andreas AU - Synetos A AUID- ORCID: 0000-0001-8516-1177 AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. AD - Faculty of Medicine, European University of Cyprus, Egkomi 2404, Cyprus. FAU - Latsios, George AU - Latsios G AUID- ORCID: 0000-0002-9133-9258 AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Drakopoulou, Maria AU - Drakopoulou M AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Chrysostomidis, Grigorios AU - Chrysostomidis G AD - Department of Cardiac Surgery, Onassis Cardiac Surgery Center, 17674 Athens, Greece. FAU - Tsigkas, Grigorios AU - Tsigkas G AUID- ORCID: 0000-0002-2779-0765 AD - Department of Cardiology, University Hospital of Patras, 26504 Patras, Greece. FAU - Toutouzas, Konstantinos AU - Toutouzas K AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Tsioufis, Konstantinos AU - Tsioufis K AUID- ORCID: 0000-0002-7636-6725 AD - First Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Panoulas, Vasileios AU - Panoulas V AD - Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London UB9 6JH, UK. LA - eng PT - Journal Article PT - Review DEP - 20260401 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Coronary Angiography/methods MH - *Computed Tomography Angiography/methods/standards MH - *Coronary Artery Disease/diagnostic imaging/diagnosis MH - Aortic Valve Stenosis/surgery PMC - PMC13117171 OTO - NOTNLM OT - computed tomography coronary angiography OT - coronary artery disease OT - invasive coronary angiography OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2026/05/04 06:32 MHDA- 2026/05/04 06:33 PMCR- 2026/04/01 CRDT- 2026/05/04 01:18 PHST- 2026/02/17 00:00 [received] PHST- 2026/03/18 00:00 [revised] PHST- 2026/03/23 00:00 [accepted] PHST- 2026/05/04 06:33 [medline] PHST- 2026/05/04 06:32 [pubmed] PHST- 2026/05/04 01:18 [entrez] PHST- 2026/04/01 00:00 [pmc-release] AID - medicina62040673 [pii] AID - medicina-62-00673 [pii] AID - 10.3390/medicina62040673 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Apr 1;62(4):673. doi: 10.3390/medicina62040673. PMID- 42074897 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260504 LR - 20260813 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 8 DP - 2026 Apr 18 TI - Vascular Complications in Transcatheter Aortic Valve Replacement Using 14 vs. 18 French Plug-Based Percutaneous Closure Devices: A Propensity Score-Matched Observational Study. LID - 10.3390/jcm15083095 [doi] LID - 3095 AB - Background/Objectives: Plug-based vascular closure devices (Pb-VCDs) are routinely used in 14 and 18 French (F) size for percutaneous vascular access site closure during transfemoral transcatheter aortic valve replacement (TAVR). Recently, larger 18F Pb-VCDs were linked to increased incidence of vascular complications in randomized comparisons. Smaller 14F devices are hypothesized to decrease the incidence of vascular complications, but real-world data on their safety in routine clinical practice is scarce. Methods: We performed a retrospective, propensity score-matched comparison of patients receiving either 14F or 18F Pb-VCDs during TAVR from March 2019 to December 2020. The choice of 14F or 18F Pb-VCD utilization depended on the sheath size during the procedure. No other vascular closure systems (VCDs) were used despite the MANTA (Teleflex Inc.((R)), Morrisville, NC, USA) Pb-VCD. The primary endpoints were major and minor vascular complications defined by valve academic research consortium-3 (VARC 3) criteria. Secondary endpoints included VARC-3 bleeding events, length of hospital stay and in-hospital mortality. Results: A total of 183 (14F Pb-VCD) and 110 (18F Pb-VCD) patients were included in 1:1 propensity score matching and resulted in 85 matched patient pairs. The primary endpoint of major and minor vascular complications was balanced between the groups (major: 3.5% (14F Pb-VCD) versus (vs.) 0.0% (18F Pb-VCD), p = 0.25; minor: 12.9% vs. 14.1, p = 1.00). Secondary endpoints of VARC-3 bleeding events (p = 1.00), length of hospital stay (p = 0.34), and in-hospital mortality (p = 1.00) were equally distributed. Conclusions: There is no difference in major and minor VARC-3-defined vascular complications between the 14F and 18F groups in our study. Following this real-world observational analysis, observed rates of vascular complications need to be validated in prospective controlled trials. FAU - Lerchner, Tobias AU - Lerchner T AUID- ORCID: 0000-0003-1120-4087 AD - Doctoral Programs, Witten-Herdecke University, 58455 Witten, Germany. FAU - Zapustas, Norvydas AU - Zapustas N AD - Department of Cardiology, Helios University Heart Center, Witten-Herdecke University, 42117 Wuppertal, Germany. FAU - Seyfarth, Melchior AU - Seyfarth M AUID- ORCID: 0000-0002-9473-8262 AD - Department of Cardiology, Helios University Heart Center, Witten-Herdecke University, 42117 Wuppertal, Germany. FAU - Tiroch, Klaus AU - Tiroch K AD - Department of Cardiology, Heart Center Bodensee, Witten-Herdecke University, 78464 Konstanz, Germany. FAU - Holzhey, David AU - Holzhey D AUID- ORCID: 0000-0002-0613-4419 AD - Department of Cardiothoracic Surgery, Helios University Heart Center, Witten-Herdecke University, 42117 Wuppertal, Germany. FAU - Vorpahl, Marc Michael AU - Vorpahl MM AD - Department of Cardiology, Helios Heart Center, Witten-Herdecke University, 53721 Siegburg, Germany. LA - eng PT - Journal Article DEP - 20260418 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13116924 OTO - NOTNLM OT - 14 French OT - TAVR OT - access site complications OT - plug-based vascular closure OT - structural heart COIS- K.T., M.M.V., M.S., and N.Z. have no competing interests to declare that are relevant to the content of this article. T.L. has received personal fees outside the submitted work from Bayer and Pfizer. D.H. reports to be an advisor for Medtronic outside of the submitted work. EDAT- 2026/05/04 06:33 MHDA- 2026/05/04 06:34 PMCR- 2026/04/18 CRDT- 2026/05/04 01:16 PHST- 2026/03/18 00:00 [received] PHST- 2026/04/07 00:00 [revised] PHST- 2026/04/16 00:00 [accepted] PHST- 2026/05/04 06:34 [medline] PHST- 2026/05/04 06:33 [pubmed] PHST- 2026/05/04 01:16 [entrez] PHST- 2026/04/18 00:00 [pmc-release] AID - jcm15083095 [pii] AID - jcm-15-03095 [pii] AID - 10.3390/jcm15083095 [doi] PST - epublish SO - J Clin Med. 2026 Apr 18;15(8):3095. doi: 10.3390/jcm15083095. PMID- 42073394 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260504 LR - 20260813 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 16 IP - 4 DP - 2026 Apr 1 TI - Anesthesia Type and Outcomes After Transfemoral TAVI: A Time-Sensitive Comparative Analysis. LID - 10.3390/life16040584 [doi] LID - 584 AB - Background: The optimal anesthesia strategy for transfemoral transcatheter aortic valve implantation (TAVI) remains uncertain. We evaluated the impact of local anesthesia, conscious sedation, and general anesthesia on early and long-term outcomes after TAVI. Methods: This single-center cohort included 401 patients undergoing transfemoral TAVI with local anesthesia (LA, n = 77), conscious sedation (CS, n = 147), or general anesthesia (GA, n = 177). Outcomes were assessed using hierarchical win-ratio analysis prioritizing mortality over major adverse cardiovascular and cerebrovascular events (MACCE), supported by Kaplan-Meier and restricted mean survival time analyses. Sensitivity analyses using inverse probability of treatment weighting (IPTW) were performed to account for baseline differences between groups. Results: Baseline comorbidities were broadly comparable, although GA patients had higher-risk anatomical and procedural features. In unadjusted win-ratio analyses, LA showed a significant advantage over GA at 0-6 months (win ratio [WR] 1.79; 95% CI 1.10-2.93; p = 0.020). After multivariable adjustment, LA remained superior to GA at 6-12 and 12-24 months (adjusted WR 1.67 and 1.56, both p < 0.05). One-year mortality differed significantly among groups (p = 0.012). RMST analysis demonstrated a cumulative survival advantage for LA versus GA, reaching 6.6 months at 60 months. MACCE-free survival was largely comparable across strategies. However, in IPTW-weighted analyses, anesthesia type was not independently associated with mortality or MACCE. Conclusions: Minimally invasive anesthesia strategies were associated with more favorable early survival patterns after transfemoral TAVI in primary analyses. However, after adjustment for baseline differences using IPTW, anesthesia type was not independently associated with mortality or MACCE. These findings suggest that apparent outcome differences may partly reflect underlying patient risk profiles rather than a purely causal effect of anesthesia strategy. FAU - Kiris, Tuncay AU - Kiris T AUID- ORCID: 0000-0001-9793-718X AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Esin, Fatma AU - Esin F AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Bozkurt, Hakan AU - Bozkurt H AUID- ORCID: 0009-0007-6681-7194 AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Palac, Berkay AU - Palac B AUID- ORCID: 0009-0007-6609-5187 AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Akar, Bahadir AU - Akar B AUID- ORCID: 0009-0004-0558-4583 AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Celik, Aykan AU - Celik A AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Ozdemir, Emre AU - Ozdemir E AUID- ORCID: 0000-0003-0034-3022 AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Aksun, Murat AU - Aksun M AD - Department of Anesthesiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. FAU - Karaca, Mustafa AU - Karaca M AD - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir 35360, Turkey. LA - eng PT - Journal Article DEP - 20260401 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC13117895 OTO - NOTNLM OT - MACCE OT - TAVI OT - anesthesia strategy OT - conscious sedation OT - general anesthesia OT - local anesthesia OT - restricted mean survival time OT - time-dependent ROC OT - win-ratio COIS- The authors declare no conflicts of interest. EDAT- 2026/05/04 06:32 MHDA- 2026/05/04 06:33 PMCR- 2026/04/01 CRDT- 2026/05/04 01:10 PHST- 2026/02/10 00:00 [received] PHST- 2026/03/19 00:00 [revised] PHST- 2026/03/25 00:00 [accepted] PHST- 2026/05/04 06:33 [medline] PHST- 2026/05/04 06:32 [pubmed] PHST- 2026/05/04 01:10 [entrez] PHST- 2026/04/01 00:00 [pmc-release] AID - life16040584 [pii] AID - life-16-00584 [pii] AID - 10.3390/life16040584 [doi] PST - epublish SO - Life (Basel). 2026 Apr 1;16(4):584. doi: 10.3390/life16040584. PMID- 42065941 OWN - NLM STAT- MEDLINE DCOM- 20260518 LR - 20260518 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 27 IP - 4 DP - 2026 Apr 1 TI - Long-term clinical outcomes of TAVI in hospitals without on-site cardiac surgery: insights from the MURGIA-TAVI Registry. PG - 268-276 LID - 10.2459/JCM.0000000000001875 [doi] AB - AIMS: Transcatheter aortic valve implantation (TAVI) is the standard of care for elderly (>/=70 years) or high-risk patients with severe aortic stenosis, yet current guidelines recommend its performance only in Heart Valve Centres with on-site cardiac surgery. This study evaluated procedural safety and long-term outcomes of TAVI performed in selected non-surgical centres. METHODS: We retrospectively analysed 186 consecutive patients undergoing TAVI at 'F. Miulli' Hospital between 2016 and 2024, enrolled in the MURGIA-TAVI Registry. The programme operated without institutional on-site cardiac surgery, supported by a structured Heart Team approach and a visiting surgical back-up. Outcomes were assessed according to Valve Academic Research Consortium-3 definitions and survival was evaluated up to 5 years. RESULTS: Among 186 patients (mean age 82 years; STS score 7%), transfemoral access was used in 93%. Technical success was 98.9%, with no intraprocedural deaths. Conversion to emergent cardiac surgery occurred in two patients (1.1%); both survived at 30 days. In-hospital mortality was 1.6%, never valve-related. Major complications included cardiac tamponade (1.6%), major bleeding (2.2%) and major vascular complications (1.1%). At 1 year, mortality was 15.6% with no valve-related deaths, and valve dysfunction occurred in 1.9% of patients. Five-year survival reached 52.5%. Outcomes, including rates of emergent cardiac surgery, were comparable to those reported in published registries from centres without institutional on-site cardiac surgery. CONCLUSIONS: Our findings suggest that TAVI can be safely performed in selected hospitals without on-site cardiac surgery within a structured Heart Team framework and a visiting surgical back-up, potentially expanding access, shortening waiting times, and meeting the growing demand for TAVI. CI - Copyright (c) 2026 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Mancini, Giandomenico AU - Mancini G AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Scarcia, Maria AU - Scarcia M AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Basile, Eloisa AU - Basile E AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Martimucci, Marcello AU - Martimucci M AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Guida, Pietro AU - Guida P AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Casamassima, Vito AU - Casamassima V AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Xhelo, Alessandro AU - Xhelo A AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Speziale, Giuseppe AU - Speziale G AD - Department of Cardiac Surgery, Santa Maria Hospital, Bari. FAU - Visicchio, Giuseppe AU - Visicchio G AD - Department of Cardiac Surgery, Santa Maria Hospital, Bari. FAU - Massaro, Fabrizia AU - Massaro F AD - Department of Anaesthesia and Intensive Care, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti, Italy. FAU - Magnesa, Giovanna AU - Magnesa G AD - Department of Anaesthesia and Intensive Care, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti, Italy. FAU - Langialonga, Tommaso AU - Langialonga T AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Paradies, Valeria AU - Paradies V AD - Department of Cardiology, Maasstad Hospital, Rotterdam, The Netherlands. FAU - Iorio, Elia AU - Iorio E AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. FAU - Grimaldi, Massimo AU - Grimaldi M AD - Department of Cardiology, Ente Ecclesiastico Ospedale Generale Regionale 'F. Miulli', Acquaviva delle Fonti. LA - eng PT - Journal Article DEP - 20260410 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods/statistics & numerical data MH - Registries/statistics & numerical data MH - Retrospective Studies MH - *Aortic Valve Stenosis/diagnosis/mortality/surgery MH - Hospital Mortality MH - *Postoperative Complications/epidemiology MH - Risk Factors MH - Emergency Treatment/statistics & numerical data MH - Treatment Outcome MH - Severity of Illness Index MH - Femoral Artery/surgery MH - Subclavian Artery/surgery MH - Computed Tomography Angiography MH - Electrocardiography MH - Aortic Valve/diagnostic imaging/surgery MH - Humans MH - Male MH - Female MH - Aged MH - Aged, 80 and over MH - Follow-Up Studies OTO - NOTNLM OT - Heart Team OT - Valve Academic Research Consortium-3 OT - aortic stenosis OT - on-site cardiac surgery OT - outcomes OT - transcatheter aortic valve implantation EDAT- 2026/05/01 18:44 MHDA- 2026/05/01 18:45 CRDT- 2026/05/01 12:22 PHST- 2025/12/19 00:00 [received] PHST- 2026/03/04 00:00 [accepted] PHST- 2026/05/01 18:45 [medline] PHST- 2026/05/01 18:44 [pubmed] PHST- 2026/05/01 12:22 [entrez] AID - 01244665-202604000-00003 [pii] AID - 10.2459/JCM.0000000000001875 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2026 Apr 1;27(4):268-276. doi: 10.2459/JCM.0000000000001875. Epub 2026 Apr 10. PMID- 42061671 OWN - NLM STAT- MEDLINE DCOM- 20260626 LR - 20260626 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 271 DP - 2026 Jul 15 TI - CT-Guided Risk Stratification for Selective Femoral Protection Guidewire Use in Transfemoral TAVI. PG - 198-206 LID - S0002-9149(26)00314-0 [pii] LID - 10.1016/j.amjcard.2026.04.061 [doi] AB - Despite device improvement and systematic procedure planning based on multislice computed tomography (MSCT), vascular and bleeding complications remain common adverse events after transfemoral transcatheter aortic valve implantation (TF-TAVI). To date, the best way to conduct a TF-TAVI procedure in order to reduce the occurrence and facilitate the treatment of vascular/bleeding complications is unknown. TF-TAVI streamlining includes skipping femoral protection strategies and might be the ideal solution for patients with low vascular risk. To quantify the incidence and clinical impact of operative iliofemoral vascular events after TF-TAVI and to identify MSCT-derived predictors that may inform selective use of femoral protection strategies. We analyzed 960 consecutive patients undergoing TF-TAVI with high-quality preprocedural MSCT imaging of the operative aorto-iliofemoral axis. The primary endpoint was 30-day vascular events, defined as a composite of operative iliofemoral access vascular complications (VARC-3) and/or need for balloon hemostasis. Complications related to the secondary access were adjudicated separately. Independent predictors were assessed using multivariable logistic regression. Vascular events occurred in 128 patients (13.3%), driven by operative access-site vascular (major or minor) complications (9.8%) and balloon hemostasis need (3.5%). Patients with vascular events were more often female and had smaller iliofemoral lumen dimensions, higher sheath-to-artery ratio (STAR), and more extensive circumferential calcification. At multivariable analysis, independent predictors were female sex (odds ratios [OR] 1.90; 95% confidence intervals [CI] 1.38-2.60; p < 0.001), STAR >1 (OR 1.63; 95% CI 1.12-2.40; p = 0.011), and calcification arc >/=90 degrees across all 3 iliofemoral segments (common iliac, external iliac, and common femoral arteries) (OR 2.45; 95% CI 1.04-5.74; p = 0.040). Vascular events were associated with higher 30-day mortality (4.7% vs 1.3%; p = 0.022) and major bleeding (VARC-3 type 3: 3.1% vs 1.0%; p = 0.040; type 4: 1.6% vs 0.1%; p = 0.006). In conclusion, in contemporary TF-TAVI, approximately 1 in 8 patients experiences operative iliofemoral vascular events requiring peripheral bailout measures. An MSCT-derived "fragile access" profile (female sex, STAR >1, and diffuse circumferential iliofemoral calcification) may help target protection strategies. Condensed abstract In a large cohort of 960 TF-TAVI patients, operative ilio-femoral vascular events occurred in 13.3% and were associated with increased 30-day mortality and major bleeding. Patients with events had smaller ilio-femoral lumen dimensions, higher sheath-to-artery ratio (STAR), and more extensive circumferential calcification. Independent CT-guided predictors were female sex (OR 1.90), STAR >1 (OR 1.63), and calcification arc >/=90 degrees across all three iliofemoral segments (OR 2.45). These findings support CT-based selection of femoral protection strategies, reserving ancillary access and bailout readiness for "fragile access" anatomy and reducing invasiveness when anatomy is favorable. CI - Copyright (c) 2026 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Bianchini, Francesco AU - Bianchini F AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Electronic address: enromagnoli@gmail.com. FAU - Aurigemma, Cristina AU - Aurigemma C AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Trivigno, Chiara AU - Trivigno C AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Auletta, Francesco AU - Auletta F AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Saglioccolo, Giuseppe AU - Saglioccolo G AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Casamassima, Fabio AU - Casamassima F AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Girlando, Nunzio AU - Girlando N AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Piccinni, Carlo AU - Piccinni C AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Paraggio, Lazzaro AU - Paraggio L AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Cammertoni, Federico AU - Cammertoni F AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Bruno, Piergiorgio AU - Bruno P AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Bianchini, Emiliano AU - Bianchini E AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiology, University of Galway, Galway, Ireland. FAU - Marano, Riccardo AU - Marano R AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Natale, Luigi AU - Natale L AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Trani, Carlo AU - Trani C AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. LA - eng PT - Journal Article DEP - 20260428 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Female MH - *Femoral Artery/diagnostic imaging MH - *Aortic Valve Stenosis/surgery MH - Aged, 80 and over MH - Male MH - Risk Assessment/methods MH - *Multidetector Computed Tomography/methods MH - Retrospective Studies MH - *Postoperative Complications/epidemiology/prevention & control MH - Risk Factors MH - Incidence OTO - NOTNLM OT - calcification OT - iliofemoral access OT - multislice computed tomography OT - transcatheter aortic valve implantation OT - vascular complications COIS- Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Francesco Bianchini reports a relationship with Abbott that includes: funding grants. Mattia Lunardi reports a relationship with Terumo Interventional Systems that includes: speaking and lecture fees. Mattia Lunardi reports a relationship with Abbott Vascular Inc that includes: speaking and lecture fees. Enrico Romagnoli reports a relationship with Abbott Vascular Inc that includes: speaking and lecture fees. Enrico Romagnoli reports a relationship with Terumo Interventional Systems that includes: speaking and lecture fees. Francesco Burzotta reports a relationship with Abbott Vascular Inc that includes: speaking and lecture fees. Francesco Burzotta reports a relationship with AbioMed Inc that includes: speaking and lecture fees. Francesco Burzotta reports a relationship with Medtronic that includes: speaking and lecture fees. Francesco Burzotta reports a relationship with Terumo Interventional Systems that includes: speaking and lecture fees. Carlo Trani reports a relationship with Abbott Vascular Inc that includes: speaking and lecture fees. Carlo Trani reports a relationship with AbioMed Inc that includes: speaking and lecture fees. Carlo Trani reports a relationship with Medtronic that includes: speaking and lecture fees. Carlo Trani reports a relationship with Terumo Interventional Systems that includes: speaking and lecture fees. Cristina Aurigemma reports a relationship with AbioMed Inc that includes: speaking and lecture fees. Cristina Aurigemma reports a relationship with Medtronic that includes: speaking and lecture fees. Cristina Aurigemma reports a relationship with Abbott Vascular Inc that includes: speaking and lecture fees. Cristina Aurigemma reports a relationship with Terumo Interventional Systems that includes: speaking and lecture fees. Cristina Aurigemma reports a relationship with Daiichi Sankyo Inc that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/05/01 00:32 MHDA- 2026/06/27 00:50 CRDT- 2026/04/30 19:18 PHST- 2026/03/06 00:00 [received] PHST- 2026/04/08 00:00 [revised] PHST- 2026/04/19 00:00 [accepted] PHST- 2026/06/27 00:50 [medline] PHST- 2026/05/01 00:32 [pubmed] PHST- 2026/04/30 19:18 [entrez] AID - S0002-9149(26)00314-0 [pii] AID - 10.1016/j.amjcard.2026.04.061 [doi] PST - ppublish SO - Am J Cardiol. 2026 Jul 15;271:198-206. doi: 10.1016/j.amjcard.2026.04.061. Epub 2026 Apr 28. PMID- 42053056 OWN - NLM STAT- Publisher LR - 20260903 IS - 1308-4488 (Electronic) IS - 1016-5169 (Linking) DP - 2026 Apr 29 TI - Transcatheter Management of Severe Aortic Insufficiency in a Left Ventricular Assist Device Recipient with a Small Aortic Annulus. LID - 10.5543/tkda.2026.37109 [doi] AB - We report the case of a 72-year-old woman with a HeartMate III left ventricular assist device who developed severe aortic regurgitation and New York Heart Association Class III symptoms. Given her high surgical risk and the presence of a small aortic annulus (mean diameter 18.4 mm), transfemoral transcatheter aortic valve replacement was performed using a 26-mm Evolut PRO+ self-expanding valve under transesophageal echocardiographic guidance. Temporary reduction of left ventricular assist device (LVAD) speed prevented ventricular migration during deployment. The procedure resulted in complete resolution of regurgitation without complications. This case demonstrates the feasibility and safety of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic regurgitation in patients with LVADs and small annuli, when meticulous pre-procedural planning and careful intraoperative management are employed. FAU - Keskin, Berhan AU - Keskin B AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Dursun, Atakan AU - Dursun A AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Akhundova, Aysel AU - Akhundova A AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Karaca, Ibrahim Oguz AU - Karaca IO AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Boztosun, Bilal AU - Boztosun B AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. LA - eng PT - Journal Article TT - Kucuk Aortik Anulusa Sahip Sol Ventrikul Destek Cihazi Tasiyan Hastada Ciddi Aort Kapak Yetmezliginin Transkateter Yontemle Tedavisi. DEP - 20260429 PL - Turkey TA - Turk Kardiyol Dern Ars JT - Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir JID - 9426239 SB - IM EDAT- 2026/04/29 12:43 MHDA- 2026/04/29 12:43 CRDT- 2026/04/29 06:52 PHST- 2026/04/29 12:43 [medline] PHST- 2026/04/29 12:43 [pubmed] PHST- 2026/04/29 06:52 [entrez] AID - 10.5543/tkda.2026.37109 [doi] PST - aheadofprint SO - Turk Kardiyol Dern Ars. 2026 Apr 29. doi: 10.5543/tkda.2026.37109. PMID- 42017242 OWN - NLM STAT- MEDLINE DCOM- 20261020 LR - 20261021 IS - 1942-0080 (Electronic) IS - 1941-9651 (Linking) VI - 19 IP - 10 DP - 2026 Oct TI - Impact of Virtual Reality on Transcatheter Aortic Valve Implantation: A Prospective Randomized Controlled Trial. PG - e018922 LID - 10.1161/CIRCIMAGING.125.018922 [doi] AB - BACKGROUND: Accurate preprocedural planning is crucial for a successful transcatheter aortic valve implantation to ensure patient safety and valve longevity. Through 3-dimensional visualization, virtual reality (VR) offers the potential to enhance this process. The study investigated whether the inclusion of VR in preprocedural planning can improve the procedural preparation, impact intraprocedural parameters, and improve short-term patient outcomes. METHODS: This randomized, prospective, controlled study included 140 patients who underwent transcatheter aortic valve implantation at the University Hospital Duesseldorf between April and August 2024. In the control group, preprocedural planning was based on multislice computed tomography data using 3mensio software, while in the intervention group, it was supplemented with VR software. In addition, interventionalists assessed both tools via a structured questionnaire. RESULTS: The evaluation did not reveal any relevant differences in patient characteristics. VR was superior to 3mensio software with respect to the 3-dimensional understanding (P<0.001). Similarly, depth perception, visualization of atherosclerotic plaques, and iliofemoral tortuosity were better in the VR group. Both methods were found to be useful and helpful in preparing for the procedure. There were no significant differences in procedural data between the 2 groups. However, the VR group had a lower rate of bleeding at the access site (P<0.05). There was no significant difference in the length of hospital stay or postprocedural transthoracic echocardiography data evaluations. CONCLUSIONS: The data show that VR visualization can optimize preparation for the procedure by improving the 3-dimensional understanding of the aortic valve and adjacent structures. The detailed visualization of the access routes can lead to a reduction in periprocedural complications. FAU - Kanschik, Dominika AU - Kanschik D AUID- ORCID: 0000-0001-7927-8045 AD - Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty (D.K., D. Steinhoff, K.K., M.K., T.Z., C.J.). FAU - Steinhoff, Dominik AU - Steinhoff D AD - Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty (D.K., D. Steinhoff, K.K., M.K., T.Z., C.J.). FAU - Klein, Kathrin AU - Klein K AD - Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty (D.K., D. Steinhoff, K.K., M.K., T.Z., C.J.). FAU - Lichtenberg, Artur AU - Lichtenberg A AUID- ORCID: 0000-0001-8580-6369 AD - Department of Cardiac Surgery, Medical Faculty (A.L., C.B., D. Stadnik, M.S.), University Hospital and Heinrich-Heine University, Germany. AD - Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Germany (A.L., M.K., T.Z., C.J.). FAU - Ballazs, Christina AU - Ballazs C AUID- ORCID: 0000-0001-9575-8081 AD - Department of Cardiac Surgery, Medical Faculty (A.L., C.B., D. Stadnik, M.S.), University Hospital and Heinrich-Heine University, Germany. FAU - Stadnik, Dmytro AU - Stadnik D AUID- ORCID: 0000-0002-5109-222X AD - Department of Cardiac Surgery, Medical Faculty (A.L., C.B., D. Stadnik, M.S.), University Hospital and Heinrich-Heine University, Germany. FAU - Scherner, Maximilian AU - Scherner M AUID- ORCID: 0009-0006-6543-5226 AD - Department of Cardiac Surgery, Medical Faculty (A.L., C.B., D. Stadnik, M.S.), University Hospital and Heinrich-Heine University, Germany. FAU - Antoch, Gerald AU - Antoch G AD - Department of Diagnostic and Interventional Radiology, Medical Faculty (G.A.), University Hospital and Heinrich-Heine University, Germany. FAU - Kelm, Malte AU - Kelm M AUID- ORCID: 0000-0003-0060-1052 AD - Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty (D.K., D. Steinhoff, K.K., M.K., T.Z., C.J.). AD - Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Germany (A.L., M.K., T.Z., C.J.). FAU - Zeus, Tobias AU - Zeus T AUID- ORCID: 0000-0002-4517-0068 AD - Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty (D.K., D. Steinhoff, K.K., M.K., T.Z., C.J.). AD - Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Germany (A.L., M.K., T.Z., C.J.). FAU - Jung, Christian AU - Jung C AUID- ORCID: 0000-0001-8325-250X AD - Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty (D.K., D. Steinhoff, K.K., M.K., T.Z., C.J.). AD - Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Germany (A.L., M.K., T.Z., C.J.). LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20260422 PL - United States TA - Circ Cardiovasc Imaging JT - Circulation. Cardiovascular imaging JID - 101479935 SB - IM MH - Humans MH - *Virtual Reality MH - Female MH - Prospective Studies MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Male MH - Aged, 80 and over MH - *Multidetector Computed Tomography MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Treatment Outcome MH - *Aortic Valve/surgery/diagnostic imaging MH - Imaging, Three-Dimensional MH - Aged MH - *Surgery, Computer-Assisted/methods OTO - NOTNLM OT - diagnostic imaging OT - transcatheter aortic valve implantation OT - virtual reality COIS- None. EDAT- 2026/04/22 06:33 MHDA- 2026/10/20 17:34 CRDT- 2026/04/22 05:03 PHST- 2026/10/20 17:34 [medline] PHST- 2026/04/22 06:33 [pubmed] PHST- 2026/04/22 05:03 [entrez] AID - 10.1161/CIRCIMAGING.125.018922 [doi] PST - ppublish SO - Circ Cardiovasc Imaging. 2026 Oct;19(10):e018922. doi: 10.1161/CIRCIMAGING.125.018922. Epub 2026 Apr 22. PMID- 42013298 OWN - NLM STAT- MEDLINE DCOM- 20260703 LR - 20260813 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 108 IP - 1 DP - 2026 Jul TI - Pre-Existing and New-Onset Atrial Fibrillation in Patients Undergoing Transcatheter Aortic Valve Implantation. PG - 114-123 LID - 10.1002/ccd.70632 [doi] AB - BACKGROUND: Atrial fibrillation (AF) is a frequent comorbidity in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). In addition, new-onset AF can occur after TAVI. However, data on how AF affects outcomes in patients undergoing TAVI remain conflicting. AIMS: To assess clinical outcomes in patients with severe aortic valve stenosis with AF who undergo TAVI in a large real-world global cohort. METHODS: The CENTER2-study includes 25,771 patients that underwent TAVI between 2007 and 2022. The database consists of patient-level pooled data from 10 clinical studies. Objectives were rates of new-onset AF /= 30 kg/m(2)) undergoing transfemoral TAVR. Patients were randomized to tirzepatide therapy or standard care. The primary endpoint was HALT incidence at 6 months assessed by 4D-CT or transesophageal echocardiography (TEE). Secondary endpoints included PVL severity, major adverse valve events (MAVE), inflammatory biomarker changes, weight reduction, and bleeding outcomes. RESULTS: Among 260 randomized patients, tirzepatide therapy significantly reduced HALT incidence (8.4% vs 21.6%, p = 0.002) and >/= mild PVL (10.7% vs 25.3%, p = 0.006) at 6 months. Tirzepatide was associated with marked reductions in CRP and body weight without an increase in major bleeding. Multivariable analysis identified tirzepatide use, CRP reduction >30%, and BMI <32 kg/m(2) at follow-up as independent predictors of HALT absence. CONCLUSIONS: Metabolic modulation with tirzepatide significantly improves post-TAVR valve healing and hemodynamics in obese patients. These findings introduce a novel cardio-metabolic strategy to reduce structural valve complications following TAVR. TRIAL SUMMARY: TAVR-MET STUDY: The TAVR-MET trial was a prospective, randomized, multicenter study designed to evaluate whether metabolic modulation with tirzepatide, a dual GIP/GLP-1 receptor agonist, could improve bioprosthetic valve outcomes following transcatheter aortic valve replacement (TAVR) in obese patients. Obesity is increasingly recognized as a key determinant of post-TAVR complications, particularly subclinical leaflet thrombosis (HALT) and paravalvular leak (PVL), driven by chronic inflammation, endothelial dysfunction, and a prothrombotic state. Tirzepatide has demonstrated potent weight-reducing, anti-inflammatory, and vascular protective effects, but its role in structural valve outcomes had not previously been explored. The trial enrolled 260 obese patients (BMI >/= 30 kg/m(2)) undergoing transfemoral TAVR across eight high-volume centers. Participants were randomized to receive tirzepatide initiated four weeks before TAVR and continued for 12 months, or standard care alone. All patients received guideline-directed antithrombotic therapy. The primary endpoint was the incidence of HALT at six months assessed by advanced imaging. Secondary endpoints included PVL severity, major adverse valve events, inflammatory biomarker changes, weight reduction, and bleeding outcomes. At six months, tirzepatide therapy was associated with a significant reduction in HALT compared with standard care, as well as a marked decrease in >/= mild paravalvular leak. These structural valve improvements were accompanied by substantial weight loss and significant reductions in systemic inflammatory markers, without an increase in major bleeding or adverse safety signals. Multivariable analysis confirmed tirzepatide use and inflammation reduction as independent predictors of improved valve outcomes. In conclusion, the TAVR-MET trial provides the first clinical evidence that targeted metabolic therapy can favorably influence bioprosthetic valve healing after TAVR. These findings support a novel cardio-metabolic strategy for improving post-TAVR outcomes in obese patients and highlight the importance of addressing metabolic inflammation alongside procedural excellence in contemporary structural heart interventions. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Thirugnanam, A M AU - Thirugnanam AM AD - Department of Interventional Cardiology, TX Hospitals, Hyderabad, Telangana, India. Electronic address: drcardio9000@gmail.com. FAU - Chandrakanth AU - Chandrakanth AD - Department of Interventional Cardiology, TX Hospitals, Hyderabad, Telangana, India. FAU - Pruthvi AU - Pruthvi AD - Department of Interventional Cardiology, TX Hospitals, Hyderabad, Telangana, India. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Review DEP - 20260323 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 RN - OYN3CCI6QE (Tirzepatide) SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve/physiopathology/diagnostic imaging/surgery/drug effects MH - *Aortic Valve Insufficiency/prevention & control/physiopathology/diagnostic imaging/etiology MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology/complications MH - Heart Valve Prosthesis MH - *Obesity/diagnosis/complications/drug therapy/physiopathology MH - Prospective Studies MH - Risk Factors MH - *Thrombosis/diagnostic imaging/etiology/physiopathology/prevention & control MH - Time Factors MH - *Tirzepatide/adverse effects/therapeutic use MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Treatment Outcome MH - United States OTO - NOTNLM OT - Cardio-metabolic therapy OT - GLP-1/GIP agonist OT - Hypoattenuated leaflet thickening OT - Obesity OT - Paravalvular leak OT - Subclinical leaflet thrombosis OT - TAVR OT - Tirzepatide OT - Transcatheter aortic valve replacement OT - Valve durability COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. No external funding, grants, or material support were received from pharmaceutical or medical device companies for the conduct of this study. EDAT- 2026/04/19 13:11 MHDA- 2026/08/20 23:35 CRDT- 2026/04/18 22:08 PHST- 2026/01/30 00:00 [received] PHST- 2026/03/10 00:00 [revised] PHST- 2026/03/16 00:00 [accepted] PHST- 2026/08/20 23:35 [medline] PHST- 2026/04/19 13:11 [pubmed] PHST- 2026/04/18 22:08 [entrez] AID - S1553-8389(26)00102-8 [pii] AID - 10.1016/j.carrev.2026.03.011 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2026 Aug;89:87-90. doi: 10.1016/j.carrev.2026.03.011. Epub 2026 Mar 23. PMID- 41987217 OWN - NLM STAT- MEDLINE DCOM- 20260527 LR - 20260813 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 21 IP - 1 DP - 2026 Apr 15 TI - Safety and effectiveness of balloon-expandable Myval transcatheter aortic valve implantation: a single-center, real-world evidence from Kazakhstan. LID - 10.1186/s13019-026-04087-9 [doi] LID - 277 AB - BACKGROUND: Untreated aortic stenosis (AS) leads to significant mortality and morbidity. Balloon-expandable Myval transcatheter heart valve (THV) has demonstrated safety and effectiveness for treating severe AS in patients at intermediate or high risk for surgery. This retrospective observational study aimed to analyze the safety and efficacy of Myval THV in AS patients who underwent transcatheter aortic valve implantation (TAVI) at a single-center. METHODS: Data from 100 consecutive patients who underwent transfemoral TAVI for severe symptomatic AS with Myval THV were analyzed. Baseline characteristics including medical history, clinical features, procedural data, laboratory and echocardiographic data, and outcome data at discharge and 30 days were collected retrospectively. Outcomes as defined according to the consensus document of the Valve Academic Research Consortium-3 were determined. RESULTS: Baseline characteristics of 100 patients were: 64% males, mean age: 70.87 +/- 7.85 years, mean body mass index: 27.97 +/- 4.30 Kg/m(2), Society of Thoracic Surgeons risk score: 2.88 +/- 2.18% and log EuroSCORE: 3.34 +/- 2.82% respectively. Following transfemoral TAVI, mean and peak gradients were reduced (p < 0.001). There was a significant improvement in Vmax 2.50 +/- 1.52 m/s (p < 0.0001), left ventricular ejection fraction 50.5 +/- 10.64% (p = 0.0003), aortic valve area 1.76 +/- 0.52 (p = 0.0013), and indexed aortic valve area 0.92 +/- 0.28 (p = 0.0034) at discharge which continued at 30-day follow-up. Nearly 94% of patients were asymptomatic and in the New York Heart Association class I-II, with 22% of patients reduced the degree of mitral regurgitation at 30 days. At discharge, only 4.12% had moderate aortic regurgitation while 73.2% had none. Two patients had stroke while 15 patients had conduction disturbances, which led to the implantation of permanent pacemakers. No death or hospitalization were reported. Life-threatening bleeding and access-related complications did not occur in any patient. The rates of the device and technical success were 95%. CONCLUSION: Real-world data on the use of technologically advanced Myval THV leads to safe and precise orthotopic positioning in TAVI patients, ensuring optimal, large effective orifice area, and normal hemodynamic status. CI - (c) 2026. The Author(s). FAU - Mussayev, Abdurashid AU - Mussayev A AD - Department of the Catheterization Laboratory, University Medical Center, Astana, 010000, Kazakhstan. abdurashid.mussayev@gmail.com. FAU - Alimbayev, Serik AU - Alimbayev S AD - Department of Interventional Cardiology, University Medical Center, Astana, 010000, Kazakhstan. FAU - Amanzholova, Zhanar AU - Amanzholova Z AD - Department of Interventional Cardiology, University Medical Center, Astana, 010000, Kazakhstan. amanzholova.j96@gmail.com. FAU - Tanaliyev, Nursultan AU - Tanaliyev N AD - Department of Interventional Cardiology, University Medical Center, Astana, 010000, Kazakhstan. FAU - Kali, Aknur AU - Kali A AD - Department of Interventional Cardiology, University Medical Center, Astana, 010000, Kazakhstan. FAU - Murzagaliyev, Muradym AU - Murzagaliyev M AD - Department of Adult Cardiac Surgery, University Medical Center, Astana, 010000, Kazakhstan. FAU - Seidanov, Dinmukhamed AU - Seidanov D AD - Department of Anesthesiology, University Medical Center, Astana, 010000, Kazakhstan. FAU - Bimakhan, Almas Zhangirkhanuly AU - Bimakhan AZ AD - Department of Radiology and Nuclear Medicine, University Medical Center, Astana, 010000, Kazakhstan. FAU - Lesbekov, Timur AU - Lesbekov T AD - Department of Adult Cardiac Surgery, University Medical Center, Astana, 010000, Kazakhstan. FAU - Kamzayeva, Tolganay AU - Kamzayeva T AD - Department of the Catheterization Laboratory, University Medical Center, Astana, 010000, Kazakhstan. FAU - Orynbassar, Nursultan AU - Orynbassar N AD - Department of the Catheterization Laboratory, University Medical Center, Astana, 010000, Kazakhstan. FAU - Raissov, Yerkezhan AU - Raissov Y AD - Department of Interventional Cardiology, University Medical Center, Astana, 010000, Kazakhstan. FAU - Pya, Yuriy AU - Pya Y AD - Department of Adult Cardiac Surgery, University Medical Center, Astana, 010000, Kazakhstan. LA - eng PT - Journal Article PT - Observational Study DEP - 20260415 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/adverse effects MH - *Aortic Valve Stenosis/surgery/diagnosis MH - Female MH - Retrospective Studies MH - Male MH - Treatment Outcome MH - Aged MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - Echocardiography MH - *Aortic Valve/surgery/diagnostic imaging MH - Follow-Up Studies MH - Aged, 80 and over PMC - PMC13214117 OTO - NOTNLM OT - Aortic stenosis OT - Kazakhstan OT - Myval OT - Real-world study OT - TAVI OT - Transcatheter heart valve COIS- Declarations. Ethics approval and consent to participate: The study was approved by the institutional ethics committee and was performed according to the guidelines provided by the committee. being a retrospective study, it was exempted from the informed consent process. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2026/04/16 13:09 MHDA- 2026/05/27 06:33 PMCR- 2026/04/15 CRDT- 2026/04/16 01:12 PHST- 2025/10/04 00:00 [received] PHST- 2026/04/06 00:00 [accepted] PHST- 2026/05/27 06:33 [medline] PHST- 2026/04/16 13:09 [pubmed] PHST- 2026/04/16 01:12 [entrez] PHST- 2026/04/15 00:00 [pmc-release] AID - 10.1186/s13019-026-04087-9 [pii] AID - 4087 [pii] AID - 10.1186/s13019-026-04087-9 [doi] PST - epublish SO - J Cardiothorac Surg. 2026 Apr 15;21(1):277. doi: 10.1186/s13019-026-04087-9. PMID- 41973212 OWN - NLM STAT- Publisher LR - 20260413 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) DP - 2026 Apr 13 TI - In-hospital outcomes and cost-effectiveness of transcatheter aortic valve replacement among younger patients: a double/debiased machine learning approach using electronic health records in Germany. LID - 10.1007/s00392-026-02911-9 [doi] AB - BACKGROUND: The prevalence of severe symptomatic aortic stenosis is increasing with population aging. Although surgical aortic valve replacement (SAVR) has traditionally been the standard treatment, transfemoral transcatheter aortic valve replacement (TF-TAVR) is increasingly used. The optimal treatment for patients aged 60-75 remains debated. METHODS: This retrospective cohort study analyzed 28,805 German patients who underwent isolated SAVR or TF-TAVR (2018-2022). We applied double/debiased machine learning estimators that combined adaptive lasso variable selection with propensity score-based weighting across 21 baseline characteristics. Cost-effectiveness was assessed via incremental cost-effectiveness ratios (ICER) and cost-effectiveness acceptability curves from in-hospital and 1-year perspectives. RESULTS: Compared with SAVR, TF-TAVR was associated with a significant reduction in in-hospital mortality (causal risk ratio [RR] 0.65; p = 0.012), along with lower rates of bleeding (RR 0.29; p < 0.001), postoperative delirium (RR 0.32; p < 0.001), and mechanical ventilation > 48 h (RR 0.39; p < 0.001). No significant difference was observed in acute kidney injury rates (RR 0.89; p = 0.150). However, reimbursement was substantially higher for TF-TAVR (euro7071 more per case, p < 0.001). A hypothetical shift from SAVR to TF-TAVR was associated with an ICER of euro857,413 (95% CI euro472,195-euro4,310,651) from the in-hospital perspective and euro196,422 (95% CI euro123,873-euro457,813) from the 1-year perspective. Notably, unadjusted analyses indicated a narrowing cost gap over time: Reimbursement for TF-TAVR decreased by approximately 12% between 2018 and 2022, while SAVR costs remained stable. Consequently, TF-TAVR is becoming increasingly cost-effective. CONCLUSION: Given an estimated life expectancy of 11 to 25 years in this population, the incremental costs per life saved associated with a hypothetical shift from SAVR to TF-TAVR appear justifiable. Nonetheless, individual patient circumstances must always be considered in decision-making. CI - (c) 2026. The Author(s). FAU - Kaier, Klaus AU - Kaier K AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AUID- ORCID: 0000-0003-2767-8009 AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. constantin.vonzurmuehlen@uniklinik-freiburg.de. AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. constantin.vonzurmuehlen@uniklinik-freiburg.de. FAU - Hazard, Derek AU - Hazard D AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Heidenreich, Adrian AU - Heidenreich A AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Jackel, Markus AU - Jackel M AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Oettinger, Vera AU - Oettinger V AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Werner, Jonas AU - Werner J AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Gottardi, Roman AU - Gottardi R AD - Department of Cardiovascular Surgery, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. AD - Centre of Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Valina, Christian AU - Valina C AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Centre-University of Freiburg, University Heart Centre Freiburg-Bad Krozingen, Freiburg, Germany. LA - eng PT - Journal Article DEP - 20260413 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM OTO - NOTNLM OT - Aortic stenosis OT - Cost-effectiveness OT - Electronic health records OT - In-hospital outcomes OT - Younger patients COIS- Declarations. Conflict of interest: DW received fees from Abiomed, AstraZeneca, Bayer, Boehringer Ingelheim, Berlin-Chemie, Edwards Lifesciences, Medtronic, and Novartis. All other authors have no competing interest. EDAT- 2026/04/13 12:37 MHDA- 2026/04/13 12:37 CRDT- 2026/04/13 11:13 PHST- 2025/06/25 00:00 [received] PHST- 2026/03/26 00:00 [accepted] PHST- 2026/04/13 12:37 [medline] PHST- 2026/04/13 12:37 [pubmed] PHST- 2026/04/13 11:13 [entrez] AID - 10.1007/s00392-026-02911-9 [pii] AID - 10.1007/s00392-026-02911-9 [doi] PST - aheadofprint SO - Clin Res Cardiol. 2026 Apr 13. doi: 10.1007/s00392-026-02911-9. PMID- 41970484 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260413 LR - 20260813 IS - 2434-0790 (Electronic) IS - 2434-0790 (Linking) VI - 8 IP - 4 DP - 2026 Apr 10 TI - Initial Outcomes After Trans-Right Subclavian Transcatheter Aortic Valve Implantation: Analysis of Device Coaxiality. PG - 650-656 LID - 10.1253/circrep.CR-25-0243 [doi] AB - BACKGROUND: Trans-subclavian access transcatheter aortic valve implantation (TAVI), typically from the left side, is feasible. However, right subclavian artery access is technically challenging because of the anatomical orientation, resulting in malalignment of the transcatheter heart valve within the aortic annular plane. METHODS AND RESULTS: We aimed to evaluate procedural outcomes, device-annulus alignment, and clinical efficacy of right trans-subclavian (RtTS) TAVI. Of a consecutive 423 patients who underwent TAVI, 32 cases performed via right and left subclavian access were analyzed. Implanted device depth and angle were analyzed angiographically. The device-annulus angle was measured angiographically. Fifteen of 22 patients were treated with a balloon-expandable valve, and 7 patients received a self-expanding valve, via RtTS. Procedural success was achieved in all cases. Compared with femoral and left subclavian approaches, RtTS led to a significantly larger device-annulus angle (6.0 degrees vs. 8.7 degrees ; P<0.05), with deep left coronary cusp implantation (2.4 vs. 4.4 mm; P=0.05). Post-procedural transcatheter heart valve function was comparable across the groups, and no patients had greater than moderate paravalvular leakage. However, the incidence of symptomatic stroke occurred in 2 patients in the RtTS group (9.1%; P=0.21). CONCLUSIONS: RtTS TAVI is a feasible alternative access route, with comparable procedural and clinical outcomes to those of conventional approaches, albeit with a higher risk of stroke. CI - Copyright (c) 2026, THE JAPANESE CIRCULATION SOCIETY. FAU - Hamada, Ryusuke AU - Hamada R AD - Department of Cardiovascular Surgery, Kindai University Faculty of Medicine Sakai Japan. FAU - Onishi, Kyohei AU - Onishi K AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. FAU - Yasuda, Masakazu AU - Yasuda M AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. AD - Division of Cardiology, Sakurabashi Watanabe Advanced Healthcare Hospital Osaka Japan. FAU - Fujita, Kosuke AU - Fujita K AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. FAU - Soejima, Naoko AU - Soejima N AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. FAU - Miyoshi, Tatsuya AU - Miyoshi T AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. FAU - Matsumura, Koichiro AU - Matsumura K AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. FAU - Kotani, Shinsuke AU - Kotani S AD - Department of Cardiovascular Surgery, Kindai University Faculty of Medicine Sakai Japan. FAU - Okamura, Atsunori AU - Okamura A AD - Division of Cardiology, Sakurabashi Watanabe Advanced Healthcare Hospital Osaka Japan. FAU - Iwanaga, Yoshitaka AU - Iwanaga Y AD - Division of Cardiology, Sakurabashi Watanabe Advanced Healthcare Hospital Osaka Japan. FAU - Sakaguchi, Genichi AU - Sakaguchi G AD - Department of Cardiovascular Surgery, Kindai University Faculty of Medicine Sakai Japan. FAU - Nakazawa, Gaku AU - Nakazawa G AD - Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine Sakai Japan. LA - eng PT - Journal Article DEP - 20260129 PL - Japan TA - Circ Rep JT - Circulation reports JID - 101746642 PMC - PMC13065447 OTO - NOTNLM OT - Alternative access OT - Right axillary artery OT - Right subclavian artery OT - Transcatheter aortic valve implantation (TAVI) COIS- G.N. is a proctor for Edwards (SAPIEN), Medtronic (Evolut), and Abbott (Navitor). The other authors have no conflicts of interest to declare. EDAT- 2026/04/13 18:17 MHDA- 2026/04/13 18:18 PMCR- 2026/01/29 CRDT- 2026/04/13 06:34 PHST- 2025/10/06 00:00 [received] PHST- 2025/11/10 00:00 [revised] PHST- 2025/11/30 00:00 [accepted] PHST- 2026/04/13 18:18 [medline] PHST- 2026/04/13 18:17 [pubmed] PHST- 2026/04/13 06:34 [entrez] PHST- 2026/01/29 00:00 [pmc-release] AID - 10.1253/circrep.CR-25-0243 [doi] PST - epublish SO - Circ Rep. 2026 Jan 29;8(4):650-656. doi: 10.1253/circrep.CR-25-0243. eCollection 2026 Apr 10. PMID- 41969667 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260413 LR - 20260813 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - Sodium-glucose cotransporter-2 inhibitor use is associated with reduced acute kidney injury after transcatheter aortic valve implantation. PG - 1799940 LID - 10.3389/fcvm.2026.1799940 [doi] LID - 1799940 AB - BACKGROUND: Acute kidney injury (AKI) remains a clinically relevant complication after transcatheter aortic valve implantation (TAVI). Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) have demonstrated nephroprotective effects in chronic kidney disease (CKD); however, TAVI-specific data are limited. METHODS: We analyzed a single-center registry of consecutive patients who underwent transfemoral TAVI for aortic stenosis between January 2015 and December 2025. After exclusions, 532 patients were included (SGLT-2i users, n = 112; non-users, n = 420). The primary endpoint was post-procedural AKI. Secondary outcomes were need for hemodialysis and in-hospital mortality. Propensity score matching (PSM) was performed (1:1), yielding 110 matched pairs. RESULTS: In the overall cohort, AKI occurred more frequently in SGLT-2i non-users than users (16.0% vs. 4.5%, p < 0.001), along with a higher requirement for hemodialysis (6.0% vs. 0.9%, p = 0.025). In the CKD subgroup, non-users had higher AKI (35.0% vs. 4.5%, p < 0.001) and hemodialysis rates (15.0% vs. 0.0%, p = 0.005), whereas outcomes were similar in the non-CKD subgroup. In the PSM cohort, non-users had higher AKI (20.0% vs. 4.5%, p < 0.001), hemodialysis (7.3% vs. 0.9%, p = 0.035), and in-hospital mortality (10.0% vs. 1.8%, p = 0.019). In the PSM CKD subgroup, non-users demonstrated markedly higher AKI (43.2% vs. 4.5%, p < 0.001), hemodialysis requirement (13.6% vs. 0.0%, p = 0.026), and in-hospital mortality (20.5% vs. 2.3%, p = 0.015), while non-CKD subgroup showed comparable outcomes. In multivariable analysis, SGLT-2i use independently predicted lower AKI risk in both the overall and matched cohorts. CONCLUSIONS: SGLT-2i use was associated with reduced AKI after TAVI, particularly in patients with CKD, and remained significant after propensity matching and multivariable adjustment. CI - (c) 2026 Keskin, Hakgor, Khidolda, Dursun, Akhundova, Savur, Olgun, Onder, Besiroglu, Dursun, Cakal, Gunes, Karaca, Guler and Boztosun. FAU - Keskin, Berhan AU - Keskin B AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Hakgor, Aykun AU - Hakgor A AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Khidolda, Yerkenur AU - Khidolda Y AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Dursun, Atakan AU - Dursun A AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Akhundova, Aysel AU - Akhundova A AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Savur, Umeyir AU - Savur U AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Olgun, Fatih Erkam AU - Olgun FE AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Onder, Ozlem AU - Onder O AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Besiroglu, Mehmet AU - Besiroglu M AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Dursun, Melike Zeynep AU - Dursun MZ AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Cakal, Beytullah AU - Cakal B AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Gunes, Haci Murat AU - Gunes HM AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Karaca, Ibrahim Oguz AU - Karaca IO AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Guler, Ekrem AU - Guler E AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Boztosun, Bilal AU - Boztosun B AD - Department of Cardiology, Istanbul Medipol University, Medipol Mega University Hospital, Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20260327 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13065653 OTO - NOTNLM OT - SGLT-2 inhibitors OT - acute kidney injury OT - contrast-inducednephropathy OT - propensity score matching OT - transcatheter aortic valve implantation COIS- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/04/13 18:17 MHDA- 2026/04/13 18:18 PMCR- 2026/03/27 CRDT- 2026/04/13 06:28 PHST- 2026/01/30 00:00 [received] PHST- 2026/02/26 00:00 [revised] PHST- 2026/03/09 00:00 [accepted] PHST- 2026/04/13 18:18 [medline] PHST- 2026/04/13 18:17 [pubmed] PHST- 2026/04/13 06:28 [entrez] PHST- 2026/03/27 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1799940 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Mar 27;13:1799940. doi: 10.3389/fcvm.2026.1799940. eCollection 2026. PMID- 41968274 OWN - NLM STAT- MEDLINE DCOM- 20260715 LR - 20260913 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 7 DP - 2026 Jun TI - The Impact of Vascular Access Complications in Patients Undergoing Transcatheter Aortic Valve Replacement. PG - 2373-2382 LID - 10.1002/ccd.70560 [doi] AB - BACKGROUND: Vascular complications remain a significant concern in transfemoral transcatheter aortic valve replacement (TAVR). AIMS: Determine the incidence of vascular complications following TAVR and evaluate their impact on short- and long-term clinical outcomes. METHODS: We conducted a retrospective observational analysis of patients undergoing transfemoral TAVR at a single institution. Patients were stratified into three groups: Group 0 (no perioperative complications), Group 1 (vascular complications), and Group 2 (non-vascular complications). The primary outcome was early- and late-mortality. Propensity score matching was performed to compare outcomes between Group 0 and Group 1. RESULTS: Among 5230 patients, 4391 (84.0%) were in Group 0, 154 (2.9%) in Group 1, and 685 (13.1%) in Group 2. In Group 1, 36.4% experienced intraoperative bleeding requiring intervention, 27.3% had intraoperative limb ischemia or dissection, and 16.2% required postoperative takeback for limb ischemia. In-hospital mortality was 12/154 (7.8%) in Group 1, compared with 7/4391 (0.2%) in Group 0 and 45/685 (6.6%) in Group 2 (p < 0.001). Thirty-day mortality was 16/154 (10.4%) in Group 1 versus 117/4391 (2.7%) in Group 0 and 70/685 (10.2%) in Group 2 (p < 0.001). Propensity-matched analysis showed Group 1 had fourfold higher 30-day mortality (OR 4.02, 95% CI 1.98-8.18, p < 0.001). One-year mortality was 29/148 (19.6%) for Group 1 compared with 72/592 (12.2%) for Group 0, with 5-year survival similar between groups (Group 1: 51.1%, Group 0: 50.9%, log-rank p = 0.214), while unmatched Group 2 had 43.1% 5-year survival. CONCLUSION: While vascular complications after TAVR are uncommon, they are linked to substantially worse early outcomes, whereas long-term survival among patients who survive the initial postoperative period remains comparable, emphasizing the critical impact during the early phase. CI - (c) 2026 Wiley Periodicals LLC. FAU - Mesar, Tomaz AU - Mesar T AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Jackson, Ariana AU - Jackson A AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Chachati, George AU - Chachati G AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Jacquemyn, Xander AU - Jacquemyn X AUID- ORCID: 0000-0001-8421-0686 AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Ahmad, Danial AU - Ahmad D AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Kliner, Dustin AU - Kliner D AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Serna-Gallegos, Derek AU - Serna-Gallegos D AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Toma, Catalin AU - Toma C AUID- ORCID: 0000-0003-0187-2962 AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - West, David AU - West D AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Makani, Amber AU - Makani A AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. FAU - Sultan, Ibrahim AU - Sultan I AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. LA - eng PT - Journal Article PT - Observational Study DEP - 20260412 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/physiopathology/surgery/diagnostic imaging MH - *Aortic Valve Stenosis/mortality/diagnostic imaging/surgery/physiopathology/therapy MH - *Cardiac Catheterization/adverse effects/mortality/methods MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Femoral Artery MH - Hospital Mortality MH - Incidence MH - Propensity Score MH - Punctures MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Treatment Outcome OTO - NOTNLM OT - complications OT - long-term survival OT - morbidity OT - transcatheter aortic valve replacement (TAVR) OT - vascular complications EDAT- 2026/04/13 00:31 MHDA- 2026/06/01 12:39 CRDT- 2026/04/12 23:23 PHST- 2026/02/22 00:00 [revised] PHST- 2025/11/20 00:00 [received] PHST- 2026/03/16 00:00 [accepted] PHST- 2026/06/01 12:39 [medline] PHST- 2026/04/13 00:31 [pubmed] PHST- 2026/04/12 23:23 [entrez] AID - 10.1002/ccd.70560 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Jun;107(7):2373-2382. doi: 10.1002/ccd.70560. Epub 2026 Apr 12. PMID- 41962213 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260528 LR - 20260813 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 5 DP - 2026 May TI - Stroke Risk After TAVR: Balloon-Expandable vs Self-Expanding Valves in Community Practice. PG - 102727 LID - S2772-963X(26)00148-1 [pii] LID - 10.1016/j.jacadv.2026.102727 [doi] LID - 102727 AB - BACKGROUND: Stroke is a serious complication after transcatheter aortic valve replacement (TAVR), yet contemporary data from community hospital practice are limited. OBJECTIVES: The purpose of this study was to evaluate the association between valve type and the risk of stroke within 1 year after contemporary TAVR in community practice. METHODS: We analyzed patients who underwent TAVR across CommonSpirit Health hospitals from January 2021 to February 2023 using data from the Society of Thoracic Surgeons (STS)/American College of Cardiology Transcatheter Valve Therapy Registry. Valve type was categorized as balloon-expandable valves or self-expanding valves (SEV). The primary outcome was stroke within 1 year. Kaplan-Meier methods were used to compare stroke-free survival between valve types. Baseline differences were adjusted using inverse probability of treatment weighting. Independent predictors of stroke were identified using weighted time-to-event models. RESULTS: A total of 6,663 patients underwent TAVR during the study period; 5,445 (81.7%) received balloon-expandable valve, and 1,218 (18.3%) received SEV. More females received a SEV (56.7% vs 37.5%; P < 0.001). The STS risk score (4.5 +/- 3.8 vs 4.0 +/- 3.5; P < 0.001) was higher in the SEV group. A total of 87 (1.3%) patients experienced stroke within the study period. The primary endpoint of stroke-free survival at 1 year was not different between valve types (log-rank P = 0.448). After inverse probability of treatment weighting adjustment, valve type was not associated with stroke (adjusted HR: 1.54; 95% CI: 0.79-2.68; P = 0.294). Age, lower body mass index, prior stroke, STS risk, and alternative access were associated with stroke. CONCLUSIONS: In this registry of patients receiving TAVR, valve type did not predict stroke at 1 year. The predominant drivers of stroke were clinical variables: age, STS risk, and a history of stroke. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kumar, Sant AU - Kumar S AD - Creighton University School of Medicine, Phoenix, Arizona, USA; St. Joseph Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: sant.j.kumar@gmail.com. FAU - Elison, David AU - Elison D AD - Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA. FAU - Pershad, Ashish AU - Pershad A AD - St. Joseph Hospital and Medical Center, Phoenix, Arizona, USA; Chandler Regional Medical Center, Chandler, Arizona, USA. FAU - Falluji, Nezar AU - Falluji N AD - Creighton University School of Medicine, Phoenix, Arizona, USA; St. Joseph Hospital and Medical Center, Phoenix, Arizona, USA. LA - eng PT - Journal Article DEP - 20260409 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC13091329 OTO - NOTNLM OT - TAVR OT - balloon-expandable valve OT - self-expanding valve OT - stroke COIS- Funding support and author disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/04/11 00:32 MHDA- 2026/04/11 00:33 PMCR- 2026/04/09 CRDT- 2026/04/10 18:03 PHST- 2026/01/02 00:00 [received] PHST- 2026/02/24 00:00 [revised] PHST- 2026/03/09 00:00 [accepted] PHST- 2026/04/11 00:33 [medline] PHST- 2026/04/11 00:32 [pubmed] PHST- 2026/04/10 18:03 [entrez] PHST- 2026/04/09 00:00 [pmc-release] AID - S2772-963X(26)00148-1 [pii] AID - 102727 [pii] AID - 10.1016/j.jacadv.2026.102727 [doi] PST - ppublish SO - JACC Adv. 2026 May;5(5):102727. doi: 10.1016/j.jacadv.2026.102727. Epub 2026 Apr 9. PMID- 41935336 OWN - NLM STAT- MEDLINE DCOM- 20260627 LR - 20260921 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 21 IP - 1 DP - 2026 Apr 4 TI - Outcome of transcarotid transcatheter aortic valve replacement with balloon expandable valve. LID - 10.1186/s13019-026-03996-z [doi] LID - 240 AB - INTRODUCTION: Transcarotid (TC) access in transcatheter aortic valve replacement (TAVR) has been performed as one of alternative options when transfemoral (TF) access is not feasible. Short-term outcomes of TC compared with TF access were reported, however, mid to long-term outcome is poorly documented. METHODS: Between May 2019 and September 2023, 1578 patients underwent TAVR with balloon expandable valve. Of 1578, 86 had TAVR through TC access, TF access in 1492. Propensity score matching was performed among the two groups and postoperative outcomes were evaluated using log-rank test and Cox proportional hazards model. RESULTS: 86 pairs were matched. There was no significant difference in 30 day mortality rate between TC and TF group, which were 3.5% (3/86) and 0% (0/86), respectively (p = 0.25). The incidence of postoperative in-hospital stroke was similar (TC: 6.9% (6/86) vs. TF: 3.5% (3/86), p = 0.30). The cumulative 5-year survivals of patients in TC and TF groups were 60.6% and 76.4%, respectively. A significant difference was not noted between the two groups (p = 0.06). On multivariate analysis, past medical history of atrial fibrillation, reduced left ventricular ejection fraction, and TC access were associated with increased mid to long-term mortality. The incidence of stroke at 5year follow-up in TC group did not differ compared with that of TF group (16.6% versus 9.7%, p = 0.49). TC access was not a predictor for late stroke (p = 0.40). CONCLUSIONS: Transcarotid access should be an alternative access when transfemoral access is not feasible. Transcarotid access might increase the long-term mortality, however, not a risk factor for postoperative stroke. FAU - Nakai, Chikashi AU - Nakai C AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. seiginohirohorita@gmail.com. FAU - Azhagiri, Nikhil AU - Azhagiri N AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Liu, Junyi AU - Liu J AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Zuo, Mei Xing G AU - Zuo MXG AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Tarabichi, Saeed AU - Tarabichi S AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - Danduch, Eduardo AU - Danduch E AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. FAU - DeLago, Augustion AU - DeLago A AD - Department of Cardiology, Capital Cardiology Associates, Albany, NY, USA. FAU - Samy, Sanjay AU - Samy S AD - Department of Cardiothoracic Surgery, Albany Medical Center, 50 New Scotland Ave, Albany, 12208, NY, USA. LA - eng PT - Journal Article DEP - 20260404 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM EIN - J Cardiothorac Surg. 2026 Sep 5;21(1):670. doi: 10.1186/s13019-026-04681-x. PMID: 42701186 MH - Humans MH - Female MH - *Aortic Valve Stenosis/surgery MH - *Transcatheter Aortic Valve Replacement/methods MH - Male MH - Aged, 80 and over MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Postoperative Complications/epidemiology MH - Retrospective Studies MH - Aged MH - *Aortic Valve/surgery PMC - PMC13192166 COIS- Declarations. Competing interests: The authors declare no competing interests. EDAT- 2026/04/05 04:22 MHDA- 2026/06/27 18:39 PMCR- 2026/04/04 CRDT- 2026/04/04 23:35 PHST- 2025/08/21 00:00 [received] PHST- 2026/03/25 00:00 [accepted] PHST- 2026/06/27 18:39 [medline] PHST- 2026/04/05 04:22 [pubmed] PHST- 2026/04/04 23:35 [entrez] PHST- 2026/04/04 00:00 [pmc-release] AID - 10.1186/s13019-026-03996-z [pii] AID - 3996 [pii] AID - 10.1186/s13019-026-03996-z [doi] PST - epublish SO - J Cardiothorac Surg. 2026 Apr 4;21(1):240. doi: 10.1186/s13019-026-03996-z. PMID- 41930772 OWN - NLM STAT- MEDLINE DCOM- 20260714 LR - 20260714 IS - 1540-8175 (Electronic) IS - 0742-2822 (Linking) VI - 43 IP - 4 DP - 2026 Apr TI - Predictive Value of Machine Learning-Based Echocardiographic Myocardial Texture After Transcatheter Aortic Valve Replacement. PG - e70439 LID - 10.1111/echo.70439 [doi] AB - OBJECTIVES: Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for treating severe aortic valve stenosis. This study aimed to develop an interpretable machine learning (ML) model based on echocardiographic myocardial texture for predicting 1-year clinical endpoints following TAVR via the femoral artery. METHODS: We retrospectively studied 121 patients who underwent transfemoral TAVR between January 2019 and October 2023, and data from external validation centers were collected between January 2019 and October 2023 to validate and evaluate the model externally. The composite outcome of all-cause mortality and heart failure events was used as the clinical endpoint. Based on echocardiographic imaging of myocardial texture analysis, nine widely used ML algorithms were used to construct models. Three predictive models were then constructed based on the best machine mode, with Shapley additive explanations for the interpretation of the model and the assessment of the contributions of the different characteristics. RESULTS: Among the nine ML models, the Extra Tree (ET) model had the best discriminative ability. An explainable final ET model was established with two features. The final model accurately predicted the clinical endpoint 1 year after transfemoral TAVR in both internal and external validations, and the results in the COX multifactorial regression analysis showed that LVEF <50% was an independent predictor of the clinical endpoint 1 year after transfemoral TAVR. In addition, Kaplan-Meier survival curves showed that patients with high Rad-Score values had lower survival rates than those with low Rad-Score values. CONCLUSIONS: This novel method based on echocardiographic myocardial texture with ML may have the potential to be used for predicting clinical endpoints 1 year after transfemoral TAVR and may be used as a convenient tool to facilitate its utility in clinical settings. CI - (c) 2026 Wiley Periodicals LLC. FAU - Zheng, Lu AU - Zheng L AD - Department of Medical Ultrasonics, First People's Hospital of Yulin, YuLin, People's Republic of China. FAU - Zhang, Shan AU - Zhang S AD - Pubei County No. 1 Vocational Technical School, Qinzhou, People's Republic of China. FAU - Yin, Hongxia AU - Yin H AD - Department of Medical Ultrasonics, First People's Hospital of Yulin, YuLin, People's Republic of China. FAU - Chen, Haiyan AU - Chen H AD - Department of Medical Ultrasonics, First People's Hospital of Yulin, YuLin, People's Republic of China. FAU - Liang, Guizi AU - Liang G AD - Department of Medical Ultrasonics, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China. FAU - Deng, Yan AU - Deng Y AD - Department of Medical Ultrasonics, First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China. LA - eng GR - 82060051/National Natural Science Foundation of China/ GR - 82460082/National Natural Science Foundation of China/ GR - 2023GXNSFAA026173/Guangxi Natural Science Foundation/ GR - S2024018/Guangxi Medical and Health Appropriate Technology Development and Promotion Application/ GR - GXXNXG202301/Precision Medicine Foundation of Guangxi Key Laboratory of Cardio-cerebrovascular Disease/ GR - Z-A20240482/Guangxi Health Commission of Self-funded Western Medicine Research/ GR - G201903053/Guangxi medical ''139'Program for Training High-level Backbone Talents/ GR - 202307/Young Leader Talent Training Program of Guangxi Medical University/ GR - Project of training one thousand young and middle aged backbone teachers of Guangxi/ PT - Journal Article PL - United States TA - Echocardiography JT - Echocardiography (Mount Kisco, N.Y.) JID - 8511187 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Female MH - *Machine Learning MH - Retrospective Studies MH - Male MH - *Echocardiography/methods MH - *Aortic Valve Stenosis/surgery MH - Predictive Value of Tests MH - Aged, 80 and over MH - Predictive Learning Models MH - Aged OTO - NOTNLM OT - aortic stenosis OT - machine learning OT - myocardial texture OT - transcatheter aortic valve replacement EDAT- 2026/04/03 13:36 MHDA- 2026/04/03 13:37 CRDT- 2026/04/03 08:03 PHST- 2026/03/06 00:00 [revised] PHST- 2025/12/25 00:00 [received] PHST- 2026/03/20 00:00 [accepted] PHST- 2026/04/03 13:37 [medline] PHST- 2026/04/03 13:36 [pubmed] PHST- 2026/04/03 08:03 [entrez] AID - 10.1111/echo.70439 [doi] PST - ppublish SO - Echocardiography. 2026 Apr;43(4):e70439. doi: 10.1111/echo.70439. PMID- 41929462 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260403 LR - 20260813 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - Impact of TriGUARD 3 on cerebral protection in Chinese patients undergoing transcatheter aortic valve replacement. PG - 1694878 LID - 10.3389/fcvm.2026.1694878 [doi] LID - 1694878 AB - INTRODUCTION: In China, evidence regarding cerebral embolic protection device (CEPD) use during transcatheter aortic valve replacement (TAVR) for severe aortic stenosis treatment is limited. This study evaluated the TriGUARD 3 (TG3) CEPD performance in patients undergoing TAVR. METHODS: Data from two studies were pooled: the CEPD group was derived from a multicenter TG3 trial in China, whereas the control group was obtained from a single-center registry. All participants underwent transfemoral TAVR and completed pre- and postoperative diffusion-weighted magnetic resonance imaging (DW-MRI). The primary outcome was total cerebral ischemic lesion volume on DW-MRI. RESULTS: No significant difference was observed between groups in total lesion volume CEPD [n = 62] vs. control [n = 56]; 256.53 [interquartile range (IQR), 44.12-667.99] vs. 271.88 [IQR, 96.10-650.87]; p = 0.456. Median regression analysis in the overall cohort showed no significant association between CEPD use and total lesion volume (p = 0.181). Nonetheless, among patients with bicuspid aortic valve (BAV) stenosis, the CEPD group demonstrated significantly lower total lesion volume [165.43 (IQR, 32.96-311.13) vs. 309.38 (IQR, 96.10-788.49); p = 0.025], average lesion volume [61.3 (IQR, 23.44-89.65) vs. 93.75 (IQR, 51.73-137.07); p = 0.019], and maximum single-lesion volume [89.65 (IQR, 28.13-174.02) vs. 164.14 (IQR, 75.00-365.08); p = 0.019]. Median regression revealed that CEPD use was significantly associated with reductions in total, average, and maximum single-lesion volumes (median differences: -406.1, -82.2, and -137.6; all p < 0.05), independent of age, sex, hypertension, diabetes, valve type, and pre-dilatation. CONCLUSION: In patients with severe aortic stenosis undergoing transfemoral TAVR, TG3 CEPD did not significantly reduce the total lesion volume on DW-MRI. In the BAV subgroup, an association was observed between device use and reductions in total, average, and maximum single-lesion volumes. This exploratory finding is hypothesis-generating and should be further elucidated in larger randomized studies. CI - (c) 2026 Li, Wang, Zhou, Zhou, Chen, Luo, Wang, Jin, Peng, Dong, Jin, Wang, Xu and Han. FAU - Li, Yanbin AU - Li Y AD - The State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China. AD - Department of Cardiology, Benxi Central Hospital, Benxi, Liaoning, China. FAU - Wang, Bin AU - Wang B AD - The State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China. FAU - Zhou, Shichen AU - Zhou S AD - The State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China. FAU - Zhou, Yujie AU - Zhou Y AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Chen, Mao AU - Chen M AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Luo, Jianfang AU - Luo J AD - Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China. FAU - Wang, Jianan AU - Wang J AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. FAU - Jin, Jun AU - Jin J AD - Department of Cardiology, Xinqiao Hospital, Army Medical University, Chongqing, Chongqing, China. FAU - Peng, Xiaoping AU - Peng X AD - Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. FAU - Dong, Jianzeng AU - Dong J AD - Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. FAU - Jin, Zening AU - Jin Z AD - Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. FAU - Wang, Yongjun AU - Wang Y AD - Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. FAU - Xu, Kai AU - Xu K AD - The State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China. FAU - Han, Yaling AU - Han Y AD - The State Key Laboratory of Frigid Zone Cardiovascular Diseases, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China. LA - eng PT - Journal Article DEP - 20260318 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13038980 OTO - NOTNLM OT - bicuspid stenosis OT - cerebral ischemia OT - diffusion-weighted imaging OT - embolic protection OT - neuroprotection OT - transcatheter valve replacement COIS- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/04/03 06:30 MHDA- 2026/04/03 06:31 PMCR- 2026/03/18 CRDT- 2026/04/03 05:00 PHST- 2025/08/29 00:00 [received] PHST- 2026/02/02 00:00 [revised] PHST- 2026/02/11 00:00 [accepted] PHST- 2026/04/03 06:31 [medline] PHST- 2026/04/03 06:30 [pubmed] PHST- 2026/04/03 05:00 [entrez] PHST- 2026/03/18 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1694878 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Mar 18;13:1694878. doi: 10.3389/fcvm.2026.1694878. eCollection 2026. PMID- 41913450 OWN - NLM STAT- MEDLINE DCOM- 20260714 LR - 20260915 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 6 DP - 2026 May TI - Navigating Vascular Access Strategies for Transcatheter Aortic Valve Replacement in Patients With Peripheral Artery Disease: A Literature Review. PG - 2100-2109 LID - 10.1002/ccd.70573 [doi] AB - Transcatheter aortic valve replacement (TAVR) is the preferred treatment for severe aortic stenosis (AS) in high-risk surgical patients. The transfemoral (TF) access is the gold standard due to its minimally invasive nature and favorable outcomes. However, peripheral artery disease (PAD), common in TAVR candidates, can complicate TF access due to calcification, tortuosity, and vessel narrowing. This literature review evaluates vascular access strategies for TAVR in patients with PAD, highlighting recent advances that support expanded use of TF access. A narrative literature review was conducted in scientific databases up to 14 April 2025. Studies reporting on access strategies for TAVR in patients with PAD were included. The SANRA scale was utilized to ensure methodological quality. TF access remains the preferred route for TAVR, associated with lower mortality and complication rates compared to alternative approaches. Tools like the Hostile Score has further strengthened pre-procedural planning by quantifying iliofemoral complexity and helping clinicians determine the safest and most feasible access route. Advances in technology have enhanced TF feasibility in patients with PAD, enabling device delivery despite complex anatomy. When TF access is not viable, alternative routes remain feasible but are linked to increased risks, including stroke and vascular complications. Expanding the eligibility for TF access through vessel preparation and imaging-guided planning can improve safety and outcomes in PAD patients undergoing TAVR. A personalized approach based on anatomy feasibility, supported with risk stratification tools and multidisciplinary collaboration is essential to selecting the optimal vascular access strategy. CI - (c) 2026 Wiley Periodicals LLC. FAU - Aufazhafarin, Nadhifa Tanesha AU - Aufazhafarin NT AUID- ORCID: 0009-0009-8812-0181 AD - Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. FAU - Saputra, Pandit Bagus Tri AU - Saputra PBT AUID- ORCID: 0000-0002-5815-0592 AD - Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. FAU - Widiarti, Wynne AU - Widiarti W AUID- ORCID: 0000-0003-2045-5689 AD - Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. FAU - Putra, Rendra Mahardhika AU - Putra RM AUID- ORCID: 0009-0002-9231-3268 AD - Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. AD - Universitas Airlangga Hospital, Surabaya, East Java, Indonesia. FAU - Luthfah, Nadya AU - Luthfah N AD - Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. FAU - Budiarto, Raden Mohammad AU - Budiarto RM AD - Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. FAU - Putranto, J Nugroho Eko AU - Putranto JNE AUID- ORCID: 0000-0002-3501-1872 AD - Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. FAU - Multazam, Chaq El Chaq Zamzam AU - Multazam CECZ AD - National Heart and Lung Institute, Imperial College London, London, UK. FAU - Alkaff, Firas Farisi AU - Alkaff FF AUID- ORCID: 0000-0002-5628-1345 AD - Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands. AD - Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia. LA - eng PT - Journal Article PT - Review DEP - 20260330 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Peripheral Arterial Disease/complications/physiopathology/diagnostic imaging/mortality MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Aortic Valve Stenosis/surgery/complications/diagnostic imaging/physiopathology/mortality MH - Risk Factors MH - Treatment Outcome MH - *Femoral Artery/diagnostic imaging MH - Risk Assessment MH - Punctures MH - Female MH - Male MH - *Aortic Valve/surgery/diagnostic imaging OTO - NOTNLM OT - cardiovascular disease OT - endovascular intervention OT - peripheral artery disease OT - transcatheter aortic valve replacement OT - vascular access EDAT- 2026/03/31 06:59 MHDA- 2026/05/15 06:30 CRDT- 2026/03/31 01:32 PHST- 2026/03/02 00:00 [revised] PHST- 2025/07/02 00:00 [received] PHST- 2026/03/16 00:00 [accepted] PHST- 2026/05/15 06:30 [medline] PHST- 2026/03/31 06:59 [pubmed] PHST- 2026/03/31 01:32 [entrez] AID - 10.1002/ccd.70573 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 May;107(6):2100-2109. doi: 10.1002/ccd.70573. Epub 2026 Mar 30. PMID- 41906603 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260330 LR - 20260813 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 3 DP - 2026 Mar TI - Long-Term Outcomes After Transcatheter Aortic Valve Replacement in Nonagenarians: Impact of Frailty and Malnutrition. PG - 102614 LID - S2772-963X(26)00031-1 [pii] LID - 10.1016/j.jacadv.2026.102614 [doi] LID - 102614 AB - BACKGROUND: The role of transcatheter aortic valve replacement (TAVR) in nonagenarians remains uncertain, especially regarding long-term outcomes and prognostic factors. OBJECTIVES: This study aimed to evaluate long-term outcomes of TAVR in nonagenarians, focusing on cause-specific mortality and the prognostic influence of frailty and malnutrition. METHODS: We analyzed 4,623 patients who underwent transfemoral TAVR in a multicenter Japanese registry, including 700 aged >/=90 years. Outcomes were followed for 5 years. We analyzed all-cause mortality, cause-specific mortality, and the prognostic impact of the Clinical Frailty Scale and Geriatric Nutritional Risk Index. RESULTS: At 5 years, all-cause mortality was higher in patients aged >/=90 years than in those <90 years (53.2% vs37.0%, P < 0.001), primarily due to noncardiovascular deaths such as senility and infections (32.5% vs 19.9%; P < 0.001). Cardiovascular mortality was similar (20.3% vs 17.0%; P = 0.198). Multivariable analysis showed that age >/=90 years was not an independent predictor; frailty and malnutrition were the strongest prognostic factors. A Clinical Frailty Scale-Geriatric Nutritional Risk Index heatmap revealed marked heterogeneity, identifying subgroups of nonagenarians with preserved nutrition and low frailty who achieved favorable long-term survival. CONCLUSIONS: In this large multicenter registry, excess mortality in nonagenarians after TAVR was driven mainly by noncardiovascular causes. Frailty and malnutrition, rather than chronological age, were central determinants of long-term outcomes. These findings emphasize that TAVR candidacy in nonagenarians should be guided on geriatric assessment of frailty and nutrition to identify patients most likely to achieve meaningful survival while avoiding futile interventions. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kobayashi, Tetsuya AU - Kobayashi T AD - Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. Electronic address: https://twitter.com/kobate_2. FAU - Noguchi, Masahiko AU - Noguchi M AD - Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. Electronic address: m.noguchi.0918@gmail.com. FAU - Yamamoto, Masanori AU - Yamamoto M AD - Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan. FAU - Ito, Joji AU - Ito J AD - Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Uyarasu, Japan. FAU - Kato, Nahoko AU - Kato N AD - Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. FAU - Muraishi, Makio AU - Muraishi M AD - Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. FAU - Yoshino, Kunihiko AU - Yoshino K AD - Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Uyarasu, Japan. FAU - Sakai, Hiroki AU - Sakai H AD - Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Uyarasu, Japan. FAU - Shimura, Tetsuro AU - Shimura T AD - Department of Cardiology, Gifu Heart Center, Gifu, Japan. FAU - Hioki, Hirofumi AU - Hioki H AD - Department of Cardiology, IMS Tokyo Katsushika General Hospital, Tokyo, Japan. FAU - Shirai, Shinichi AU - Shirai S AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ishizu, Kenichi AU - Ishizu K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Yashima, Fumiaki AU - Yashima F AD - Department of Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan. FAU - Naganuma, Toru AU - Naganuma T AD - Department of Cardiology, New Tokyo Hospital, Matsudo, Japan. FAU - Watanabe, Yusuke AU - Watanabe Y AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Yamanaka, Futoshi AU - Yamanaka F AD - Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Nakazawa, Gaku AU - Nakazawa G AD - Department of Cardiology, Kindai University, Osaka, Japan. FAU - Izumo, Masaki AU - Izumo M AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Asami, Masahiko AU - Asami M AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Nishina, Hidetaka AU - Nishina H AD - Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan. FAU - Fuku, Yasushi AU - Fuku Y AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Okayama, Japan. FAU - Otsuka, Toshiaki AU - Otsuka T AD - Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. CN - OCEAN-TAVI Investigators LA - eng PT - Journal Article PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC13352011 OTO - NOTNLM OT - frailty OT - long-term outcomes OT - malnutrition OT - nonagenarians OT - transcatheter aortic valve replacement COIS- Funding support and author disclosures The OCEAN-TAVI registry is supported by Edwards-Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, and Daiichi-Sankyo. The sponsors had no role in study design, data collection, analysis, or manuscript preparation. Dr Ito is a clinical proctor for Edwards Lifesciences. Dr Izumo is a screening proctor for Edwards Lifesciences. Dr Ishizu is a proctor of intracardiac echocardiography for Johnson and Johnson. Drs Yashima and Nishina are clinical proctors for Medtronic. Drs Ohno and Shimura are clinical proctors for Medtronic and Abbott Medical. Drs Yamamoto, Shirai, Naganuma, Watanabe, Nakazawa, Asami, Fuku, and Hayashida served as clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/03/30 06:29 MHDA- 2026/03/30 06:30 PMCR- 2026/03/25 CRDT- 2026/03/30 02:53 PHST- 2025/10/15 00:00 [received] PHST- 2026/01/12 00:00 [revised] PHST- 2026/01/17 00:00 [accepted] PHST- 2026/03/30 06:30 [medline] PHST- 2026/03/30 06:29 [pubmed] PHST- 2026/03/30 02:53 [entrez] PHST- 2026/03/25 00:00 [pmc-release] AID - S2772-963X(26)00031-1 [pii] AID - 102614 [pii] AID - 10.1016/j.jacadv.2026.102614 [doi] PST - ppublish SO - JACC Adv. 2026 Mar;5(3):102614. doi: 10.1016/j.jacadv.2026.102614. PMID- 41904385 OWN - NLM STAT- MEDLINE DCOM- 20260627 LR - 20260926 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 26 IP - 1 DP - 2026 Mar 28 TI - Safety and efficacy of single versus dual arterial access in transfemoral transcatheter aortic valve implantation: a systematic review and meta-analysis of propensity-matched cohort. LID - 10.1186/s12872-026-05764-2 [doi] LID - 427 AB - PURPOSE OF REVIEW: Transfemoral transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS). Although dual arterial access (DAA) is commonly used for catheter control and haemodynamic monitoring, single arterial access (SAA) has emerged as a minimalist strategy aimed at reducing procedural complexity and access-site complications. However, comparative outcome data remain limited. RECENT FINDINGS: Four propensity score-matched observational studies comprising 540 patients (50.4% SAA) were included. Compared with DAA, SAA was associated with a significantly lower risk of total vascular complications (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17-0.67; p < 0.001), largely driven by reductions in minor access-site events (OR 0.44, 95% CI 0.20-0.95; p = 0.04), while rates of major vascular complications were similar between groups. There were no significant differences in all-cause mortality, stroke or transient ischaemic attack, paravalvular leak, or major bleeding. SAA was also associated with shorter procedural time (mean difference [MD] -17.1 min, 95% CI -32.8, -1.4; p = 0.03) and lower contrast volume use (MD -28.6 mL, 95% CI -55.3, -1.9; p = 0.04), although substantial heterogeneity was observed. In patients with symptomatic severe AS undergoing transfemoral TAVI, SAA appears to be a safe and feasible alternative to DAA and is associated with fewer vascular complications without compromising major clinical outcomes. Future prospective and randomised studies incorporating procedural complexity and device-specific outcomes are needed to confirm these results and better define optimal patient selection. FAU - Adamu, Umar G AU - Adamu UG AD - Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa. Umar.adamu@wits.ac.za. AD - Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of Witwatersrand, York Road, Parktown, South Africa. Umar.adamu@wits.ac.za. FAU - Mashilo, David AU - Mashilo D AD - Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa. FAU - Mutyaba, Arthur AU - Mutyaba A AD - Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa. FAU - Patel, Anupa AU - Patel A AD - Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa. FAU - Farrel, Hellig AU - Farrel H AD - Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, South Africa. AD - Sunninghill Hospital, Sunninghill, Johannesburg, 2191, South Africa. FAU - Tsabedze, Nqoba AU - Tsabedze N AD - Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20260328 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Humans MH - *Femoral Artery/diagnostic imaging MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods/mortality MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging/mortality MH - Risk Factors MH - *Catheterization, Peripheral/adverse effects/methods/mortality MH - Propensity Score MH - Punctures MH - Female MH - Risk Assessment MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Male MH - Severity of Illness Index PMC - PMC13202855 OTO - NOTNLM OT - Dual arterial access OT - Meta-analysis OT - Single arterial access OT - Transcatheter aortic valve implantation OT - Vascular complications COIS- Declarations. Ethics approval and consent to participate: None declared. Competing interests: The authors declare no competing interests. EDAT- 2026/03/29 07:35 MHDA- 2026/06/27 12:36 PMCR- 2026/03/28 CRDT- 2026/03/28 23:23 PHST- 2026/01/20 00:00 [received] PHST- 2026/03/18 00:00 [accepted] PHST- 2026/06/27 12:36 [medline] PHST- 2026/03/29 07:35 [pubmed] PHST- 2026/03/28 23:23 [entrez] PHST- 2026/03/28 00:00 [pmc-release] AID - 10.1186/s12872-026-05764-2 [pii] AID - 5764 [pii] AID - 10.1186/s12872-026-05764-2 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2026 Mar 28;26(1):427. doi: 10.1186/s12872-026-05764-2. PMID- 41904366 OWN - NLM STAT- MEDLINE DCOM- 20260703 LR - 20260813 IS - 1573-742X (Electronic) IS - 0929-5305 (Print) IS - 0929-5305 (Linking) VI - 59 IP - 5 DP - 2026 Jun TI - Angio-Seal plug-based versus dual ProGlide for transfemoral hemostasis in transcatheter aortic valve replacement: a systematic review and meta-analysis. PG - 1167-1178 LID - 10.1007/s11239-026-03261-z [doi] AB - Transcatheter aortic valve replacement (TAVR) carries risks of vascular and bleeding complications. We aimed to study the effectiveness of Angio-Seal combined with Perclose ProGlide versus dual Perclose ProGlide following transfemoral TAVR. We searched PubMed, Cochrane Library, Scopus, and WOS from inception until November 2024 for studies comparing Parclose ProGlide with Angio-Seal versus dual Parclose ProGlide in transfemoral TAVR. The primary outcome was major vascular complications, while other secondary outcomes were bleeding complications, the need for additional vascular closure device (VCD), minor vascular complications, unplanned surgical intervention, mortality, hematoma, pseudoaneurysm, and dissection. Dichotomous outcomes were pooled and analyzed using odds ratio (OR) with 95% confidence interval (CI) via the DerSimonian-Laird random-effect model. Seven studies (two RCTs and five observational studies) comprising 1,766 patients were included. In RCT-only analyses, single Perclose ProGlide combined with Angio-Seal showed no significant difference compared with dual Perclose ProGlide in major vascular complications (OR = 0.54, 95% CI [0.28-1.04], P = 0.07) or major/life-threatening bleeding (OR = 0.66, 95% CI [0.25-1.74], P = 0.40). However, it significantly reduced the need for additional vascular closure devices (OR = 0.11, 95% CI [0.05-0.24], P < 0.01) and minor vascular complications (OR = 0.52, 95% CI [0.38-0.72], P < 0.01). For dual Perclose ProGlide combined with Angio-Seal, no RCTs were available; observational evidence suggested a reduction in major/life-threatening bleeding compared to dual Perclose ProGlide (OR = 0.43, 95% CI [0.21 to0.92], p = 0.03), while there was no significant difference between the two groups upon excluding Costa et al. (EuroIntervention, 17:728-735, 2021) (OR = 0.56, 95% CI [0.26 to 1.21], p = 0.14). Based on the available RCTs, the combination of single Perclose ProGlide with Angio-Seal during transfemoral TAVR significantly reduces the need for additional vascular closure devices. It may also reduce minor vascular complications, but this effect is not consistently robust. The pooled analysis of observational studies suggests a potential benefit of dual Perclose ProGlide combined with Angio-Seal for major/life-threatening bleeding. However, this finding was not robust in sensitivity analyses and no RCTs have evaluated this strategy. CI - (c) 2026. The Author(s). FAU - Alnomani, Yousef Radwan AU - Alnomani YR AD - Faculty of Medicine, Benha University, Benha, Egypt. yousefradwan2429@gmail.com. FAU - Algazar, Mansour AU - Algazar M AD - Faculty of Medicine, Al-Azhar University, Asyut, Egypt. AD - Medical Research group of Egypt (MRGE), Cairo, Egypt. FAU - Omar, Mohamed Mosad AU - Omar MM AD - Faculty of Medicine, Cairo University, Cairo, Egypt. AD - Medical Research group of Egypt (MRGE), Cairo, Egypt. FAU - Aldemerdash, Mohamed A AU - Aldemerdash MA AD - Faculty of Medicine, Sohag university, Sohag, Egypt. AD - Medical Research group of Egypt (MRGE), Cairo, Egypt. FAU - Henes, Kerollos AU - Henes K AD - Department of Cardiology, El-Mabarra Health Insurance Hospital, Asyut, Egypt. AD - Medical Research group of Egypt (MRGE), Cairo, Egypt. FAU - Arafa, Amr AU - Arafa A AD - Department of Nephrology, Alexandria University, Alexandria, Egypt. FAU - Rageh, Bushra Muneer AU - Rageh BM AD - Department of Physiology, Sana'a University, Sana'a, Yemen. AD - Medical Research group of Egypt (MRGE), Cairo, Egypt. FAU - Abdelaziz, Ahmed AU - Abdelaziz A AD - Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA. AD - Medical Research group of Egypt (MRGE), Cairo, Egypt. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20260328 PL - Netherlands TA - J Thromb Thrombolysis JT - Journal of thrombosis and thrombolysis JID - 9502018 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Vascular Closure Devices MH - Femoral Artery MH - *Hemostatic Techniques/instrumentation MH - Hemorrhage/prevention & control/etiology MH - Hemostasis PMC - PMC13331922 OTO - NOTNLM OT - Angio-Seal OT - Closure device OT - Perclose ProGlide OT - Plug-based OT - Suture-based OT - TAVR COIS- Declarations. Competing interests: The authors declare no competing interests. Consent for publication: Not applicable. Ethical approval: Not applicable. EDAT- 2026/03/29 07:35 MHDA- 2026/07/03 12:33 PMCR- 2026/03/28 CRDT- 2026/03/28 23:19 PHST- 2025/12/23 00:00 [received] PHST- 2026/02/27 00:00 [accepted] PHST- 2026/07/03 12:33 [medline] PHST- 2026/03/29 07:35 [pubmed] PHST- 2026/03/28 23:19 [entrez] PHST- 2026/03/28 00:00 [pmc-release] AID - 10.1007/s11239-026-03261-z [pii] AID - 3261 [pii] AID - 10.1007/s11239-026-03261-z [doi] PST - ppublish SO - J Thromb Thrombolysis. 2026 Jun;59(5):1167-1178. doi: 10.1007/s11239-026-03261-z. Epub 2026 Mar 28. PMID- 41901616 OWN - NLM STAT- MEDLINE DCOM- 20260331 LR - 20260813 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 3 DP - 2026 Mar 13 TI - SGLT2 Inhibitor Therapy and Long-Term Outcomes After Transcatheter Aortic Valve Implantation in Patients with Low Ejection Fraction. LID - 10.3390/medicina62030535 [doi] LID - 535 AB - Background and Objectives: Patients with impaired left ventricular ejection fraction (LVEF) undergoing transcatheter aortic valve implantation (TAVI) remain at high risk for adverse outcomes despite successful procedures. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve outcomes in heart failure, but their long-term impact after TAVI is not well established. Materials and Methods: This single-center retrospective study included patients with LVEF < 50% who underwent transfemoral TAVI between January 2015 and September 2025. Patients were stratified according to SGLT2i use. The primary outcome was a composite of all-cause mortality and heart failure (HF) hospitalization requiring intravenous diuretics. Secondary outcomes included all-cause mortality, HF hospitalization, and changes in echocardiographic parameters at 6 months. Inverse probability of treatment weighting (IPTW) based on propensity scores was applied to adjust for baseline differences. Time-to-event analyses were performed using IPTW-weighted Cox models and adjusted survival curves. Results: The study included 226 patients (78 SGLT2i users, 148 non-users) with a median follow-up of 37 months. After IPTW adjustment, SGLT2i use was associated with a lower rate of the composite outcome (32.8% vs. 50.8%, p = 0.019) and a lower crude long-term mortality (32.8% vs. 47.4%, p = 0.056). Acute kidney injury after TAVI occurred less frequently among SGLT2i users (3.4% vs. 17.4%, p = 0.013). In IPTW-weighted Cox analyses, SGLT2i use was associated with a reduced risk of all-cause mortality (HR 0.57, 95% CI 0.32-0.98) and the composite outcome (HR 0.56, 95% CI 0.33-0.96). SGLT2i users demonstrated greater reductions in left ventricular end-diastolic diameter at 6 months. Conclusions: In patients with impaired LVEF undergoing TAVI, SGLT2 inhibitor therapy was associated with improved long-term survival, better composite outcome-free survival, and lower rates of post-TAVI acute kidney injury. Larger prospective studies are warranted to confirm these findings. FAU - Keskin, Berhan AU - Keskin B AUID- ORCID: 0000-0002-5879-2245 AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Hakgor, Aykun AU - Hakgor A AUID- ORCID: 0000-0001-8252-0373 AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Khidolda, Yerkenur AU - Khidolda Y AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Dursun, Atakan AU - Dursun A AUID- ORCID: 0000-0001-5074-5340 AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Akhundova, Aysel AU - Akhundova A AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Savur, Umeyir AU - Savur U AUID- ORCID: 0000-0003-1320-9033 AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Olgun, Fatih Erkam AU - Olgun FE AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Onder, Ozlem AU - Onder O AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Gul, Yasar Gokhan AU - Gul YG AUID- ORCID: 0000-0001-9531-4317 AD - Department of Anesthesiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Cakal, Beytullah AU - Cakal B AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Demir, Bulent AU - Demir B AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Gunes, Haci Murat AU - Gunes HM AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Karaca, Ibrahim Oguz AU - Karaca IO AUID- ORCID: 0000-0002-4281-0867 AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Guler, Ekrem AU - Guler E AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. FAU - Boztosun, Bilal AU - Boztosun B AD - Department of Cardiology, Istanbul Medipol University, 34214 Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20260313 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - *Transcatheter Aortic Valve Replacement/mortality MH - Stroke Volume MH - *Heart/drug effects MH - *Sodium-Glucose Transporter 2 Inhibitors/pharmacology/therapeutic use MH - Retrospective Studies MH - Humans MH - Male MH - Female MH - Aged MH - Aged, 80 and over MH - Turkey/epidemiology MH - Heart Failure/epidemiology MH - Postoperative Complications/epidemiology/prevention & control MH - Acute Kidney Injury/epidemiology PMC - PMC13027847 OTO - NOTNLM OT - SGLT2 inhibitors OT - cardiac remodeling OT - heart failure OT - low ejection fraction OT - mortality OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/03/28 06:40 MHDA- 2026/03/28 06:41 PMCR- 2026/03/13 CRDT- 2026/03/28 01:33 PHST- 2026/02/15 00:00 [received] PHST- 2026/02/28 00:00 [revised] PHST- 2026/03/12 00:00 [accepted] PHST- 2026/03/28 06:41 [medline] PHST- 2026/03/28 06:40 [pubmed] PHST- 2026/03/28 01:33 [entrez] PHST- 2026/03/13 00:00 [pmc-release] AID - medicina62030535 [pii] AID - medicina-62-00535 [pii] AID - 10.3390/medicina62030535 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Mar 13;62(3):535. doi: 10.3390/medicina62030535. PMID- 41901565 OWN - NLM STAT- MEDLINE DCOM- 20260714 LR - 20260813 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 3 DP - 2026 Mar 4 TI - Transcatheter Aortic Valve Implantation in Low-Risk and Younger Patients with Porcelain Aorta: A State-of-the-Art Narrative Review. LID - 10.3390/medicina62030483 [doi] LID - 483 AB - Background and Objectives: Porcelain aorta is an anatomy-driven high-risk phenotype characterized by extensive calcification of the ascending aorta, which complicates surgical aortic valve replacement by increasing embolic and technical hazards during cannulation and cross-clamping. As transcatheter aortic valve implantation (TAVI) expands into younger and low-surgical-risk populations, porcelain aorta creates a distinct clinical dilemma: optimizing short-term procedural safety while ensuring durable long-term outcomes and preserving future treatment options. Materials and Methods: We performed a targeted literature search of MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL), with the last search conducted on 31 January 2026. We synthesized contemporary clinical evidence on TAVI in patients with imaging-defined porcelain aorta, focusing on neurological outcomes, procedural strategies to reduce embolic risk, access considerations, valve performance, cerebral embolic protection, and implications for lifetime valve management (including coronary access and feasibility of future valve-in-valve interventions). Results: The evidence base specific to porcelain aorta in the contemporary TAVI era is limited and largely observational. Across published cohorts, TAVI avoids direct ascending aortic cannulation and cross-clamping and is generally associated with favorable early safety, with a recurring directional signal toward lower neurological risk compared with surgical strategies that require manipulation of a severely calcified ascending aorta. Interpretation is constrained by heterogeneity in porcelain-aorta definitions, patient selection, valve platforms and access routes, as well as, variability in neurological endpoint definitions and adjudication. Conclusions: In patients with porcelain aorta, TAVI is frequently favored because it minimizes ascending aortic manipulation and may mitigate neurological and procedural hazards. In younger and low-risk patients, Heart Team decision-making should incorporate lifetime management principles, including access planning, preservation of future coronary access, and procedural strategies to reduce embolic risk (with consideration of cerebral embolic protection when appropriate). FAU - Stanitsa, Nikoleta AU - Stanitsa N AD - Department of Cardiac Surgery, Evangelismos General Hospital, 10676 Athens, Greece. FAU - Tsibinos, Michalis AU - Tsibinos M AD - Department of Cardiac Surgery, Evangelismos General Hospital, 10676 Athens, Greece. FAU - Tempelis, Emmanouel AU - Tempelis E AD - Department of Cardiac Surgery, Evangelismos General Hospital, 10676 Athens, Greece. FAU - Paliaroutas, Orestis AU - Paliaroutas O AD - 1st Orthopedic Surgery Department, KAT General Hospital, 14561 Athens, Greece. FAU - Trikas, Grigoris AU - Trikas G AUID- ORCID: 0009-0007-8721-005X AD - Department of Cardiology, Nimitz Hospital, 11521 Athens, Greece. FAU - Samiotis, Ilias AU - Samiotis I AD - Department of Cardiac Surgery, Evangelismos General Hospital, 10676 Athens, Greece. FAU - Dedeilias, Panagiotis AU - Dedeilias P AD - Department of Cardiac Surgery, Evangelismos General Hospital, 10676 Athens, Greece. LA - eng PT - Journal Article PT - Review DEP - 20260304 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Aorta/abnormalities MH - *Aortic Diseases/surgery/complications MH - Risk Factors MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Calcinosis PMC - PMC13028285 OTO - NOTNLM OT - aortic stenosis OT - cerebral embolic protection OT - lifetime management OT - low surgical risk OT - porcelain aorta OT - stroke OT - structural valve deterioration OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/03/28 06:39 MHDA- 2026/03/28 06:40 PMCR- 2026/03/04 CRDT- 2026/03/28 01:33 PHST- 2026/01/10 00:00 [received] PHST- 2026/02/24 00:00 [revised] PHST- 2026/02/27 00:00 [accepted] PHST- 2026/03/28 06:40 [medline] PHST- 2026/03/28 06:39 [pubmed] PHST- 2026/03/28 01:33 [entrez] PHST- 2026/03/04 00:00 [pmc-release] AID - medicina62030483 [pii] AID - medicina-62-00483 [pii] AID - 10.3390/medicina62030483 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Mar 4;62(3):483. doi: 10.3390/medicina62030483. PMID- 41895563 OWN - NLM STAT- MEDLINE DCOM- 20260713 LR - 20260806 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 297 DP - 2026 Jul TI - Design and rationale of the prospective, randomized, controlled trial to assess the management of moderate aortic stenosis by clinical surveillance or transcatheter aortic valve replacement: The PROGRESS Trial. PG - 107433 LID - S0002-8703(26)00095-5 [pii] LID - 10.1016/j.ahj.2026.107433 [doi] AB - BACKGROUND: For patients with moderate aortic stenosis (AS), current US guidelines recommend clinical surveillance every 1 to 2 years. However, moderate AS has been associated with increased morbidity and mortality in multiple observational studies, suggesting a possible role for earlier treatment with transcatheter aortic valve replacement (TAVR). To date, no large, randomized trial has examined whether an early intervention with TAVR will improve outcomes among these patients. STUDY DESIGN AND OBJECTIVES: The PROGRESS trial is a prospective, open-label, randomized, controlled, multicenter trial that includes up to 750 patients with moderate AS and at-risk features randomized 1:1 to either clinical surveillance or transfemoral TAVR with the SAPIEN 3/SAPIEN 3 Ultra/SAPIEN 3 Ultra RESILIA transcatheter heart valve (Edwards Lifesciences, Irvine, CA). Patients are stratified by site, left ventricular ejection fraction, and peak jet velocity. The primary effectiveness endpoint is the composite of death or heart failure event with or without hospitalization at 2 years. The primary safety endpoint (evaluated in the TAVR arm only) is a composite of death, stroke, life threatening or fatal bleeding, acute kidney injury stage 4, hospitalization due to device- or procedure-related complications, or valve dysfunction requiring reintervention at 30 days. Patients will be followed annually through 10 years. CONCLUSIONS: The PROGRESS trial is the first large, randomized trial assessing the role of early intervention among patients with moderate AS with at-risk features compared to clinical surveillance. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT04889872. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Genereux, Philippe AU - Genereux P AD - Morristown Medical Center, Gagnon Cardiovascular Institute, Morristown, NJ. Electronic address: philippe.genereux@atlantichealth.org. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA. FAU - Bax, Jeroen J AU - Bax JJ AD - Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands. FAU - Pibarot, Philippe AU - Pibarot P AD - Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Lindman, Brian R AU - Lindman BR AD - Cardiovascular Medicine Division, Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN. FAU - Prince, Heather AU - Prince H AD - Edwards Lifesciences, Irvine, California. FAU - Park, Brandon AU - Park B AD - Edwards Lifesciences, Irvine, California. FAU - Cohen, David J AU - Cohen DJ AD - St. Francis Hospital and Heart Center, Roslyn, NY; Cardiovascular Research Foundation, New York, NY. FAU - Mack, Michael J AU - Mack MJ AD - Department of Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott and White the Heart Hospital Plano, Plano, TX. FAU - Leon, Martin B AU - Leon MB AD - Cardiovascular Research Foundation, New York, NY; Division of Cardiology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY. LA - eng SI - ClinicalTrials.gov/NCT04889872 PT - Clinical Trial Protocol PT - Journal Article DEP - 20260325 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/diagnosis/mortality MH - *Transcatheter Aortic Valve Replacement/methods MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Multicenter Studies as Topic MH - Female MH - Severity of Illness Index MH - Treatment Outcome MH - Heart Valve Prosthesis COIS- Disclosures Philippe Genereux: Abbott Vascular (Consultant), ECHO IQ (Consultant and Stock Option), Edwards Lifesciences (Principal Investigator and Consultant), Egnite (Consultant and Stock Option), Haemonetics Corporation (Consultant), Medtronic (Consultant), Pi-Cardia (Consultant and Stock Option), Puzzle Medical inc. (Consultant and Stock Option), Sparrow Acoustic (Consultant and Stock Option), Teleflex Inc. (Consultant), Antegrade Medical (Consultant and Stock Option), Spiralis Medical Inc. (Consultant and Stock Option), 4C Medical (Consultant). Raj Makkar: research grants and travel support from Edwards Lifesciences, Abbott, Boston Scientific, Medtronic, and JenaValve; and equity in and being an advisor for iCardio. Jeroen J. Bax: The department of Cardiology at Leiden University Medical Center, The Netherlands has received unrestricted research grants from Edwards Lifesciences and Abbott. Philippe Pibarot: Received institutional funding from Edwards Lifesciences, Medtronic, Pi-Cardia, Cardiac Success, Boston Sc., Novartis for echocardiography core laboratory analyses and research studies in the field of valvular heart disease, for which he received no personal compensation. P Pibarot has received lecture fees from Edwards Lifesciences and Medtronic. Brian R. Lindman: Consultant- Anteris, AstraZeneca, Medtronic, Kardigan; Consultant and Institutional Grant/Contract- Edwards Lifesciences; PI of EARLY TAVR and PROGRESS biobank core lab (Edwards Lifesciences). Heather Prince: Employee of Edwards Lifesciences. Brandon Park: Employee of Edwards Lifesciences. David J. Cohen: received consulting income from Edwards Lifesciences, Abbott, Boston Scientific, and research grants to his institution from Edwards Lifesciences, Boston Scientific, Abbott, and Philips. Michael J. Mack: Trial Co-PI for Abbott, Edwards Lifesciences; Trial Study Chair for Medtronic. Martin B. Leon: institutional clinical research support from Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott. EDAT- 2026/03/28 00:42 MHDA- 2026/05/03 05:27 CRDT- 2026/03/27 20:18 PHST- 2026/02/23 00:00 [received] PHST- 2026/03/20 00:00 [revised] PHST- 2026/03/24 00:00 [accepted] PHST- 2026/05/03 05:27 [medline] PHST- 2026/03/28 00:42 [pubmed] PHST- 2026/03/27 20:18 [entrez] AID - S0002-8703(26)00095-5 [pii] AID - 10.1016/j.ahj.2026.107433 [doi] PST - ppublish SO - Am Heart J. 2026 Jul;297:107433. doi: 10.1016/j.ahj.2026.107433. Epub 2026 Mar 25. PMID- 41893831 OWN - NLM STAT- MEDLINE DCOM- 20260713 LR - 20260813 IS - 2379-139X (Electronic) IS - 2379-1381 (Print) IS - 2379-1381 (Linking) VI - 12 IP - 3 DP - 2026 Mar 4 TI - Eye Lens Radiation Exposure During TAVI: Current Evidence and Imaging-Based Strategies for Dose Reduction. LID - 10.3390/tomography12030036 [doi] LID - 36 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly performed in fluoroscopy-intensive environments, raising concerns about occupational eye lens dose (equivalent dose to the eye lens, Hp (3)) and the risk of radiation-induced cataract, particularly after the reduction of recommended annual eye lens dose limits to 20 mSv. PURPOSE: To summarize evidence on eye lens radiation exposure during TAVI, identify procedural and occupational determinants, and review strategies to reduce exposure with a focus on imaging optimization. METHODS: We performed a narrative review of observational and prospective studies reporting direct eye-level dose measurements or validated surrogate eye lens dose estimates (head-level, chest-level, or DAP-normalized) during TAVI and related structural heart procedures. This approach was chosen to provide a qualitative synthesis of the available evidence rather than a formal systematic review. RESULTS: Reported operator eye lens doses typically ranged from 30 to 110 microSv per procedure, with higher exposure during transapical/transaortal access and among staff working close to the patient (e.g., anesthesiologists and circulating nurses). Additional shielding and lead-free drapes reduced normalized eye dose by approximately 25-40%, and RADPAD((R)) use reduced operator eye-level dose from 24.3 to 14.8 microSv per procedure (p = 0.008). At these levels, cumulative exposure may approach recommended regulatory limits after approximately 150-300 procedures, depending on role, access route, and shielding practices. CONCLUSION: In conclusion, Occupational eye lens exposure during TAVI is clinically relevant and strongly influenced by access route, staff positioning, and imaging-system use. Dose reduction should combine routine eye protection and dedicated eye-level dosimetry with imaging optimization (low pulse-rate fluoroscopy, minimized Digital-Subtraction-Angiography (DSA)/cine acquisitions, tight collimation, avoidance of unnecessary magnification, and correct positioning of ceiling-suspended shields and table skirts). FAU - Zanon, Chiara AU - Zanon C AUID- ORCID: 0000-0002-7917-5027 AD - Department of Radiology, University of Padua, Via Giustiniani 2, 35128 Padua, Italy. FAU - Fiocco, Alessandro AU - Fiocco A AD - Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35128 Padua, Italy. FAU - Tarzia, Vincenzo AU - Tarzia V AD - Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35128 Padua, Italy. FAU - Quaia, Emilio AU - Quaia E AUID- ORCID: 0000-0003-2020-9365 AD - Department of Radiology, University of Padua, Via Giustiniani 2, 35128 Padua, Italy. LA - eng PT - Journal Article PT - Review DEP - 20260304 PL - Switzerland TA - Tomography JT - Tomography (Ann Arbor, Mich.) JID - 101671170 SB - IM MH - Humans MH - Fluoroscopy/adverse effects MH - *Lens, Crystalline/radiation effects MH - *Occupational Exposure/prevention & control MH - Radiation Dosage MH - *Radiation Exposure/prevention & control MH - *Radiation Protection/methods MH - *Radiography, Interventional/adverse effects MH - *Transcatheter Aortic Valve Replacement/methods PMC - PMC13030497 OTO - NOTNLM OT - TAVI OT - cataract OT - dosimetry OT - eye lens dose OT - fluoroscopy OT - imaging optimization OT - occupational radiation OT - shielding OT - structural heart interventions OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/03/27 17:38 MHDA- 2026/03/27 18:52 PMCR- 2026/03/04 CRDT- 2026/03/27 11:34 PHST- 2026/01/07 00:00 [received] PHST- 2026/02/07 00:00 [revised] PHST- 2026/02/28 00:00 [accepted] PHST- 2026/03/27 18:52 [medline] PHST- 2026/03/27 17:38 [pubmed] PHST- 2026/03/27 11:34 [entrez] PHST- 2026/03/04 00:00 [pmc-release] AID - tomography12030036 [pii] AID - tomography-12-00036 [pii] AID - 10.3390/tomography12030036 [doi] PST - epublish SO - Tomography. 2026 Mar 4;12(3):36. doi: 10.3390/tomography12030036. PMID- 41885690 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260603 LR - 20260813 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 6 DP - 2026 Jun TI - Single Versus Double Perclose Devices for TF-TAVR Access Closure: A Noninferiority Randomized Controlled Trial. PG - 898-906 LID - S2772-3747(26)00095-5 [pii] LID - 10.1016/j.jacasi.2026.01.028 [doi] AB - BACKGROUND: The Double Perclose ProGlide (Abbott Vascular Devices) is widely adopted device for closing the main arterial access in transfemoral transcatheter aortic valve replacement (TF-TAVR). Previous observational studies have compared the single device vs double device approach, yielding controversial results and highlighting a gap in clinical randomized controlled trials. OBJECTIVES: The authors sought to evaluate the effectiveness and safety of single vs double Perclose ProGlide devices in patients undergoing TF-TAVR. METHODS: The Single-Closure trial was been launched in 2024 (NCT06173115). It is an investigator-initiated, open-label, multicenter, noninferior, randomized controlled trial designed to compare the clinical outcomes of single vs double Perclose closure devices. Eligible participants include patients over 65 years of age with severe aortic stenosis and indicated for TF-TAVR. These patients are randomly assigned in a 1:1 ratio to either the single Perclose closure group or the double Perclose closure group. RESULTS: The primary endpoint of the trial is the composite of access site or access-related major and minor vascular complications during hospitalization for the index procedure, as defined by the Valve Academic Research Consortium 3 criteria. CONCLUSIONS: This trial aims to compare the clinical outcomes of single vs double Perclose closure. Results of this trial may provide valuable insights into the optimal strategy for large-bore vascular closure. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Jiang, Jubo AU - Jiang J AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Wang, Lihan AU - Wang L AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Hu, Po AU - Hu P AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Ren, Kaida AU - Ren K AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Lin, Xinping AU - Lin X AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Zhu, QiFeng AU - Zhu Q AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Fan, Jiaqi AU - Fan J AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - He, Yuxin AU - He Y AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Guo, Yuchao AU - Guo Y AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Liu, Qiong AU - Liu Q AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Liang, Jie AU - Liang J AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Li, Huajun AU - Li H AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Yan, Huixiang AU - Yan H AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China; Transvascular Implantation Devices Research Institute, Hangzhou, China; Binjiang Institute of Zhejiang University, Hangzhou, China. Electronic address: wangjianan111@zju.edu.cn. FAU - Liu, Xianbao AU - Liu X AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China; Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China; Transvascular Implantation Devices Research Institute, Hangzhou, China; Binjiang Institute of Zhejiang University, Hangzhou, China. Electronic address: liuxb@zju.edu.cn. LA - eng PT - Journal Article DEP - 20260326 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC13244112 OTO - NOTNLM OT - Perclose ProGlide OT - transcatheter aortic valve replacement OT - transfemoral OT - vascular complications COIS- Funding Support and Author Disclosures This work was supported by Key R & D Projects of Zhejiang Province (2024C03024 for Dr J. Wang). EDAT- 2026/03/26 13:31 MHDA- 2026/03/26 13:32 PMCR- 2026/03/26 CRDT- 2026/03/26 10:09 PHST- 2025/08/04 00:00 [received] PHST- 2026/01/07 00:00 [revised] PHST- 2026/01/16 00:00 [accepted] PHST- 2026/03/26 13:32 [medline] PHST- 2026/03/26 13:31 [pubmed] PHST- 2026/03/26 10:09 [entrez] PHST- 2026/03/26 00:00 [pmc-release] AID - S2772-3747(26)00095-5 [pii] AID - 10.1016/j.jacasi.2026.01.028 [doi] PST - ppublish SO - JACC Asia. 2026 Jun;6(6):898-906. doi: 10.1016/j.jacasi.2026.01.028. Epub 2026 Mar 26. PMID- 41866133 OWN - NLM STAT- In-Process LR - 20260623 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 42 IP - 6 DP - 2026 Jun TI - Author Correction for "Dual ProGlide vs ProGlide and Angio-Seal for Femoral Access Hemostasis After Transcatheter Aortic Valve Replacement: A Randomised Comparative Trial" [Canadian Journal of Cardiology. Volume 41, Issue 1, January 2025, Pages 12-20. doi: 10.1016/j.cjca.2025.08.363]. PG - 1236 LID - S0828-282X(26)00170-4 [pii] LID - 10.1016/j.cjca.2026.03.001 [doi] FAU - Yeh, Chih-Fan AU - Yeh CF AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Kao, Hsien-Li AU - Kao HL AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Ko, Tsung-Yu AU - Ko TY AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, Medical College, National Taiwan University, Taipei, Taiwan. FAU - Chen, Chun-Kai AU - Chen CK AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, Medical College, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan. FAU - Tsai, Cheng-Hsuan AU - Tsai CH AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Huang, Ching-Chang AU - Huang CC AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chen, Ying-Hsien AU - Chen YH AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chan, Chih-Yang AU - Chan CY AD - Division of Cardiovascular Surgery, Department of Surgery and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Lin, Mao-Shin AU - Lin MS AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. LA - eng PT - Published Erratum DEP - 20260324 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM EFR - Can J Cardiol. 2025 Jan;41(1):12-20. doi: 10.1016/j.cjca.2024.09.001. PMID: 39245341 EDAT- 2026/03/23 01:33 MHDA- 2026/03/23 01:33 CRDT- 2026/03/22 20:20 PHST- 2026/03/23 01:33 [pubmed] PHST- 2026/03/23 01:33 [medline] PHST- 2026/03/22 20:20 [entrez] AID - S0828-282X(26)00170-4 [pii] AID - 10.1016/j.cjca.2026.03.001 [doi] PST - ppublish SO - Can J Cardiol. 2026 Jun;42(6):1236. doi: 10.1016/j.cjca.2026.03.001. Epub 2026 Mar 24. PMID- 41856455 OWN - NLM STAT- MEDLINE DCOM- 20260711 LR - 20260711 IS - 1873-1570 (Electronic) IS - 0300-9572 (Linking) VI - 222 DP - 2026 May TI - Post-cardiac arrest brain injury model: neurobiomarker kinetics following global cerebral hypoperfusion-reperfusion. PG - 111063 LID - S0300-9572(26)00109-7 [pii] LID - 10.1016/j.resuscitation.2026.111063 [doi] AB - BACKGROUND: Post-cardiac arrest brain injury is driven by both global cerebral hypoperfusion and subsequent reperfusion. However, hyperacute blood-based neurobiomarker kinetics after precisely defined (very) low-flow intervals remain poorly characterized. During transcatheter aortic valve implantation (TAVI), rapid ventricular pacing (RVP) induces a transient pulseless ventricular tachycardia, functionally mimicking brief cardiac arrest. METHODS: In this single-center, prospective, self-controlled cohort study, adults undergoing TAVI were enrolled. RVP (120-200 bpm) was applied to transiently suppress forward flow. Invasive aortic pressure, common carotid (CCA) and middle cerebral artery (MCA) flow were recorded continuously. Serum samples were obtained pre-procedure and 20, 65, 110 and 200 min after RVP. Neuron specific enolase (NSE), and S100 were measured as neurobiomarkers. RESULTS: In case of the 76 enrolled patients, median cumulative RVP duration was 60 s (IQR 41-92). During RVP, MCA and CCA flow showed a very low-flow state while aortic pressure fell below the presumed autoregulatory threshold. NSE concentrations increased progressively from baseline to 200 min (T0: 10.6 [9.1-13.0]; T20: 12.8 [11.6-15.5]; T65: 15.1 [13.0-18.6]; T110: 15.8 [13.8-18.6]; T200: 17.0 [14.2-20.5] microg/L). S100B concentrations showed an inverse U-shaped profile (T0: 0.05 [0.04-0.07]; T20: 0.13 [0.10-0.18]; T65: 0.14 [0.11-0.23]; T110: 0.11 [0.08-0.16]; T200: 0.08 [0.06-0.12] microg/L). No patient developed neurological deficits. CONCLUSIONS: Controlled (very) low-flow episodes during TAVI induce measurable, but clinically silent, elevations of NSE and S100. Neurobiomarkers reflects with distinct kinetics on ischaemia and reperfusion following a short, very low-flow cardiac arrest. CI - Copyright (c) 2026 The Author(s). Published by Elsevier B.V. All rights reserved. FAU - Papp, Abel AU - Papp A AD - Department of Anaesthesiology and Intensive Therapy, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary; Hungarian National Ambulance Service, Marko str. 22, H-1055 Budapest, Hungary. Electronic address: pappabel0219@gmail.com. FAU - Horvath, Levente L AU - Horvath LL AD - Department of Anaesthesiology and Intensive Therapy, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary. Electronic address: leventehory.horvath@gmail.com. FAU - Nagy, Zsofia AU - Nagy Z AD - Department of Laboratory Medicine, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary. Electronic address: zsofia.nagy@aok.pte.hu. FAU - Gaal, Anna AU - Gaal A AD - Department of Neurology, Semmelweis University, Balassa str. 6, H-1083 Budapest, Hungary. Electronic address: gaal.anna@semmelweis.hu. FAU - Debreczeni, Robert AU - Debreczeni R AD - Department of Neurology, Semmelweis University, Balassa str. 6, H-1083 Budapest, Hungary. Electronic address: debreczeni.robert@semmelweis.hu. FAU - Pinter, Tunde AU - Pinter T AD - Gottsegen National Cardiovascular Center, Haller str. 29, H-1096 Budapest, Hungary. Electronic address: tunde.pinter@gokvi.hu. FAU - Czeiter, Endre AU - Czeiter E AD - Department of Neurosurgery, Medical School, University of Pecs, Ret str. 2, H-7623 Pecs, Hungary; Molecular Medicine Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag str. 20, H-7624 Pecs, Hungary; HUN-REN-PTE Clinical Neuroscience MR Research Group, University of Pecs, Ret str. 2, H-7623 Pecs, Hungary. Electronic address: endre.czeiter@gmail.com. FAU - Vamos, Zoltan AU - Vamos Z AD - Department of Anaesthesiology and Intensive Therapy, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary; Hungarian National Ambulance Service, Marko str. 22, H-1055 Budapest, Hungary. Electronic address: vamos.zoltan@pte.hu. CN - Experimental Oxiology Workgroup Collaborators LA - eng PT - Journal Article DEP - 20260317 PL - Ireland TA - Resuscitation JT - Resuscitation JID - 0332173 RN - EC 4.2.1.11 (Phosphopyruvate Hydratase) RN - 0 (Biomarkers) RN - 0 (S100 Proteins) SB - IM MH - Humans MH - Male MH - *Phosphopyruvate Hydratase/blood MH - Prospective Studies MH - Female MH - Aged, 80 and over MH - Aged MH - *Brain Injuries/etiology/blood/physiopathology MH - *Reperfusion Injury/etiology MH - Cerebrovascular Circulation/physiology MH - Biomarkers/blood MH - *Heart Arrest/complications MH - S100 Proteins/blood OTO - NOTNLM OT - Acute brain injury OT - Cardiac arrest OT - NSE OT - Neurobiomarker OT - PCABI OT - S100 OT - TAVI OT - hypoperfusion OT - reperfusion COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. FIR - Amrein, Krisztina IR - Amrein K IRAD- Department of Neurosurgery, Medical School, University of Pecs, Ret str. 2, H-7623 Pecs, Hungary; Molecular Medicine Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag str. 20, H-7624 Pecs, Hungary; HUN-REN-PTE Clinical Neuroscience MR Research Group, University of Pecs, Ret str. 2, H-7623 Pecs, Hungary. FIR - Beri, Laura IR - Beri L IRAD- Department of Anaesthesiology and Intensive Therapy, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary. FIR - Kristaly, Christopher IR - Kristaly C IRAD- Central Department of Anesthesiology and Intensive Care, North-Pest Central Hospital-Military Hospital, Robert Karoly blvd. 44, H-1134 Budapest, Hungary. FIR - Nagy, Orsolya IR - Nagy O IRAD- Department of Anaesthesiology and Intensive Therapy, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary. FIR - Nemet, Istvan IR - Nemet I IRAD- Department of Laboratory Medicine, Medical School, University of Pecs, Ifjusag str. 13, H-7624 Pecs, Hungary. FIR - Nyiradi, Jozsef IR - Nyiradi J IRAD- Department of Neurosurgery, Medical School, University of Pecs, Ret str. 2, H-7623 Pecs, Hungary; Molecular Medicine Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag str. 20, H-7624 Pecs, Hungary. EDAT- 2026/03/20 00:59 MHDA- 2026/05/01 00:32 CRDT- 2026/03/19 20:17 PHST- 2026/01/23 00:00 [received] PHST- 2026/02/28 00:00 [revised] PHST- 2026/03/02 00:00 [accepted] PHST- 2026/05/01 00:32 [medline] PHST- 2026/03/20 00:59 [pubmed] PHST- 2026/03/19 20:17 [entrez] AID - S0300-9572(26)00109-7 [pii] AID - 10.1016/j.resuscitation.2026.111063 [doi] PST - ppublish SO - Resuscitation. 2026 May;222:111063. doi: 10.1016/j.resuscitation.2026.111063. Epub 2026 Mar 17. PMID- 41839741 OWN - NLM STAT- MEDLINE DCOM- 20260711 LR - 20260913 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 6 DP - 2026 May TI - Percutaneous Endovascular Management of MANTA-Related Vascular Occlusion. PG - 1945-1952 LID - 10.1002/ccd.70556 [doi] AB - BACKGROUND: Vascular closure devices (VCDs) are the standard alternative to surgical cutdown for large-bore arterial access (LBAA) but can lead to complications like bleeding and common femoral artery (CFA) occlusion that require intervention. This manuscript outlines our approach using percutaneous endovascular intervention (PEI) to manage femoral artery occlusion caused by the MANTA (Teleflex, Morrisville, SC), the only collagen plug-based VCD indicated for LBAA. METHODS: Consecutive patients who experienced occlusive complications following MANTA deployment at the conclusion of transcutaneous aortic valve replacement (TAVR) underwent PEI to address occlusion. Clinical and procedural characteristics of the patients, as well as their short- and long-term follow-up data, were analyzed. RESULTS: A total of 1445 patients underwent TAVR, in whom LBAA was closed with MANTA VCD between August 2017 and July 2024, among whom 34 patients (2.4%) experienced occlusive complications. These patients had a mean age of 79 +/- 8 years, and 59% were female. The mean CFA diameter was 7.8 +/- 1.1 mm, with mild vessel stenosis present in 41% and calcification in 44% of patients. An 18 French MANTA device was used for closure in 82% of patients. The primary mechanism was plug internalization, which was observed in 88% of our cohort and led to total vessel occlusion in 56% of patients. Bleeding occurred in 38% of patients in association with occlusion. All patients were approached with PEI, achieving an overall procedural success rate of 97%. Lesion crossing was accomplished via an antegrade approach in 71% of patients, with the remaining 29% requiring a retrograde approach. Stenting was the definitive treatment in 85% of patients, with 90% of these involving an oversized VIABAHN (Gore Medical, Newark, DE) self-expanding stent. One patient experienced profunda artery occlusion after stent placement that required surgery. At 1-month follow-up, no vessel occlusions or bleeding were reported. CONCLUSION: Femoral artery occlusion from MANTA deployment after TAVR can be effectively treated with PEI. Low complication rates at 1 month suggest PEI is safe and reliable, but longer follow-up is needed to assess long-term vessel outcomes. CI - (c) 2026 Wiley Periodicals LLC. FAU - Haberman, Dan AU - Haberman D AUID- ORCID: 0000-0003-2897-8919 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Alkhofash, Rama AU - Alkhofash R AD - Georgetown University School of Medicine, Washington, USA. FAU - Czulada, Evan AU - Czulada E AUID- ORCID: 0009-0008-1502-2006 AD - Georgetown University School of Medicine, Washington, USA. FAU - Lupu, Lior AU - Lupu L AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Abusnina, Waiel AU - Abusnina W AUID- ORCID: 0000-0003-2617-8483 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Chitturi, Kalyan R AU - Chitturi KR AUID- ORCID: 0000-0003-0602-2684 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Chaturvedi, Abhishek AU - Chaturvedi A AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Galo, Jason AU - Galo J AUID- ORCID: 0000-0001-9036-7049 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Verma, Beni AU - Verma B AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Rogers, Toby AU - Rogers T AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. AD - Cardiovascular Intervention Program, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Satler, Lowell F AU - Satler LF AUID- ORCID: 0000-0001-6446-2683 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Bernardo, Nelson L AU - Bernardo NL AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Waksman, Ron AU - Waksman R AUID- ORCID: 0000-0002-4063-9226 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Ben-Dor, Itsik AU - Ben-Dor I AUID- ORCID: 0009-0006-6026-9097 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. LA - eng PT - Journal Article DEP - 20260316 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Female MH - *Femoral Artery/diagnostic imaging/physiopathology MH - Treatment Outcome MH - *Endovascular Procedures/adverse effects/instrumentation MH - Time Factors MH - Aged MH - Male MH - Aged, 80 and over MH - *Hemostatic Techniques/adverse effects/instrumentation MH - *Arterial Occlusive Diseases/diagnostic imaging/etiology/therapy/physiopathology MH - Punctures MH - *Catheterization, Peripheral/adverse effects MH - *Vascular Closure Devices MH - Risk Factors MH - Retrospective Studies MH - Hemorrhage/prevention & control/etiology OTO - NOTNLM OT - MANTA OT - covered stent OT - femoral artery occlusion OT - percutaneous endovascular intervention OT - vascular closure device EDAT- 2026/03/17 00:34 MHDA- 2026/05/15 06:29 CRDT- 2026/03/16 23:32 PHST- 2025/07/16 00:00 [revised] PHST- 2025/01/07 00:00 [received] PHST- 2026/03/10 00:00 [accepted] PHST- 2026/05/15 06:29 [medline] PHST- 2026/03/17 00:34 [pubmed] PHST- 2026/03/16 23:32 [entrez] AID - 10.1002/ccd.70556 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 May;107(6):1945-1952. doi: 10.1002/ccd.70556. Epub 2026 Mar 16. PMID- 41831821 OWN - NLM STAT- MEDLINE DCOM- 20260711 LR - 20260812 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 128 DP - 2026 Jul TI - Outcome of a Prospective Registry to Evaluate the Performance of the MANTA Vascular Closure Device in EVAR Patients. PG - 349-357 LID - S0890-5096(26)00130-5 [pii] LID - 10.1016/j.avsg.2026.02.036 [doi] AB - BACKGROUND: Percutaneous endovascular aortic repair (pEVAR) has become the gold standard in the treatment of aortic aneurysms. Vascular puncture site complications can have severe implications on morbidity and mortality of patients, underlining the necessity for safe and effective closure devices. The MANTA vascular closure device (VCD) has shown to be safe and effective in patients undergoing endovascular aortic repair (EVAR) and transcatheter aortic valve replacement (TAVR). However, most of these trials were conducted in TAVR patients, involved highly selected populations, and had a retrospective design. This study aims to address the limited real-world data on the performance of the MANTA device in EVAR patients. METHODS: We performed a multicenter, prospective, observational, non-\randomized study on the performance of the MANTA VCD (Teleflex Inc., Pennsylvania, USA) in patients receiving percutaneous EVAR. We selected patients within instructions for use of MANTA VCD. Time to hemostasis was measured. All patients had a clinical evaluation before discharge and at 30 days. A computed tomography angiography was performed at 30 days of index procedure. Primary outcome was technical success defined as successful vessel closure within 5 minutes after MANTA VCD deployment, without rebleeding and without the need of any additional procedures. Secondary outcome was technical failure defined as closure device failure, infection, bleeding, perforation, lower leg ischemia, hematoma >5 cm, seroma, pseudoaneurysm, arteriovenous fistula, distal embolization, femoral artery thrombosis, and arterial dissection within 30 days after the index procedure. RESULTS: Patient inclusion took place between January 2019 and November 2023. A total of 279 groins were treated with the MANTA VCD, and every patient received EVAR through femoral access. Technical success was seen in 263 groins (94.3%). Adverse events were seen in 16 groins (5.7%). The median time to hemostasis was 1 minute 0 seconds in both the right and left common femoral artery (interquartile range right: 11min10sec, left: 1m40sec). Immediate suture of the femoral artery during index procedure due to bleeding of the femoral artery was seen in 10 groins (3.6%). Postprocedural complications were seen in another 6 groins (2.2%) of which 2 patients (0.7%) received adjunctive surgical procedures. CONCLUSION: The MANTA VCD was found to be a safe and effective closure device in patient receiving pEVAR repair with a high technical success rate. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Goeteyn, Jens AU - Goeteyn J AD - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. Electronic address: jens.goeteyn@catharinaziekenhuis.nl. FAU - Jongen, Audrey AU - Jongen A AD - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. FAU - Loos, Maarten AU - Loos M AD - Department of Vascular Surgery, Maxima Medisch Centrum, Eindhoven, The Netherlands. FAU - Yazar, Ozan AU - Yazar O AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands. FAU - Zwetsloot, Jenny AU - Zwetsloot J AD - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. FAU - van Sambeek, Marc R H M AU - van Sambeek MRHM AD - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; Department of Biomedical Technology, University of Technology Eindhoven, Eindhoven, The Netherlands. FAU - Bode, Aron AU - Bode A AD - Department of Vascular Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. FAU - Cuypers, Philippe AU - Cuypers P AD - Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20260313 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 SB - IM MH - Humans MH - *Endovascular Aneurysm Repair/adverse effects MH - *Vascular Closure Devices MH - Treatment Outcome MH - Female MH - Aged, 80 and over MH - Prospective Studies MH - Male MH - *Hemostatic Techniques/instrumentation/adverse effects MH - Time Factors MH - Registries MH - Aged MH - Punctures MH - Risk Factors MH - Equipment Design EDAT- 2026/03/15 05:36 MHDA- 2026/05/13 00:29 CRDT- 2026/03/14 20:16 PHST- 2025/12/13 00:00 [received] PHST- 2026/02/13 00:00 [revised] PHST- 2026/02/14 00:00 [accepted] PHST- 2026/05/13 00:29 [medline] PHST- 2026/03/15 05:36 [pubmed] PHST- 2026/03/14 20:16 [entrez] AID - S0890-5096(26)00130-5 [pii] AID - 10.1016/j.avsg.2026.02.036 [doi] PST - ppublish SO - Ann Vasc Surg. 2026 Jul;128:349-357. doi: 10.1016/j.avsg.2026.02.036. Epub 2026 Mar 13. PMID- 41790669 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20261020 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 105 IP - 10 DP - 2026 Mar 6 TI - Endothelial activation and stress index (EASIX) as a predictor of acute kidney injury in patients undergoing transcatheter aortic valve replacement: A retrospective cohort study. PG - e47957 LID - 10.1097/MD.0000000000047957 [doi] LID - e47957 AB - Transcatheter aortic valve replacement (TAVR) is being performed in increasingly complex, high-risk cohorts, and contrast-induced nephropathy (CIN) remains a major determinant of morbidity and mortality. The endothelial-damage score EASIX (lactate dehydrogenase x creatinine/platelet count) is a validated prognostic index in hematology and critical care but has never been explored after TAVR. We retrospectively analyzed 130 consecutive severe AC patients (mean age 76.8 +/- 8.4 years; 47.8% male) who underwent transfemoral TAVR (February 2019-March 2021). CIN was defined as a >/=25% or >/=0.5 mg/dL creatinine rise within 72 hours. The predictive value of EASIX was assessed with receiver operating characteristic analysis and multivariable logistic regression. CIN occurred in 15.4% (n = 20). Baseline EASIX was higher in CIN+ vs CIN- (2.92 +/- 1.28 vs 1.33 +/- 1.30; P < .001). An EASIX threshold >/= 1.904 predicted CIN with 90.3% sensitivity and 86.2% specificity (area under the curve 0.91; P < .001). In multivariable analysis, EASIX (OR 2.62; P = .023), contrast volume, and baseline eGFR independently predicted CIN. EASIX, obtainable from routine laboratories, is an independent, high-performance predictor of CIN after TAVR and may facilitate pre-procedural risk stratification. CI - Copyright (c) 2026 the Author(s). Published by Wolters Kluwer Health, Inc. FAU - Ozen, Yasin AU - Ozen Y AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. FAU - Tezcan, Huseyin AU - Tezcan H AUID- ORCID: 0000-0002-8140-874 AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. FAU - Ozalp, Halil AU - Ozalp H AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. FAU - Karaibrahimoglu, Adnan AU - Karaibrahimoglu A AD - Biostatistics & Medical Informatics Deptartment, Suleyman Demirel University, Medical School, Isparta, Turkiye. FAU - Yildiz, Kaan Burak AU - Yildiz KB AD - Department of Cardiology, Ankara City Hospital, Ankara, Turkey. FAU - Kuyumcu, Mevlut Serdar AU - Kuyumcu MS AD - Department of Cardiology, Suleyman Demirel University Medical Faculty Hospital, Isparta, Turkey. FAU - Tuncez, Abdullah AU - Tuncez A AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. FAU - Gurses, Kadri Murat AU - Gurses KM AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. FAU - Ozbay, Mustafa Bilal AU - Ozbay MB AD - Department of Medicine, Penn Medicine Princeton Medical Center, Plainsboro, NJ. FAU - Ertem, Ahmet Goktug AU - Ertem AG AD - Department of Cardiology, Ankara City Hospital, Ankara, Turkey. FAU - Yalcin, Muhammed Ulvi AU - Yalcin MU AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. FAU - Aygul, Nazif AU - Aygul N AD - Department of Cardiology, Selcuk University Faculty of Medicine, Konya, Turkey. LA - eng PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - EC 1.1.1.27 (L-Lactate Dehydrogenase) SB - IM EIN - Medicine (Baltimore). 2026 Oct 9;105(41):e50457. doi: 10.1097/MD.0000000000050457. PMID: 42854078 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Retrospective Studies MH - *Acute Kidney Injury/chemically induced/diagnosis/etiology/blood MH - Female MH - Contrast Media/adverse effects MH - Aged MH - Creatinine/blood MH - Aged, 80 and over MH - L-Lactate Dehydrogenase/blood MH - Predictive Value of Tests MH - Platelet Count MH - Aortic Valve Stenosis/surgery MH - Risk Factors MH - ROC Curve MH - Prognosis PMC - PMC12975259 OTO - NOTNLM OT - EASIX OT - aortic stenosis OT - contrast-induced nephropathy OT - endothelial dysfunction OT - transcatheter aortic valve replacement COIS- The authors have no funding and conflicts of interest to disclose. EDAT- 2026/03/06 19:44 MHDA- 2026/03/08 01:37 PMCR- 2026/03/06 CRDT- 2026/03/06 13:33 PHST- 2025/07/27 00:00 [received] PHST- 2025/11/12 00:00 [accepted] PHST- 2026/03/08 01:37 [medline] PHST- 2026/03/06 19:44 [pubmed] PHST- 2026/03/06 13:33 [entrez] PHST- 2026/03/06 00:00 [pmc-release] AID - 00005792-202603060-00049 [pii] AID - MD-D-25-09412 [pii] AID - 10.1097/MD.0000000000047957 [doi] PST - ppublish SO - Medicine (Baltimore). 2026 Mar 6;105(10):e47957. doi: 10.1097/MD.0000000000047957. PMID- 41788180 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260306 LR - 20260813 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 12 DP - 2025 TI - Reduced ejection fraction as the sole potential limitation for wire pacing in transfemoral aortic valve replacement. PG - 1579898 LID - 10.3389/fcvm.2025.1579898 [doi] LID - 1579898 AB - BACKGROUND: In recent years, fast-track protocols have been developed for transcatheter aortic valve replacement/implantation (TAVR/TAVI) to further simplify the procedure. Traditionally, intraprocedural rapid ventricular pacing for valve deployment is achieved via a transvenous temporary pacing wire inserted into the right ventricle. AIM: The aim of the present study was to assess the safety and efficacy of a temporary left ventricular pacing (wire pacing) technique during the TAVI procedure. METHODS: In this prospective observational study, 307 consecutive patients undergoing TAVI with either the Edwards SAPIEN S3 (N = 161; 52.4%) or the Medtronic Evolut Pro+ (N = 146; 47.6%) were included. Left ventricular pacing was performed using the valve delivery guidewire. The primary endpoint was defined as successful rapid pacing. Safety outcomes and both qualitative and quantitative secondary endpoints were also analyzed and compared to those of a conventional previous TAVI cohort that received transvenous right ventricular pacing. RESULTS: Left ventricular pacing was successful in 93.8% of cases (n = 288). Moreover, 16 patients (5.4%) required a temporary pacing wire during the procedure due to complete heart block. Procedural success of TAVI was achieved in 98.0% of patients (n = 294). Periprocedural complications were low and included an in-hospital death rate of 1.6%, major bleeding in 1.3% of patients, and permanent pacemaker implantation in 10.2% of patients following TAVI. No incidence of cardiac perforation or tamponade was observed. Safety outcomes were comparable to those of the conventional right ventricular pacing group. Reduced left ventricular ejection fraction (LVEF) was significantly associated with unsuccessful left ventricular guidewire pacing (p = 0.036). An LVEF cutoff of <52% best predicted left ventricular stimulation failure (area under the curve 0.632, sensitivity 63.2%, specificity 63.8%, p = 0.045). CONCLUSION: Wire pacing is safe and effective, should be preferred for TAVI, and eliminates the risk of complications associated with transvenous pacing wires. Nonetheless, caution is advised when using this technique in patients with reduced ejection fraction or a high risk of conduction disorders. CI - (c) 2026 d'Almeida, Stephan, Jork, Andress, Krohn-Grimberghe, Morike, Rottbauer, Gonska and Buckert. FAU - d'Almeida, Sascha AU - d'Almeida S AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Stephan, Tilman AU - Stephan T AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Jork, Susanna AU - Jork S AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Andress, Stefanie AU - Andress S AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Krohn-Grimberghe, Marvin AU - Krohn-Grimberghe M AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Morike, Johannes AU - Morike J AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Rottbauer, Wolfgang AU - Rottbauer W AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Gonska, Birgid AU - Gonska B AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. FAU - Buckert, Dominik AU - Buckert D AD - Department of Cardiology, Angiology, Pneumology and Internal Intensive Care, University of Ulm, Ulm, Germany. LA - eng PT - Journal Article DEP - 20260218 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC12957126 OTO - NOTNLM OT - LVEF/left ventricular ejection fraction OT - TAVI OT - TAVR OT - rapid pacing OT - transvenous pacemaker OT - wire pacing COIS- The authors declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/03/06 09:08 MHDA- 2026/03/06 09:09 PMCR- 2026/02/18 CRDT- 2026/03/06 04:44 PHST- 2025/02/19 00:00 [received] PHST- 2025/12/03 00:00 [revised] PHST- 2025/12/09 00:00 [accepted] PHST- 2026/03/06 09:09 [medline] PHST- 2026/03/06 09:08 [pubmed] PHST- 2026/03/06 04:44 [entrez] PHST- 2026/02/18 00:00 [pmc-release] AID - 10.3389/fcvm.2025.1579898 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Feb 18;12:1579898. doi: 10.3389/fcvm.2025.1579898. eCollection 2025. PMID- 41780659 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260803 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 267 DP - 2026 May 15 TI - Incidence, Predictors, and Outcomes of Stroke Following Transcatheter Aortic Valve Implantation: A Multicenter Australian Experience. PG - 154-159 LID - S0002-9149(26)00128-1 [pii] LID - 10.1016/j.amjcard.2026.03.005 [doi] AB - Stroke is a serious complication following transcatheter aortic valve implantation, associated with increased disability and mortality. Despite this, there is a lack of patient-level data examining stroke in contemporary, lower-risk transcatheter aortic valve implantation (TAVI) populations and limited literature exploring the temporal evolution in stroke incidence among real-world cohorts. We aimed to assess the incidence, predictors, and outcomes of stroke in a modern group of TAVI patients across the clinical risk spectrum. We performed a retrospective analysis of prospectively collected data from 2014 to 2025, included in an Australian multicenter registry. Stroke and other outcome measures were defined in accordance with the Valve Academic Research Consortium-3 guidelines. Of 3,823 patients, median age 82 (interquartile range [IQR]: 77, 86), 60% male, and median STS score 3.3 (2.0, 5.3), 54 (1.4%) patients experienced a stroke before hospital discharge. Stroke incidence did not reduce across the study period (2014 to 2017: 0.8% vs 2018 to 2021: 1.4% vs 2022 to 2025: 1.5%, p(trend) = 0.651). Independent predictors of stroke were previous radiotherapy (adjusted odds ratio [aOR]: 2.8, 95% CI 1.1 to 7.3, p = 0.033), use of a self-expanding valve (aOR: 2.9, 95% CI 1.4 to 6.1, p = 0.004), and nonfemoral access (aOR 3.6, 95% CI 1.1 to 12.2, p = 0.040). Post-TAVI stroke was a strong predictor of 12-month all-cause mortality in Cox proportional hazards regression modelling (adjusted hazard ratio: 7.8, 95% CI 3.9 to 15.7, p < 0.001). In conclusion, stroke remains an uncommon but serious TAVI complication in contemporary practice. Despite demographic and procedural evolution, there was no reduction in stroke incidence across the study period. Further research investigating novel strategies for stroke prevention is required. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Butala, Anant D AU - Butala AD AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia. FAU - Nanayakkara, Shane AU - Nanayakkara S AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia; Department of Cardiology, Cabrini Hospital, Melbourne, Victoria, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Victoria, Australia. FAU - Johnston, Rozanne AU - Johnston R AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia. FAU - Gardner, Ellen AU - Gardner E AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia. FAU - Gartner, Elisha AU - Gartner E AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia. FAU - Palmer, Sonny AU - Palmer S AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia; Department of Cardiology, Epworth Hospital, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. FAU - Noaman, Samer AU - Noaman S AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia. FAU - Htun, Nay M AU - Htun NM AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia; Department of Cardiology, Cabrini Hospital, Melbourne, Victoria, Australia. FAU - Kaye, David M AU - Kaye DM AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Victoria, Australia. FAU - Walton, Antony S AU - Walton AS AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Victoria, Australia; Department of Cardiology, Epworth Hospital, Melbourne, Victoria, Australia. FAU - Stub, Dion AU - Stub D AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia; Department of Cardiology, Cabrini Hospital, Melbourne, Victoria, Australia; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: d.stub@alfred.org.au. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20260302 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Incidence MH - Australia/epidemiology MH - *Stroke/epidemiology/etiology MH - Female MH - Male MH - Retrospective Studies MH - *Aortic Valve Stenosis/surgery MH - Aged, 80 and over MH - Risk Factors MH - *Postoperative Complications/epidemiology MH - Registries OTO - NOTNLM OT - aortic stenosis OT - outcomes OT - predictors OT - stroke OT - transcatheter aortic valve implantation COIS- Declaration of competing interest Professor Stub is on the medical advisory boards of Edwards, Medtronic, and Anteris. Professor Walton is on the medical advisory boards of Medtronic, Abbott, and Edwards. These disclosures had no impact on the manuscript. EDAT- 2026/03/05 00:39 MHDA- 2026/04/28 00:35 CRDT- 2026/03/04 19:12 PHST- 2026/01/04 00:00 [received] PHST- 2026/02/21 00:00 [revised] PHST- 2026/03/01 00:00 [accepted] PHST- 2026/04/28 00:35 [medline] PHST- 2026/03/05 00:39 [pubmed] PHST- 2026/03/04 19:12 [entrez] AID - S0002-9149(26)00128-1 [pii] AID - 10.1016/j.amjcard.2026.03.005 [doi] PST - ppublish SO - Am J Cardiol. 2026 May 15;267:154-159. doi: 10.1016/j.amjcard.2026.03.005. Epub 2026 Mar 2. PMID- 41778700 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260304 LR - 20260813 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 3 DP - 2026 Mar TI - Suitability for Transcarotid Transcatheter Aortic Valve Replacement in the Japanese Population. PG - 345-357 LID - S2772-3747(25)00597-6 [pii] LID - 10.1016/j.jacasi.2025.10.018 [doi] AB - BACKGROUND: Transcarotid (TC) transcatheter aortic valve replacement (TAVR) has shown favorable outcomes in selected Western populations; however, data on its suitability in patients undergoing TAVR remain scarce. OBJECTIVES: The purpose of this study was to investigate the anatomical characteristics of the common carotid artery (CCA) and the suitability of Japanese patients for TC-TAVR. METHODS: This single-center retrospective study included consecutive patients who underwent TAVR between April 2023 and March 2024. Patients were categorized into a tough-transfemoral (TF) group, who may require an alternative approach, and a viable-TF group. TC-TAVR suitability was determined based on the CCA diameter, exposure site calcification, atherosclerotic plaque, and contralateral carotid artery stenosis. RESULTS: Among 336 patients, the right CCA was larger than the left CCA (6.6 +/- 1.0 mm vs 6.4 +/- 0.9 mm; P < 0.001) but exhibited greater tortuosity (44 of 336 [13.1%; 95% CI: 9.9%-17.1%] vs 9 of 336 [2.7%; 95% CI: 1.4%-5.0%]; P < 0.001). The tough-TF group had a higher incidence of major vascular complications (12 of 117 [10.3%; 95% CI: 6.0%-17.1%]) compared with the viable-TF group (3 of 219 [1.4%; 95% CI: 0.5%-3.9%]; P < 0.001). Overall suitability for TC-TAVR was high (306 of 336 [91.1%; 95% CI: 87.5%-93.7%]); however, it was significantly lower in the tough-TF group than in the viable-TF group (101 of 117 [86.3%; 95% CI: 78.9%-91.4%] vs 205 of 219 [93.6%; 95% CI: 89.6%-96.2%]; P = 0.042). Multivariate regression analysis identified peripheral artery disease as a negative predictor of suitability (OR: 0.42; 95% CI: 0.19-0.99; P = 0.039). CONCLUSIONS: Although TC-TAVR suitability was compromised in the tough-TF group, 86% remained suitable, suggesting that TC-TAVR may serve as a promising approach in the Japanese population. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Nakashima, Masaki AU - Nakashima M AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. Electronic address: nakashima.ma.71@gmail.com. FAU - Satomi, Natsuko AU - Satomi N AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Tazawa, Daishi AU - Tazawa D AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Kosuga, Momo AU - Kosuga M AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Maeda, Manabu AU - Maeda M AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Teng, Yun AU - Teng Y AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Kobayashi, Yuta AU - Kobayashi Y AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan; Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan. FAU - Saigan, Makoto AU - Saigan M AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Toki, Yusuke AU - Toki Y AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Enta, Yusuke AU - Enta Y AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan; Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan. FAU - Miyasaka, Masaki AU - Miyasaka M AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan; Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan. FAU - Munehisa, Yoshiko AU - Munehisa Y AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. FAU - Yamamoto, Akihiro AU - Yamamoto A AD - Department of Cardiovascular Surgery, Sendai Kousei Hospital, Miyagi, Japan. FAU - Tada, Norio AU - Tada N AD - Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan. LA - eng PT - Journal Article PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC12959277 OTO - NOTNLM OT - aortic valve stenosis OT - atherosclerosis OT - common carotid artery OT - heart valve prosthesis implantation OT - ischemic heart disease OT - vascular complications COIS- Funding Support and Author Disclosures Dr Tada is a clinical proctor for Edwards Lifesciences, Medtronic, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/03/04 14:26 MHDA- 2026/03/04 14:27 PMCR- 2026/03/03 CRDT- 2026/03/04 08:28 PHST- 2025/05/08 00:00 [received] PHST- 2025/09/22 00:00 [revised] PHST- 2025/10/02 00:00 [accepted] PHST- 2026/03/04 14:27 [medline] PHST- 2026/03/04 14:26 [pubmed] PHST- 2026/03/04 08:28 [entrez] PHST- 2026/03/03 00:00 [pmc-release] AID - S2772-3747(25)00597-6 [pii] AID - 10.1016/j.jacasi.2025.10.018 [doi] PST - ppublish SO - JACC Asia. 2026 Mar;6(3):345-357. doi: 10.1016/j.jacasi.2025.10.018. PMID- 41772987 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260813 IS - 2149-2271 (Electronic) IS - 2149-2263 (Print) IS - 2149-2263 (Linking) VI - 30 IP - 50 DP - 2026 Mar TI - Postoperative Right Ventriculo-Pulmonary Artery Coupling Assessed by TAPSE/PASP as a Predictor of Long-Term Outcomes After TAVI. PG - 190-199 LID - 10.14744/AnatolJCardiol.2026.5716 [doi] AB - BACKGROUND: Right ventriculo-pulmonary artery (RV-PA) coupling, commonly assessed by the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP), has emerged as an important prognostic marker in various cardiovascular diseases. However, its predictive value after transcatheter aortic valve implantation (TAVI) remains insufficiently defined. This study aimed to evaluate whether postoperative TAPSE/PASP is independently associated with long-term all-cause mortality in patients undergoing transfemoral TAVI. METHODS: We retrospectively analyzed 786 consecutive patients who underwent transfemoral TAVI between June 2020 and March 2025. Postoperative TAPSE/PASP was measured within the first week after the procedure. Receiver-operating characteristic (ROC) curve analysis determined the optimal TAPSE/PASP cut-off for predicting long-term mortality. Survival analyses were performed using the Kaplan-Meier method and Cox proportional hazards regression. RESULTS: During a median follow-up of 509 days (interquartile range: 283-847), 61 patients (9.0%) died. Receiver-operating characteristic (ROC) analysis identified 0.52 mm/mmHg as the optimal postoperative TAPSE/PASP cut-off (AUC = 0.626, P < .001, 95% CI: 0.57-0.68). Patients with TAPSE/PASP <0.52 (n = 278) had worse clinical, echocardiographic, and laboratory profiles than those with TAPSE/PASP >/=0.52 (n = 508). Kaplan-Meier analysis demonstrated significantly reduced survival in the lower TAPSE/PASP group (12.6% vs. 5.1% mortality, log-rank P < .001). In multiple Cox regression, age (HR = 1.044, P = .044, 95% CI: 1.001-1.089), chronic obstructive pulmonary disease (COPD) (HR = 2.261, P = .012, 95% CI: 1.192-4.290), and postoperative TAPSE/PASP (HR = 0.856 per 0.1 mm/mm Hg increase, P = .033, 95% CI: 0.743-0.988) remained independent predictors of long-term mortality. CONCLUSIONS: Lower postoperative TAPSE/PASP (<0.52 mm/mmHg) is independently associated with increased long-term mortality after TAVI, supporting its use for early postoperative risk stratification. FAU - Tanyeri Uzel, Seda AU - Tanyeri Uzel S AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Keskin, Berhan AU - Keskin B AD - Department of Cardiology, Bagcilar Medipol Mega University Hospital, Istanbul, Turkiye. FAU - Balaban, Ismail AU - Balaban I AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Eminoglu, Halit AU - Eminoglu H AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Kultursay, Barkin AU - Kultursay B AD - Department of Cardiology, Tunceli State Hospital, Tunceli, Turkiye. FAU - Bozan, Baver AU - Bozan B AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Kovanci, Tezel AU - Kovanci T AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Sen, Dogan AU - Sen D AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Karacam, Murat AU - Karacam M AD - Department of Cardiology, Bitlis State Hospital, Bitlis, Turkiye. FAU - Keten, Ferhat AU - Keten F AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Guvendi Sengor, Busra AU - Guvendi Sengor B AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Acar, Rezzan Deniz AU - Acar RD AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Karagoz, Ali AU - Karagoz A AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. FAU - Alizade, Elnur AU - Alizade E AD - Department of Cardiology, Kartal Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkiye. LA - eng PT - Journal Article PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 SB - IM MH - Humans MH - Retrospective Studies MH - Female MH - Male MH - *Pulmonary Artery/physiopathology/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/mortality MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/mortality MH - ROC Curve MH - Echocardiography MH - Prognosis MH - Aged PMC - PMC12979063 EDAT- 2026/03/03 06:30 MHDA- 2026/03/07 18:37 PMCR- 2026/02/25 CRDT- 2026/03/03 03:13 PHST- 2026/03/07 18:37 [medline] PHST- 2026/03/03 06:30 [pubmed] PHST- 2026/03/03 03:13 [entrez] PHST- 2026/02/25 00:00 [pmc-release] AID - ajc-30-3-190 [pii] AID - 10.14744/AnatolJCardiol.2026.5716 [doi] PST - ppublish SO - Anatol J Cardiol. 2026 Mar;30(50):190-199. doi: 10.14744/AnatolJCardiol.2026.5716. PMID- 41766699 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260302 LR - 20260813 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 8 IP - 2 DP - 2026 Feb TI - An Analysis of Patient Recovery and Opinions on Driving Post-Transcatheter Aortic Valve Insertion (TAVI): the TAVI-D Study. PG - 164-173 LID - 10.1016/j.cjco.2025.10.011 [doi] AB - BACKGROUND: Transcatheter aortic valve insertion (TAVI) is heralded for being minimally invasive and requiring shorter recovery, compared to surgical aortic valve replacement. In 2023, the Canadian Cardiovascular Society published guidelines recommending a 1-month driving (noncommercial drivers) restriction for both procedures. A 2024 Canadian physician survey study showed overwhelming support for a shorter TAVI guideline. METHODS: An observational prospective assessment of TAVI patient recovery was conducted from June 2024 to January 2025 at the Mazankowski Alberta Heart Institute. Post-TAVI patients were followed clinically and completed a 17-question survey examining symptoms, clinical events, and opinions on driving. RESULTS: Of 111 participants, 96.4% received transfemoral (TF) TAVI. Of patients requiring pacemaker insertion (n = 20), 95% were symptomatic within 1 week of their procedure (1 was symptomatic at 2 weeks). A total of 65% of pacemaker-requiring patients (n = 13 of 20) were implanted during TAVI admission. Readmission for pacemaker insertion (n = 7) occurred in 71.4% (n = 5) within 2 weeks and 28.6% (n = 2) after 3 weeks, a calculated population on-the-road risk of harm of 0.0014%. A total of 90% of pacemaker patients had pre- and/or post-TAVI conduction abnormalities. Two patients developed atrial fibrillation and new right bundle branch block requiring pacemaker insertion at, respectively, 4 and 7 days post-TAVI-a 0.0004% risk. A total of 52.3% expressed that a 1-month driving restriction was "too long." CONCLUSIONS: With calculated population on-the-road risks of harm well below the established Canadian Cardiovascular Society threshold of 0.005% (1 of 20,000), we propose shortening noncommercial driving restrictions, to 48 hours for patients with successful uncomplicated transfemoral TAVI without conduction disturbances, and to 2 weeks for those with asymptomatic conduction abnormalities who do not receive a pacemaker. CI - (c) 2025 The Authors. FAU - Jarvis, Catherine R AU - Jarvis CR AD - Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. FAU - Gouda, Pishoy AU - Gouda P AD - Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. FAU - Ezekowitz, Justin AU - Ezekowitz J AD - Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. FAU - Smith, Holly AU - Smith H AD - Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. FAU - Tyrrell, Benjamin AU - Tyrrell B AD - CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, Alberta, Canada. FAU - Welsh, Robert C AU - Welsh RC AD - Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. LA - eng PT - Journal Article DEP - 20251029 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC12946799 OTO - NOTNLM OT - aortic stenosis OT - driving OT - patient engagement OT - post-procedure guidelines OT - public safety OT - transcatheter aortic valve replacement EDAT- 2026/03/02 13:16 MHDA- 2026/03/02 13:17 PMCR- 2025/10/29 CRDT- 2026/03/02 06:24 PHST- 2025/08/30 00:00 [received] PHST- 2025/10/06 00:00 [accepted] PHST- 2026/03/02 13:17 [medline] PHST- 2026/03/02 13:16 [pubmed] PHST- 2026/03/02 06:24 [entrez] PHST- 2025/10/29 00:00 [pmc-release] AID - S2589-790X(25)00649-3 [pii] AID - 10.1016/j.cjco.2025.10.011 [doi] PST - epublish SO - CJC Open. 2025 Oct 29;8(2):164-173. doi: 10.1016/j.cjco.2025.10.011. eCollection 2026 Feb. PMID- 41766252 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260913 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 107 IP - 6 DP - 2026 May TI - Long-Term Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement in Patients With Small Aortic Annuli. PG - 1763-1773 LID - 10.1002/ccd.70533 [doi] AB - BACKGROUND: Prosthesis-patient mismatch (PPM) remains common following transcatheter aortic valve replacement (TAVR) and is associated with worse clinical outcomes. PPM is of particular concern in small aortic annuli (SAA). AIMS: To compare the incidence, predictors, and long-term impact of PPM in SAA TAVR. METHODS: Single-center retrospective registry analysis of native, severe aortic stenosis patients with computed tomography-derived annulus area /=35 mmHg) in 61.2%, and reduced TAPSE (/=80 years, in males, and in those with preserved left ventricular ejection fraction and normal stroke volume index (SVi).RV afterload, as reflected by elevated sPAP and impaired RV-PA coupling, is a key driver of post-TAVI mortality, outperforming isolated RV systolic measurements. The TAPSE/sPAP ratio is a robust, integrative marker whose prognostic value is modulated by age, sex and left heart function. These findings support incorporating RV-PA coupling into routine pre-TAVI assessment to improve risk stratification and identify vulnerable patients before intervention FAU - Boxhammer, Elke AU - Boxhammer E AUID- ORCID: 0000-0002-6589-3853 AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. e.boxhammer@salk.at. FAU - Aglas, Sophie AU - Aglas S AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Clodi, Nikolaus AU - Clodi N AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Lichtenauer, Michael AU - Lichtenauer M AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Rezar, Richard AU - Rezar R AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Dinges, Christian AU - Dinges C AD - Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Granitz, Christina AU - Granitz C AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Cozowicz, Crispiana AU - Cozowicz C AD - Department of Anesthesiology, Perioperative Medicine and Critical Care Medicine, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Hoppe, Uta C AU - Hoppe UC AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. FAU - Hammerer, Matthias AU - Hammerer M AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria. LA - eng PT - Journal Article DEP - 20260225 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 SB - IM MH - Humans MH - Male MH - Aged, 80 and over MH - *Ventricular Function, Right/physiology MH - Retrospective Studies MH - Prognosis MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery/physiopathology/mortality MH - Female MH - *Pulmonary Artery/physiopathology/diagnostic imaging MH - Echocardiography MH - *Tricuspid Valve/diagnostic imaging/physiopathology MH - Risk Assessment PMC - PMC13279594 OTO - NOTNLM OT - RV-PA Coupling OT - Right Heart Function OT - TAPSE OT - TAVI OT - sPAP COIS- Declarations. Conflicts of interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest. Declaration of generative AI: During the preparation of this work the author(s) used Artificial Intelligence tools, including Perplexity, OpenEvidence, Claude, and ChatGPT in order to improve writing. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article. EDAT- 2026/02/25 13:36 MHDA- 2026/06/27 18:37 PMCR- 2026/02/25 CRDT- 2026/02/25 11:26 PHST- 2026/01/04 00:00 [received] PHST- 2026/02/09 00:00 [accepted] PHST- 2026/06/27 18:37 [medline] PHST- 2026/02/25 13:36 [pubmed] PHST- 2026/02/25 11:26 [entrez] PHST- 2026/02/25 00:00 [pmc-release] AID - 10.1007/s12928-026-01257-3 [pii] AID - 1257 [pii] AID - 10.1007/s12928-026-01257-3 [doi] PST - ppublish SO - Cardiovasc Interv Ther. 2026 Jul;41(3):724-736. doi: 10.1007/s12928-026-01257-3. Epub 2026 Feb 25. PMID- 41738462 OWN - NLM STAT- Publisher LR - 20260225 IS - 1940-1574 (Electronic) IS - 0003-3197 (Linking) DP - 2026 Feb 25 TI - Single Versus Double Perclose Vascular Closure Device in Transfemoral Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis. PG - 33197261422791 LID - 10.1177/00033197261422791 [doi] AB - Complications related to vascular closure devices (VCDs) remain relatively common after transcatheter aortic valve implantation (TAVI), while the optimal suture-based strategy remains a subject of debate. This systematic review and meta-analysis aim to evaluate the efficacy and safety of single versus double Perclose VCD in patients undergoing transfemoral TAVI. A literature search was conducted across PubMed, Scopus, and Cochrane databases to identify appropriate studies. The primary outcome was technical success; secondary outcomes included vascular and bleeding complications, bailout interventions, and all-cause mortality. Seven studies (3940 patients) fulfilled the inclusion criteria. Technical success was comparable between the two strategies (relative risk [RR]: .89; 95% confidence interval [CI]: .64-1.22), while the single Perclose strategy was associated with a lower risk of major vascular complications (RR: .61; 95% CI: .40-.92), major bleeding (RR: .28; 95% CI: .11-.73) and bailout surgical interventions (RR: .45; 95% CI: .24-.84). There were no differences in minor vascular complications and all-cause mortality. Stepwise closure with the upfront single Perclose strategy demonstrated comparable technical success and a more favorable safety profile regarding major vascular complications and bleeding compared with the double Perclose strategy. Additional randomized controlled trials are essential to validate these findings. FAU - Vythoulkas-Biotis, Nikolaos AU - Vythoulkas-Biotis N AUID- ORCID: 0009-0002-4217-3922 AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Theodoropoulou, Theoni AU - Theodoropoulou T AUID- ORCID: 0000-0002-0384-1716 AD - First Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Gialamas, Ioannis AU - Gialamas I AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Lysandrou, Antonios AU - Lysandrou A AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Pantelidis, Panteleimon AU - Pantelidis P AUID- ORCID: 0000-0001-5394-832X AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Zakynthinos, Georgios E AU - Zakynthinos GE AUID- ORCID: 0000-0003-4444-0967 AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Oikonomou, Evangelos AU - Oikonomou E AUID- ORCID: 0000-0001-8079-0599 AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Katsianos, Efstratios AU - Katsianos E AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Vavuranakis, Manolis AU - Vavuranakis M AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Siasos, Gerasimos AU - Siasos G AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. FAU - Kalogeras, Konstantinos AU - Kalogeras K AD - Third Department of Cardiology, Sotiria Chest Diseases Hospital, School of Medicine, National and Kapodistrian University, Athens, Greece. LA - eng PT - Journal Article DEP - 20260225 PL - United States TA - Angiology JT - Angiology JID - 0203706 SB - IM OTO - NOTNLM OT - Perclose OT - femoral access OT - outcomes OT - single device OT - vascular closure device EDAT- 2026/02/25 13:35 MHDA- 2026/02/25 13:35 CRDT- 2026/02/25 06:52 PHST- 2026/02/25 13:35 [medline] PHST- 2026/02/25 13:35 [pubmed] PHST- 2026/02/25 06:52 [entrez] AID - 10.1177/00033197261422791 [doi] PST - aheadofprint SO - Angiology. 2026 Feb 25:33197261422791. doi: 10.1177/00033197261422791. PMID- 41735656 OWN - NLM STAT- MEDLINE DCOM- 20260918 LR - 20261008 IS - 1615-2573 (Electronic) IS - 0910-8327 (Linking) VI - 41 IP - 10 DP - 2026 Oct TI - Impact of short membranous septal length on overall survival after transcatheter aortic valve replacement. PG - 695-708 LID - 10.1007/s00380-026-02668-1 [doi] AB - Transcatheter aortic valve replacement (TAVR) is an established therapy for severe aortic stenosis, although conduction disturbances, especially atrioventricular block and new-onset left bundle branch block (LBBB) remain associated with adverse outcomes. Short membranous septal length (MSL) has been linked to post-TAVR conduction abnormalities, but its prognostic significance is unclear. We retrospectively analyzed 258 patients who underwent transfemoral TAVR. MSL was measured on contrast-enhanced CT, and left ventricular ejection fraction (LVEF) was assessed at baseline, 1 week, and 1 year. The primary endpoint was all-cause mortality; secondary was a composite of mortality or heart failure hospitalization. Patients were classified by MSL 6 mm. The short MSL group had higher rates of new-onset LBBB (p = 0.047), mortality (p = 0.046), and the composite endpoint (p = 0.039). MSL FX/Navitor, FX > Navitor). PRO+ had a positive IDD, indicating deeper LCC implantation. Navitor had a negative IDD, demonstrating shallower implantation on LCC, and FX showed co-axial implantation. CONCLUSION: PRO+ with double spines showed vertical axis, Navitor with non-spine showed horizontal axis, whereas FX demonstrated co-axiality at the point of no recapture. This knowledge may help refine the manipulation of procedural implantation based on the shaft rigidity in each device to gain co-axiality. CI - (c) 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Teng, Yun AU - Teng Y AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Enta, Yusuke AU - Enta Y AUID- ORCID: 0000-0003-1931-1012 AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Saigan, Makoto AU - Saigan M AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Satomi, Natsuko AU - Satomi N AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Kobayashi, Yuta AU - Kobayashi Y AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Nakashima, Masaki AU - Nakashima M AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Kosuga, Momo AU - Kosuga M AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Maeda, Manabu AU - Maeda M AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Toki, Yusuke AU - Toki Y AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Munehisa, Yoshiko AU - Munehisa Y AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. FAU - Miyasaka, Masaki AU - Miyasaka M AD - Department of Cardiology, The Jikei University, Tokyo, Japan. FAU - Taguri, Masataka AU - Taguri M AUID- ORCID: 0000-0001-8902-0056 AD - Department of Health Data Science, Tokyo Medical University, Tokyo, Japan. FAU - Toyoda, Shigeru AU - Toyoda S AD - Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan. FAU - Tada, Norio AU - Tada N AD - Division of Cardiovascular Medicine, Sendai Kosei Hospital, Sendai, Japan. LA - eng PT - Comparative Study PT - Journal Article DEP - 20260208 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - *Heart Valve Prosthesis MH - Retrospective Studies MH - Prosthesis Design MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Aged, 80 and over MH - Female MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - Male MH - *Bioprosthesis MH - Severity of Illness Index MH - Aged PMC - PMC13043791 OTO - NOTNLM OT - aortic stenosis OT - co-axiality OT - self-expanding valve OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2026/02/09 06:30 MHDA- 2026/04/02 06:30 PMCR- 2026/04/02 CRDT- 2026/02/09 02:54 PHST- 2026/01/04 00:00 [revised] PHST- 2025/09/08 00:00 [received] PHST- 2026/02/02 00:00 [accepted] PHST- 2026/04/02 06:30 [medline] PHST- 2026/02/09 06:30 [pubmed] PHST- 2026/02/09 02:54 [entrez] PHST- 2026/04/02 00:00 [pmc-release] AID - CCD70512 [pii] AID - 10.1002/ccd.70512 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Apr;107(5):1537-1546. doi: 10.1002/ccd.70512. Epub 2026 Feb 8. PMID- 41653973 OWN - NLM STAT- MEDLINE DCOM- 20260715 LR - 20260807 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 42 IP - 7 DP - 2026 Jul TI - Incidence and Predictors of Pacemaker Implantation Post-Transcatheter Aortic Valve Replacement in Patients with Pre-existing Right Bundle-Branch Block. PG - 1559-1574 LID - S0828-282X(26)00106-6 [pii] LID - 10.1016/j.cjca.2026.01.060 [doi] AB - BACKGROUND: Pre-existing right bundle branch block (RBBB) is the leading predictor of permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). The applicability of conventional PPI predictors in this high-risk subgroup remains unclear. This review evaluates PPI incidence and associated predictors in TAVI patients with pre-existing RBBB. METHODS: A systematic review of PubMed, Scopus, Embase, and Web of Science identified studies reporting PPI incidence and predictors in RBBB patients undergoing TAVI. Studies not addressing RBBB-specific factors were excluded. Pooled PPI incidence was calculated, and a qualitative narrative synthesis of predictors was performed. RESULTS: Of 2269 identified references, 22 studies with 429,342 patients met the inclusion criteria. Within the RBBB cohort, the mean age was 81.6 +/- 7.4 years, with 64.2% being male, and 23.7% having atrial fibrillation. Balloon-expandable valves were used in 69.8% of cases, and the transfemoral approach in 88.6%. The pooled PPI incidence was 37% across 17 studies. Substantial interstudy heterogeneity necessitated further analysis among 13 studies reporting consistent 30-day follow-up, which yielded 39% incidence. PPI predictors in the RBBB cohort encompassed demographic, anatomic, electrophysiological, and procedural domains. CONCLUSIONS: Patients with baseline RBBB have significantly higher post-TAVI PPI rates. Identifying RBBB specific predictors could facilitate individualized procedural planning and risk stratification. This review reinforces how both traditional (eg, implantation depth) and nontraditional (eg, female sex, myocardial fibrosis, calcium volume, and distribution) factors have an amplified role in predicting PPI risk, emphasizing the need for further research in this subgroup to improve risk stratification and reduce PPI incidence. REGISTRATION: PROSPERO CRD420251057657. CI - Crown Copyright (c) 2026. Published by Elsevier Inc. All rights reserved. FAU - Prabhu, Rahul AU - Prabhu R AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia. FAU - Rao, Karan AU - Rao K AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia; School of Medicine, University of Sydney, Australia. FAU - Ciofani, Jonathan L AU - Ciofani JL AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia; School of Medicine, University of Sydney, Australia; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. FAU - Litkouhi, Princess Neila AU - Litkouhi PN AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia; School of Medicine, University of Sydney, Australia. FAU - Baer, Alexandra AU - Baer A AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. FAU - Hansen, Peter AU - Hansen P AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia; School of Medicine, University of Sydney, Australia. FAU - Bhindi, Ravinay AU - Bhindi R AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia; School of Medicine, University of Sydney, Australia. Electronic address: ravinay.bhindi@sydney.edu.au. LA - eng PT - Journal Article PT - Systematic Review DEP - 20260205 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Bundle-Branch Block/complications/epidemiology/therapy MH - *Pacemaker, Artificial/statistics & numerical data MH - Incidence MH - *Aortic Valve Stenosis/surgery/complications MH - *Postoperative Complications/epidemiology/therapy MH - Risk Factors MH - Female MH - Risk Assessment OTO - NOTNLM OT - permanent pacemaker implantation OT - right bundle branch block OT - transcatheter aortic valve replacement EDAT- 2026/02/08 00:35 MHDA- 2026/07/15 18:38 CRDT- 2026/02/07 19:12 PHST- 2025/11/05 00:00 [received] PHST- 2026/01/17 00:00 [revised] PHST- 2026/01/29 00:00 [accepted] PHST- 2026/07/15 18:38 [medline] PHST- 2026/02/08 00:35 [pubmed] PHST- 2026/02/07 19:12 [entrez] AID - S0828-282X(26)00106-6 [pii] AID - 10.1016/j.cjca.2026.01.060 [doi] PST - ppublish SO - Can J Cardiol. 2026 Jul;42(7):1559-1574. doi: 10.1016/j.cjca.2026.01.060. Epub 2026 Feb 5. PMID- 41641953 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20261013 LR - 20261015 IS - 1301-5680 (Print) IS - 2149-8156 (Electronic) IS - 1301-5680 (Linking) VI - 34 IP - 4 DP - 2026 Oct 12 TI - A rare complication of transaxillary TAVI: Management of a bioprosthetic valve entrapment in the subclavian artery. PG - 365-367 LID - 10.4274/tjtcs.2025.28745 [doi] AB - The transaxillary (TAx) approach represents the most commonly preferred alternative access route for transcatheter aortic valve implantation (TAVI) when transfemoral (TF) access is not feasible. Therefore, vascular complications and their management remain of particular importance. In this case report, we present a 75-year-old male patient with severe iliofemoral calcification who underwent TAx-TAVI and developed entrapment of the transcatheter aortic valve in the subclavian artery- a complication reported here for the first time in the literature. The entrapped valve was implanted in the subclavian artery and in the second session, the patient was successfully treated via the TF route using a low-profile in-line sheath (sheathless) system. CI - Copyright(c) 2026 The Author(s). Published by Galenos Publishing House on behalf of Turkish Society of Cardiovascular Surgery and Turkish Thoracic Surgery Association. FAU - Uslu, Sukriye AU - Uslu S AUID- ORCID: 0000-0001-7504-7637 AD - Department of Cardiology, University of Health Sciences Turkiye, Antalya Training and Research Hospital, Antalya, Turkiye. FAU - Bayar, Nermin AU - Bayar N AUID- ORCID: 0000-0001-6785-3137 AD - Department of Cardiology, University of Health Sciences Turkiye, Antalya Training and Research Hospital, Antalya, Turkiye. FAU - Arslan, Sakir AU - Arslan S AUID- ORCID: 0000-0002-2907-4957 AD - Department of Cardiology, University of Health Sciences Turkiye, Antalya Training and Research Hospital, Antalya, Turkiye. LA - eng PT - Journal Article DEP - 20260206 PL - Turkey TA - Turk Gogus Kalp Damar Cerrahisi Derg JT - Turk gogus kalp damar cerrahisi dergisi JID - 100887967 PMC - PMC13658969 OTO - NOTNLM OT - Transaxillary TAVI OT - subclavian artery complication OT - transcatheter aortic valve OT - transcatheter aortic valve implantation COIS- No conflict of interest was declared by the authors. EDAT- 2026/02/05 17:33 MHDA- 2026/02/05 17:34 PMCR- 2026/10/12 CRDT- 2026/02/05 08:46 PHST- 2026/02/05 17:34 [medline] PHST- 2026/02/05 17:33 [pubmed] PHST- 2026/02/05 08:46 [entrez] PHST- 2026/10/12 00:00 [pmc-release] AID - 10.4274/tjtcs.2025.28745 [doi] PST - ppublish SO - Turk Gogus Kalp Damar Cerrahisi Derg. 2026 Oct 12;34(4):365-367. doi: 10.4274/tjtcs.2025.28745. Epub 2026 Feb 6. PMID- 41630705 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260203 LR - 20260205 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 10 IP - 2 DP - 2026 Feb TI - Contemporary Life Expectancy Following Transfemoral Transcatheter Aortic Valve Replacement-Data From a National Registry Perspective. PG - 100780 LID - 10.1016/j.shj.2025.100780 [doi] LID - 100780 AB - BACKGROUND: The estimated lifespan following transcatheter aortic valve replacement (TAVR) is the key in the decision-making process of lifelong management of patients with severe symptomatic aortic stenosis (AS). We aimed to assess the contemporary lifespan and associated factors in patients with severe AS undergoing TAVR. METHODS: We performed a retrospective cohort study of patients who underwent TAVR at the 4 largest centers in Israel between July 2008 and March 2023. Mortality predictors were assessed using multivariable Cox regression analysis. RESULTS: The cohort included 6191 patients (51% females; mean age 82.7 ​+/- ​5.4 years; median follow-up 5.9 years). The overall estimated 5- and 10-year survival was 70 and 42%, respectively. To assess temporal trends, patients were stratified to early (2008-2015; n ​= ​2058) and late (2016-2023; n ​= ​4133) eras. Patients in the early TAVR era had significantly lower survival probability, compared to the late era (hazard ratio 2.0 (95% confidence interval 1.8-2.2), p ​< ​0.001], with an 8-year survival of 39 and 71%, respectively. Using an age threshold of >/=80 years, defined using spline analysis the 8-year survival in the early vs. late eras was 37 vs. 47% among older patients and 66 vs. 82% among younger patients. CONCLUSIONS: Lifespan following successful TAVR has markedly improved over the past decade across age groups. Notably, patients younger than 80 years, at the time of TAVR exhibit an estimated survival exceeding 10 ​years. These findings should be integrated into Heart Team decision-making for optimal lifelong management of AS. CI - (c) 2025 The Author(s). FAU - Zornitzki, Lior AU - Zornitzki L AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Freund, Ophir AU - Freund O AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. AD - Lung Institute, Tel Aviv Sourasky Medical Center, Affiliated with School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Greenberg, Inbal AU - Greenberg I AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Frydman, Shir AU - Frydman S AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Konigstein, Maayan AU - Konigstein M AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Steinvil, Arie AU - Steinvil A AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Barbash, Israel AU - Barbash I AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. AD - Interventional Cardiology Unit, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Ramat Gan, Israel. FAU - Kornowski, Ran AU - Kornowski R AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. AD - Cardiology Department, Rabin Medical Center, Petah Tikva, Israel. FAU - Elbaz, Gabby G AU - Elbaz GG AD - Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel. AD - Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel. FAU - Dvir, Danny AU - Dvir D AD - Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. AD - Department of Cardiology, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Finkelstein, Ariel AU - Finkelstein A AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Topilsky, Yan AU - Topilsky Y AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Halkin, Amir AU - Halkin A AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Banai, Shmuel AU - Banai S AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. FAU - Ben-Shoshan, Jeremy AU - Ben-Shoshan J AD - Division of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Grey Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel. LA - eng PT - Journal Article DEP - 20251205 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC12861024 OTO - NOTNLM OT - AS OT - Age OT - Frailty OT - Mortality OT - Prognosis OT - TAVR COIS- The authors report no conflict of interest. EDAT- 2026/02/03 13:34 MHDA- 2026/02/03 13:35 PMCR- 2025/12/05 CRDT- 2026/02/03 04:14 PHST- 2025/10/18 00:00 [received] PHST- 2025/11/22 00:00 [revised] PHST- 2025/11/27 00:00 [accepted] PHST- 2026/02/03 13:35 [medline] PHST- 2026/02/03 13:34 [pubmed] PHST- 2026/02/03 04:14 [entrez] PHST- 2025/12/05 00:00 [pmc-release] AID - S2474-8706(25)00372-0 [pii] AID - 100780 [pii] AID - 10.1016/j.shj.2025.100780 [doi] PST - epublish SO - Struct Heart. 2025 Dec 5;10(2):100780. doi: 10.1016/j.shj.2025.100780. eCollection 2026 Feb. PMID- 41618948 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260603 LR - 20260813 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 6 DP - 2026 Jun TI - Procedural Pattern, Clinical Outcomes, and Cost Analysis of Transcatheter Aortic Valve Replacement in Korea. PG - 885-895 LID - S2772-3747(25)00708-2 [pii] LID - 10.1016/j.jacasi.2025.11.020 [doi] AB - BACKGROUND: Little information exists about national-based data on patients undergoing transcatheter aortic valve replacement (TAVR) in Asia and the associated costs. OBJECTIVES: This study aims to assess the baseline characteristics, procedural patterns, clinical outcomes, and cost expenses of patients with severe aortic stenosis who underwent TAVR in Korea. METHODS: We used the patient-level data from the National Health Insurance Review and Assessment Service registry, spanning from May 2015 to June 2021. The primary clinical outcome was all-cause mortality. Rehospitalization rates and procedural costs were also analyzed. RESULTS: During the study period, 3,463 patients (mean age: 80.5 +/- 5.9 years; 54.0% female) underwent TAVR at 39 hospitals in Korea. The annual number of TAVR procedures and the number of performing centers increased steadily. The proportion of low-risk patients (Society of Thoracic Surgeons Predicted Risk of Mortality /= moderate paravalvular regurgitation (PVR). Secondary outcomes encompassed procedural complications and efficiency metrics. Pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. RESULTS: Seven studies (one randomized controlled trial, six observational) with 2,990 patients (LA: n = 1,229; LAS: n = 1,761) were included. We found no significant differences between LA and LAS in all-cause mortality (RR 0.67, 95% CI 0.35-1.29, p = 0.23), stroke (RR 0.77, 95% CI 0.37-1.62, p = 0.49), AKI (RR 0.67, 95% CI 0.26-1.73, p = 0.41), or PVR (RR 1.03, 95% CI 0.63-1.69, p = 0.91). Rates of vascular complications, pacemaker implantation, and major bleeding were also comparable. Procedural efficiency metrics, including procedure time (MD 2.76 min, 95% CI -2.70-8.21, p = 0.32) and hospital length of stay (MD -0.48 days, 95% CI -1.16-0.19, p = 0.16), did not differ significantly between groups. CONCLUSIONS: In patients undergoing transfemoral TAVI, a minimalist approach using LA alone is non-inferior to LAS regarding short-term safety, efficacy, and procedural efficiency. These findings suggest that anesthetic strategy may be individualized based on patient-specific factors and operator experience while maintaining comparable clinical outcomes. REGISTRATION: PROSPERO CRD420251146705. CI - (c) 2026. Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Hendrianus, Hendrianus AU - Hendrianus H AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. AD - Division of Cardiology, Natuna General Hospital, Natuna, Indonesia. FAU - Lee, Sang Yeub AU - Lee SY AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. FAU - Jeong, Young-Hoon AU - Jeong YH AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. AD - Chung-Ang University Thrombosis and Biomarker Center, Chung-Ang University Medical Center, Gwangmyeong, South Korea. FAU - Won, Hoyoun AU - Won H AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Division of Cardiology, Chung-Ang University Hospital, Seoul, South Korea. FAU - Cho, Jun Hwan AU - Cho JH AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. FAU - Jo, Jinhwan AU - Jo J AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. FAU - Park, Kyung Taek AU - Park KT AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Division of Cardiology, Chung-Ang University Hospital, Seoul, South Korea. FAU - Park, Gyu Tae AU - Park GT AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Division of Cardiology, Chung-Ang University Hospital, Seoul, South Korea. FAU - Cho, Eun Jeong AU - Cho EJ AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. FAU - Ohlmann, Patrick AU - Ohlmann P AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Kim, Sang-Wook AU - Kim SW AUID- ORCID: 0000-0002-7208-8596 AD - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. swkimcv@cau.ac.kr. AD - Heart and Brain Hospital, Chung-Ang University Medical Center, Gwangmyeong, South Korea. swkimcv@cau.ac.kr. LA - eng PT - Journal Article DEP - 20260128 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM OTO - NOTNLM OT - All-cause mortality OT - Local anaesthesia OT - Meta-analysis OT - Sedation OT - Transcatheter aortic valve implantation COIS- Declarations. Ethical approval: Since this work is a systematic review of published literature and uses published data, no additional ethics approval was required. Competing interests: The authors declare no competing interests. EDAT- 2026/01/28 13:13 MHDA- 2026/01/28 13:13 CRDT- 2026/01/28 11:14 PHST- 2025/11/19 00:00 [received] PHST- 2026/01/05 00:00 [accepted] PHST- 2026/01/28 13:13 [medline] PHST- 2026/01/28 13:13 [pubmed] PHST- 2026/01/28 11:14 [entrez] AID - 10.1007/s00392-026-02849-y [pii] AID - 10.1007/s00392-026-02849-y [doi] PST - aheadofprint SO - Clin Res Cardiol. 2026 Jan 28. doi: 10.1007/s00392-026-02849-y. PMID- 41597490 OWN - NLM STAT- MEDLINE DCOM- 20260701 LR - 20260701 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 1 DP - 2026 Jan 18 TI - TAVI Performance at a Single Center over Several Years: Procedural and Clinical Outcomes. LID - 10.3390/medicina62010204 [doi] LID - 204 AB - Background and Objectives: Transcatheter aortic valve implantation (TAVI) has become the mainstay of treatment for symptomatic aortic stenosis (AS) in patients over 70 years of age. It is also indicated for younger patients with significant comorbidities, for valve-in-valve interventions, and in selected patients with severe aortic insufficiency. We aimed to evaluate procedural and clinical outcomes of transfemoral TAVI performed over the course of 12 years by the same operators using different bioprosthetic valves. Materials and Methods: Between 2012 and 2023, 375 patients underwent TAVI in our clinic, with six types of bioprosthetic valves (Edwards Sapien XT, Medtronic Valves [CoreValve and Evolut R], Portico, Myval, Acurate Neo, and Direct Flow Medical). A transfemoral approach was used in all patients. The procedural and clinical outcomes were defined according to Valve Academic Research Consortium-3 (VARC-3) criteria. Results: The mean age of the patients was 78.4 +/- 7.3, and their median STS score was 4.2 (2.9-5.9). Of the 375 patients, 361 had severe AS, 4 had severe aortic insufficiency, 5 were valve-in-valve, and 5 were valve-in-TAVI. Seven patients required a second valve implantation: four due to embolization of the prosthetic valve and three due to deep implantation of the prosthetic valve. Based on the VARC-3 criteria, the rates of technical success and device success were 90.4% and 85.3%, respectively. Major vascular complications were observed in 18 (4.8%) patients. Also, 42 (11.2%) patients required permanent pacemaker implantation. The incidence of moderate or worse paravalvular leak was 2.9%. The peri-procedural, 30-day, 1-year, and 5-year mortality rates were 5.1%, 4.3%, 15.2%, and 45.6%, respectively. STS scores (HR:1.129, 95%CI: 1.068-1.192, p < 0.001) and post-TAVI acute kidney injury (HR:3.993, 95%CI:1.629-9.785, p = 0.002) were detected as independent predictors of mortality in Cox regression analysis. Conclusions: This registry demonstrated the evolution of TAVI procedures at a single center over 12 years. A high level of collaboration between experienced operators and innovations in devices seem to be the key features for achieving high procedural success and low complication rates. FAU - Dursun, Huseyin AU - Dursun H AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Senturk, Bihter AU - Senturk B AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Colluoglu, Tugce AU - Colluoglu T AUID- ORCID: 0000-0002-2227-6177 AD - Department of Cardiology, Faculty of Medicine, Karabuk University, Karabuk 78200, Turkey. FAU - Oktay, Cisem AU - Oktay C AUID- ORCID: 0009-0003-7671-9740 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Uysal, Hacer AU - Uysal H AUID- ORCID: 0009-0001-3694-2310 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Simsek, Husna Tugce AU - Simsek HT AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Karaoglan, Sercan AU - Karaoglan S AUID- ORCID: 0009-0001-0236-7696 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. FAU - Tanriverdi, Zulkif AU - Tanriverdi Z AUID- ORCID: 0000-0002-1053-1417 AD - Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa 63300, Turkey. FAU - Kaya, Dayimi AU - Kaya D AUID- ORCID: 0000-0003-1364-7770 AD - Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Turkey. LA - eng PT - Journal Article DEP - 20260118 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects/statistics & numerical data/standards MH - Female MH - Aged, 80 and over MH - Treatment Outcome MH - Male MH - *Aortic Valve Stenosis/surgery MH - Aged MH - Retrospective Studies MH - Heart Valve Prosthesis MH - Postoperative Complications PMC - PMC12843616 OTO - NOTNLM OT - aortic stenosis OT - outcomes OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/01/28 07:48 MHDA- 2026/01/28 19:20 PMCR- 2026/01/18 CRDT- 2026/01/28 01:14 PHST- 2025/12/11 00:00 [received] PHST- 2026/01/07 00:00 [revised] PHST- 2026/01/10 00:00 [accepted] PHST- 2026/01/28 19:20 [medline] PHST- 2026/01/28 07:48 [pubmed] PHST- 2026/01/28 01:14 [entrez] PHST- 2026/01/18 00:00 [pmc-release] AID - medicina62010204 [pii] AID - medicina-62-00204 [pii] AID - 10.3390/medicina62010204 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Jan 18;62(1):204. doi: 10.3390/medicina62010204. PMID- 41581752 OWN - NLM STAT- MEDLINE DCOM- 20260715 LR - 20260715 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 42 IP - 7 DP - 2026 Jul TI - Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Implantation: The Prognostic Effect of Right-sided cardiopulmonary Remodelling. PG - 1458-1468 LID - S0828-282X(26)00057-7 [pii] LID - 10.1016/j.cjca.2026.01.029 [doi] AB - BACKGROUND: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI) for aortic stenosis (AS) is associated with adverse outcomes. In this study we evaluated the prognostic effect of PPM after TAVI in relation to baseline right-sided cardiopulmonary remodelling. METHODS: Consecutive patients who underwent transfemoral TAVI for severe symptomatic AS between 2015 and 2022 were identified (n = 1118). PPM was defined at discharge according to Valve Academic Research Consortium-3 criteria. Baseline right-sided cardiopulmonary remodelling was defined as either right ventricular dysfunction (RVD: tricuspid annular plane systolic excursion < 17 mm) or pulmonary hypertension (PH: pulmonary arterial systolic pressure >/= 60 mm Hg). We used multivariable Cox regression to identify independent predictors of all-cause mortality. RESULTS: Moderate and severe PPM were observed in 235 (21.0%) and 72 (6.4%) patients, respectively, and RVD and PH in 95 (8.5%) and 286 (26.0%) patients, respectively. Moderate (adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 1.15-1.76; P < 0.001) and severe (aHR, 5.94; 95% CI, 4.45-7.94; P < 0.001) PPM were independently associated with all-cause mortality. In patients with moderate and severe PPM, PH (aHR, 1.48; 95% CI, 1.08-2.03; P = 0.014) and RVD (aHR, 2.14; 95% CI, 1.07-4.29; P = 0.033) were significant and independent predictors of all-cause mortality. In patients with baseline RVD/PH, severe PPM (aHR, 4.75; 95% CI, 3.20-7.04; P < 0.001) remained significantly and independently associated with all-cause mortality. CONCLUSIONS: PPM is associated with increased risk of mortality after TAVI, particularly in patients with preexisting right-sided cardiopulmonary remodelling. These results support the need for improved detection and prevention of PPM after TAVI, especially in vulnerable subgroups of AS patients with RVD/PH. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Androshchuk, Vitaliy AU - Androshchuk V AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom. Electronic address: V.Androshchuk@nhs.net. FAU - Long, Edouard AU - Long E AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom. FAU - Chehab, Omar AU - Chehab O AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom. FAU - Wilcox, Joshua AU - Wilcox J AD - Cardiovascular Directorate, St Thomas' Hospital, London, United Kingdom. FAU - McDonaugh, Benedict AU - McDonaugh B AD - Cardiovascular Directorate, St Thomas' Hospital, London, United Kingdom. FAU - Lucchese, Gianluca AU - Lucchese G AD - Cardiovascular Directorate, St Thomas' Hospital, London, United Kingdom. FAU - Rajani, Ronak AU - Rajani R AD - School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom. FAU - Pibarot, Philippe AU - Pibarot P AD - Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Prendergast, Bernard AU - Prendergast B AD - Cleveland Clinic London, London, United Kingdom. FAU - Patterson, Tiffany AU - Patterson T AD - Cardiovascular Directorate, St Thomas' Hospital, London, United Kingdom. FAU - Redwood, Simon AU - Redwood S AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom. LA - eng PT - Journal Article DEP - 20260123 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Female MH - Male MH - Prognosis MH - *Heart Valve Prosthesis/adverse effects MH - Aged, 80 and over MH - *Ventricular Dysfunction, Right/physiopathology/diagnosis/etiology MH - *Ventricular Remodeling/physiology MH - *Postoperative Complications/diagnosis/epidemiology/etiology MH - *Hypertension, Pulmonary MH - Retrospective Studies MH - Echocardiography OTO - NOTNLM OT - Prosthesis-patient mismatch OT - aortic stenosis OT - pulmonary hypertension OT - right ventricular dysfunction OT - transcatheter aortic valve implantation EDAT- 2026/01/26 00:33 MHDA- 2026/07/15 18:38 CRDT- 2026/01/25 19:14 PHST- 2025/11/15 00:00 [received] PHST- 2025/12/26 00:00 [revised] PHST- 2026/01/16 00:00 [accepted] PHST- 2026/07/15 18:38 [medline] PHST- 2026/01/26 00:33 [pubmed] PHST- 2026/01/25 19:14 [entrez] AID - S0828-282X(26)00057-7 [pii] AID - 10.1016/j.cjca.2026.01.029 [doi] PST - ppublish SO - Can J Cardiol. 2026 Jul;42(7):1458-1468. doi: 10.1016/j.cjca.2026.01.029. Epub 2026 Jan 23. PMID- 41581387 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260226 LR - 20260226 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 2 DP - 2026 Feb TI - Left Ventricular Ejection Fraction in Patients Undergoing Transcatheter Aortic Valve Implantation: Insights From the COMPARE-TAVI-1 Study. PG - 102547 LID - S2772-963X(25)00976-7 [pii] LID - 10.1016/j.jacadv.2025.102547 [doi] LID - 102547 AB - BACKGROUND: Reduced LV ejection fraction (LVEF) in aortic stenosis may result from afterload mismatch or reduced contractility. Limited data exist on post-transcatheter aortic valve implantation (TAVI) LVEF changes and factors linked to persistent low LVEF. OBJECTIVES: The aim of this substudy was to identify variables associated with persistent low LVEF after TAVI. METHODS: The COMPARE-TAVI 1 trial is an all-comer study in which patients scheduled for transfemoral TAVI were randomized 1:1 to receive either the Sapien 3/Sapien 3 Ultra or Myval/Myval Octacor transcatheter heart valve. Patients were categorized into 2 groups based on their baseline LVEF: low LVEF (40%). Serial LVEF were analyzed alongside 12-month mortality. RESULTS: Of 1,029 patients, men comprised 60%. The mean LVEF was 55% +/- 14%. Among patients with low baseline LVEF (n = 151, 15%), the mean LVEF improved from 31% +/- 6% to 45% +/- 15% at 1 month, and 52% +/- 14% at 12 months (P < 0.001). However, 20% of these patients had persistent LVEF /= 65 years who underwent elective transfemoral TAVI between August 2012 and December 2022. NPS was calculated using the neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, serum albumin, and total cholesterol levels. Patients were stratified into low NPS (0-2) and high NPS (3-4) groups. The primary endpoint was 30-day all-cause mortality. RESULTS: The mean age was 79.81 +- 7.68 years, and 54.9% patients were female. The high NPS group comprised 191 patients (62.0%), while 117 patients (38.0%) were in the low NPS group. Thirty-day mortality was significantly higher in patients with high NPS (16.8% vs. 4.3%, P < 0.001), representing nearly a four-fold increased risk. NPS demonstrated good discriminative ability for mortality prediction (area under the curve: 0.692, 95% confidence interval: 0.611-0.774, P < 0.001), performing comparably to established surgical risk scores. Independent predictors of mortality included age (odds ratio [OR] 1.067, P = 0.039), neutrophil-to-lymphocyte ratio (OR 1.062, P = 0.048), and pulmonary artery pressure (OR 1.039, P = 0.006). CONCLUSION: The Naples Prognostic Score is a significant predictor of early mortality following TAVI and offers a simple, readily available tool for preoperative risk stratification. Patients with high NPS may benefit from enhanced perioperative monitoring and targeted interventions. FAU - Kahraman, Erkan AU - Kahraman E AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye. FAU - Polat, Fuat AU - Polat F AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye. FAU - Uzman, Osman AU - Uzman O AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye. FAU - Cam, Ridvan AU - Cam R AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye. FAU - Ozdemir, Gunseli Miray AU - Ozdemir GM AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye. FAU - Velibey, Yalcin AU - Velibey Y AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye. LA - eng PT - Journal Article TT - Ileri Aort Darligi Nedeniyle Transkateter Aort Kapak Implantasyonu Uygulanan Hastalarda 30 Gunluk Mortalite ve Major Kardiyovaskuler Olaylar icin Naples Prognostik Skorunun Prediktif Degeri. DEP - 20260116 PL - Turkey TA - Turk Kardiyol Dern Ars JT - Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir JID - 9426239 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/mortality MH - Female MH - *Transcatheter Aortic Valve Replacement/mortality/adverse effects MH - Retrospective Studies MH - Aged, 80 and over MH - Male MH - Prognosis MH - Aged MH - Predictive Value of Tests MH - Severity of Illness Index MH - Risk Assessment/methods MH - Risk Factors EDAT- 2026/01/16 17:21 MHDA- 2026/02/20 13:10 CRDT- 2026/01/16 03:03 PHST- 2026/02/20 13:10 [medline] PHST- 2026/01/16 17:21 [pubmed] PHST- 2026/01/16 03:03 [entrez] AID - 10.5543/tkda.2025.00266 [doi] PST - ppublish SO - Turk Kardiyol Dern Ars. 2026 Feb 20;54(2):109-120. doi: 10.5543/tkda.2025.00266. Epub 2026 Jan 16. PMID- 41538775 OWN - NLM STAT- MEDLINE DCOM- 20260506 LR - 20260626 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 38 IP - 5 DP - 2026 May TI - Early outcomes of facilitated transfemoral versus alternative access for transcatheter aortic valve replacement in patients with peripheral arterial disease. LID - 10.25270/jic/25.00171 [doi] AB - OBJECTIVES: Transfemoral (TF) access for transcatheter aortic valve replacement (TAVR) may be challenging in patients with peripheral arterial disease (PAD). Alternative access through intra- and extrathoracic approaches can be performed. Recently, a facilitated TF access strategy, which involves the use of intravascular lithotripsy to optimize the iliofemoral arteries prior to TAVR, has been utilized. The aim of this study was to evaluate early outcomes of facilitated TF access compared to alternative access in patients with severe PAD. METHODS: Patients with severe PAD who underwent TAVR from 2021 to 2023 were included in the study and were divided into 2 groups: facilitated and alternative access. The primary endpoint was a composite of mortality, stroke, and vascular complications. Mortality was evaluated in-hospital and at 1-month follow-up. RESULTS: Of 150 TAVR patients with severe PAD, 24 underwent facilitated access. Baseline characteristics including age, Society of Thoracic Surgeons score, and mean gradients were similar between the 2 groups. The most common alternative access was transsubclavian, followed by transcarotid. Primary outcomes were numerically higher in the alternative access group (14% vs 8%); however, this did not reach statistical significance (P = .49). General anesthesia use and postoperative length of stay were higher in the alternative access group. Postoperative and 1-month mortalities were similar between the 2 groups. CONCLUSIONS: Although the primary endpoint did not reach statistical significance, the numerical trend toward better outcomes in the facilitated TAVR group indicates a potential advantage. Large-scale prospective studies are required to determine the appropriate access strategy for TAVR in patients with severe PAD. FAU - Mustafa, Ahmad AU - Mustafa A AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Wang, Denny AU - Wang D AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Dutton, Cole AU - Dutton C AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Kodra, Arber AU - Kodra A AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Shakir, Muhammad Abubakar AU - Shakir MA AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Goldberg, Ythan AU - Goldberg Y AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Chau, Mei AU - Chau M AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Thampi, Shankar AU - Thampi S AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Mehla, Priti AU - Mehla P AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Wei, Chapman AU - Wei C AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Liu, Shangyi AU - Liu S AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Cinelli, Michael AU - Cinelli M AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Rutkin, Bruce AU - Rutkin B AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Koss, Elana AU - Koss E AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Maniatis, Gregory AU - Maniatis G AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Iribarne, Alexander AU - Iribarne A AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Patel, Apurva AU - Patel A AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Wilson, Sean AU - Wilson S AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Omar, Wally AU - Omar W AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Kalimi, Robert AU - Kalimi R AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Hartman, Alan AU - Hartman A AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. FAU - Scheinerman, Jacob AU - Scheinerman J AD - Cardiovascular Institute, Northwell, New Hyde Park, New Yor. FAU - Kliger, Chad AU - Kliger C AD - Cardiovascular Institute, Northwell, New Hyde Park, New York. Email: ckliger@northwell.edu. LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Male MH - Female MH - *Femoral Artery/surgery MH - *Aortic Valve Stenosis/surgery/complications MH - *Peripheral Arterial Disease/complications/diagnosis MH - Aged, 80 and over MH - Treatment Outcome MH - *Postoperative Complications/epidemiology MH - *Catheterization, Peripheral/methods MH - Aged MH - Follow-Up Studies MH - Retrospective Studies OTO - NOTNLM OT - TAVR OT - alternative access OT - intravascular lithotripsy OT - transcatheter aortic valve replacement EDAT- 2026/01/15 18:47 MHDA- 2026/05/06 18:32 CRDT- 2026/01/15 16:23 PHST- 2026/05/06 18:32 [medline] PHST- 2026/01/15 18:47 [pubmed] PHST- 2026/01/15 16:23 [entrez] AID - 10.25270/jic/25.00171 [doi] PST - ppublish SO - J Invasive Cardiol. 2026 May;38(5). doi: 10.25270/jic/25.00171. PMID- 41530497 OWN - NLM STAT- MEDLINE DCOM- 20260626 LR - 20260626 IS - 1279-8517 (Electronic) IS - 0930-1038 (Linking) VI - 48 IP - 1 DP - 2026 Jan 13 TI - Arterial variation relevant to transfemoral transcatheter aortic valve replacement (TF-TAVR): a cadaveric and literature based analysis. PG - 41 LID - 10.1007/s00276-025-03813-7 [doi] AB - PURPOSE: Transfemoral transcatheter aortic valve replacement (TF-TAVR) is the preferred vascular access route for aortic valve implantation, but procedural success is highly dependable on iliofemoral vascular anatomy. This study aimed to directly assess anatomic risk factors for TF-TAVR using cadaveric dissection and highlight their relevance in the context of imaging-based literature. METHODS: Thirty-two formalin-embalmed cadavers (64 limbs) were dissected to assess luminal diameters of the common femoral (CFA), external iliac (EIA), and common iliac arteries (CIA). Anatomical configurations of the femoral triangle, bifurcation patterns of the CFA, atherosclerotic burden, and sheath-to-artery ratios (SFAR, SEIAR, SCIAR) for 14-18 F sheath sizes were recorded. RESULTS: High CFA bifurcation and posteriorly originating deep arteries of the thigh (DAT) were present in 39.1% and 57.8% of limbs, respectively. Mean diameters were 8.44 +/- 1.75 mm for the CFA, 7.90 +/- 1.55 mm for the EIA, and 9.53 +/- 1.97 mm for the CIA. SFAR and SEIAR values increased with sheath size, reaching high-risk thresholds (>/= 1.05) in up to 19.4% of cadavers for SFAR and 28.1% for SEIAR at 18 F. Female cadavers had significantly greater SFAR and SEIAR values across all sheath sizes (p < 0.007). Moderate-to-severe atherosclerosis was present in 11.3% of CFA specimens and was associated with significantly reduced CFA diameter (p < 0.001). CONCLUSIONS: Commonly used sheath sizes in TF-TAVR may approach or exceed anatomical thresholds in a subset of patients. These findings provide anatomical context that supports preprocedural imaging practices and may inform device development and procedural education, particularly with attention to sex-specific vascular differences. FAU - Heins, Robert J AU - Heins RJ AD - Department of Anatomical Sciences, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA. Robert.Heins@kansascity.edu. FAU - Konstanty, Jordan AU - Konstanty J AD - Department of Anatomical Sciences, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA. FAU - Morehouse, Jessica AU - Morehouse J AD - Department of Anatomical Sciences, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA. FAU - Hodge, Travis AU - Hodge T AD - Department of Anatomical Sciences, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA. FAU - Sloan, Sara S AU - Sloan SS AD - Department of Anatomical Sciences, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA. LA - eng PT - Journal Article DEP - 20260113 PL - Germany TA - Surg Radiol Anat JT - Surgical and radiologic anatomy : SRA JID - 8608029 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/adverse effects MH - *Femoral Artery/anatomy & histology MH - Cadaver MH - Female MH - *Iliac Artery/anatomy & histology MH - Male MH - *Anatomic Variation MH - Aged, 80 and over MH - Aged MH - Risk Factors MH - Aortic Valve/surgery OTO - NOTNLM OT - Aortic valve replacement OT - Femoral artery OT - Transfemoral OT - Vascular access COIS- Declarations. Competing interests: The authors declare no competing interests. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Biosafety Committee of Kansas City University (IBC code: 2215767-4). Consent for publication: All authors gave consent for the publication of the report. EDAT- 2026/01/14 00:37 MHDA- 2026/06/27 00:51 CRDT- 2026/01/13 23:33 PHST- 2025/08/22 00:00 [received] PHST- 2025/12/23 00:00 [accepted] PHST- 2026/06/27 00:51 [medline] PHST- 2026/01/14 00:37 [pubmed] PHST- 2026/01/13 23:33 [entrez] AID - 10.1007/s00276-025-03813-7 [pii] AID - 10.1007/s00276-025-03813-7 [doi] PST - epublish SO - Surg Radiol Anat. 2026 Jan 13;48(1):41. doi: 10.1007/s00276-025-03813-7. PMID- 41527810 OWN - NLM STAT- MEDLINE DCOM- 20260402 LR - 20260915 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 107 IP - 5 DP - 2026 Apr TI - Extremity Function After Transfemoral Transcatheter Aortic Valve Implantation: A TAVI XS Sub-Study. PG - 1293-1302 LID - 10.1002/ccd.70470 [doi] AB - BACKGROUND: Physical decline after transcatheter aortic valve implantation (TAVI) is associated with worse outcomes. However, data on post-TAVI extremity function are limited. This sub-study of the TAVI XS trial aimed to assess extremity function after transfemoral TAVI, evaluate functional decline, compare outcomes between upper-and lower-extremity secondary access approaches and identify predictors of functional decline after TAVI. METHODS: The TAVI XS was a randomized clinical trial comparing upper- and lower-extremity secondary access during TAVI. Patients were assessed for extremity function at baseline and at 30 days using the Lower Extremity Function Scale (higher score indicating better function) and the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (higher score indicating worse function). RESULTS: Lower-extremity (45.0 [IQR 35.0-57.0] to 52.0 [39.0-63.0]; p < 0.001), and upper-extremity function (11.4 [2.3-25.0] to 6.8 [0-22.7]; p = 0.003) improved after TAVI. Relevant decline in lower-extremity function occurred in 20 (8.4%) patients, and in upper-extremity function in 19 (8.0%) patients. No differences in post-TAVI function were observed between upper- or lower-extremity secondary access (lower-extremity: 10.1% vs. 6.7%; p = 0.35, upper-extremity: 7.6% vs. 8.4%; p = 0.81). Predictors (OR [95% CI]) of clinically relevant decline were baseline use of dual antiplatelet therapy/oral anticoagulants (4.17 [1.39-12.49]; p = 0.01) for lower-extremity function and multiple punctures (4.05 [1.46-11.24]; p = 0.007) for upper-extremity function. Age inversely affected lower- (0.92 [0.85-0.99/year]; p = 0.02) and upper-extremity function (0.93 [0.86-0.99/year]; p = 0.04). CONCLUSIONS: The incidence of clinically relevant decline in extremity function after TAVI is low. No differences in reported extremity function were observed between the upper- and lower-extremity secondary access approach. Predictors of decline were antithrombotic therapy and multiple punctures. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05672823. CI - (c) 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Versteeg, Geert A A AU - Versteeg GAA AUID- ORCID: 0009-0002-1583-2953 AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Rooijakkers, Maxim J P AU - Rooijakkers MJP AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Hemelrijk, Kimberley I AU - Hemelrijk KI AD - Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands. FAU - Vlaar, Pieter J AU - Vlaar PJ AD - Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands. FAU - Overduin, Daniel C AU - Overduin DC AUID- ORCID: 0009-0004-1368-5499 AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. FAU - van Wely, Marleen H AU - van Wely MH AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Aarts, Hugo M AU - Aarts HM AD - Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands. FAU - van Ginkel, Dirk-Jan AU - van Ginkel DJ AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. FAU - Stens, Niels A AU - Stens NA AUID- ORCID: 0000-0001-7487-151X AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. AD - Department of Medical Biosciences, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - van Nunen, Lokien X AU - van Nunen LX AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - van Geuns, Robert Jan AU - van Geuns RJ AUID- ORCID: 0000-0003-2943-5932 AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - van Garsse, Leen A F M AU - van Garsse LAFM AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Geuzebroek, Guillaume S C AU - Geuzebroek GSC AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Verkroost, Michel W A AU - Verkroost MWA AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Cetinyurek-Yavuz, Aysun AU - Cetinyurek-Yavuz A AD - Department of IQ Health, Section Biostatistics, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Heijmen, Robin H AU - Heijmen RH AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Thijssen, Dick H J AU - Thijssen DHJ AUID- ORCID: 0000-0002-7707-5567 AD - Department of Medical Biosciences, Radboud University Medical Center, Nijmegen, the Netherlands. AD - Liverpool Centre for Cardiovascular Science, Liverpool John Moores University and Liverpool Heart & Chest Hospital, University of Liverpool, Liverpool, UK. FAU - Ten Berg, Jurrien M AU - Ten Berg JM AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. AD - Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands. FAU - Tonino, Pim A L AU - Tonino PAL AD - Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands. FAU - Delewi, Ronak AU - Delewi R AD - Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands. FAU - van Royen, Niels AU - van Royen N AUID- ORCID: 0000-0001-6136-8640 AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. LA - eng SI - ClinicalTrials.gov/NCT05672823 GR - A 1678426/SVZ/Medtronic Europe/ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20260113 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - Female MH - Aged, 80 and over MH - Treatment Outcome MH - Time Factors MH - Recovery of Function MH - *Aortic Valve Stenosis/physiopathology/surgery/diagnostic imaging MH - *Femoral Artery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Male MH - Risk Factors MH - *Catheterization, Peripheral/adverse effects MH - Aged MH - *Lower Extremity/blood supply/physiopathology MH - *Upper Extremity/blood supply/physiopathology MH - Functional Status MH - Disability Evaluation MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Platelet Aggregation Inhibitors/administration & dosage MH - Punctures PMC - PMC13043799 OTO - NOTNLM OT - Lower-Extremity Function Scale (LEFS) OT - Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) OT - TAVI XS OT - aortic stenosis OT - secondary access COIS- The authors declare no conflicts of interest. EDAT- 2026/01/13 07:43 MHDA- 2026/04/02 06:30 PMCR- 2026/04/02 CRDT- 2026/01/13 04:53 PHST- 2025/12/22 00:00 [revised] PHST- 2025/11/12 00:00 [received] PHST- 2026/01/05 00:00 [accepted] PHST- 2026/04/02 06:30 [medline] PHST- 2026/01/13 07:43 [pubmed] PHST- 2026/01/13 04:53 [entrez] PHST- 2026/04/02 00:00 [pmc-release] AID - CCD70470 [pii] AID - 10.1002/ccd.70470 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Apr;107(5):1293-1302. doi: 10.1002/ccd.70470. Epub 2026 Jan 13. PMID- 41518364 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260304 LR - 20260813 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 3 DP - 2026 Mar TI - Hemolysis After TAVR Using the Fifth-Generation Balloon-Expandable Valve: Comparison With the Third-Generation Valve. PG - 360-369 LID - S2772-3747(25)00664-7 [pii] LID - 10.1016/j.jacasi.2025.11.008 [doi] AB - BACKGROUND: Hemolytic anemia (HA) following transcatheter aortic valve replacement (TAVR) using the fifth-generation SAPIEN 3 Ultra RESILIA (S3UR) valves has been reported nationwide since its approval in Japan. OBJECTIVES: The purpose of this study was to investigate the incidence and predictors of hemolysis in fifth-generation S3UR, in comparison with third-generation SAPIEN 3 (S3). METHODS: We studied 230 consecutive patients who underwent transfemoral TAVR using S3 or S3UR between April 1, 2021, and July 31, 2024; 113 S3 and 117 S3UR. Clinically relevant HA was defined as a decline in hemoglobin of >/=2 g/dL from baseline and a nadir hemoglobin <10.0 g/dL, serum lactate dehydrogenase >500 IU/L, serum haptoglobin <10 mg/dL, reticulocyte count >2%, and no other cause of anemia, identified between postprocedure and 30-day follow-up. Incidence of HA between S3 and S3UR, and factors associated with HA in S3UR were evaluated. RESULTS: S3UR cases, compared with S3, tended to have a lower degree of paravalvular aortic regurgitation (AR); however, the incidence of HA was significantly higher (10 of 117 [8.5%; 95% CI: 4.4%-16.0%] vs 1 of 113 [0.9%; 95% CI: 0.05%-5.5%]; P = 0.006). In S3UR, severe annular calcification, chronic hemodialysis, use of 20-mm valve, no beta-blocker use, and presence of trace or mild paravalvular AR were associated with HA. However, case-based evaluation suggested that associated factors may be multifactorial. CONCLUSIONS: Incidence of HA after TAVR was higher in fifth-generation S3UR than in third-generation S3. Annular calcification, chronic hemodialysis, 20-mm size valve, no beta-blocker use, and presence of paravalvular AR were associated with HA in S3UR. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kurashima, Shinichi AU - Kurashima S AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Okada, Atsushi AU - Okada A AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: okada.atsushi.hp@ncvc.go.jp. FAU - Irie, Yuki AU - Irie Y AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Sakamoto, Takahiro AU - Sakamoto T AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Moriuchi, Kenji AU - Moriuchi K AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Amano, Masashi AU - Amano M AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Amaki, Makoto AU - Amaki M AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Kanzaki, Hideaki AU - Kanzaki H AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Mitsui, Kentaro AU - Mitsui K AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Takagi, Kensuke AU - Takagi K AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Asaumi, Yasuhide AU - Asaumi Y AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Kakuta, Takashi AU - Kakuta T AD - Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Kawamoto, Naonori AU - Kawamoto N AD - Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Fukushima, Satsuki AU - Fukushima S AD - Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Yamamoto, Kazuhiro AU - Yamamoto K AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Kitai, Takeshi AU - Kitai T AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Izumi, Chisato AU - Izumi C AD - Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. LA - eng PT - Journal Article DEP - 20260110 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC12959276 OTO - NOTNLM OT - SAPIEN OT - aortic regurgitation OT - hemolytic anemia OT - paravalvular OT - transcatheter aortic valve implantation COIS- Funding Support and Author Disclosures This work was partly supported by a Grant-in-Aid for Early-Career Scientists from the Japan Society for the Promotion of Science (20K17171). Dr Kanzaki is a consultant for Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/01/10 22:40 MHDA- 2026/01/10 22:41 PMCR- 2026/01/10 CRDT- 2026/01/10 10:28 PHST- 2025/03/31 00:00 [received] PHST- 2025/10/16 00:00 [revised] PHST- 2025/11/04 00:00 [accepted] PHST- 2026/01/10 22:41 [medline] PHST- 2026/01/10 22:40 [pubmed] PHST- 2026/01/10 10:28 [entrez] PHST- 2026/01/10 00:00 [pmc-release] AID - S2772-3747(25)00664-7 [pii] AID - 10.1016/j.jacasi.2025.11.008 [doi] PST - ppublish SO - JACC Asia. 2026 Mar;6(3):360-369. doi: 10.1016/j.jacasi.2025.11.008. Epub 2026 Jan 10. PMID- 41517603 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260110 LR - 20260113 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 1 DP - 2026 Jan 2 TI - Minimally Invasive Aortic Valve Replacement in Elderly Patients: Insights from a Large Cohort. LID - 10.3390/jcm15010354 [doi] LID - 354 AB - Background/Objectives: Transcatheter aortic valve implantation (TAVI) has become the leading treatment option for patients suffering from aortic valve stenosis aged over 70, except in cases of specific contraindications like bicuspid valves, inappropriate access routes, or endocarditis. Minimally invasive aortic valve replacement (MIAVR) has emerged as a potential way to combine the durability of surgery with reduced procedural trauma. This study aims to assess the safety and feasibility of MIAVR in elderly patients. Methods: A total of 990 patients were included in this retrospective cohort study. Among them, 261 (26%) were aged 70 years or older (elderly cohort), and 729 (74%) were younger than 70 years (younger cohort). All patients were followed for at least 30 days postoperatively, with survival data collected through May 2025. Multivariable logistic regression, linear regression, and Kaplan-Meier survival analyses were performed. Results: Elderly patients were more likely to be female (51% vs. 40%, p = 0.001) and carried a heavier burden of vascular and renal comorbidity: renal impairment 33% vs. 17% and extracardiac arteriopathy 45% vs. 30% (both p < 0.001). Major bleeding occurred more frequently in the elderly cohort (7.7% vs. 4.1%; p = 0.02), as did new permanent pacemaker implantation (10% vs. 5.8%; p = 0.021) and sepsis (3.4% vs. 1.1%; p = 0.012). Rates of stroke, perioperative myocardial infarction, ECMO/right-heart failure, re-thoracotomy, and postoperative dialysis were low and comparable across age groups (all p > 0.20). Overall, 30-day mortality was 2.4% (24/990), with crude mortality approximately threefold higher among patients aged >/=70 years (4.6% vs. 1.6%). Conclusions: Our findings indicate that MIAVR is a feasible and safe surgical option across age groups; Elevated morbidity in elderly patients is primarily due to bleeding, pacemaker implantation, and sepsis, while rates of stroke, renal failure, and myocardial infarction are low. FAU - Amanov, Lukman AU - Amanov L AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Arjomandi Rad, Arian AU - Arjomandi Rad A AUID- ORCID: 0000-0002-4931-4049 AD - Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford University NHS Foundation Trust, Oxford OX3 9DU, UK. FAU - Ali-Hasan-Al-Saegh, Sadeq AU - Ali-Hasan-Al-Saegh S AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Jauken, Antonia Annegret AU - Jauken AA AUID- ORCID: 0009-0003-1893-2578 AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Zotos, Prokopis-Andreas AU - Zotos PA AD - Department of Cardiac Surgery, Thessaly University, 38221 Larissa, Greece. FAU - Athanasiou, Thanos AU - Athanasiou T AD - Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford University NHS Foundation Trust, Oxford OX3 9DU, UK. FAU - Ruemke, Stefan AU - Ruemke S AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Karsten, Jan AU - Karsten J AD - Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, Germany. FAU - Salman, Jawad AU - Salman J AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Ius, Fabio AU - Ius F AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Deniz, Ezin AU - Deniz E AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Schmack, Bastian AU - Schmack B AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Ruhparwar, Arjang AU - Ruhparwar A AUID- ORCID: 0000-0003-2725-9912 AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Zubarevich, Alina AU - Zubarevich A AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. FAU - Weymann, Alexander AU - Weymann A AD - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. LA - eng PT - Journal Article DEP - 20260102 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12786521 OTO - NOTNLM OT - aortic stenosis OT - elderly OT - minimally invasive aortic valve replacement OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2026/01/10 06:31 MHDA- 2026/01/10 06:32 PMCR- 2026/01/02 CRDT- 2026/01/10 01:16 PHST- 2025/11/02 00:00 [received] PHST- 2025/12/07 00:00 [revised] PHST- 2025/12/30 00:00 [accepted] PHST- 2026/01/10 06:32 [medline] PHST- 2026/01/10 06:31 [pubmed] PHST- 2026/01/10 01:16 [entrez] PHST- 2026/01/02 00:00 [pmc-release] AID - jcm15010354 [pii] AID - jcm-15-00354 [pii] AID - 10.3390/jcm15010354 [doi] PST - epublish SO - J Clin Med. 2026 Jan 2;15(1):354. doi: 10.3390/jcm15010354. PMID- 41502402 OWN - NLM STAT- In-Process LR - 20260602 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 84 IP - 5 DP - 2026 TI - Transcarotid transcatheter aortic valve implantation in selected patients. Authors' reply. PG - 691-692 LID - 10.33963/v.phj.110582 [doi] FAU - Sobczynski, Robert AU - Sobczynski R AD - Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. sobczynski@poczta.fm. FAU - Trebacz, Jaroslaw AU - Trebacz J AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. FAU - Kleczynski, Pawel AU - Kleczynski P AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Stapor, Maciej AU - Stapor M AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Konstanty-Kalandyk, Janusz AU - Konstanty-Kalandyk J AD - Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. AD - Department of Cardiac Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Kapelak, Boguslaw AU - Kapelak B AD - Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. AD - Department of Cardiac Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Legutko, Jacek AU - Legutko J AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. LA - eng PT - Journal Article DEP - 20260108 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM EDAT- 2026/01/08 07:13 MHDA- 2026/01/08 07:13 CRDT- 2026/01/08 04:33 PHST- 2026/01/07 00:00 [received] PHST- 2026/01/07 00:00 [accepted] PHST- 2026/01/08 07:13 [pubmed] PHST- 2026/01/08 07:13 [medline] PHST- 2026/01/08 04:33 [entrez] AID - VM/OJS/J/110582 [pii] AID - 10.33963/v.phj.110582 [doi] PST - ppublish SO - Kardiol Pol. 2026;84(5):691-692. doi: 10.33963/v.phj.110582. Epub 2026 Jan 8. PMID- 41498463 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260107 LR - 20260129 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 1 DP - 2026 Jan TI - Transcatheter Electrosurgery in the Asia-Pacific: Implementation and Innovations. PG - 1-15 LID - S2772-3747(25)00651-9 [pii] LID - 10.1016/j.jacasi.2025.10.025 [doi] AB - Transcatheter electrosurgery involves the precise application of high-frequency electrical currents to modify or perforate cardiac structures during structural heart interventions. Adoption of these techniques in the Asia-Pacific region has grown significantly alongside the expansion of structural heart programs. Techniques such as Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Coronary Artery Obstruction (BASILICA), Undermining Iatrogenic Coronary Obstruction With Radiofrequency Needle (UNICORN), Laceration of the Anterior Mitral Leaflet to Prevent Outflow Obstruction (LAMPOON), and Balloon Assisted Translocation of the Mitral Anterior Leaflet to Prevent Left Ventricular Outflow Obstruction (BATMAN) have been employed by regional interventionalists to lacerate native or prosthetic heart valves before transcatheter valve implantation, thereby mitigating the risks of coronary or left ventricular outflow tract obstruction. In addition, transcaval access has facilitated transcatheter aortic valve replacement in patients with limited iliofemoral vascular access. This narrative review, authored by the Asia-Pacific Electrosurgery Working Group, explores the evolution of transcatheter electrosurgery, highlighting regional adoption, variations, and innovative contributions. Furthermore, it discusses prevailing challenges and future directions, emphasizing the importance of standardized training and collaborative innovation efforts. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Wong, Chun-Ka AU - Wong CK AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR; Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom. FAU - Poon, Karl AU - Poon K AD - University of Queensland, Brisbane, Australia; The Prince Charles Hospital, Metro North Health, Brisbane, Australia. FAU - So, Kent Chak-Yu AU - So KC AD - Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR; Li Ka Shing Institutes of Health Science, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR. FAU - Yin, Wei-Hsian AU - Yin WH AD - Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan. FAU - Lee, Yung-Tsai AU - Lee YT AD - Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan. FAU - Chandavimol, Mann AU - Chandavimol M AD - Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. FAU - Chan, Kwong-Yue Eric AU - Chan KE AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR; Cardiac Medical Unit, Grantham Hospital, Hong Kong SAR. FAU - Chan, Daniel Tai-Leung AU - Chan DT AD - Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR; Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR. FAU - Lai, Leo Kar Lok AU - Lai LKL AD - Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Park, Duk-Woo AU - Park DW AD - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Ho, Kay-Woon AU - Ho KW AD - Department of Cardiology, National Heart Centre Singapore, Singapore. FAU - Kim, Jung-Sun AU - Kim JS AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. FAU - Kaneko, Tsuyoshi AU - Kaneko T AD - Department of Surgery, Washington University in St Louis, St Louis, Missouri, USA. FAU - Bapat, Vinayak N AU - Bapat VN AD - Department of Cardiac Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA. FAU - Yeung, Alan AU - Yeung A AD - Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California, USA. FAU - Wongpraparut, Nattawut AU - Wongpraparut N AD - Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. FAU - Chiu, Ho-On Alston Conrad AU - Chiu HAC AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR. FAU - Lee, Ching-Wei AU - Lee CW AD - Cardiovascular Center, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Tang, Gilbert H L AU - Tang GHL AD - Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China. FAU - Khan, Jaffar M AU - Khan JM AD - St Francis Hospital and Heart Center, Roslyn, New York, USA. FAU - Lam, Simon Cheung-Chi AU - Lam SC AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR; Cardiology Division, Department of Medicine, Queen Mary Hospital, Hong Kong SAR. Electronic address: drsimonlam@hotmail.com. LA - eng PT - Journal Article PT - Review PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC12833607 OTO - NOTNLM OT - transcatheter aortic valve replacement OT - transcatheter electrosurgery OT - transcatheter mitral valve replacement COIS- Funding Support and Author Disclosures Dr Poon is a consultant for Anteris and is a proctor/speakers bureau for Edwards Lifesciences/Abbott. Dr So is a physician proctor for Abbott Structural Heart, Boston Scientific, Edwards Lifesciences, and Medtronic; and serves as consultant for Venus Medtech and Jenscare. Dr Yin is proctor and advisor for Medtronic and Edwards Lifesciences and receives consulting fees and honoraria. Dr Hayashida is clinical proctor for Edwards Lifesciences, Medtronic, and Abbot. Dr Ohno is a clinical proctor of transcatheter aortic valve implantation (TAVI) for Medtronic and a clinical proctor of TAVI and transcatheter edge-to-edge repair for Abbott Medical and has received speaker fees from Medtronic and Abbott Medical. Dr Ho received speaker fees from Edwards Lifesciences, Abbott Vascular, and Medtronic. Dr Kaneko serves as an advisory board member for Edwards Lifesciences, Abbott, 4C Medical, and Anteris; and a consultant for Medtronic. Dr Tang has received speakers honoraria and served as a physician proctor, consultant, advisory board member, TAVR publications committee member, RESTORE study steering and screening committee member, APOLLO trial screening committee member, and IMPACT MR steering committee member for Medtronic; has received speakers honoraria and served as a physician proctor, consultant, advisory board member, ENVISION trial screening committee member, and TRILUMINATE trial anatomic eligibility and publications committee member for Abbott Structural Heart; has served as an advisory board member for Boston Scientific; a consultant for Shockwave Medical, Anteris, Philips, Edwards Lifesciences, Peija Medical, and Shenqi Medical Technology; and has received speakers honoraria from Siemens Healthineers. Dr Khan received consulting/proctoring fees from Abbott, Edwards Lifesciences, and Medtronic; has equity in Transmural systems and Cuspa Medical; and is co-inventor on patents, assigned to the National Institutes of Health, on leaflet modification devices. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/01/07 13:18 MHDA- 2026/01/07 13:19 PMCR- 2026/01/06 CRDT- 2026/01/07 08:28 PHST- 2025/09/17 00:00 [received] PHST- 2025/10/27 00:00 [accepted] PHST- 2026/01/07 13:19 [medline] PHST- 2026/01/07 13:18 [pubmed] PHST- 2026/01/07 08:28 [entrez] PHST- 2026/01/06 00:00 [pmc-release] AID - S2772-3747(25)00651-9 [pii] AID - 10.1016/j.jacasi.2025.10.025 [doi] PST - ppublish SO - JACC Asia. 2026 Jan;6(1):1-15. doi: 10.1016/j.jacasi.2025.10.025. PMID- 41498285 OWN - NLM STAT- MEDLINE DCOM- 20260625 LR - 20260625 IS - 1813-9175 (Electronic) IS - 1813-9175 (Linking) VI - 2026 DP - 2026 Jan 5 TI - Clampless transcarotid transcatheter aortic valve implantation. LID - 10.1510/mmcts.2025.120 [doi] AB - The use of transcatheter aortic valve implantation (TAVI) has become the most popular technique of aortic valve intervention. Classically, TAVI is performed via femoral arterial access. However, some patients who have severe peripheral arterial disease do not have safely accessible femoral arteries. In such patients, the use of carotid access has been well described via the 'clamp-and-sew' technique. We describe a minimally invasive carotid access technique for TAVI deployment. The right common carotid is accessed by a 3 cm suprasternal incision. The carotid sheath is entered, and the surgeon obtains proximal and distal control of the carotid artery. The surgeon then makes two opposing purse strings over the anterior surface of the carotid artery. The Seldinger technique is used to obtain access to the carotid artery, followed by placement of the TAVI sheath. The valve is then deployed and echocardiographically confirmed. Upon removal of the TAVI sheath, the purse strings are tightened and sequentially tied. Haemostasis is achieved and skin is closed. This minimally invasive TAVI technique provides an option for patients with unfavourable peripheral access sites while offering the benefits of TAVI compared to open valve replacement. CI - (c) The Author 2026. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Crane, Joshua AU - Crane J AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Smith, Ansley AU - Smith A AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Endo, Toyokazu AU - Endo T AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Pahwa, Siddharth AU - Pahwa S AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Slaughter, Mark AU - Slaughter M AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Trivedi, Jaimin AU - Trivedi J AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Ganzel, Brian AU - Ganzel B AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA FAU - Gallo, Michele AU - Gallo M AD - Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA LA - eng PT - Journal Article PT - Video-Audio Media DEP - 20260105 PL - England TA - Multimed Man Cardiothorac Surg JT - Multimedia manual of cardiothoracic surgery : MMCTS JID - 101495626 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation MH - *Aortic Valve Stenosis/surgery MH - *Minimally Invasive Surgical Procedures/methods MH - *Aortic Valve/surgery MH - *Carotid Artery, Common/surgery OTO - NOTNLM OT - Aortic valve disease OT - Minimally invasive aortic valve surgery OT - TAVI EDAT- 2026/01/07 13:17 MHDA- 2026/01/07 13:18 CRDT- 2026/01/07 06:33 PHST- 2026/01/07 13:18 [medline] PHST- 2026/01/07 13:17 [pubmed] PHST- 2026/01/07 06:33 [entrez] AID - 10.1510/mmcts.2025.120 [doi] PST - epublish SO - Multimed Man Cardiothorac Surg. 2026 Jan 5;2026. doi: 10.1510/mmcts.2025.120. PMID- 41497994 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260107 LR - 20260109 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 4 IP - 12 DP - 2025 Dec TI - Comparative Effectiveness of Balloon Aortic Valvuloplasty via Transradial and Transfemoral Access. PG - 104015 LID - 10.1016/j.jscai.2025.104015 [doi] LID - 104015 AB - BACKGROUND: Balloon aortic valvuloplasty (BAV) is commonly performed as a bridge to therapy, for stratification, or as a palliative procedure in cases of severe aortic stenosis. The complication rate of transfemoral access BAV (transfemoral valvuloplasty [TFV]) is comparable to that of transcatheter aortic valve replacement. Transradial access BAV (transradial valvuloplasty [TRV]) is technically feasible; however, comparative data for TFV are lacking. We aim to compare TFV and TRV in terms of technical and hemodynamic success, periprocedural safety, and short-term clinical outcomes. METHODS: Consecutive patients undergoing BAV at a tertiary center from 2021 to 2024 were assessed. TRV was performed with ultrasound guidance and an 8F short sheath equipped with compatible balloons. Hemodynamic success was defined as a reduction in gradient of 30% or more. The primary outcome was the periprocedural composite of a Valve Academic Research Consortium (VARC) 3 major vascular complication, grade 3 to 4 bleeding, and balloon entrapment, and nonaccess-related events, including complete heart block, periprocedural stroke, hypotension, severe aortic insufficiency, and periprocedural death. The secondary outcome was the 30-day composite of all-cause mortality, cardiac-related hospitalization, and discharge failure. Inverse probability of treatment weighting, followed by multivariate regression, was employed to address confounders. RESULTS: 105 TRV and 148 TFV were included. Technical success rate was 96.2% for TRV and 98.7% for TFV (P = .21). The primary outcome event rate was significantly lower in the TRV compared to the TFV group: 2.53% vs 17.47%; adjusted odds ratio, 0.13; 95% CI, 0.04-0.49; P = .003. Technical and hemodynamic success and secondary outcomes were comparable between TRV and TFV. CONCLUSIONS: In comparison to TFV, TRV is associated with lower rates of periprocedural safety events while maintaining similar short-term clinical outcomes and hemodynamic performance. CI - (c) 2025 The Author(s). FAU - Fang, Jonathan X AU - Fang JX AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. AD - Department of Cardiology, National Heart Centre Singapore, Singapore. FAU - Villablanca, Pedro A AU - Villablanca PA AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Frisoli, Tiberio M AU - Frisoli TM AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Engel Gonzalez, Pedro AU - Engel Gonzalez P AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Lee, James C AU - Lee JC AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Fram, Georgi K AU - Fram GK AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Lai, Leo Kar Lok AU - Lai LKL AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. AD - Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China. FAU - Giustino, Gennaro AU - Giustino G AD - Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey. FAU - Alrayes, Hussayn AU - Alrayes H AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Kamel-Abusalha, Louie B AU - Kamel-Abusalha LB AD - College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio. FAU - Ellauzi, Rama AU - Ellauzi R AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Gregerson, Samuel AU - Gregerson S AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - Chiang, Michael AU - Chiang M AD - Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China. FAU - So, Kent Chak-Yu AU - So KC AD - Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China. FAU - Wang, Dee Dee AU - Wang DD AD - NCH Rooney Heart Institute, Naples, Florida. FAU - O'Neill, William W AU - O'Neill WW AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. FAU - O'Neill, Brian P AU - O'Neill BP AD - Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan. LA - eng PT - Journal Article DEP - 20251118 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC12766047 OTO - NOTNLM OT - balloon aortic valvuloplasty OT - radial access OT - severe aortic stenosis EDAT- 2026/01/07 06:30 MHDA- 2026/01/07 06:31 PMCR- 2025/11/18 CRDT- 2026/01/07 04:57 PHST- 2025/02/15 00:00 [received] PHST- 2025/07/28 00:00 [revised] PHST- 2025/09/09 00:00 [accepted] PHST- 2026/01/07 06:31 [medline] PHST- 2026/01/07 06:30 [pubmed] PHST- 2026/01/07 04:57 [entrez] PHST- 2025/11/18 00:00 [pmc-release] AID - S2772-9303(25)01461-9 [pii] AID - 104015 [pii] AID - 10.1016/j.jscai.2025.104015 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2025 Nov 18;4(12):104015. doi: 10.1016/j.jscai.2025.104015. eCollection 2025 Dec. PMID- 41485619 OWN - NLM STAT- MEDLINE DCOM- 20260202 LR - 20260202 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 448 DP - 2026 Apr 1 TI - Coronary access after TAVR with the 4th and 5th -generation self-expanding Evolut valves: The EPROMPT-CA study. PG - 134073 LID - S0167-5273(25)01116-7 [pii] LID - 10.1016/j.ijcard.2025.134073 [doi] AB - BACKGROUND: As transcatheter aortic valve replacement (TAVR) expands to lower-risk patients, optimizing post-TAVR coronary access and identifying its determinants have become increasingly important. OBJECTIVES: To evaluate coronary access and assess CT predictors of selective access post-TAVR with the Evolut FX/FX+ valves. METHODS: This single-center, prospective study enrolled patients undergoing transfemoral TAVR with Evolut FX/FX+ valves. Coronary access was attempted immediately post-deployment, with CT performed at 30-60 days. The primary endpoint was coronary access success. CTs were analyzed for predictors of access success. RESULTS: A total of 143 patients (103 FX, 40 FX+) were enrolled; post-TAVR CT was completed in 76 (55 FX, 21 FX+). Coronary access was successful in 95.1 % of left coronary artery (LCA) and 83 % of right coronary artery (RCA) attempts. Success rates were similar between FX and FX+, but FX+ required less contrast (5.45 vs. 8.92 mL; p < 0.001) and fewer catheters (1.13 vs. 1.32; p = 0.014) for LCA. Access determinants differed by artery: LCA access was primarily associated with ostial position relative to the aortic cusp and transcatheter heart valve frame, while RCA access was mainly influenced by larger aortic root and valve dimensions. Commissural and coronary alignment were not associated with selective access. None of the identified associations reliably predicted selective coronary access, and subjective predictions by CT readers were also inaccurate. CONCLUSIONS: Post-TAVR coronary access using Evolut FX/FX+ valves was more frequently successful for the LCA than the RCA. The FX+ valve facilitated coronary access with reduced procedural effort. CT identified distinct anatomical determinants for LCA versus RCA access. However, CT-derived analyses did not reliably predict coronary access success. CI - Copyright (c) 2026 Elsevier B.V. All rights reserved. FAU - Lupu, Lior AU - Lupu L AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Rogers, Toby AU - Rogers T AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Abusnina, Waiel AU - Abusnina W AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Haberman, Dan AU - Haberman D AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Cellamare, Matteo AU - Cellamare M AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Zhang, Cheng AU - Zhang C AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Sawant, Vaishnavi AU - Sawant V AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Ali, Syed W AU - Ali SW AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Ozturk, Sevket T AU - Ozturk ST AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Chitturi, Kalyan R AU - Chitturi KR AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Chaturvedi, Abhishek AU - Chaturvedi A AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Ben-Dor, Itsik AU - Ben-Dor I AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Satler, Lowell F AU - Satler LF AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Waksman, Ron AU - Waksman R AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: ron.waksman@medstar.net. LA - eng PT - Journal Article DEP - 20260102 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/trends MH - Female MH - Male MH - Prospective Studies MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery/diagnostic imaging MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Coronary Vessels/diagnostic imaging/surgery MH - *Aortic Valve/surgery/diagnostic imaging MH - Treatment Outcome MH - Follow-Up Studies MH - Coronary Angiography/methods OTO - NOTNLM OT - Commissural alignment OT - Coronary access OT - Evolut FX OT - Evolut FX + OT - Post-TAVR imaging OT - Transcatheter aortic valve replacement (TAVR) EDAT- 2026/01/05 00:49 MHDA- 2026/02/03 00:27 CRDT- 2026/01/04 19:37 PHST- 2025/08/20 00:00 [received] PHST- 2025/11/26 00:00 [revised] PHST- 2025/11/30 00:00 [accepted] PHST- 2026/02/03 00:27 [medline] PHST- 2026/01/05 00:49 [pubmed] PHST- 2026/01/04 19:37 [entrez] AID - S0167-5273(25)01116-7 [pii] AID - 10.1016/j.ijcard.2025.134073 [doi] PST - ppublish SO - Int J Cardiol. 2026 Apr 1;448:134073. doi: 10.1016/j.ijcard.2025.134073. Epub 2026 Jan 2. PMID- 41484037 OWN - NLM STAT- MEDLINE DCOM- 20260907 LR - 20260914 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 90 DP - 2026 Sep TI - Suture-based vs plug-based vascular access closure in patients undergoing transcatheter transfemoral aortic valve implantation. PG - 11-15 LID - S1553-8389(25)00621-9 [pii] LID - 10.1016/j.carrev.2025.12.016 [doi] AB - BACKGROUND AND AIMS: Suture-based vascular closure devices (S-VCD) plus the liberal use of an additional small plug-based VCD have been demonstrated to be superior to "pure" plug-based VCD (P-VCD) in patients treated with transcatheter aortic valve implantation (TAVI). Preliminary data suggests that the systematic use of the arteriotomy-site ballooning plus concomitant manual compression following P-VCD (MANTA, Teleflex) delivery may optimize the device apposition and should be adopted to improve the final hemostatic efficacy. METHODS: Consecutive patients undergoing transfemoral TAVI at two Italian centers were included. Patients treated with S-VCD and balloon assisted P-VCD were matched for major variables. The primary outcome was the occurrence of any in-hospital vascular complication. All outcomes were defined according to the Valve Academic Research Consortium (VARC)-3 statement. RESULTS: Overall, 799 patients were included (S-VCD: 451; balloon-assisted P-VCD: 348). Patients in the S-VCD group received 2 ProGlides (Abbott Vascular Inc.) plus the liberal use of an additional small plug-based VCD. Patients in the P-VCD group received the systematic use of the arteriotomy-site ballooning plus concomitant manual compression. After matching, 123 pairs of subjects were selected. The primary outcome occurred in 11.4 % of patients in the S-VCD group and 6.5 % in the balloon assisted P-VCD group (OR 0.56, 95 % CI (0.22-1.40); p = 0.217). Major VARC-3 vascular complications were more frequent in the S-VCD cohort (OR 0.12, 95 % CI (0.01-0.96); p = 0.048). No differences were found for the composite of major vascular complications and in-hospital death (OR 0.59, 95 % CI (0.19-1.88); p = 0.377). Any VARC-3 access related bleedings were slightly more frequent in the S-VCD group (OR 0.27, 95 % CI (0.07-0.99); p = 0.048), while no differences were evident for major bleedings (OR 0.28, 95 % CI (0.06-1.40); p = 0.122). CONCLUSIONS: The balloon-assisted P-VCD showed similar vascular outcomes compared to traditional S-VCD in patients undergoing transfemoral TAVI. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Paolucci, Luca AU - Paolucci L AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Buono, Andrea AU - Buono A AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Colucci, Michele AU - Colucci M AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Basile, Mattia AU - Basile M AD - Cardiac Surgery Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Galasso, Michele AU - Galasso M AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Lenci, Ludovica AU - Lenci L AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Marino, Angelo Giuseppe AU - Marino AG AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Scarpelli, Mario AU - Scarpelli M AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Focaccio, Amelia AU - Focaccio A AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Maselli, Daniele AU - Maselli D AD - Cardiac Surgery Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Briguori, Carlo AU - Briguori C AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. Electronic address: carlobriguori@clinicamediterranea.it. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20251225 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery/diagnostic imaging MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality MH - Cardiac Catheterization MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Femoral Artery/diagnostic imaging MH - *Hemorrhage/prevention & control/etiology/mortality MH - Hemostatic Techniques/adverse effects/instrumentation/mortality MH - Italy MH - Punctures MH - Retrospective Studies MH - Risk Factors MH - Suture Techniques/adverse effects/mortality/instrumentation MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Treatment Outcome MH - *Vascular Closure Devices OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - Vascular closure device COIS- Declaration of competing interest None. EDAT- 2026/01/04 00:32 MHDA- 2026/09/07 23:34 CRDT- 2026/01/03 22:06 PHST- 2025/10/16 00:00 [received] PHST- 2025/12/09 00:00 [revised] PHST- 2025/12/19 00:00 [accepted] PHST- 2026/09/07 23:34 [medline] PHST- 2026/01/04 00:32 [pubmed] PHST- 2026/01/03 22:06 [entrez] AID - S1553-8389(25)00621-9 [pii] AID - 10.1016/j.carrev.2025.12.016 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2026 Sep;90:11-15. doi: 10.1016/j.carrev.2025.12.016. Epub 2025 Dec 25. PMID- 41483996 OWN - NLM STAT- MEDLINE DCOM- 20260223 LR - 20260309 IS - 1471-6771 (Electronic) IS - 0007-0912 (Linking) VI - 136 IP - 3 DP - 2026 Mar TI - Management of anaesthesia for transfemoral transcatheter aortic valve implantation: an Italian interdisciplinary consensus statement. PG - 824-835 LID - S0007-0912(25)00801-3 [pii] LID - 10.1016/j.bja.2025.10.052 [doi] AB - BACKGROUND: Transfemoral transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for patients with severe aortic stenosis who are at elevated surgical risk. Despite widespread use, optimal periprocedural anaesthetic management remains highly variable, and evidence-based guidance is lacking. METHODS: An interdisciplinary panel of Italian experts in anaesthesiology, cardiology, and cardiac surgery conducted a systematic review of the literature and used the RAND/UCLA Appropriateness Method to evaluate 1032 clinical scenarios across a range of risk profiles and comorbid conditions. Ratings were conducted over three rounds, including a moderated in-person meeting to refine and discuss appropriateness scores. RESULTS: A minimally invasive approach, local anaesthesia alone, and conscious sedation were judged appropriate across most clinical scenarios. Invasive monitoring, such as placement of an additional arterial catheter or a central venous catheter, was recommended only in selected high-risk patients. Several approaches or interventions were consistently rated inappropriate across all evaluated scenarios, including nurse-administered anaesthesia, pulmonary artery catheterisation, and cardiac output monitoring using pulse wave analysis. Other approaches, such as general anaesthesia and deep sedation, were considered inappropriate in most cases but retained uncertainty in select clinical contexts. Several recommendations were rated as necessary to define a minimum standard of care. CONCLUSIONS: This Italian consensus statement provides practical, expert-driven recommendations to standardise anaesthetic care for transfemoral TAVI. While many recommendations reached strong consensus, areas of uncertainty remain, underscoring the need for further clinical research. Patient-centred, individualised decision-making remains essential, guided by institutional experience and procedural complexity. CI - Copyright (c) 2025 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved. FAU - Ajello, Valentina AU - Ajello V AD - Department of Cardiothoracic Anaesthesia, University Hospital Tor Vergata, Rome, Italy. FAU - Fresilli, Stefano AU - Fresilli S AD - Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - D'Amico, Filippo AU - D'Amico F AD - Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: damico.filippo@hsr.it. FAU - Franceschini, Giulia AU - Franceschini G AD - Department of Cardiothoracic Anaesthesia, University Hospital Tor Vergata, Rome, Italy. FAU - Aloisio, Tommaso AU - Aloisio T AD - Department of Cardiac Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Gottin, Leonardo AU - Gottin L AD - Unit of Cardiothoracic and Vascular Intensive Care Verona Hospital and University Trust, Department of Surgery, Dentistry and Paediatrics and Gynaecology, University of Verona, Verona, Italy. FAU - Baiocchi, Massimo AU - Baiocchi M AD - Cardiothoracic and Vascular Anaesthesia and Intensive Care, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy. FAU - Guarracino, Fabio AU - Guarracino F AD - Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. FAU - Bertini, Pietro AU - Bertini P AD - Department of Anaesthesia and Intensive Care Medicine, Casa di Cura Privata San Rossore, Pisa, Italy. FAU - Napodano, Massimo AU - Napodano M AD - Cardiologia Interventistica. Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedale Universita di Padova, Padua, Italy. FAU - D'Amora, Mauro AU - D'Amora M AD - Department of Cardiac, Thoracic, and Vascular Anaesthesia, University Hospital "San Giovanni Di Dio e Ruggi D'Aragona", Salerno, Italy. FAU - Panascia, Ettore AU - Panascia E AD - Anaesthesia and Critical Care Medicine III - CAST, Policlinico University Hospital, Catania, Italy. FAU - Meani, Paolo AU - Meani P AD - Cardio-Thoracic and Vascular Anaesthesia and Intensive Care, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. FAU - Weltert, Luca AU - Weltert L AD - Heart Surgery Department, Saint Camillus International University for Health Sciences, Rome, Italy. FAU - Monaco, Fabrizio AU - Monaco F AD - Departement of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum - University of Bologna, Italy; Cardiothoracic and Vascular Anesthesia and Intensive Care IRCCS Azienda Ospedaliero-Universitaria Sant'Orsola, BolognaVia Massarenti, Bologna, Italy. FAU - Pieri, Marina AU - Pieri M AD - Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. FAU - Sangalli, Fabio AU - Sangalli F AD - Department of Anaesthesia and Intensive Care, ASST Brianza, University of Milano-Bicocca, Vimercate, Italy. FAU - Santonocito, Cristina AU - Santonocito C AD - Anaesthesia and Critical Care Medicine III - CAST, Policlinico University Hospital, Catania, Italy. FAU - Silvetti, Simona AU - Silvetti S AD - Department of Cardiac Anesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS- IRCCS Cardiovascular Network, Italy. FAU - Landoni, Giovanni AU - Landoni G AD - Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. FAU - Ranucci, Marco AU - Ranucci M AD - Department of Cardiac Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Scolletta, Sabino AU - Scolletta S AD - Department of Medical Science, Surgery, and Neurosciences, Urgency-Emergency Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy. FAU - Paternoster, Gianluca AU - Paternoster G AD - Department of Health Sciences, Anaesthesia and ICU, School of Medicine, University of Basilicata San Carlo Hospital, Potenza, Italy. LA - eng PT - Consensus Statement PT - Journal Article PT - Systematic Review DEP - 20260103 PL - England TA - Br J Anaesth JT - British journal of anaesthesia JID - 0372541 SB - IM MH - Humans MH - *Anesthesia/methods/standards MH - *Aortic Valve Stenosis/surgery MH - Femoral Artery MH - Italy MH - *Transcatheter Aortic Valve Replacement/methods OTO - NOTNLM OT - RAND/UCLA Appropriateness Method OT - anaesthesia OT - cardiac surgery OT - cardiology OT - expert consensus OT - transcatheter aortic valve implantation COIS- Declaration of interest The authors declare that they have no conflicts of interest. EDAT- 2026/01/04 00:32 MHDA- 2026/02/24 00:30 CRDT- 2026/01/03 22:03 PHST- 2025/06/06 00:00 [received] PHST- 2025/09/26 00:00 [revised] PHST- 2025/10/17 00:00 [accepted] PHST- 2026/02/24 00:30 [medline] PHST- 2026/01/04 00:32 [pubmed] PHST- 2026/01/03 22:03 [entrez] AID - S0007-0912(25)00801-3 [pii] AID - 10.1016/j.bja.2025.10.052 [doi] PST - ppublish SO - Br J Anaesth. 2026 Mar;136(3):824-835. doi: 10.1016/j.bja.2025.10.052. Epub 2026 Jan 3. PMID- 41474535 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251231 LR - 20260103 IS - 2090-911X (Electronic) IS - 1110-2608 (Print) IS - 1110-2608 (Linking) VI - 77 IP - 1 DP - 2025 Dec 31 TI - Transradial vs transfemoral secondary access outcomes in transcatheter aortic valve replacement: an updated systematic review and meta-analysis. PG - 113 LID - 10.1186/s43044-025-00706-3 [doi] LID - 113 AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure with associated risks that are influenced by the choice of secondary vascular access used. The impact of transradial secondary access (TRSA) compared to transfemoral secondary access (TFSA) on adverse events remains uncertain. Therefore, we conducted an updated meta-analysis to compare procedural complications between TRSA and TFSA in TAVR. METHODS: We systematically searched PubMed, Scopus, and the Cochrane Library for studies comparing TRSA and TFSA in patients undergoing TAVR. The primary endpoints were 30-day rates of each of the following: access-related bleeding, access-related vascular complications, stroke/transient ischemic attack (TIA), myocardial infarction (MI), acute kidney injury (AKI stage III or higher), and all-cause mortality. Leave-one-out sensitivity analyses and subgroup analyses stratified by primary access route were performed to assess the consistency of the findings. RESULTS: Seven studies with 6327 patients were included, comprising of six observational studies and one randomized controlled trial TRSA was associated with significantly lower odds of mortality (OR 0.55, 95% CI [0.39, 0.78], p = 0.0007), stroke/TIA (OR 0.58, 95% CI [0.39, 0.87], p = 0.009), major/life-threatening bleeding (OR 0.50, 95% CI [0.30, 0.83], p = 0.008), and major vascular complications (OR 0.59, 95% CI [0.41, 0.85], p = 0.004). Additionally, we stratified outcomes for patients undergoing transfemoral primary access (TFPA) to determine whether the primary access route influences results. The transradial group demonstrated significantly lower odds of 30-day all-cause mortality (OR 0.49, 95% CI [0.28, 0.87], p = 0.01), and 30-day minor bleeding (OR 0.48, 95% CI [0.27, 0.86], p = 0.01). CONCLUSIONS: Key limitations included predominance of non-randomized studies and high heterogeneity in some outcomes. In patients undergoing TAVR, TRSA is associated with significantly lower complications compared to TFSA, suggesting it may be a superior alternative. CI - (c) 2025. The Author(s). FAU - Ishfaq, Hashim AU - Ishfaq H AD - Medical College, Aga Khan University, Karachi, Pakistan. FAU - Shaikh, Reyan Hussain AU - Shaikh RH AD - Medical College, Aga Khan University, Karachi, Pakistan. FAU - Fatima, Emaan AU - Fatima E AD - Medical College, Aga Khan University, Karachi, Pakistan. emaan.fatima@scholar.aku.edu. FAU - Jamshed, Mian Muinuddin AU - Jamshed MM AD - Medical College, Aga Khan University, Karachi, Pakistan. FAU - Ishfaq, Hamza AU - Ishfaq H AD - Northwest Health-Porter, Valparaiso, USA. FAU - Lukan, Abdulkareem AU - Lukan A AD - Advocate Illinois Masonic Medical Center, Chicago, USA. FAU - Inam, Hina AU - Inam H AD - Department of Cardiothoracic Surgery, Aga Khan University Hospital, Karachi, Pakistan. FAU - Ibrahim, Muhammad Bilal AU - Ibrahim MB AD - John H. Stroger, Jr. Hospital of Cook County, Chicago, USA. FAU - Shaka, Hafeez AU - Shaka H AD - John H. Stroger, Jr. Hospital of Cook County, Chicago, USA. LA - eng PT - Journal Article PT - Review DEP - 20251231 PL - Germany TA - Egypt Heart J JT - The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology JID - 9106952 PMC - PMC12756211 OTO - NOTNLM OT - Femoral access OT - Radial access OT - Secondary access OT - Transcatheter aortic valve implantation OT - Transcatheter aortic valve replacement COIS- Declarations. Ethics approval and consent to participate: Not applicable. This study is a secondary analysis of data already published in the scientific literature and therefore did not require approval by an institutional review board or ethics committee. Competing interests: The authors declare no competing interests. EDAT- 2025/12/31 12:55 MHDA- 2025/12/31 12:56 PMCR- 2025/12/31 CRDT- 2025/12/31 11:56 PHST- 2025/07/06 00:00 [received] PHST- 2025/11/21 00:00 [accepted] PHST- 2025/12/31 12:56 [medline] PHST- 2025/12/31 12:55 [pubmed] PHST- 2025/12/31 11:56 [entrez] PHST- 2025/12/31 00:00 [pmc-release] AID - 10.1186/s43044-025-00706-3 [pii] AID - 706 [pii] AID - 10.1186/s43044-025-00706-3 [doi] PST - epublish SO - Egypt Heart J. 2025 Dec 31;77(1):113. doi: 10.1186/s43044-025-00706-3. PMID- 41470144 OWN - NLM STAT- MEDLINE DCOM- 20251231 LR - 20260102 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 61 IP - 12 DP - 2025 Nov 30 TI - Osaka Prognostic Score Predicts In-Hospital and One-Year Mortality Following Transcatheter Aortic Valve Implantation. LID - 10.3390/medicina61122142 [doi] LID - 2142 AB - Background and Objectives: Conventional risk models may not adequately capture key biological determinants of mortality following transcatheter aortic valve implantation (TAVI), such as inflammation, malnutrition, and immune dysfunction. The Osaka Prognostic Score (OPS), incorporating CRP, albumin, and lymphocyte count, may address this gap. We aimed to evaluate the prognostic value of OPS for predicting in-hospital and one-year all-cause mortality after TAVI. Materials and Methods: In this retrospective single-center cohort study, 244 patients who underwent transfemoral TAVI between December 2022 and January 2024 were analyzed. OPS was calculated at baseline (range: 0-3), and its prognostic value for in-hospital and one-year all-cause mortality was evaluated using multivariable Cox regression, ROC analysis, and restricted cubic spline (RCS) modeling. Results: In-hospital and one-year mortality rates were 11.5% and 21.7%, respectively. Higher OPS scores were significantly associated with mortality in both periods. OPS independently predicted in-hospital mortality (HR: 2.018; 95% CI: 1.632-2.521; p = 0.017) and one-year mortality (HR: 2.125; 95% CI: 1.300-3.473; p = 0.003). ROC analysis yielded AUC values of 0.776 and 0.859 for in-hospital and one-year mortality, respectively. Kaplan-Meier curves revealed significantly reduced survival in patients with higher OPS (log-rank p < 0.001), and RCS analysis demonstrated a significant nonlinear association between increasing OPS values and mortality risk (p < 0.001). Conclusions: OPS is a simple, cost-effective, and biologically relevant prognostic index that independently predicts both in-hospital and one-year mortality following TAVI. By integrating markers of inflammation, nutrition, and immune competence, OPS may offer additional value in risk stratification and support clinical decision-making in this high-risk population. FAU - Akdogan, Murat AU - Akdogan M AUID- ORCID: 0000-0003-1175-3203 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Yucel, Emine Cansu AU - Yucel EC AUID- ORCID: 0009-0004-9854-0554 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Tas, Alperen AU - Tas A AUID- ORCID: 0000-0002-1696-7449 AD - Department of Cardiology, Kirsehir Training and Research Hospital, 40080 Kirsehir, Turkey. FAU - Sahin, Yusuf Bozkurt AU - Sahin YB AUID- ORCID: 0000-0003-3523-8783 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Tunca, Cagatay AU - Tunca C AUID- ORCID: 0000-0001-7111-8450 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Kivrak, Ahmet AU - Kivrak A AUID- ORCID: 0000-0001-5232-8436 AD - Department of Cardiology, School of Medicine, Hacettepe University, 06000 Ankara, Turkey. FAU - Akbuga, Kursat AU - Akbuga K AUID- ORCID: 0000-0002-7716-6143 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Tanik, Veysel Ozan AU - Tanik VO AUID- ORCID: 0000-0002-7193-4324 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Sezgin, Ali AU - Sezgin A AUID- ORCID: 0000-0003-0139-7962 AD - Department of Cardiology, Ankara Etlik City Hospital, 06000 Ankara, Turkey. FAU - Ozlek, Bulent AU - Ozlek B AUID- ORCID: 0000-0001-5429-1323 AD - Department of Cardiology, School of Medicine, Mugla Sitki Kocman University, 48999 Mugla, Turkey. LA - eng PT - Journal Article DEP - 20251130 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 RN - 9007-41-4 (C-Reactive Protein) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/mortality MH - Male MH - Female MH - Retrospective Studies MH - Aged, 80 and over MH - Prognosis MH - *Hospital Mortality MH - Aged MH - ROC Curve MH - Risk Assessment/methods MH - Cohort Studies MH - Aortic Valve Stenosis/surgery/mortality MH - Proportional Hazards Models MH - Japan/epidemiology MH - Risk Factors MH - C-Reactive Protein/analysis PMC - PMC12734656 OTO - NOTNLM OT - Osaka prognostic score OT - all-cause mortality OT - inflammation OT - malnutrition OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2025/12/31 07:37 MHDA- 2025/12/31 07:38 PMCR- 2025/11/30 CRDT- 2025/12/31 01:01 PHST- 2025/10/26 00:00 [received] PHST- 2025/11/28 00:00 [revised] PHST- 2025/11/28 00:00 [accepted] PHST- 2025/12/31 07:38 [medline] PHST- 2025/12/31 07:37 [pubmed] PHST- 2025/12/31 01:01 [entrez] PHST- 2025/11/30 00:00 [pmc-release] AID - medicina61122142 [pii] AID - medicina-61-02142 [pii] AID - 10.3390/medicina61122142 [doi] PST - epublish SO - Medicina (Kaunas). 2025 Nov 30;61(12):2142. doi: 10.3390/medicina61122142. PMID- 41461016 OWN - NLM STAT- MEDLINE DCOM- 20260205 LR - 20260817 IS - 1531-7080 (Electronic) IS - 0268-4705 (Linking) VI - 41 IP - 2 DP - 2026 Mar 1 TI - Innovations in robotic aortic valve surgery. PG - 74-80 LID - 10.1097/HCO.0000000000001272 [doi] AB - PURPOSE OF REVIEW: This review explores the contemporary minimally invasive strategies in management of aortic valve disease, highlighting the innovative advancements in robotic approaches, particularly right transaxillary robotic aortic valve replacement (RAVR). RECENT FINDINGS: Over the past two decades, there has been increasing interest by patients and providers for less invasive alternatives to conventional sternotomy for treatment of aortic valve disease. Such strategies include transcatheter and minimally invasive surgical approaches such as mini-sternotomy, right anterior thoracotomy and robotic-assisted techniques. A major milestone was achieved in January 2020 with the introduction of RAVR, utilizing the established right transaxillary lateral 3 cm mini-thoracotomy platform commonly used for robotic mitral surgery. SUMMARY: RAVR provides a nonsternotomy, rib-sparing surgical option that offers the longitudinal benefits of conventional surgical aortic valve replacement (SAVR). As transcatheter aortic valve replacement (TAVR) expands into nonprohibitive risk populations, RAVR may provide similar minimally invasive advantages yet with the added benefit of comprehensive therapy to include concomitant procedures, particularly in low and intermediate surgical risk patients. Importantly, RAVR has facilitated a transformative advance in cardiac surgery, providing a platform for nearly all cardiac surgery with progressive complexity. CI - Copyright (c) 2025 Wolters Kluwer Health, Inc. All rights reserved. FAU - Darehzereshki, Ali AU - Darehzereshki A AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, USA. FAU - Wei, Lawrence AU - Wei L FAU - Badhwar, Vinay AU - Badhwar V LA - eng PT - Journal Article PT - Review DEP - 20251229 PL - United States TA - Curr Opin Cardiol JT - Current opinion in cardiology JID - 8608087 SB - IM MH - Humans MH - *Robotic Surgical Procedures/methods MH - *Aortic Valve/surgery MH - *Heart Valve Prosthesis Implantation/methods MH - Minimally Invasive Surgical Procedures/methods MH - *Aortic Valve Disease/surgery MH - Transcatheter Aortic Valve Replacement/methods OTO - NOTNLM OT - minimally invasive cardiac surgery OT - robotic aortic valve replacement OT - robotic cardiac surgery EDAT- 2025/12/29 19:18 MHDA- 2026/02/05 06:32 CRDT- 2025/12/29 14:54 PHST- 2026/02/05 06:32 [medline] PHST- 2025/12/29 19:18 [pubmed] PHST- 2025/12/29 14:54 [entrez] AID - 00001573-990000000-00245 [pii] AID - 10.1097/HCO.0000000000001272 [doi] PST - ppublish SO - Curr Opin Cardiol. 2026 Mar 1;41(2):74-80. doi: 10.1097/HCO.0000000000001272. Epub 2025 Dec 29. PMID- 41460190 OWN - NLM STAT- MEDLINE DCOM- 20260113 LR - 20260608 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 68 IP - 1 DP - 2026 Jan 6 TI - Ten-Year Outcomes of Transcatheter versus Surgical Aortic Valve Replacement: Extended Follow-up from the OBSERVANT Study. LID - ezaf476 [pii] LID - 10.1093/ejcts/ezaf476 [doi] AB - OBJECTIVES: To compare long-term clinical outcomes of patients undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) in the Italian clinical practice and enrolled in the multicentre OBSERVANT (Observational Study of Effectiveness of SAVR-TAVI Procedures for Severe Aortic Stenosis Treatment) Study. METHODS: Propensity score matching was used to compare patients undergoing SAVR or transfemoral (TF) TAVR with similar baseline characteristics. The primary end points were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) at 10 years. Prespecified secondary end points included cerebrovascular accidents, repeat aortic intervention, repeat hospitalization due to cardiac reasons and heart failure. All outcomes were adjudicated through a linkage with administrative databases. RESULTS: From the entire cohort (n = 5707 SAVR and n = 1911 TAVR treated between December 2010 and June 2012), 650 matched pairs of patients were considered. At 10 years, TF-TAVR was associated with a higher risk of all-cause mortality (Hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.22-1.59; P < .001) and MACCE (HR 1.33, 95% CI 1.18-1.51; P < .001) compared to SAVR. Secondary end-points did not differ for rehospitalization for heart failure (P = .443) or cardiac reasons (P = .552), and for cerebrovascular events (P = .573), but TAVR had a significantly lower risk of repeat aortic intervention (Sub-distributional HR [SHR], 0.33; 95% CI, 0.12-0.91; P = .024] at 10 years. CONCLUSIONS: At 10 years, early generation TAVR had a significantly higher risk of all-cause mortality and MACCE, but a lower risk of repeat aortic intervention in clinical practice. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Costa, Giuliano AU - Costa G AUID- ORCID: 0000-0003-3770-8988 AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", University of Catania, Catania, 95100, Italy. FAU - Barbanti, Marco AU - Barbanti M AUID- ORCID: 0000-0002-4903-5437 AD - Department of Medicine and Surgery, Universita degli Studi di Enna "Kore", Enna, 94100, Italy. AD - Division of Cardiology, Umberto I Hospital, Enna, 94100, Italy. FAU - Rosato, Stefano AU - Rosato S AUID- ORCID: 0000-0002-6690-5537 AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, 00161, Italy. FAU - Badoni, Gabriella AU - Badoni G AUID- ORCID: 0000-0003-0562-4923 AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, 00161, Italy. FAU - Biancari, Fausto AU - Biancari F AUID- ORCID: 0000-0001-5028-8186 AD - Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milano, 20138, Italy. FAU - Tatari, Mahin AU - Tatari M AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, 00161, Italy. AD - Department of Statistical Sciences, University of Rome "La Sapienza", Rome, 00185, Italy. FAU - Baglio, Giovanni AU - Baglio G AUID- ORCID: 0000-0001-8313-794X AD - Italian National Agency for Regional Healthcare Services, Rome, 00187, Italy. FAU - D'Errigo, Paola AU - D'Errigo P AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, 00161, Italy. CN - OBSERVANT Research Group LA - eng GR - Italian Ministry of Health/ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/mortality/adverse effects/methods MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/mortality MH - Aged MH - Treatment Outcome MH - Follow-Up Studies MH - *Heart Valve Prosthesis Implantation/mortality/methods/adverse effects MH - *Aortic Valve/surgery MH - Postoperative Complications/epidemiology MH - Propensity Score MH - Italy/epidemiology OTO - NOTNLM OT - SAVR OT - TAVR OT - comparison OT - long-term OT - real-world FIR - Seccareccia, Fulvia IR - Seccareccia F FIR - D'Errigo, Paola IR - D'Errigo P FIR - Rosato, Stefano IR - Rosato S FIR - Maraschini, Alice IR - Maraschini A FIR - Badoni, Gabriella IR - Badoni G FIR - Tamburino, Corrado IR - Tamburino C FIR - Barbanti, Marco IR - Barbanti M FIR - Santoro, Gennaro IR - Santoro G FIR - Santini, Francesco IR - Santini F FIR - Onorati, Francesco IR - Onorati F FIR - Grossi, Claudio IR - Grossi C FIR - Ranucci, Marco IR - Ranucci M FIR - Covello, Remo Daniel IR - Covello RD FIR - Fusco, Danilo IR - Fusco D FIR - De Palma, Rossana IR - De Palma R FIR - Scondotto, Salvatore IR - Scondotto S EDAT- 2025/12/29 13:02 MHDA- 2026/01/13 13:15 CRDT- 2025/12/29 09:55 PHST- 2025/08/25 00:00 [received] PHST- 2025/10/24 00:00 [revised] PHST- 2025/12/10 00:00 [accepted] PHST- 2026/01/13 13:15 [medline] PHST- 2025/12/29 13:02 [pubmed] PHST- 2025/12/29 09:55 [entrez] AID - 8406925 [pii] AID - 10.1093/ejcts/ezaf476 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2026 Jan 6;68(1):ezaf476. doi: 10.1093/ejcts/ezaf476. PMID- 41443784 OWN - NLM STAT- MEDLINE DCOM- 20251224 LR - 20260724 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 24 DP - 2025 Dec 22 TI - Mid-Term Outcomes of a Novel TAVR Device for Pure Aortic Regurgitation: A Prospective, Multicenter Trial. PG - 3040-3051 LID - S1936-8798(25)02596-8 [pii] LID - 10.1016/j.jcin.2025.10.017 [doi] AB - BACKGROUND: Patients with severe aortic regurgitation (AR) frequently face high surgical risks, rendering them ineligible for surgery. Transcatheter aortic valve replacement (TAVR) is now a primary therapy for aortic valve stenosis. However, its application in pure native AR has been relatively limited. OBJECTIVES: The aim of this study was to evaluate the mid-term efficacy and safety of a novel self-expanding transfemoral TAVR device designed for treating pure native AR. METHODS: A prospective, single-arm clinical trial (ChiCTR2300075152) enrolled 110 consecutive patients with severe pure AR from 15 centers. The Pioneer Valve system with a rotatable feature and 3 independently angle-adjustable locators was used. Outcomes up to 1-year follow-up were reported per Valve Academic Research Consortium 3 criteria. The median clinical follow-up duration was 348 days (Q1-Q3: 342-357 days). RESULTS: The mean age was 73.37 +/- 4.21 years, with a median Society of Thoracic Surgeons score of 5.97% (Q1-Q3: 4.04%-8.63%). Technical success was achieved in 109 of 110 cases (99.1%), and valve migration occurred in 1 case. Mean aortic valve gradient and mean effective orifice area at 30 days were 7.88 +/- 2.7 mm Hg and 2.2 +/- 0.64 cm(2), respectively. New permanent pacemaker implantation occurred in 23 of 105 cases (21.9%; 95% CI: 14.3%-29.8%). All-cause mortality was 3 of 110 (2.7%; 95% CI: 0.9%-8.3%) at 1 year. Significant improvements in NYHA functional class, Kansas City Cardiomyopathy Questionnaire score, and positive left ventricular remodeling were observed up to 1 year. CONCLUSIONS: This study demonstrates that the Pioneer Valve provides a safe and effective alternative for high-risk or inoperable patients with severe pure AR, achieving favorable mid-term outcomes with stable hemodynamic performance. CI - Copyright (c) 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Xiao, Bowen AU - Xiao B AD - Department of Cardiovascular Surgery, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China; Cardiovascular Research Laboratory, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China. FAU - Liu, Lulu AU - Liu L AD - Department of Cardiovascular Surgery, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China; Cardiovascular Research Laboratory, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China. FAU - Guo, Yansong AU - Guo Y AD - Department of Cardiology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China. FAU - Liu, Jian AU - Liu J AD - Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Yang, Pengwei AU - Yang P AD - Department of Cardiovascular Medicine, Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou, China. FAU - Xiao, Yingbin AU - Xiao Y AD - Department of Cardiovascular Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China. FAU - Xiu, Jiancheng AU - Xiu J AD - Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China. FAU - Zhang, Junjie AU - Zhang J AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Fang, Zhenfei AU - Fang Z AD - Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China. FAU - Zhang, Gejun AU - Zhang G AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. FAU - Jiang, Hong AU - Jiang H AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. FAU - Liu, Jinping AU - Liu J AD - Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Liu, Xianbao AU - Liu X AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Shen, Yangyang AU - Shen Y AD - Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. FAU - Yang, Jian AU - Yang J AD - Department of Cardiovascular Surgery, The First Affiliated Hospital of Air Force Medical University, Xi'an, China. FAU - Zhang, Haibo AU - Zhang H AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Shi, Jun AU - Shi J AD - Department of Cardiovascular Surgery, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China; Cardiovascular Research Laboratory, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China. FAU - Ye, Jian AU - Ye J AD - Division of Cardiac Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Guo, Yingqiang AU - Guo Y AD - Department of Cardiovascular Surgery, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China; Cardiovascular Research Laboratory, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China. Electronic address: drguoyq@wchscu.cn. LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Male MH - Prospective Studies MH - Female MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Aged MH - *Aortic Valve Insufficiency/physiopathology/diagnostic imaging/surgery/mortality MH - Time Factors MH - Prosthesis Design MH - *Aortic Valve/physiopathology/diagnostic imaging/surgery MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects/mortality MH - Aged, 80 and over MH - Severity of Illness Index MH - Recovery of Function MH - Hemodynamics MH - Risk Factors OTO - NOTNLM OT - aortic valve regurgitation OT - pure native aortic regurgitation OT - self-expandable transcatheter heart valve OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures This study was supported, in part, by the 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (ZYGD22010) to Dr Yingqiang Guo. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/12/25 00:30 MHDA- 2025/12/25 00:31 CRDT- 2025/12/24 20:53 PHST- 2025/04/19 00:00 [received] PHST- 2025/10/02 00:00 [revised] PHST- 2025/10/10 00:00 [accepted] PHST- 2025/12/25 00:31 [medline] PHST- 2025/12/25 00:30 [pubmed] PHST- 2025/12/24 20:53 [entrez] AID - S1936-8798(25)02596-8 [pii] AID - 10.1016/j.jcin.2025.10.017 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Dec 22;18(24):3040-3051. doi: 10.1016/j.jcin.2025.10.017. PMID- 41440849 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251224 LR - 20251226 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 12 IP - 12 DP - 2025 Nov 30 TI - Temporal Dynamics of the Association Between Acute Kidney Injury and Mortality After Transcatheter Aortic Valve Implantation: Insights from Time-Varying and Landmark Survival Analyses. LID - 10.3390/jcdd12120470 [doi] LID - 470 AB - BACKGROUND: Acute kidney injury (AKI) is a frequent complication following transcatheter aortic valve implantation (TAVI) and has been linked to increased mortality. However, the temporal pattern of this association remains uncertain. This study aimed to evaluate the time-dependent impact of AKI on mortality after TAVI using advanced survival analyses. METHODS: We retrospectively analyzed 381 consecutive patients who underwent transfemoral TAVI between December 2016 and October 2024 at two tertiary cardiovascular centers. AKI was defined according to the Acute Kidney Injury Network (AKIN) criteria. The primary outcome was all-cause mortality. Patients were categorized into AKI and non-AKI groups. Clinical outcomes, including 30-day, 1-year, and overall mortality, were evaluated. RESULTS: Among 381 patients who underwent TAVI, 59 (15.5%) developed AKI according to the AKIN criteria. During a 33.9 months (18.0-59.2) median follow-up of overall mortality was significantly higher in the AKI group compared with those without AKI. In the multivariate Cox regression analysis, AKI was significantly associated with long-term mortality (HR: 2.07, 95% CI 1.32-3.25; p = 0.002). The time-varying hazard ratio curve demonstrated that the excess mortality risk associated with AKI was most pronounced in the early period and gradually declined thereafter. In time-interval-specific analyses, AKI was strongly associated with mortality within the first month (HR 6.30, 95% CI 3.03-13.08, p < 0.001) and remained significant up to 12 months (HR 2.18, 95% CI 1.32-3.59, p = 0.002). Beyond the first year, this association attenuated and lost statistical significance at 12-36 months (HR 0.90, p = 0.79), 36-60 months (HR 0.57, p = 0.24), and >60 months (HR 0.43, p = 0.13). CONCLUSIONS: AKI is an important predictor of early and mid-term mortality following TAVI, but its long-term prognostic impact is less pronounced. Preventive strategies and early management of AKI may improve outcomes in this high-risk population. FAU - Yildirim, Seda Elcim AU - Yildirim SE AUID- ORCID: 0000-0001-5175-0491 AD - Department of Cardiology, School of Medicine, Balikesir University, 10900 Balikesir, Turkey. FAU - Akar, Bahadir AU - Akar B AD - Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, 35360 Izmir, Turkey. FAU - Palac, Berkay AU - Palac B AD - Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, 35360 Izmir, Turkey. FAU - Bozkurt, Hakan AU - Bozkurt H AD - Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, 35360 Izmir, Turkey. FAU - Yildirim, Tarik AU - Yildirim T AUID- ORCID: 0000-0002-6314-7371 AD - Department of Cardiology, School of Medicine, Balikesir University, 10900 Balikesir, Turkey. FAU - Kiris, Tuncay AU - Kiris T AUID- ORCID: 0000-0001-9793-718X AD - Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, 35360 Izmir, Turkey. FAU - Avci, Eyup AU - Avci E AD - Department of Cardiology, School of Medicine, Balikesir University, 10900 Balikesir, Turkey. LA - eng PT - Journal Article DEP - 20251130 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC12733526 OTO - NOTNLM OT - acute kidney injury OT - all-cause mortality OT - time-varying Cox regression OT - transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2025/12/24 12:54 MHDA- 2025/12/24 12:55 PMCR- 2025/11/30 CRDT- 2025/12/24 09:45 PHST- 2025/10/22 00:00 [received] PHST- 2025/11/20 00:00 [revised] PHST- 2025/11/29 00:00 [accepted] PHST- 2025/12/24 12:55 [medline] PHST- 2025/12/24 12:54 [pubmed] PHST- 2025/12/24 09:45 [entrez] PHST- 2025/11/30 00:00 [pmc-release] AID - jcdd12120470 [pii] AID - jcdd-12-00470 [pii] AID - 10.3390/jcdd12120470 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2025 Nov 30;12(12):470. doi: 10.3390/jcdd12120470. PMID- 41425443 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251222 LR - 20251224 IS - 2772-9931 (Electronic) IS - 2772-9931 (Linking) VI - 3 IP - 4 DP - 2025 Dec TI - National Midterm Outcomes of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement. PG - 1045-1050 LID - 10.1016/j.atssr.2025.05.008 [doi] AB - BACKGROUND: This study compared the early and midterm outcomes of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in a real-world entire population in Korea. METHODS: During 5 years from June 2015 to May 2019, 1468 patients underwent primary isolated transfemoral TAVI and 3897 patients underwent primary isolated SAVR in Korea. Early and midterm clinical outcomes were compared between the groups, and propensity score-matched analysis was also performed to balance between the groups. Subgroup analyses were performed by dividing the overall cohort into 6 age-subgroups of <65, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and >/=85 years. Follow-up was 100% complete. Median follow-up duration was 2.5 years in the TAVI group and 3.0 years in the SAVR group. RESULTS: There was no difference in periprocedural mortality between the groups in the overall cohort (3.2% in TAVI vs 3.5% in SAVR, P =.66), whereas SAVR demonstrated higher periprocedural mortality in the matched cohort (2.9% in TAVI vs 5.6% in SAVR, P =.003). Cumulative incidence of all-cause mortality was not significantly different between TAVI and SAVR in the matched cohort (hazard ratio, 0.96; 95% CI, 0.79-1.16; P =.64), and was also not significantly different in every matched age-subgroup. Other midterm clinical outcomes, including stroke, endocarditis, and reintervention, were comparable between the groups, whereas the cumulative incidence of permanent pacemaker implantation was significantly higher in TAVI. CONCLUSIONS: TAVI and SAVR demonstrated comparable midterm survival in the real-world entire population from 2015 to 2019 in Korea. Comparable midterm survival was also demonstrated between all age-subgroups. CI - (c) 2025 Published by Elsevier Inc. on behalf of The Society of Thoracic Surgeons. FAU - Sohn, Suk Ho AU - Sohn SH AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Kyung Hwan AU - Kim KH AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Kang, Yoonjin AU - Kang Y AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Choi, Jae Woong AU - Choi JW AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Lee, Seung Hyun AU - Lee SH AD - Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Shinn, Sung Ho AU - Shinn SH AD - Shinn Sung Ho Cardiovascular Center, Guri, Gyeonggi-do, Republic of Korea. FAU - Yoo, Jae Suk AU - Yoo JS AD - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. LA - eng PT - Journal Article DEP - 20250604 PL - United States TA - Ann Thorac Surg Short Rep JT - Annals of thoracic surgery short reports JID - 9918506088006676 PMC - PMC12712155 EDAT- 2025/12/22 18:09 MHDA- 2025/12/22 18:10 PMCR- 2025/06/04 CRDT- 2025/12/22 06:44 PHST- 2025/05/19 00:00 [accepted] PHST- 2025/12/22 18:10 [medline] PHST- 2025/12/22 18:09 [pubmed] PHST- 2025/12/22 06:44 [entrez] PHST- 2025/06/04 00:00 [pmc-release] AID - S2772-9931(25)00185-8 [pii] AID - 10.1016/j.atssr.2025.05.008 [doi] PST - epublish SO - Ann Thorac Surg Short Rep. 2025 Jun 4;3(4):1045-1050. doi: 10.1016/j.atssr.2025.05.008. eCollection 2025 Dec. PMID- 41408688 OWN - NLM STAT- MEDLINE DCOM- 20260306 LR - 20261004 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 4 DP - 2026 Mar TI - Transcatheter Aortic Valve Implantation via Percutaneous Axillary Access-A UK Registry. PG - 997-1004 LID - 10.1002/ccd.70435 [doi] AB - BACKGROUND: Alternative access for transcatheter aortic valve implantation (TAVI) is required for the small subset of patients in whom transfemoral (TF) access is not feasible. The most commonly used alternative access route in the United Kingdom is the subclavian/axillary artery, and historically, most have been performed via surgical cutdown. Transaxillary TAVI can be undertaken via a percutaneous route. However, there exists limited data on the safety and efficacy of this technique. AIMS: This study aims to describe the UK experience of percutaneous axillary (PAx) TAVI. METHODS: This retrospective, multicenter study included every TAVI center in the United Kingdom which had performed > 10 PAx TAVI cases as of November 1, 2023. Each center provided data on all PAx cases carried out up to December 31, 2023. Procedural and clinical endpoints as well as adverse events were assessed according to Valve Academic Research Consortium (VARC)-3 definitions. RESULTS: Nine UK TAVI centers contributed data from 210 PAx cases. VARC-3 technical success was achieved in 92.4%. The incidence of major VARC-3 vascular access site complications was 7.1%, major or life-threatening VARC-3 bleeding occurred in 5.3%, a covered stent was used in 25.2%, and vascular surgical intervention was required in 3.3%. The incidence of in-hospital stroke and mortality were 7.1% and 3.3%, respectively. No statistically significant differences were observed between PAx carried out under conscious sedation (non-GA) and GA with respect to clinical outcomes. CONCLUSION: PAx TAVI is viable and can be performed under conscious sedation with no detriment in terms of clinical outcomes. However, the elevated risk of stroke is a concern. CI - (c) 2025 Wiley Periodicals LLC. FAU - Ali, Noman AU - Ali N AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Cunnington, Michael S AU - Cunnington MS AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Muir, Douglas AU - Muir D AD - Department of Cardiology, James Cook University Hospital, Middlesborough, UK. FAU - Vijayan, Seth AU - Vijayan S AD - Department of Cardiology, James Cook University Hospital, Middlesborough, UK. FAU - Telyuk, Pyotr AU - Telyuk P AD - Department of Cardiology, James Cook University Hospital, Middlesborough, UK. FAU - Nadir, Adnan M AU - Nadir AM AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Zorman, Mark AU - Zorman M AD - Department of Cardiology, Oxford Universities Hospital, Oxford, UK. FAU - Kharbanda, Rajesh AU - Kharbanda R AD - Department of Cardiology, Oxford Universities Hospital, Oxford, UK. FAU - Blackman, Daniel J AU - Blackman DJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Malkin, Christopher J AU - Malkin CJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Dospinescu, Ciprian AU - Dospinescu C AD - Department of Cardiology, Aberdeen Royal Infirmary, Aberdeen, UK. FAU - Baradi, Arul AU - Baradi A AD - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK. FAU - Hildick-Smith, David AU - Hildick-Smith D AD - Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK. FAU - Hartley, Adam AU - Hartley A AD - Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK. FAU - Malik, Iqbal AU - Malik I AD - Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK. FAU - Dorman, Stephen AU - Dorman S AD - Department of Cardiology, Bristol Heart Institute, Bristol, UK. FAU - Panoulas, Vasileios AU - Panoulas V AUID- ORCID: 0000-0002-9894-9200 AD - Department of Cardiology, Royal Brompton and Harefield Hospital, London, UK. FAU - Konstantinos, Konstantinou AU - Konstantinos K AD - Department of Cardiology, Royal Brompton and Harefield Hospital, London, UK. FAU - Doshi, Sagar AU - Doshi S AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Williams, Paul D AU - Williams PD AD - Department of Cardiology, James Cook University Hospital, Middlesborough, UK. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20251217 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - United Kingdom MH - *Axillary Artery/diagnostic imaging MH - Retrospective Studies MH - Registries MH - Female MH - Treatment Outcome MH - Aged, 80 and over MH - Male MH - *Catheterization, Peripheral/adverse effects/mortality MH - Aged MH - Time Factors MH - Risk Factors MH - Punctures MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/mortality/physiopathology MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Risk Assessment OTO - NOTNLM OT - percutaneous axillary TAVI OT - stroke OT - transaxillary EDAT- 2025/12/18 07:20 MHDA- 2026/03/06 19:43 CRDT- 2025/12/18 00:28 PHST- 2025/12/01 00:00 [revised] PHST- 2025/09/10 00:00 [received] PHST- 2025/12/11 00:00 [accepted] PHST- 2026/03/06 19:43 [medline] PHST- 2025/12/18 07:20 [pubmed] PHST- 2025/12/18 00:28 [entrez] AID - 10.1002/ccd.70435 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Mar;107(4):997-1004. doi: 10.1002/ccd.70435. Epub 2025 Dec 17. PMID- 41404755 OWN - NLM STAT- MEDLINE DCOM- 20260108 LR - 20260912 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 15 IP - 1 DP - 2026 Jan 6 TI - Paradoxical Normal-Flow Aortic Stenosis Despite Reduced Left Ventricular Ejection Fraction: Insights From the Randomized COMPARE-TAVI 1 Trial. PG - e045521 LID - 10.1161/JAHA.125.045521 [doi] LID - e045521 AB - BACKGROUND: The hemodynamic profile and remodeling patterns of paradoxical low-flow, low-gradient aortic stenosis are well understood. However, some patients with severe aortic stenosis exhibit eccentric remodeling with enlarged left ventricular cavities, enabling a normal flow, low ejection fraction (NF-LEF) phenotype. We assessed the prevalence, hemodynamic characteristics, and post-transcatheter aortic valve implantation outcomes of NF-LEF. METHODS: In this substudy of the COMPARE-TAVI 1 trial, 979 patients undergoing transfemoral transcatheter aortic valve implantation were stratified by left ventricular ejection fraction (LVEF) (< or >/=50%) and stroke volume index (< or >/=35 mL/m(2)) into 4 groups: normal flow, normal LVEF, NF-LEF, low flow, normal ejection fraction, and low flow, low ejection fraction. RESULTS: NF-LEF was observed in 10.7% of patients. Reduced LVEF was associated with previous myocardial infarction, pacemakers, New York Heart Association class >2, atrial fibrillation, moderate or worse mitral regurgitation, and larger left ventricular cavities (P<0.001) with eccentric hypertrophy (P=0.004). Compared with low-flow, low-ejection fraction, patients with NF-LEF more frequently had moderate or worse aortic regurgitation (P=0.007), whereas low flow, low ejection fraction showed poorer diastolic indices, suggesting diastolic dysfunction with high left ventricular filling pressures. Patients with low flow, normal ejection fraction were the most symptomatic and showed less improvement in 6-minute walk distance at 1 year compared with normal flow, normal ejection fraction. During follow-up, both low-flow groups demonstrated significant increases in stroke volume index (P<0.001), whereas LVEF also improved among patients with reduced LVEF (P<0.001). CONCLUSIONS: NF-LEF is a prevalent aortic stenosis phenotype characterized by preserved flow despite reduced LVEF, likely driven by eccentric remodeling with moderate or worse aortic regurgitation and more favorable diastolic properties, with similar survival and time-to-event outcomes across phenotypes after transcatheter aortic valve implantation at long-term follow-up. Despite higher comorbidity burdens, patients with NF-LEF showed functional and clinical improvements comparable with normal flow, normal ejection fraction, indicating a severe aortic stenosis phenotype. FAU - Ravn, Emil Johannes AU - Ravn EJ AUID- ORCID: 0000-0002-8992-5493 AD - Department of Cardiology Odense University Hospital Odense Denmark. FAU - Christiansen, Ulrik AU - Christiansen U AD - Department of Cardiology Aalborg University Hospital Aalborg Denmark. FAU - Nissen, Henrik AU - Nissen H AUID- ORCID: 0000-0002-0842-3644 AD - Department of Cardiology Odense University Hospital Odense Denmark. FAU - Povlsen, Jonas Agerlund AU - Povlsen JA AUID- ORCID: 0000-0001-9655-0493 AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. FAU - Alcaraz Frederiksen, Christian AU - Alcaraz Frederiksen C AUID- ORCID: 0000-0001-6583-2885 AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. FAU - Hvitfelt Poulsen, Steen AU - Hvitfelt Poulsen S AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. AD - Department of Clinical Medicine Aarhus University Hospital Aarhus Denmark. FAU - Clavel, Marie-Annick AU - Clavel MA AUID- ORCID: 0000-0002-8924-740X AD - Department of Cardiology Odense University Hospital Odense Denmark. FAU - Carter-Storch, Rasmus AU - Carter-Storch R AUID- ORCID: 0000-0002-0359-8728 AD - Department of Cardiology Odense University Hospital Odense Denmark. FAU - Fur, Christian Byskov AU - Fur CB AUID- ORCID: 0009-0009-7335-4911 AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. FAU - Thim, Troels AU - Thim T AUID- ORCID: 0000-0002-1014-5559 AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. FAU - Freeman, Philip AU - Freeman P AD - Department of Cardiology Aalborg University Hospital Aalborg Denmark. FAU - Uttenthal, Frederik AU - Uttenthal F AUID- ORCID: 0009-0008-4787-3980 AD - Department of Cardiology Aalborg University Hospital Aalborg Denmark. FAU - Christiansen, Evald Hoj AU - Christiansen EH AUID- ORCID: 0000-0002-8740-4862 AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. FAU - Terkelsen, Christian Juhl AU - Terkelsen CJ AUID- ORCID: 0000-0003-0205-9551 AD - Department of Cardiology Aarhus University Hospital Aarhus Denmark. AD - Department of Clinical Medicine Aarhus University Hospital Aarhus Denmark. FAU - Dahl, Jordi Sanchez AU - Dahl JS AUID- ORCID: 0000-0002-8345-204X AD - Department of Cardiology Odense University Hospital Odense Denmark. AD - Department of Clinical Research University of Southern Denmark Odense Denmark. AD - Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20251217 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Humans MH - *Aortic Valve Stenosis/physiopathology/surgery/diagnosis/diagnostic imaging MH - *Stroke Volume/physiology MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Ventricular Function, Left/physiology MH - Aged, 80 and over MH - Aged MH - Treatment Outcome MH - *Ventricular Remodeling MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - Hemodynamics MH - *Ventricular Dysfunction, Left/physiopathology MH - Severity of Illness Index MH - Recovery of Function PMC - PMC12908996 OTO - NOTNLM OT - aortic stenosis OT - left ventricular ejection fraction OT - paradox normal-flow aortic stenosis OT - stroke volume OT - transcatheter aortic valve implantation COIS- C.J.T. reports lecture fees, proctor fees, and research grants from Edwards Lifesciences, Meril Life Sciences, Terumo, and Medtronic. P.F. reports lecture fees and proctor fees from Meril Life Sciences. E.H.C. reports previous proctoring or lecture fees from Boston Scientific, Edwards, Meril Life Sciences, and Abbott, and research grants from Abbott. H.N. reports lecture fees and proctor fees from Edwards Lifesciences and Meril Life Sciences. F.U. reports proctor fees from Meril Life Sciences. M.A.C. received research grants from Edwards Lifesciences, Medtronic, Pi-Cardia, Rednvia, and Novartis without direct compensation. The remaining coauthors report no conflicts of interest in regard to this article. EDAT- 2025/12/17 06:39 MHDA- 2026/01/08 17:52 PMCR- 2025/12/03 CRDT- 2025/12/17 05:53 PHST- 2026/01/08 17:52 [medline] PHST- 2025/12/17 06:39 [pubmed] PHST- 2025/12/17 05:53 [entrez] PHST- 2025/12/03 00:00 [pmc-release] AID - JAH370115 [pii] AID - 10.1161/JAHA.125.045521 [doi] PST - ppublish SO - J Am Heart Assoc. 2026 Jan 6;15(1):e045521. doi: 10.1161/JAHA.125.045521. Epub 2025 Dec 17. PMID- 41400032 OWN - NLM STAT- In-Process LR - 20260602 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 84 IP - 5 DP - 2026 TI - Transcarotid transcatheter aortic valve implantation in selected patients. PG - 689-690 LID - 10.33963/v.phj.110228 [doi] FAU - Engin, Mesut AU - Engin M AD - Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Mimar Sinan Town, Yildirim/Bursa, Turkiye. mesut_kvc_cor@hotmail.com. FAU - Taner, Temmuz AU - Taner T AD - Department of Cardiovascular Surgery, University of Health Sciences, Bursa City Hospital, Bursa, Turkiye. FAU - Ari, Hasan AU - Ari H AD - Department of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkiye. LA - eng PT - Journal Article DEP - 20251216 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM EDAT- 2025/12/16 06:28 MHDA- 2025/12/16 06:28 CRDT- 2025/12/16 05:44 PHST- 2025/12/16 00:00 [received] PHST- 2025/12/16 00:00 [accepted] PHST- 2025/12/16 06:28 [pubmed] PHST- 2025/12/16 06:28 [medline] PHST- 2025/12/16 05:44 [entrez] AID - VM/OJS/J/110228 [pii] AID - 10.33963/v.phj.110228 [doi] PST - ppublish SO - Kardiol Pol. 2026;84(5):689-690. doi: 10.33963/v.phj.110228. Epub 2025 Dec 16. PMID- 41397632 OWN - NLM STAT- MEDLINE DCOM- 20260101 LR - 20260111 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 446 DP - 2026 Mar 1 TI - Percutaneous axillary vs femoral access for transcatheter aortic valve replacement: Insights from a 2164-patient study. PG - 134093 LID - S0167-5273(25)01136-2 [pii] LID - 10.1016/j.ijcard.2025.134093 [doi] AB - BACKGROUND: Transaxillary (TAx) access is increasingly adopted for transcatheter aortic valve implantation (TAVR) in patients with challenging iliofemoral anatomy. We aimed at evaluating the early clinical outcomes of TAx vs transfemoral (TF) access for TAVR. METHODS: We conducted a retrospective observational study stemming from the prospective RISPEVA registry, including all consecutive patients undergoing TAVR since 2013 at our Institution, where TAx is the only alternative access site whenever TF is contraindicated. RESULTS: A total of 2164 patients were included: 60 (2.8 %) in the TAx group, and 2104 (97.2 %) in the TF group. Notably, no patient required alternative accesses or was referred for surgical aortic valve replacement. Baseline characteristics, including surgical risk scores such as EuroScore II (TAx = 5.3 +/- 5.7, TF = 3.6 +/- 3.7, p < 0.001) and comorbidities such as prior myocardial infarction (TAx = 10 [17.2 %], TF = 157 [8.1 %], p = 0.025), were clearly disfavoring the TAx group. Despite higher procedural times in the TAx group (69 +/- 24 vs 59 +/- 13 min, p < 0.001), procedural success rates were high in both groups (TAx = 58 [96.7 %], TF = 2077 [98.7 %], p = 0.191). Similarly, at 1-month follow-up there were no significant differences in all-cause mortality (TAx = 1 [1.7 %], TF = 26 [1.2 %], p = 0.534), stroke (TAx = 1 [1.7 %], TF = 11 [0.5 %], p = 0.287), myocardial infarction (TAx = 1 [1.7 %], TF = 8 [0.4 %], p = 0.224), major vascular complication (TAx = 4 [6.7 %], TF = 90 [4.3 %], p = 0.329), or major bleeding (TAx = 1 [1.7 %], TF = 36 [1.7 %], p = 1), as well as their composite (TAx = 7 [11.7 %], TF = 155 [7.4 %], risk difference = 4.3 % [95 % confidence interval - 3.9 % to 12.5 %], p = 0.210). Similar findings were obtained at multivariable adjusted analyses and those based on inverse probability of treatment weighting, despite their limited reliability given low event-per-variable ratios and instability. CONCLUSIONS: In this single-center retrospective study, TAx TAVR was feasible whenever TF was not envisionable, and yielded quite favorable short-term clinical outcomes. While promising, these findings remain descriptive and hypothesis-generating, thus requiring additional prospective and randomized validation. CI - Copyright (c) 2025 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Corcione, Nicola AU - Corcione N AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Giordano, Salvatore AU - Giordano S AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Ferraro, Paolo AU - Ferraro P AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Morello, Alberto AU - Morello A AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Cimmino, Michele AU - Cimmino M AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Albanese, Michele AU - Albanese M AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Avellino, Raffaella AU - Avellino R AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Biondi-Zoccai, Giuseppe AU - Biondi-Zoccai G AD - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. Electronic address: giuseppe.biondizoccai@uniroma1.it. FAU - Pepe, Martino AU - Pepe M AD - Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), Aldo Moro University of Bari, Bari, Italy. FAU - Giordano, Arturo AU - Giordano A AD - Cardiovascular Interventional Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20251213 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/mortality MH - Female MH - Male MH - Retrospective Studies MH - *Femoral Artery/surgery MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery/diagnosis MH - *Axillary Artery/surgery/diagnostic imaging MH - Registries MH - Treatment Outcome MH - Follow-Up Studies OTO - NOTNLM OT - Aortic stenosis OT - Axillary access OT - Femoral access OT - Transcatheter aortic valve replacement EDAT- 2025/12/16 00:35 MHDA- 2026/01/02 00:33 CRDT- 2025/12/15 19:43 PHST- 2025/10/21 00:00 [received] PHST- 2025/12/09 00:00 [revised] PHST- 2025/12/12 00:00 [accepted] PHST- 2026/01/02 00:33 [medline] PHST- 2025/12/16 00:35 [pubmed] PHST- 2025/12/15 19:43 [entrez] AID - S0167-5273(25)01136-2 [pii] AID - 10.1016/j.ijcard.2025.134093 [doi] PST - ppublish SO - Int J Cardiol. 2026 Mar 1;446:134093. doi: 10.1016/j.ijcard.2025.134093. Epub 2025 Dec 13. PMID- 41396306 OWN - NLM STAT- MEDLINE DCOM- 20260612 LR - 20260813 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 115 IP - 7 DP - 2026 Jul TI - Ultrasound versus angiographic guided access in transfemoral TAVI: intra-operator evaluation of vascular and bleeding complications. PG - 1230-1240 LID - 10.1007/s00392-025-02805-2 [doi] AB - BACKGROUND: Both angiography roadmap (RM) and ultrasound (US) are commonly used to obtain femoral arterial access during transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to evaluate the effect of implementation of an US-guided approach on vascular and bleeding complications. METHODS: Vascular complications and bleeding at the main access site were compared using 4-year data from two experienced TAVI-operators, who changed their practice from an exclusively RM- to an exclusively US-guided technique for access in transfemoral TAVI. RESULTS: A total of 1026 patients were analyzed (RM: n = 485, US: n = 541) with a mean age of 80.7 +/- 6.3 years; 47.7% were female and 37.1% received a balloon-expandable valve. Main access vascular complications, bleedings, or their composite were lower in the US-group (RM vs. US: 16.1% vs. 8.3%, p < 0.001). US was a protective factor for vascular complications, bleeding and their composite (adjusted odds ratio [OR] 0.51, 95%-confidence interval [CI] 0.33-0.77, p = 0.002; adjusted OR 0.46, 95%-CI 0.28-0.78, p = 0.003; and adjusted OR: 0.47; 95% CI 0.32-0.70, p < 0.001, respectively). Fluoroscopy time (14 [interquartile range (IQR) 11 - 20] min vs. 13 [IQR 10 - 17] min, p < 0.001), contrast use (88 [IQR 69 - 111] ml vs. 84 [IQR 65 - 110] ml, p = 0.049) and procedure time (52 [IQR 44 - 67] min vs. 49 [IQR 41 - 62] min, p = 0.02) were lower in the US-group. CONCLUSIONS: US-guided femoral access was associated with significantly fewer complications compared with RM-guidance, supporting its adoption even among operators experienced with angiographic guidance. CI - (c) 2025. The Author(s). FAU - Lankisch, Niklas AU - Lankisch N AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Iannopollo, Gianmarco AU - Iannopollo G AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. AD - Department of Cardiology, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy. FAU - Dumpies, Oliver AU - Dumpies O AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Abdelhafez, Ahmed AU - Abdelhafez A AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Rotta Detto Loria, Johannes AU - Rotta Detto Loria J AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Richter, Ines AU - Richter I AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Feistritzer, Hans-Josef AU - Feistritzer HJ AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Desch, Steffen AU - Desch S AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Noack, Thilo AU - Noack T AD - Department of Structural Heart Disease/Cardiac Surgery, Heart Center Leipzig at Leipzig University, Leipzig, Germany. FAU - Thiele, Holger AU - Thiele H AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Majunke, Nicolas AU - Majunke N AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AUID- ORCID: 0000-0002-9596-558X AD - Department of Internal Medicine/Cardiology and Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Strumpellstr. 39, 04289, Leipzig, Germany. mohamed.abdel-wahab@medizin.uni-leipzig.de. LA - eng PT - Comparative Study PT - Journal Article DEP - 20251215 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Female MH - *Femoral Artery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Aged, 80 and over MH - *Ultrasonography, Interventional/methods/adverse effects MH - Male MH - *Aortic Valve Stenosis/surgery/diagnosis MH - *Hemorrhage/etiology/epidemiology MH - Risk Factors MH - *Angiography/methods/adverse effects MH - Retrospective Studies MH - *Catheterization, Peripheral/methods/adverse effects MH - Treatment Outcome MH - Aged PMC - PMC13249720 OTO - NOTNLM OT - Angiography OT - Roadmap OT - TAVI OT - Ultrasound OT - Vascular access COIS- Declarations. Conflict of interest: MAW reports that his hospital receives speaker's honoraria and/or consultancy fees on his behalf from Boston Scientific, Abbott and Medtronic. All other authors have no conflicts of interest to declare. EDAT- 2025/12/15 13:10 MHDA- 2026/06/12 00:37 PMCR- 2025/12/15 CRDT- 2025/12/15 11:12 PHST- 2025/09/22 00:00 [received] PHST- 2025/11/09 00:00 [accepted] PHST- 2026/06/12 00:37 [medline] PHST- 2025/12/15 13:10 [pubmed] PHST- 2025/12/15 11:12 [entrez] PHST- 2025/12/15 00:00 [pmc-release] AID - 10.1007/s00392-025-02805-2 [pii] AID - 2805 [pii] AID - 10.1007/s00392-025-02805-2 [doi] PST - ppublish SO - Clin Res Cardiol. 2026 Jul;115(7):1230-1240. doi: 10.1007/s00392-025-02805-2. Epub 2025 Dec 15. PMID- 41391990 OWN - NLM STAT- MEDLINE DCOM- 20260820 LR - 20260902 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 89 DP - 2026 Aug TI - Durability of balloon-expandable and self-expandable transcatheter aortic valves in patients with a large aortic annulus. PG - 68-75 LID - S1553-8389(25)00612-8 [pii] LID - 10.1016/j.carrev.2025.12.006 [doi] AB - BACKGROUND: Limited evidence has been available on the long-term prognosis and valve durability of balloon-expandable transcatheter heart valve (BE-THV) and self-expandable transcatheter heart valve (SE-THV) in patients with large aortic annulus (LAA). OBJECTIVES: To compare the long-term outcomes between the BE-THV and SE-THV. METHODS: We retrospectively analyzed 1054 patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) for tricuspid aortic valve stenosis with LAA, defined as an annulus area > 430 mm(2), using either a BE-THV (SAPIEN 3, Edwards Life Sciences) or SE-THV (Evolut R/PRO, Medtronic). The 7-year cumulative incidences of all-cause mortality and bioprosthetic valve failure (BVF) were evaluated in the overall cohort and the propensity score (PS)-matched cohort. RESULTS: Among the 1054 patients with LAA, 829 (78.7 %) received a BE-THV. The PS-matched population resulted in 218 pairs. The cumulative incidence of all-cause mortality 7 years after TAVI was comparable between the BE-THV and SE-THV groups in the overall cohort (58.6 % vs. 67.6 %, log-rank P = 0.848) and the PS-matched cohort (53.2 % vs. 69.9 %, log-rank P = 0.173). In the overall cohort, the BE-THV group demonstrated a lower exposure-adjusted BVF rate as compared with the SE-THV, although the difference was not significant (6.1 vs. 9.6 events per 1000 patient-years, P = 0.258). This trend became pronounced after PS matching (3.3 vs. 9.9 events per 1000 patient-years, P = 0.017), which was also confirmed by Gray's test (P = 0.032). CONCLUSIONS: In the current analysis focusing on patients with LAA, the BE-THV and SE-THV groups had a comparable long-term prognosis, but the BE-THV group had a lower BVF rate than did the SE-THV group. CLINICAL TRIAL REGISTRATION: UMIN000020423. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Ishizu, Kenichi AU - Ishizu K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. Electronic address: k.ishizu.04ri@gmail.com. FAU - Shirai, Shinichi AU - Shirai S AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Hayashi, Masaomi AU - Hayashi M AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Morofuji, Toru AU - Morofuji T AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Isotani, Akihiro AU - Isotani A AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ohno, Nobuhisa AU - Ohno N AD - Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Kakumoto, Shinichi AU - Kakumoto S AD - Department of Anesthesiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ando, Kenji AU - Ando K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Yamamoto, Masanori AU - Yamamoto M AD - Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan. FAU - Hioki, Hirofumi AU - Hioki H AD - Department of Cardiology, IMS Tokyo Katsushika General Hospital, Tokyo, Japan. FAU - Shimura, Tetsuro AU - Shimura T AD - Department of Cardiology, Gifu Heart Center, Gifu, Japan. FAU - Yashima, Fumiaki AU - Yashima F AD - Department of Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan. FAU - Naganuma, Toru AU - Naganuma T AD - Department of Cardiology, New Tokyo Hospital, Matsudo, Japan. FAU - Asami, Masahiko AU - Asami M AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Watanabe, Yusuke AU - Watanabe Y AD - Division of Cardiology, Teikyo University Hospital, Tokyo, Japan. FAU - Yamanaka, Futoshi AU - Yamanaka F AD - Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Nakazawa, Gaku AU - Nakazawa G AD - Division of Cardiology, Department of Medicine, Kindai University, Osakasayama, Japan. FAU - Noguchi, Masahiko AU - Noguchi M AD - Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. FAU - Izumo, Masaki AU - Izumo M AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Nishina, Hidetaka AU - Nishina H AD - Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan. FAU - Fuku, Yasushi AU - Fuku Y AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Otsuka, Toshiaki AU - Otsuka T AD - Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. CN - OCEAN-TAVI Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20251211 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve/diagnostic imaging/surgery/physiopathology MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology/mortality MH - *Balloon Valvuloplasty/adverse effects/mortality MH - *Bioprosthesis MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - Prosthesis Failure MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Treatment Outcome OTO - NOTNLM OT - Balloon-expandable transcatheter heart valve OT - Large aortic annulus OT - Self-expandable transcatheter heart valve OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest Dr. Ishizu is a proctor of intracardiac echocardiography for Johnson and Johnson. Dr. Yashima and Dr. Nishina are clinical proctor for Medtronic. Dr. Asami and Dr.Ohno is a clinical proctor for Abbott Medical and Medtronic. Dr. Fuku is a clinical proctor for Edwards Lifesciences and Medtronic. Dr. Izumo is a screening proctor for Edwards Lifesciences. Dr. Naganuma is a clinical proctor for Edwards Lifesciences and Abbott Medical. Dr. Yamamoto, Dr. Shirai, Dr. Watanabe, Dr. Nakazawa, Dr. Fuku, and Dr. Hayashida, are clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. The remaining authors have nothing to disclose. EDAT- 2025/12/15 00:28 MHDA- 2026/08/20 23:35 CRDT- 2025/12/14 22:00 PHST- 2025/10/21 00:00 [received] PHST- 2025/12/07 00:00 [revised] PHST- 2025/12/09 00:00 [accepted] PHST- 2026/08/20 23:35 [medline] PHST- 2025/12/15 00:28 [pubmed] PHST- 2025/12/14 22:00 [entrez] AID - S1553-8389(25)00612-8 [pii] AID - 10.1016/j.carrev.2025.12.006 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2026 Aug;89:68-75. doi: 10.1016/j.carrev.2025.12.006. Epub 2025 Dec 11. PMID- 41378498 OWN - NLM STAT- In-Process LR - 20260504 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 84 IP - 4 DP - 2026 TI - Transcarotid TAVI with the Myval Octacor valve: A single-center initial experience. PG - 536-539 LID - 10.33963/v.phj.110134 [doi] FAU - Sobczynski, Robert AU - Sobczynski R AD - Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. sobczynski@poczta.fm. FAU - Trebacz, Jaroslaw AU - Trebacz J AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. FAU - Kleczynski, Pawel AU - Kleczynski P AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Stapor, Maciej AU - Stapor M AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Konstanty-Kalandyk, Janusz AU - Konstanty-Kalandyk J AD - Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. AD - Department of Cardiac Surgery and Transplantation, Jagiellonian University Medical College, Institute of Cardiology, Krakow, Poland. FAU - Kapelak, Boguslaw AU - Kapelak B AD - Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. AD - Department of Cardiac Surgery and Transplantation, Jagiellonian University Medical College, Institute of Cardiology, Krakow, Poland. FAU - Legutko, Jacek AU - Legutko J AD - Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. LA - eng PT - Journal Article DEP - 20251211 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM EDAT- 2025/12/11 13:04 MHDA- 2025/12/11 13:04 CRDT- 2025/12/11 06:13 PHST- 2025/12/11 00:00 [received] PHST- 2025/12/11 00:00 [accepted] PHST- 2025/12/11 13:04 [pubmed] PHST- 2025/12/11 13:04 [medline] PHST- 2025/12/11 06:13 [entrez] AID - VM/OJS/J/110134 [pii] AID - 10.33963/v.phj.110134 [doi] PST - ppublish SO - Kardiol Pol. 2026;84(4):536-539. doi: 10.33963/v.phj.110134. Epub 2025 Dec 11. PMID- 41377913 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251211 LR - 20251213 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 12 DP - 2025 TI - Clinical outcomes of monitored anesthesia care vs. general anesthesia in transfemoral transcatheter aortic valve implantation: a single-center retrospective study. PG - 1652045 LID - 10.3389/fcvm.2025.1652045 [doi] LID - 1652045 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a preferred treatment for severe aortic stenosis in high-risk patients. In China, general anesthesia (GA) remains the standard; however, monitored anesthesia care (MAC) offers a less-invasive alternative. In this study, we compared the outcomes between MAC and GA in transfemoral TAVI. METHODS: We retrospectively analyzed the data from 106 consecutive patients (54 MAC, 52 GA) who underwent TAVI at a The Second Affiliated Hospital of Harbin Medical University from January 2021 to November 2023. MAC involved administration of a combination of local anesthesia with dexmedetomidine/remifentanil sedation, whereas GA involved endotracheal intubation. We compared procedural metrics, complications, and lengths of hospital stays. RESULTS: The baseline characteristics were comparable between the groups (mean age: 70.3 +/- 7.3 years, 46% with reduced ejection fraction). The MAC group showed shorter procedure times (102 +/- 25 vs. 145 +/- 42 min, p < 0.0001) and hospital stays (10.5 +/- 3.7 vs. 14.1 +/- 5.1 days, p < 0.0001), compared with the GA group. Safety outcomes were similar between the groups: 30-day mortality (5.8% vs. 7.4% in the MAC and GA groups, respectively, p = 0.734), stroke (1.9% in both groups), and major vascular complications (3.8% vs. 5.6%). The GA group had higher valve-in-valve rates (13% vs. 1.9%, p = 0.024) and postoperative hypotension (4 vs. 0 patients), compared with the MAC group. Pacemaker implantation was more frequent in the MAC group vs. the GA group (13% vs. 3.8%, p = 0.229). CONCLUSIONS: The use of MAC for TAVI is comparably safe to using GA, with potential advantages in recovery speed and resource utilization. A heart team approach, including cardiac anesthesiologists, is critical for optimal patient selection. CI - (c) 2025 Zhang, Chen, Yu and Zhang. FAU - Zhang, Haoran AU - Zhang H AD - Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. AD - The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. FAU - Chen, Tao AU - Chen T AD - Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. AD - The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. FAU - Yu, Bo AU - Yu B AD - Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. AD - The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. FAU - Zhang, Donghui AU - Zhang D AD - Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. AD - The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. LA - eng PT - Journal Article DEP - 20251125 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC12687134 OTO - NOTNLM OT - aortic stenosis OT - minimalist approach OT - monitored anesthesia care OT - transcatheter aortic valve implantation OT - transfemoral COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/12/11 07:44 MHDA- 2025/12/11 07:45 PMCR- 2025/11/25 CRDT- 2025/12/11 05:28 PHST- 2025/06/23 00:00 [received] PHST- 2025/11/04 00:00 [revised] PHST- 2025/11/10 00:00 [accepted] PHST- 2025/12/11 07:45 [medline] PHST- 2025/12/11 07:44 [pubmed] PHST- 2025/12/11 05:28 [entrez] PHST- 2025/11/25 00:00 [pmc-release] AID - 10.3389/fcvm.2025.1652045 [doi] PST - epublish SO - Front Cardiovasc Med. 2025 Nov 25;12:1652045. doi: 10.3389/fcvm.2025.1652045. eCollection 2025. PMID- 41375646 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251211 LR - 20251214 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 23 DP - 2025 Nov 24 TI - High-Flow Nasal Oxygenation During Sedation for Transcatheter Aortic Valve Replacement: The HIGH-OXY-TAVR Randomised-Controlled Trial. LID - 10.3390/jcm14238347 [doi] LID - 8347 AB - Background: Data on high flow nasal oxygenation (HFNO) efficacy in hypoxia prevention in transcatheter aortic valve replacement (TAVR) are conflictive. We aimed to determine the benefit of HFNO in preventing the occurrence of desaturations during TAVR. Methods: An investigator-initiated, proof of concept, single-centre, randomised, and controlled trial on 132 adult patients who were scheduled to undergo transfemoral TAVR was conducted. Patients were randomised (1:1) to HFNO (H-group) with a flow rate of 50 L min(-1) and FiO(2) 0.6 or standard of care oxygen therapy (S-group). The primary endpoint was the number of patients with a desaturation episode (SpO(2) < 93%) for >10 s during TAVR. Secondary outcomes included arterial partial pressure of oxygen (pO(2)) 45 min from sedation start and changes in glomerular filtration rate from baseline to 12 h post-procedure. Results: Between 23 November and 24 July, a per-protocol analysis was performed in a total of 125 patients (H-group n = 64; S- group n = 61; 49 females). The number of patients with any desaturation episode was significantly lower in the H-group [13/64 (20%, 95% CI: 12-32%)] than in the S-group [31/61 (51%, 95% CI: 39-63%), RR: 0.39 (95%CI: 0.23-0.68)]. At 45 min, mean (SD) pO(2) was higher in the H-group (24(9.8) kPa vs. 16.7(7.5) kPa; p < 0.005). A significant improvement in delta median (IQR) difference on glomerular filtration rate was observed in the H-group [1.6(-1-7.9) mL min(-1) 1.73 m(-2)] with respect to the S-group [0.2(-6.1-3.1) mL min(-1) 1.73 m(-2); p-value: 0.013]. Conclusions: This trial demonstrated that HFNO provides a better oxygenation pattern than standard oxygen therapy during TAVR. Larger studies focusing on long-term clinical outcomes are warranted to evaluate the benefit of HFNO during sedation for TAVR procedures. FAU - Gimenez-Mila, Marc AU - Gimenez-Mila M AUID- ORCID: 0000-0002-3483-7592 AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. AD - Institut d'Investigacio August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain. FAU - Manzano-Valls, Antoni AU - Manzano-Valls A AUID- ORCID: 0009-0003-4329-7959 AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. AD - Facultat de Medicina i Ciencies de La Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain. FAU - Abdul-Jawad, Omar AU - Abdul-Jawad O AD - Cardiology Department, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain. FAU - Arguis, Maria Jose AU - Arguis MJ AUID- ORCID: 0000-0002-0451-8195 AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. AD - Institut d'Investigacio August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain. FAU - Brugaletta, Salvatore AU - Brugaletta S AUID- ORCID: 0000-0001-5845-1435 AD - Cardiology Department, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain. FAU - Carnaval, Thiago AU - Carnaval T AD - Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Spain. FAU - Carretero, Maria Jose AU - Carretero MJ AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Flores-Umanzor, Eduardo AU - Flores-Umanzor E AUID- ORCID: 0000-0002-6428-241X AD - Cardiology Department, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain. FAU - Freixa, Xavier AU - Freixa X AD - Cardiology Department, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain. FAU - Ibanez, Cristina AU - Ibanez C AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Italiano, Stefano AU - Italiano S AUID- ORCID: 0000-0001-7775-284X AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Lopez-Baamonde, Manuel AU - Lopez-Baamonde M AUID- ORCID: 0000-0001-5537-1755 AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Martinez-Otero, Samira AU - Martinez-Otero S AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Matute, Purificacion AU - Matute P AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Pozo, Mireia AU - Pozo M AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Navarro-Ripoll, Ricard AU - Navarro-Ripoll R AUID- ORCID: 0000-0003-3534-5917 AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. AD - Institut d'Investigacio August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain. FAU - Perdomo, Juan Manuel AU - Perdomo JM AUID- ORCID: 0000-0001-7458-297X AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Regueiro, Ander AU - Regueiro A AD - Cardiology Department, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain. FAU - Rovira, Irene AU - Rovira I AUID- ORCID: 0000-0003-3415-027X AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Vega, Francisco Javier AU - Vega FJ AD - Department of Anaesthesia and Intensive Care, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. FAU - Videla, Sebastian AU - Videla S AUID- ORCID: 0000-0001-5049-1379 AD - Clinical Research Support Area, Clinical Pharmacology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain. AD - Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, 08193 Bellaterra, Spain. FAU - Sabate, Manel AU - Sabate M AUID- ORCID: 0000-0002-2316-3705 AD - Institut d'Investigacio August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain. AD - Facultat de Medicina i Ciencies de La Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain. AD - Cardiology Department, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain. LA - eng PT - Journal Article DEP - 20251124 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12693371 OTO - NOTNLM OT - aortic stenosis OT - high-flow nasal oxygenation OT - hypoxia OT - sedation OT - transcatheter aortic valve replacement COIS- No conflicts of interest concerning this article are reported. EDAT- 2025/12/11 07:42 MHDA- 2025/12/11 07:43 PMCR- 2025/11/24 CRDT- 2025/12/11 01:10 PHST- 2025/11/04 00:00 [received] PHST- 2025/11/17 00:00 [revised] PHST- 2025/11/21 00:00 [accepted] PHST- 2025/12/11 07:43 [medline] PHST- 2025/12/11 07:42 [pubmed] PHST- 2025/12/11 01:10 [entrez] PHST- 2025/11/24 00:00 [pmc-release] AID - jcm14238347 [pii] AID - jcm-14-08347 [pii] AID - 10.3390/jcm14238347 [doi] PST - epublish SO - J Clin Med. 2025 Nov 24;14(23):8347. doi: 10.3390/jcm14238347. PMID- 41375580 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251211 LR - 20251214 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 23 DP - 2025 Nov 21 TI - Aortic Valve Replacement vs. Balloon-Expandable and Self-Expandable Transcatheter Implantation in Low-Risk Patients. LID - 10.3390/jcm14238278 [doi] LID - 8278 AB - Objectives: This study sought to compare midterm outcomes of low-risk patients who underwent a surgical aortic valve replacement (SAVR) vs. balloon-expandable (BE) or self-expandable (SE) transcatheter aortic valve implantation (TAVI). Methods: Data on consecutive patients undergoing SAVR or transfemoral TAVI between 2017 and 2022 were collected. Patients were separated into three groups according to the type of prosthesis: a biological surgical prosthesis, BE prosthesis and SE prosthesis. The three groups were compared in terms of baseline characteristics, post-procedural outcomes and long-term survival. Results: A total of 542 patients were enrolled, and 221 received a surgical prothesis, 150 received a BE prosthesis and 171 received an SE prosthesis. TAVI patients were older and had a higher risk profile compared to surgical patients. Propensity score matching resulted in an excellent matching of nearly 80 patients in each group. In the matched cohort, SE prostheses were associated with a significantly higher incidence of stroke (SE group 6.3%, BE group 0, SAVR group 2.3%, p = 0.045), para-valvular leak (SE group 8.1%, BE group 2.4%, SAVR group 0, p = 0.017) and left bundle branch block (SE group 23.8%, BE group 18.2%, SAVR group 0%, p < 0.001). Regarding 5-year mortality, no significant differences were reported between the BE and SE TAVI (13.6% vs. 22.5%, p = 0.066). However, when comparing surgery versus TAVI, the SE prosthesis showed a significantly higher 5-year mortality (22.5% vs. 11.6%, p = 0.042). Instead, the BE prosthesis demonstrated its non-inferiority compared to the surgical prosthesis (13.6% vs. 11.6%, p = 0.249). Conclusions: The BE prosthesis should be considered the prosthesis of choice for patients with a long life expectancy requiring a transcatheter procedure. FAU - Lodo, Vittoria AU - Lodo V AD - Department of Cardiac Surgery, Mauriziano Hospital, 10128 Turin, Italy. FAU - Italiano, Enrico Giuseppe AU - Italiano EG AUID- ORCID: 0000-0001-6948-5913 AD - Division of Cardiac Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padua, Italy. FAU - Weltert, Luca AU - Weltert L AUID- ORCID: 0000-0001-6094-8280 AD - Department of Cardiovascular Sciences, European Hospital, 00142 Rome, Italy. FAU - Zingarelli, Edoardo AU - Zingarelli E AD - Department of Cardiac Surgery, Mauriziano Hospital, 10128 Turin, Italy. FAU - Viscido, Cristina AU - Viscido C AUID- ORCID: 0000-0001-5606-3228 AD - Department of Cardiovascular Anesthesia and Intensive Care, Mauriziano Hospital, 10128 Turin, Italy. FAU - Buono, Gabriella AU - Buono G AD - Department of Cardiovascular Anesthesia and Intensive Care, Mauriziano Hospital, 10128 Turin, Italy. FAU - Centofanti, Paolo AU - Centofanti P AD - Department of Cardiac Surgery, Mauriziano Hospital, 10128 Turin, Italy. LA - eng PT - Journal Article DEP - 20251121 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12693321 OTO - NOTNLM OT - SAVR OT - aortic valve stenosis OT - balloon-expandable TAVI OT - low-risk OT - self-expandable TAVI COIS- The authors declare no conflicts of interest. EDAT- 2025/12/11 07:42 MHDA- 2025/12/11 07:43 PMCR- 2025/11/21 CRDT- 2025/12/11 01:10 PHST- 2025/10/18 00:00 [received] PHST- 2025/11/18 00:00 [revised] PHST- 2025/11/19 00:00 [accepted] PHST- 2025/12/11 07:43 [medline] PHST- 2025/12/11 07:42 [pubmed] PHST- 2025/12/11 01:10 [entrez] PHST- 2025/11/21 00:00 [pmc-release] AID - jcm14238278 [pii] AID - jcm-14-08278 [pii] AID - 10.3390/jcm14238278 [doi] PST - epublish SO - J Clin Med. 2025 Nov 21;14(23):8278. doi: 10.3390/jcm14238278. PMID- 41372013 OWN - NLM STAT- MEDLINE DCOM- 20260509 LR - 20260509 IS - 1875-2128 (Electronic) IS - 1875-2128 (Linking) VI - 119 IP - 5 DP - 2026 May TI - Transcatheter aortic valve implantation-related vascular access complications: Are balloon-expandable stent grafts a good option? PG - 325-332 LID - S1875-2136(25)00823-X [pii] LID - 10.1016/j.acvd.2025.10.329 [doi] AB - BACKGROUND: Among the most challenging complications of transfemoral transcatheter aortic valve implantation (TF-TAVI) are vascular access complications (VACs), with access-site bleeding frequently impacting outcomes despite preclosing techniques. Endovascular bailout strategies have become increasingly common despite historical concerns about stent placement in flexing zones. AIMS: To evaluate the efficacy and safety of balloon-expandable stent graft (BESG) implantation for VACs in patients undergoing TF-TAVI with a preclosure device. METHODS: This retrospective single-centre study included all consecutive patients who underwent TF-TAVI between January 2010 and December 2020. BESG implantation was used for persistent femoral bleeding following closure failure. Baseline, procedural and clinical data were compared between BESG recipients and controls in accordance with Valve Academic Research Consortium 3 (VARC-3) criteria. RESULTS: Among 1248 patients (mean+/-standard deviation age 83.1+/-7.3 years; 52.3% female), 225 (18.0%) had persistent femoral bleeding, and 98 (7.8%) required BESG implantation. Compared with controls, patients with BESG had larger sheath sizes (e.g. size 18 Fr: 73.5% vs 47.8%, P<0.001) and higher contrast use (199.2+/-81.9 vs 150.1+/-64.0mL, P<0.001). At 1 year, the composite endpoint of all-cause death, vascular reintervention or new-onset claudication occurred in 34.7% of patients with BESG and 29.0% of controls (P=0.24). After propensity matching, outcomes remained comparable (risk ratio 0.98, 95% confidence interval 0.58-1.65; P=0.95). CONCLUSION: In this retrospective single-centre cohort, BESG implantation appeared to be safe and may be an effective fully percutaneous bailout option for access-site bleeding after TF-TAVI. CI - Copyright (c) 2025 Elsevier Masson SAS. All rights reserved. FAU - Saiydoun, Gabriel AU - Saiydoun G AD - Department of Cardiac and Thoracic Surgery, Pitie-Salpetriere Hospital, Sorbonne University, AP-HP, 75013 Paris, France. Electronic address: gabrielsaiydoun@gmail.com. FAU - Gallet, Romain AU - Gallet R AD - Department of Cardiology, Henri-Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Saade, Saade AU - Saade S AD - Department of Cardiac Surgery, Strasbourg University hospital, 67000 Strasbourg, France. FAU - Boukantar, Madjid AU - Boukantar M AD - Department of Cardiology, Henri-Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Brasselet, Camille AU - Brasselet C AD - Department of Cardiology, Henri-Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Chiaroni, Paul-Mathieu AU - Chiaroni PM AD - Department of Cardiology, Henri-Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Radu, Costin AU - Radu C AD - Department of Cardiac Surgery, Henri Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Lellouche, Nicolas AU - Lellouche N AD - Department of Cardiology, Henri-Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Gunga, Ziyad AU - Gunga Z AD - Department of Cardiac Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Folliguet, Thierry AU - Folliguet T AD - Department of Cardiac Surgery, Henri Mondor university hospital, AP-HP, 94000 Creteil, France. FAU - Teiger, Emmanuel AU - Teiger E AD - Department of Cardiology, Henri-Mondor university hospital, AP-HP, 94000 Creteil, France. LA - eng PT - Journal Article DEP - 20251120 PL - Netherlands TA - Arch Cardiovasc Dis JT - Archives of cardiovascular diseases JID - 101465655 SB - IM MH - Humans MH - Retrospective Studies MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Aged, 80 and over MH - Aged MH - Treatment Outcome MH - Risk Factors MH - *Femoral Artery/diagnostic imaging/injuries MH - Prosthesis Design MH - *Catheterization, Peripheral/adverse effects/mortality/instrumentation MH - *Hemorrhage/etiology MH - Time Factors MH - Punctures MH - *Stents MH - *Blood Vessel Prosthesis MH - Risk Assessment MH - *Blood Vessel Prosthesis Implantation/adverse effects/instrumentation/mortality OTO - NOTNLM OT - Balloon-expandable stent graft OT - Femoral bleeding OT - Preclosure techniques OT - Transfemoral TAVI OT - Vascular access complications COIS- Disclosure of interest E.T. reports receiving support from Medtronic. The other authors declare that they have no competing interest. EDAT- 2025/12/11 01:22 MHDA- 2026/05/10 05:19 CRDT- 2025/12/10 22:25 PHST- 2025/07/17 00:00 [received] PHST- 2025/10/11 00:00 [revised] PHST- 2025/10/20 00:00 [accepted] PHST- 2026/05/10 05:19 [medline] PHST- 2025/12/11 01:22 [pubmed] PHST- 2025/12/10 22:25 [entrez] AID - S1875-2136(25)00823-X [pii] AID - 10.1016/j.acvd.2025.10.329 [doi] PST - ppublish SO - Arch Cardiovasc Dis. 2026 May;119(5):325-332. doi: 10.1016/j.acvd.2025.10.329. Epub 2025 Nov 20. PMID- 41367708 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251210 LR - 20251212 IS - 2755-9637 (Electronic) IS - 2755-9637 (Linking) VI - 3 IP - 4 DP - 2025 Oct TI - Hemodynamic changes in supra-aortic trunks after transcatheter aortic valve implantation at duplex ultrasound examination. PG - qyaf151 LID - 10.1093/ehjimp/qyaf151 [doi] LID - qyaf151 AB - AIMS: The hemodynamic consequences of aortic stenosis (AS) on supra-aortic trunks may play a potential role during the diagnosis of concomitant internal carotid artery (ICA) stenosis by dampening blood flow velocity. To investigate the effect of AS on ICA blood flow we evaluated carotid and vertebral blood flow velocity indexes in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: Patients admitted for endovascular treatment of a severe AS underwent supra-aortic duplex ultrasound examination prior and after TAVI to be enrolled in the study. Patients with symptomatic or severe ICA stenosis were excluded. Patients with other cardiac impairments that could configure a confounding factor were excluded. One hundred and five patients of a median age of 80 years met the study inclusion criteria. The median peak systolic velocity (PSV) of the assessed supra-aortic arteries increased after TAVI: common carotid artery (CCA) from 64.5 to 78.0 cm/s (+24%; P < 0.01), ICA from 67.0 to 90.5 cm/s (+36%; P < 0.01), and vertebral artery (VA) from 44.0 to 51.0 cm/s (+17%; P < 0.01). Median end-diastolic velocity (EDV) also increased: CCA from 12.0 to 14.0 cm/s (+12%; P < 0.01), ICA from 19.0 to 23.0 cm/s (+20%; P < 0.01), and VA from 10.0 to 11.0 cm/s (+18%; P < 0.01). In parallel, median acceleration time (AT) decreased markedly at each site: CCA from 0.180 to 0.100 s (-44%; P < 0.01), ICA from 0.195 to 0.100 s (-41%; P < 0.01), and VA from 0.180 to 0.100 s (-36%; P < 0.01). CONCLUSION: Severe AS significantly affects supra-aortic arteries blood flow as assessed by duplex, by decreasing both PSV and EDV and increasing AT. This study suggests that carotid ultrasound criteria to assess ICA stenosis severity should be re-evaluated in larger multi-centre studies to validate their predictive values in patients with concomitant AS. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Pasqua, Rocco AU - Pasqua R AUID- ORCID: 0000-0003-3698-7348 AD - Cardiovascular Department, San Carlo Hospital, Via Matera 4, Potenza 85100, Italy. AD - Department of Surgery, Sapienza University of Rome, Rome, Italy. FAU - Luzi, Giampaolo AU - Luzi G AD - Cardiothoracic and Vascular Department, San Camillo Forlanini Hospital, Rome, Italy. FAU - Paternoster, Gianluca AU - Paternoster G AUID- ORCID: 0000-0002-4032-0821 AD - Cardiovascular Department, San Carlo Hospital, Via Matera 4, Potenza 85100, Italy. AD - Department of Health Science Anesthesia, University of Basilicata, Potenza, Italy. FAU - Menna, Danilo AU - Menna D AD - Cardiovascular Department, San Carlo Hospital, Via Matera 4, Potenza 85100, Italy. FAU - Orlando, Elena AU - Orlando E AD - Radiology Department, San Carlo Hospital, Potenza, Italy. FAU - Fioretti, Vincenzo AU - Fioretti V AD - Cardiovascular Department, San Carlo Hospital, Via Matera 4, Potenza 85100, Italy. FAU - Nardi, Priscilla AU - Nardi P AD - Department of Surgery, Sapienza University of Rome, Rome, Italy. FAU - Illuminati, Giulio AU - Illuminati G AD - Department of Surgery, Sapienza University of Rome, Rome, Italy. FAU - D'Andrea, Vito AU - D'Andrea V AD - Department of Surgery, Sapienza University of Rome, Rome, Italy. FAU - Stabile, Eugenio AU - Stabile E AD - Cardiovascular Department, San Carlo Hospital, Via Matera 4, Potenza 85100, Italy. AD - Department of Health Science Anesthesia, University of Basilicata, Potenza, Italy. FAU - Esposito, Andrea AU - Esposito A AD - Cardiovascular Department, San Carlo Hospital, Via Matera 4, Potenza 85100, Italy. LA - eng PT - Journal Article DEP - 20251203 PL - England TA - Eur Heart J Imaging Methods Pract JT - European heart journal. Imaging methods and practice JID - 9918697088006676 PMC - PMC12683244 OTO - NOTNLM OT - TAVI OT - aortic stenosis OT - aortic valve repair OT - duplex ultrasound OT - internal carotid artery stenosis OT - surgical aortic valve replacement COIS- Conflict of interest: None declared. EDAT- 2025/12/10 06:28 MHDA- 2025/12/10 06:29 PMCR- 2025/12/03 CRDT- 2025/12/10 04:47 PHST- 2025/05/30 00:00 [received] PHST- 2025/11/17 00:00 [accepted] PHST- 2025/12/10 06:29 [medline] PHST- 2025/12/10 06:28 [pubmed] PHST- 2025/12/10 04:47 [entrez] PHST- 2025/12/03 00:00 [pmc-release] AID - qyaf151 [pii] AID - 10.1093/ehjimp/qyaf151 [doi] PST - epublish SO - Eur Heart J Imaging Methods Pract. 2025 Dec 3;3(4):qyaf151. doi: 10.1093/ehjimp/qyaf151. eCollection 2025 Oct. PMID- 41364435 OWN - NLM STAT- MEDLINE DCOM- 20251209 LR - 20260729 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 8 IP - 12 DP - 2025 Dec 1 TI - Obstructive Coronary Artery Disease and Health Status in Transcatheter Aortic Valve Replacement: A Post Hoc Analysis of the SCOPE I Randomized Clinical Trial. PG - e2547111 LID - 10.1001/jamanetworkopen.2025.47111 [doi] LID - e2547111 AB - IMPORTANCE: Aortic stenosis (AS) and obstructive coronary artery disease (CAD) often coexist, yet the impact of obstructive CAD on clinical and patient-reported outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) remains a subject of ongoing debate. OBJECTIVES: To investigate the association of obstructive CAD with clinical outcomes and health status among patients with symptomatic severe AS undergoing TAVR. DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis of the investigator-initiated, multicenter SCOPE I (Safety and Efficacy of the Symetis ACURATE Neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis for Transcatheter Aortic Valve Implantation by Transfemoral Approach) randomized clinical trial was conducted at 20 tertiary heart centers in Europe from February 8, 2017, to February 2, 2019, with follow-up through 3 years. Data were analyzed from February 17 through August 13, 2025. EXPOSURE: Presence vs absence of obstructive CAD, defined as greater than 50% stenosis in at least 1 major epicardial coronary vessel. MAIN OUTCOMES AND MEASURES: Parameters of interest included vital and patient-reported disease-specific health status (Kansas City Cardiomyopathy Questionnaire [KCCQ] scores, ranging from 0 to 100, with higher numbers indicating better health status), and clinical efficacy according to Valve Academic Research Consortium (VARC)-3 definitions. Analyses were conducted using the as treated population. RESULTS: Of 732 patients with symptomatic severe AS undergoing TAVR (mean [SD] age, 82 [4] years; 416 [56.8%] female), obstructive CAD was identified in 373 (51.0%), 144 (38.6%) of whom underwent elective percutaneous coronary intervention (PCI) during the periprocedural period. At 3 years after TAVR, there were no statistically significant differences in patient-reported health status (eg, median [IQR] baseline overall KCCQ scores with CAD, 54.2 [40.3-69.8] vs without CAD, 55.2 [38.5-72.9] and at 3-year follow-up with CAD, 79.7 [64.4-90.6] vs without CAD, 82.3 [68.2-91.7]), mortality (all-cause death: 88 of 373 [24.7%] vs 76 of 359 [22.3%], adjusted hazard ratio, [HR], 0.97 [95% CI, 0.66-1.43]; cardiovascular death: 59 of 373 [17.6%] vs 51 of 359 [15.5%], adjusted HR, 0.87 [95% CI, 0.54-1.42]), and clinical efficacy of TAVR (163 of 313 [52.1%] vs 159 of 298 [53.4%]; adjusted risk ratio, 1.10 [95% CI, 0.92-1.32]) between patients with vs without obstructive CAD. Having (vs not having) obstructive CAD was associated with a numerically albeit not statistically significantly higher risk of myocardial infarction (18 of 372 [5.5%] vs 3 of 359 [1.1%]; adjusted HR, 3.83 [95% CI, 0.96-15.31]). Periprocedural PCI among patients with obstructive CAD did not improve clinical outcomes, patient-reported health status, nor the integrated end points of clinical outcomes and quality of life measures. CONCLUSIONS AND RELEVANCE: In this post hoc analysis of SCOPE I, patients with obstructive CAD who underwent TAVR had no statistically significant differences in survival, patient-reported health status, or VARC-3 clinical efficacy compared with patients without CAD through 3 years of follow-up. Findings suggest that a tailored approach may be essential in the treatment of TAVR candidates with severe AS and CAD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03011346. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Thiele, Holger AU - Thiele H AD - Heart Centre Leipzig at Leipzig University, Leipzig, Germany. FAU - Heg, Dik AU - Heg D AD - Department of Clinical Research, University of Bern, Bern, Switzerland. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany. FAU - Joner, Michael AU - Joner M AD - German Heart Centre, Technical University of Munich, Munich, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Internal Medicine I, St-Johannes-Hospital, Dortmund, Germany. FAU - Burgdorf, Christof AU - Burgdorf C AD - Heart and Vascular Centre, Bad Bevensen, Germany. FAU - Linke, Axel AU - Linke A AD - Department of Internal Medicine and Cardiology, Heart Centre Dresden, Technische Universitat Dresden, Dresden, Germany. FAU - Redwood, Simon AU - Redwood S AD - Department of Cardiology, St Thomas' Hospital & Cleveland Clinic London, London, UK. FAU - Hilker, Michael AU - Hilker M AD - Department of Cardiothoracic Surgery, University Medical Centre, Regensburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart Centre Hamburg, Hamburg, Germany. FAU - Kerber, Sebastian AU - Kerber S AD - Department of Cardiology, Cardiovascular Centre Bad Neustadt, Bad Neustadt, Germany. FAU - Thilo, Christian AU - Thilo C AD - Department of Internal Medicine I, RoMed Klinikum Rosenheim, Rosenheim, Germany. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Walther, Thomas AU - Walther T AD - Department of Cardiac, Thoracic and Thoracic Vascular Surgery, University Hospital Frankfurt, Frankfurt, Germany. FAU - Prendergast, Bernard AU - Prendergast B AD - Department of Cardiology, St Thomas' Hospital & Cleveland Clinic London, London, UK. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. LA - eng SI - ClinicalTrials.gov/NCT03011346 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20251201 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM CIN - doi: 10.1001/jamanetworkopen.2025.47055 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Female MH - Male MH - *Aortic Valve Stenosis/surgery/complications MH - Aged MH - *Health Status MH - Aged, 80 and over MH - *Coronary Artery Disease/complications/epidemiology/surgery MH - Treatment Outcome MH - Patient Reported Outcome Measures PMC - PMC12690430 COIS- Conflict of Interest Disclosures: Dr Lanz reported receiving travel expenses and speaker fees paid to his institution from Edwards Lifesciences and Abbott outside the submitted work. Dr Heg reported being affiliated with the Department of Clinical Research (DCR) of the University of Bern, which follows a staff policy of not accepting honoraria or consultancy fees. However, the DCR is involved in the design, conduct, or analysis of clinical studies funded by not-for-profit and for-profit organizations. In particular, pharmaceutical and medical device companies provide direct funding to some of these studies. Dr Kim reported receiving personal fees from Abbott, Boston Scientific, Edwards Lifesciences, HID Imaging, JenaValve, Meril Life Sciences, Anteris, and Products & Features GmbH; and receiving grants from Boston Scientific outside the submitted work. Dr Joner reported receiving personal fees from Abbott Vascular, Biotronik, Integris Health Private, Medtronic, Recor, TriCares, and Veryan, and receiving grants from Boston Scientific and Edwards Lifesciences; and receiving grants from Cardiac Dimensions outside the submitted work. Dr Mollmann reported receiving personal fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and Meril outside the submitted work. Dr Linke reported receiving personal fees from Abbott Laboratories, Abiomed, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Corvia, Daiichi Sankyo, and Edwards Lifesciences during the conduct of the study; receiving stock options from Filterlex, Pi-Cardia, and Transverse Medical during the conduct of the study and outside the submitted work; and receiving grants from Edwards Lifesciences, Medtronic, Meril, Novartis, and Pfizer during the conduct of the study; and receiving personal fees from Abbott Laboratories, Abiomed, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Corvia, Daiichi Sankyo, Edwards Lifesciences, Meril, Novartis, and Pfizer outside the submitted work; and receiving grants from Edwards Lifesciences outside the submitted work. Dr Conradi reported receiving personal fees from Medtronic, Abbott, JenaValve, Edwards Lifesciences, Boston Scientific, Venus Medtech, Pi-Cardia, Micro Interventions, MicroPort, Smart Canula, and 4C Medical outside the submitted work. Dr Toggweiler reported receiving personal fees from Medtronic, Edwards Lifesciences, Biosensors, Boston Scientific, Hi-D Imaging, Amarin, Armira, Sanofi, Bayer, ReCor Medical, Daiichi Sankyo, and Cardiac Dimensions; receiving grants from Abbott Vascular, Medtronic, Edwards Lifesciences, Boston Scientific, Fumedica, Novartis, Boehringer Ingelheim, and Polares Medical during the conduct of the study; having patent 10 2015 114 609.8 for a balloon catheter; and serving as a board member of Hi-D Imaging AG. Dr Prendergast reported receiving personal fees from Edwards Lifesciences, Polares Medical, and Valvosoft; and serving as a partner and board member for CERC outside the submitted work. Dr Windecker reported receiving grants from Abbott paid to his institution; receiving grants from Abiomed, Alnylam, Amicus Therapeutics, Amgen, AstraZeneca, Bayer, B. Braun, Bioanalytica, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cordis Medical, CorFlow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Fumedica, GE Healthcare, Guerbet, IACULIS, Inari Medical, Janssen AI, Johnson & Johnson, Medalliance, Medtronic, MSD Merck Sharp & Dhome, NEOVII Phamaceutica, Neutromedics AG, Novartis, NovoNordisk, OM Pharma, Optimapharm, Orchestra BioMed, Pfizer, Philips AG, Sanofi-Aventis, Servier, Shockwave Medical, Siemens Healthcare, Sinomed, SMT Sahajanand Medical Technologies, Vascular Medical, and V-Wave during the conduct of the study; serving as an advisory board member or member of the steering/executive group of trials funded by Abbott, Amgen, Abiomed, Edwards Lifesciences, EnCarda Inc, Medtronic, Novartis, and Sinomed with payments to his institution but no personal payments; serving as a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration; being an unpaid member of the Pfizer Research Award selection committee in Switzerland; serving as an expert panel member of the clinical study group of the Deutsches Zentrum fur Herz Kreislauf-Forschung (DZHK) and the Global Cardiovascular Research Funder Forum (GCRFF); serving as secretary/treasurer of the European Society of Cardiology Board and Management Group; and being a section editor for Up-to-Date and editor of the PCR EAPCI Textbook for Cardiovascular Interventions. Dr Pilgrim reported receiving grants and personal fees from Boston Scientific paid to his institution during the conduct of the study; receiving grants from Edwards Lifesciences, Medtronic, and Abbott; and receiving nonfinancial support from AT Sens outside the submitted work. No other disclosures were reported. EDAT- 2025/12/09 13:09 MHDA- 2025/12/09 13:10 PMCR- 2025/12/09 CRDT- 2025/12/09 11:32 PHST- 2025/12/09 13:10 [medline] PHST- 2025/12/09 13:09 [pubmed] PHST- 2025/12/09 11:32 [entrez] PHST- 2025/12/09 00:00 [pmc-release] AID - 2842564 [pii] AID - zoi251275 [pii] AID - 10.1001/jamanetworkopen.2025.47111 [doi] PST - epublish SO - JAMA Netw Open. 2025 Dec 1;8(12):e2547111. doi: 10.1001/jamanetworkopen.2025.47111. PMID- 41355382 OWN - NLM STAT- MEDLINE DCOM- 20260610 LR - 20260612 IS - 1799-7267 (Electronic) IS - 1457-4969 (Linking) VI - 115 IP - 2 DP - 2026 Jun TI - Defining optimal muscle surface area thresholds for sarcopenia-related mortality after cardiovascular interventions. PG - 185-193 LID - 10.1177/14574969251397740 [doi] AB - BACKGROUND AND AIMS: Psoas muscle surface area (PMA) can estimate sarcopenia related long-term mortality risk. This study explored whether this association is linear or non-linear and if a meaningful threshold defines patients at high risk. METHODS: This retrospective individual participant-level meta-analysis included four different cohorts of 3893 patients undergoing cardiovascular interventions: 1302 abdominal aortic aneurysm repairs (AAA), 1099 transcatheter aortic valve insertions (TAVI), 593 surgeries for thoracic aortic and aortic valve pathology (TA) and 899 procedures for peripheral artery disease (PAD). The association between PMA and mortality was visualized using pooled spline curves. Cox models were fitted separately within each cohort with three levels of adjustment, and hazard ratios were combined using inverse-variance meta-analysis. Results were replicated in a retrospective dataset of 561 patients undergoing carotid endarterectomy or thrombectomy for ischemic stroke, where sarcopenia status was estimated using masseter muscle surface area. RESULTS: Age and sex were the most important features associating with PMA (p < 0.001), but significant variation between the cohorts was also observed (p < 0.001). The association between PMA and long-term mortality was inverse and linear (p < 0.001). Patients with poor muscle status (Z-values -1.5 or less for PMA) had significantly higher adjusted risk of death (hazard ratio (HR) of 1.6 with 95% confidence interval (CI) 1.3-2.0, p < 0.001) when compared to all other patients. Similar results were observed in the replication cohort (HR 1.7, 95% CI 1.0-2.82, p = 0.04). CONCLUSIONS: Long-term mortality after a cardiovascular intervention increases linearly as the PMA value decreases. Patients with poor muscle status (Z-values below -1.5) seem to have consistently elevated mortality risk independent of other risk factors. FAU - Jarvinen, Otto AU - Jarvinen O AUID- ORCID: 0000-0003-2511-084X AD - Faculty of Medicine and Health Technology Tampere University Kalevantie 4 Tampere FI-33014 Finland Finnish Cardiovascular Research Centre Tampere Tampere Finland. FAU - Tynkkynen, Juho AU - Tynkkynen J AD - Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland. FAU - Lindstrom, Iisa AU - Lindstrom I AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. FAU - Virtanen, Marko AU - Virtanen M AD - Heart Hospital, Tampere University Hospital, Tampere, Finland. FAU - Maaranen, Pasi AU - Maaranen P AD - Heart Hospital, Tampere University Hospital, Tampere, Finland. FAU - Soderlund, Minea AU - Soderlund M AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. FAU - Huhtamo, Henni AU - Huhtamo H AUID- ORCID: 0009-0002-3207-8809 AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. FAU - Vakhitov, Damir AU - Vakhitov D AUID- ORCID: 0000-0003-2233-9606 AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. AD - Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland. FAU - Laurikka, Jari AU - Laurikka J AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. AD - Finnish Cardiovascular Research Centre Tampere, Tampere, Finland. AD - Heart Hospital, Tampere University Hospital, Tampere, Finland. FAU - Oksala, Niku AU - Oksala N AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. AD - Finnish Cardiovascular Research Centre Tampere, Tampere, Finland. AD - Centre for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland. FAU - Hernesniemi, Jussi AU - Hernesniemi J AD - Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. AD - Finnish Cardiovascular Research Centre Tampere, Tampere, Finland. AD - Heart Hospital, Tampere University Hospital, Tampere, Finland. LA - eng PT - Journal Article PT - Meta-Analysis DEP - 20251207 PL - England TA - Scand J Surg JT - Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society JID - 101144297 SB - IM MH - Humans MH - *Sarcopenia/mortality/complications/diagnosis/pathology MH - Retrospective Studies MH - Male MH - Female MH - *Psoas Muscles/pathology/diagnostic imaging/anatomy & histology MH - Aged MH - Aged, 80 and over MH - *Cardiovascular Surgical Procedures/mortality MH - Risk Factors MH - Risk Assessment MH - *Cardiovascular Diseases/surgery/complications/mortality OTO - NOTNLM OT - Psoas muscle area OT - cardiovascular interventions OT - mortality OT - sarcopenia COIS- Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2025/12/08 06:27 MHDA- 2026/06/11 05:38 CRDT- 2025/12/08 02:43 PHST- 2026/06/11 05:38 [medline] PHST- 2025/12/08 06:27 [pubmed] PHST- 2025/12/08 02:43 [entrez] AID - 10.1177/14574969251397740 [doi] PST - ppublish SO - Scand J Surg. 2026 Jun;115(2):185-193. doi: 10.1177/14574969251397740. Epub 2025 Dec 7. PMID- 41349586 OWN - NLM STAT- In-Process LR - 20251228 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 259 DP - 2026 Jan 15 TI - Corrigendum to "Aortic Arch Morphology and Cerebrovascular Accidents After Transfemoral Transcatheter Aortic Valve Implantation" [The American Journal of Cardiology 258 (2026), 229-233]. PG - 228 LID - S0002-9149(25)00676-9 [pii] LID - 10.1016/j.amjcard.2025.11.003 [doi] FAU - Baltruskeviciute, Laura AU - Baltruskeviciute L AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Moccetti, Federico AU - Moccetti F AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Wolfrum, Mathias AU - Wolfrum M AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Loretz, Lucca AU - Loretz L AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Brunner, Stephanie AU - Brunner S AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Hakimi, Maani AU - Hakimi M AD - Department of Vascular Surgery, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Matt, Peter AU - Matt P AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. Electronic address: stefan.toggweiler@luks.ch. LA - eng PT - Published Erratum DEP - 20251208 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM EFR - Am J Cardiol. 2026 Jan 1;258:229-233. doi: 10.1016/j.amjcard.2025.09.066. PMID: 41077218 EDAT- 2025/12/06 00:32 MHDA- 2025/12/06 00:32 CRDT- 2025/12/05 19:21 PHST- 2025/12/06 00:32 [pubmed] PHST- 2025/12/06 00:32 [medline] PHST- 2025/12/05 19:21 [entrez] AID - S0002-9149(25)00676-9 [pii] AID - 10.1016/j.amjcard.2025.11.003 [doi] PST - ppublish SO - Am J Cardiol. 2026 Jan 15;259:228. doi: 10.1016/j.amjcard.2025.11.003. Epub 2025 Dec 8. PMID- 41349150 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260129 LR - 20260207 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 5 IP - 1 DP - 2026 Jan TI - Comprehensive CT Assessment of Subclavian Artery Tortuosity: Implications for Optimal Radial Access Selection. PG - 102407 LID - S2772-963X(25)00837-3 [pii] LID - 10.1016/j.jacadv.2025.102407 [doi] LID - 102407 AB - BACKGROUND: Right radial artery access is the most commonly used approach for coronary angiography. Tortuosity of the right subclavian artery (RSA) may complicate catheter navigation. Whether the left subclavian artery (LSA) provides a less tortuous alternative remains uncertain. OBJECTIVES: The purpose of this study was to compare the tortuosity between the RSA and LSA, identify clinical predictors of subclavian tortuosity, and assess its impact on coronary angiography fluoroscopy time. METHODS: We analyzed 695 consecutive patients from the CALCI-TAVI cohort who underwent contrast-enhanced computed tomography and coronary angiography as part of their preaortic valve replacement work-up. Subclavian tortuosity was measured by a tortuosity index, corresponding to the centerline-to-straight-line distance ratio computed from three-dimensional reconstruction data. Multivariable logistic regression identified clinical predictors of increased tortuosity. The impact of high tortuosity on fluoroscopy time was also evaluated. RESULTS: RSA showed significantly greater tortuosity than LSA on average (51.8 [38.6-70.4] vs 40.00 [28.30-54.39], P < 0.001) and its tortuosity exceeded that of LSA in two-third of the population. Independent predictors of high RSA tortuosity included age >/=80 years, female gender, prior stroke, and thoracic kyphosis (P < 0.05 for all). Patients in the high tortuosity group had significantly longer fluoroscopy times 5 (3-9) vs 3 (2-5) minutes (P = 0.001). CONCLUSIONS: RSA tortuosity is significantly more frequent and pronounced than LSA tortuosity and is associated with age >/=80 years, female sex, prior stroke, and thoracic kyphosis. Elevated tortuosity contributes to longer coronary angiography procedures. These findings contribute to identify clinical profiles that may derive greater benefit from a left radial access during coronary angiography. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Arnaud, Charles-Meyer AU - Arnaud CM AD - Federation de Cardiologie Croix-Rousse / Lyon-Sud, Institut Cardiologique de Lyon, Hospices Civils de Lyon, Lyon, France. FAU - Harbaoui, Brahim AU - Harbaoui B AD - Federation de Cardiologie Croix-Rousse / Lyon-Sud, Institut Cardiologique de Lyon, Hospices Civils de Lyon, Lyon, France; CREATIS Research Laboratory, University of Lyon 1, CNRS, INSERM, Villeurbanne, France. FAU - Champin, Stanislas AU - Champin S AD - Cardiologie Interventionnelle, Centre Hospitalier de Valence, Valence, France. FAU - Besnard, Cyril AU - Besnard C AD - Cardiologie Interventionnelle, Hopital Nord-Ouest Villefranche, Villefranche-sur-Saone, France. FAU - Bonnet, Marc AU - Bonnet M AD - Cardiologie interventionnelle, Centre Hospitalier Annecy Genevois, Annecy, France. FAU - Courand, Pierre-Yves AU - Courand PY AD - Federation de Cardiologie Croix-Rousse / Lyon-Sud, Institut Cardiologique de Lyon, Hospices Civils de Lyon, Lyon, France; CREATIS Research Laboratory, University of Lyon 1, CNRS, INSERM, Villeurbanne, France. FAU - Lantelme, Pierre AU - Lantelme P AD - Federation de Cardiologie Croix-Rousse / Lyon-Sud, Institut Cardiologique de Lyon, Hospices Civils de Lyon, Lyon, France; CREATIS Research Laboratory, University of Lyon 1, CNRS, INSERM, Villeurbanne, France. Electronic address: pierre.lantelme@chu-lyon.fr. LA - eng PT - Journal Article DEP - 20251204 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC12869871 OTO - NOTNLM OT - coronary angiography OT - subclavian artery OT - vascular tortuosity COIS- Funding support and author disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/12/05 19:00 MHDA- 2025/12/05 19:01 PMCR- 2025/12/04 CRDT- 2025/12/05 18:00 PHST- 2025/07/29 00:00 [received] PHST- 2025/10/13 00:00 [revised] PHST- 2025/11/05 00:00 [accepted] PHST- 2025/12/05 19:01 [medline] PHST- 2025/12/05 19:00 [pubmed] PHST- 2025/12/05 18:00 [entrez] PHST- 2025/12/04 00:00 [pmc-release] AID - S2772-963X(25)00837-3 [pii] AID - 102407 [pii] AID - 10.1016/j.jacadv.2025.102407 [doi] PST - ppublish SO - JACC Adv. 2026 Jan;5(1):102407. doi: 10.1016/j.jacadv.2025.102407. Epub 2025 Dec 4. PMID- 41335392 OWN - NLM STAT- In-Process LR - 20260320 IS - 1868-4297 (Electronic) IS - 1868-4297 (Linking) VI - 41 IP - 2 DP - 2026 Apr TI - Emergent transcarotid transcatheter aortic valve-in-valve implantation in degenerative INSPIRIS RESILIA aortic valve. PG - 470-471 LID - 10.1007/s12928-025-01212-8 [doi] FAU - Kitano, Taiki AU - Kitano T AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-2-1 Minatojimaminami-cho, Chuo-ku, Kobe, Kobe, 650-0047, Japan. FAU - Taniguchi, Tomohiko AU - Taniguchi T AUID- ORCID: 0000-0002-4999-3432 AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-2-1 Minatojimaminami-cho, Chuo-ku, Kobe, Kobe, 650-0047, Japan. ta2guchi@kuhp.kyoto-u.ac.jp. FAU - Ehara, Natsuhiko AU - Ehara N AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-2-1 Minatojimaminami-cho, Chuo-ku, Kobe, Kobe, 650-0047, Japan. FAU - Nakane, Takeichiro AU - Nakane T AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-2-1 Minatojimaminami-cho, Chuo-ku, Kobe, Kobe, 650-0047, Japan. FAU - Esaki, Jiro AU - Esaki J AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-2-1 Minatojimaminami-cho, Chuo-ku, Kobe, Kobe, 650-0047, Japan. FAU - Furukawa, Yutaka AU - Furukawa Y AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-2-1 Minatojimaminami-cho, Chuo-ku, Kobe, Kobe, 650-0047, Japan. LA - eng PT - Journal Article DEP - 20251203 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 SB - IM EDAT- 2025/12/03 14:11 MHDA- 2025/12/03 14:11 CRDT- 2025/12/03 11:23 PHST- 2025/09/28 00:00 [received] PHST- 2025/10/20 00:00 [accepted] PHST- 2025/12/03 14:11 [pubmed] PHST- 2025/12/03 14:11 [medline] PHST- 2025/12/03 11:23 [entrez] AID - 10.1007/s12928-025-01212-8 [pii] AID - 10.1007/s12928-025-01212-8 [doi] PST - ppublish SO - Cardiovasc Interv Ther. 2026 Apr;41(2):470-471. doi: 10.1007/s12928-025-01212-8. Epub 2025 Dec 3. PMID- 41332125 OWN - NLM STAT- MEDLINE DCOM- 20260203 LR - 20260203 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 2 DP - 2026 Feb TI - Outcomes of Non-Anesthetist Led Conscious Sedation for 2000 Transcatheter Aortic Valve Implantations. PG - 639-646 LID - 10.1002/ccd.70392 [doi] AB - BACKGROUND: A minimalist approach to transcatheter aortic valve replacement (TAVR) has accompanied the increase in TAVR procedures worldwide. Comprehensive evidence regarding the safety of non-anesthetist-led conscious sedation for TAVR is lacking. AIMS: We aimed to evaluate the outcomes of patients undergoing TAVR with non-anesthetist-led conscious sedation. METHODS: This retrospective analysis included consecutive patients who underwent percutaneous transfemoral TAVR with non-anesthetist-led conscious sedation, from March 2018 to 2025, in a single high-volume center. Thirty-day outcomes were assessed. RESULTS: Of 2854 patients who underwent TAVR, 2000 (70.1%) had non-anesthetist-led conscious sedation (age: 80.7 +/- 6.5 years, 42.1% female). The annual proportion of non-anesthetist-led conscious sedation procedures increased from 37% (2018-2019) to 81% (2024-2025). Fentanyl was administered to 1986 (99.3%) patients (median: 75 mcg [IQR: 50-100]) and Midazolam to 945 (47.3%) patients (median: 1.5 mg [IQR: 1.0-2.0]). Mean procedural duration was 81.3 +/- 67.7 min. Emergency anesthetic support was required for 53 (2.7%) patients, due to: vascular access complications (n = 15), cardiac arrest (n = 14), annular rupture/aortic dissection (n = 9), profound hypotension (n = 8), agitation (n = 4), ventricular perforation (n = 2) and reduced consciousness (stroke) (n = 1). Conversion to general anesthesia was required for 24 (1.2%) patients. Emergency bail-out surgery (cardiac/vascular) was undertaken in 15 patients (0.75%). Among the 2000 patients, 30-day mortality was 1.3%, and VARC-3 technical success, device success, and early safety were achieved in 97.2%, 92.7%, and 78.9% of patients, respectively. CONCLUSIONS: Non-anesthetist-led conscious sedation can be delivered safely in most patients undergoing percutaneous transfemoral TAVR. The need for emergency anesthetic support is low. CI - (c) 2025 Wiley Periodicals LLC. FAU - Maznyczka, Annette AU - Maznyczka A AUID- ORCID: 0000-0002-0118-5153 AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Gill, Christine AU - Gill C AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Norman, Samuel AU - Norman S AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Patel, Roshan AU - Patel R AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Arockiam, Sacchin AU - Arockiam S AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Hopkins, Rebecca AU - Hopkins R AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - North, Rebecca Parker AU - North RP AD - Department of Anesthesiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Cross, Michael AU - Cross M AD - Department of Anesthesiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Cunnington, Michael AU - Cunnington M AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Malkin, Christopher J AU - Malkin CJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Blackman, Daniel J AU - Blackman DJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. FAU - Ali, Noman AU - Ali N AUID- ORCID: 0000-0002-9597-4451 AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK. LA - eng PT - Journal Article DEP - 20251202 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Hypnotics and Sedatives) SB - IM MH - Humans MH - Female MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Male MH - *Procedural Sedation/adverse effects/mortality MH - Aged, 80 and over MH - Treatment Outcome MH - Aged MH - Time Factors MH - Risk Factors MH - *Hypnotics and Sedatives/administration & dosage/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/mortality/surgery/physiopathology MH - Postoperative Complications/etiology/mortality/therapy MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology OTO - NOTNLM OT - anesthetist OT - conscious sedation OT - outcomes OT - transcatheter aortic valve replacement EDAT- 2025/12/03 07:41 MHDA- 2026/02/03 14:59 CRDT- 2025/12/03 01:25 PHST- 2025/09/10 00:00 [revised] PHST- 2025/09/10 00:00 [received] PHST- 2025/11/26 00:00 [accepted] PHST- 2026/02/03 14:59 [medline] PHST- 2025/12/03 07:41 [pubmed] PHST- 2025/12/03 01:25 [entrez] AID - 10.1002/ccd.70392 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Feb;107(2):639-646. doi: 10.1002/ccd.70392. Epub 2025 Dec 2. PMID- 41331741 OWN - NLM STAT- MEDLINE DCOM- 20260429 LR - 20260813 IS - 2058-1742 (Electronic) IS - 2058-5225 (Print) IS - 2058-1742 (Linking) VI - 12 IP - 3 DP - 2026 Apr 29 TI - Association between quality of care indicators and clinical outcomes in patients undergoing transcatheter aortic valve implantation: insights from SWEDEHEART. PG - 366-378 LID - 10.1093/ehjqcco/qcaf146 [doi] AB - AIMS: The European Society of Cardiology (ESC) has developed quality indicators (QIs) specifically for evaluating the care and outcomes for patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to evaluate TAVI care in all patients undergoing such procedures in Sweden using the ESC 2023 QIs for TAVI. METHODS AND RESULTS: We used the Swedish Transcatheter Cardiac Intervention Registry to identify all TAVI procedures performed in Swedish centres (n = 8) between 2008 and 2021. 8524 patients (median 82 years, 52.8% male) were included. In total, 24 (88.8%) of the 27 QIs could be captured from the available registry data. The attainment levels were generally high [median 97.8%, interquartile range (IQR) 91.3-100%] with small variations in attainment levels between centres. The greatest variations were observed in the QIs related to patients undergoing TAVI through transfemoral route (median 90.3%, IQR 85.6-96.9%), and in the proportion undergoing transfemoral TAVI without general anaesthesia (median 87.6%, IQR 57.1-94.4%). In total, 80% of the QIs were associated with 1-year all-cause mortality, and 85% with 1-year cardiovascular mortality. The QIs with greatest impact on 1-year mortality were the absence of coronary obstruction (adjusted HR 0.12; 95% CI 0.07-0.22), in-hospital stroke (adjusted HR 0.25; 95% CI 0.18-0.33) and no new dialysis (adjusted HR 0.25; 95% CI 0.15-0.41). CONCLUSION: In this study, the majority of the QIs were associated with both all-cause and cardiovascular mortality. Hence, the ESC 2023 QIs for TAVI may serve as a valuable tool for evaluating TAVI care, benchmarking performance, and improving patient outcomes. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Nilsson, Konrad AU - Nilsson K AUID- ORCID: 0000-0002-8329-5072 AD - Cardiology, Department of Medical Sciences, Uppsala University, Akademiska sjukhuset ing. 40, SE-751 85 Uppsala, Sweden. AD - Uppsala Clinical Research Center, Dag Hammarskjolds vag 38, SE-751 85 Uppsala, Sweden. AD - Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford OX3 7LF, UK. FAU - James, Stefan AU - James S AUID- ORCID: 0000-0003-4413-9736 AD - Cardiology, Department of Medical Sciences, Uppsala University, Akademiska sjukhuset ing. 40, SE-751 85 Uppsala, Sweden. AD - Uppsala Clinical Research Center, Dag Hammarskjolds vag 38, SE-751 85 Uppsala, Sweden. FAU - Backes, Jenny AU - Backes J AUID- ORCID: 0009-0008-3439-178X AD - School of Medical Sciences, Faculty of Medicine and Health, Orebro University, Campus USO, SE-701 82 Orebro, Sweden. AD - Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, SE-703 82 Orebro, Sweden. FAU - Gotberg, Matthias AU - Gotberg M AD - Cardiology Unit, Department of Clinical Sciences Lund, Lund University, Solvegatan 19, SE-223 62 Lund, Sweden. AD - Department of Cardiology, Skane University Hospital, Entregatan 7, SE-222 42 Lund, Sweden. FAU - Hagstrom, Henrik AU - Hagstrom H AUID- ORCID: 0000-0003-1182-4462 AD - Department of Public Health and Clinical Medicine, Umea University, SE-901 87 Umea, Sweden. AD - Heart Centre, Umea University Hospital, Daniel Naezens vag, SE-907 37 Umea, Sweden. FAU - Batra, Gorav AU - Batra G AUID- ORCID: 0000-0002-2480-9547 AD - Cardiology, Department of Medical Sciences, Uppsala University, Akademiska sjukhuset ing. 40, SE-751 85 Uppsala, Sweden. AD - Uppsala Clinical Research Center, Dag Hammarskjolds vag 38, SE-751 85 Uppsala, Sweden. LA - eng PT - Journal Article PT - Multicenter Study PL - England TA - Eur Heart J Qual Care Clin Outcomes JT - European heart journal. Quality of care & clinical outcomes JID - 101677796 SB - IM CIN - Eur Heart J Qual Care Clin Outcomes. 2026 Aug 11;12(5):883. doi: 10.1093/ehjqcco/qcag043. PMID: 41837273 MH - Humans MH - *Transcatheter Aortic Valve Replacement/standards/methods MH - Male MH - Female MH - Aged, 80 and over MH - *Quality Indicators, Health Care MH - *Registries MH - *Aortic Valve Stenosis/surgery/mortality MH - Sweden/epidemiology MH - Treatment Outcome MH - Aged MH - Postoperative Complications/epidemiology MH - Retrospective Studies PMC - PMC13124748 OTO - NOTNLM OT - Cardiovascular outcomes OT - Implementation OT - Mortality OT - Quality indicators OT - Quality of care OT - Transcatheter aortic valve implantation COIS- Conflict of interest: K.N. has received travel grants from the Swedish Society of Cardiology, the Royal Society of Arts and Scientists, Letterstedt travel scholarship and Bergmark travel outside present work. S.J. reports grants or contracts to institution from Medtronic, Edwards, Novo Nordisk, Astra Zeneca, Jansen, Amgen, personal fees from Edwards and Medtronic for proctoring valve procedures and Participation on a Data Safety Monitoring Board or Advisory Board, New Amsterdam, Celecor. G.B. reports grants to institution from the Swedish Heart Lung Foundation, the Swedish Research Council, P.O. Zetterlings Foundation, Jeanssons Foundation, AstraZeneca, Novo Nordisk and Pfizer as well as consulting fees from Bayer and honoraria for lectures from AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Novartis, Novo Nordisk and Pfizer. All outside present work. Remaining authors report no interests. EDAT- 2025/12/03 01:16 MHDA- 2026/04/29 06:34 PMCR- 2025/12/03 CRDT- 2025/12/02 23:59 PHST- 2025/07/24 00:00 [received] PHST- 2025/10/15 00:00 [revised] PHST- 2025/11/15 00:00 [accepted] PHST- 2026/04/29 06:34 [medline] PHST- 2025/12/03 01:16 [pubmed] PHST- 2025/12/02 23:59 [entrez] PHST- 2025/12/03 00:00 [pmc-release] AID - 8363232 [pii] AID - qcaf146 [pii] AID - 10.1093/ehjqcco/qcaf146 [doi] PST - ppublish SO - Eur Heart J Qual Care Clin Outcomes. 2026 Apr 29;12(3):366-378. doi: 10.1093/ehjqcco/qcaf146. PMID- 41328633 OWN - NLM STAT- MEDLINE DCOM- 20260122 LR - 20260124 IS - 1365-2362 (Electronic) IS - 0014-2972 (Print) IS - 0014-2972 (Linking) VI - 56 IP - 1 DP - 2026 Jan TI - Hemodynamic and microcirculatory early adaptations following transcatheter aortic valve implantation (TAVI): A physiological pilot study. PG - e70156 LID - 10.1111/eci.70156 [doi] LID - e70156 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) abruptly relieves aortic stenosis. The consequences for the peripheral vascular network, organ perfusion and postoperative organ dysfunction remain unclear. This study assessed hemodynamic and microcirculatory changes after TAVI, and their association with postoperative organ dysfunction. METHODS: This prospective, single-center physiological study included 20 patients with severe aortic stenosis undergoing transfemoral TAVI at Geneva University Hospitals (January-June 2024). Hemodynamic and microcirculatory assessment included arterial stiffness (tonometry), temperature gradients (T grad), reactive hyperemia (near-infrared spectroscopy and photoplethysmography) and plasma vascular endothelium growth factor (VEGF) concentrations before and after TAVI. The primary outcome was perioperative changes in macro- and microcirculatory parameters; secondary outcomes were organ dysfunction within 7 days. RESULTS: TAVI immediately increased aortic pressures and amplified pressure waves. By day 1, central-peripheral T grad decreased, perfusion index rose (from 2.5 [0.9-4.2] to 3.9 [1.9-5.5]; p < 0.05), and tissue oxygen re-saturation slope increased (from 2.6 [1.5-3.4] to 3.9 [2.8-4.7] %/s; p < 0.05), independent of macrocirculatory parameters. Large artery stiffness decreased, despite a reduction in the total arterial compliance, without changes in small-vessel resistance. Cardiac index changes showed wide interindividual variability and correlated with vascular and VEGF dynamics. Patients with postoperative organ dysfunction had higher baseline VEGF (52.9 vs. 28.7 pg/mL, p = 0.033) and greater postoperative increases. CONCLUSION: TAVI induces rapid macro- and microcirculatory changes, with early tissue perfusion improvement despite transient microcirculatory reserve impairment. VEGF dynamics were associated with postoperative complications, suggesting endothelial activation as a marker of vulnerability and linking baseline endothelial status to vascular adaptation and outcomes. CI - (c) 2025 The Author(s). European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation. FAU - Abrard, Stanislas AU - Abrard S AUID- ORCID: 0000-0002-5883-1777 AD - Geneva University Hospitals, and Hemodynamic Research Lab, Geneva Medical School, Geneva, Switzerland. AD - Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. AD - Department of Anesthesiology and Critical Care Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France. AD - Research on Health-Care Performance (RESHAPE), INSERM U1290, University Claude Bernard Lyon 1, Lyon, France. AD - Faculte de Medecine Lyon Est, Universite Claude Bernard Lyon 1, Lyon, France. FAU - Mauler, Sarah AU - Mauler S AD - Cardiology Division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. FAU - Neto Silva, Ivo AU - Neto Silva I AUID- ORCID: 0000-0002-7391-786X AD - Geneva University Hospitals, and Hemodynamic Research Lab, Geneva Medical School, Geneva, Switzerland. AD - Adult Intensive Care Division, Hopitaux Universitaires de Geneve, Geneva, Switzerland. FAU - Adamopoulos, Dyonisios AU - Adamopoulos D AD - Cardiology Division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. FAU - Bar, Stephane AU - Bar S AD - Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. AD - Department of Anesthesiology and Critical Care Medicine, Amiens University Medical Centre, Amiens, France. FAU - Hagerman, Andres AU - Hagerman A AD - Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. FAU - Schorer, Raoul AU - Schorer R AUID- ORCID: 0000-0001-7848-7021 AD - Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. FAU - Bollen Pinto, Bernardo AU - Bollen Pinto B AD - Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. FAU - Rovas, Georgios AU - Rovas G AD - Swiss Federal Institut of Technology (EPFL), Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Lausanne, Switzerland. FAU - Stergiopulos, Nikolaos AU - Stergiopulos N AD - Swiss Federal Institut of Technology (EPFL), Laboratory of Hemodynamics and Cardiovascular Technology (LHTC), Lausanne, Switzerland. FAU - Ellenberger, Christoph AU - Ellenberger C AD - Department of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland. FAU - Noble, Stephane AU - Noble S AD - Adult Intensive Care Division, Hopitaux Universitaires de Geneve, Geneva, Switzerland. FAU - Bendjelid, Karim AU - Bendjelid K AD - Geneva University Hospitals, and Hemodynamic Research Lab, Geneva Medical School, Geneva, Switzerland. AD - Cardiology Division, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. LA - eng GR - Hospices Civils de Lyon/ GR - Hopitaux Universitaires de Geneve/ PT - Journal Article DEP - 20251202 PL - England TA - Eur J Clin Invest JT - European journal of clinical investigation JID - 0245331 RN - 0 (Vascular Endothelial Growth Factor A) RN - 0 (VEGFA protein, human) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Microcirculation/physiology MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery/physiopathology MH - Pilot Projects MH - *Hemodynamics/physiology MH - Aged, 80 and over MH - Aged MH - Vascular Endothelial Growth Factor A/blood/metabolism MH - Prospective Studies MH - Adaptation, Physiological MH - Vascular Stiffness/physiology MH - Hyperemia/physiopathology MH - Postoperative Complications PMC - PMC12825404 OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - endothelial function OT - hemodynamics OT - microcirculation OT - tissue perfusion OT - vascular adaptation COIS- Stanislas Abrard has received honoraria for consulting from Viatris Inc. (France) and from Public Health Expertise (France). The other authors declare no competing interests. EDAT- 2025/12/02 07:36 MHDA- 2026/01/22 07:43 PMCR- 2026/01/22 CRDT- 2025/12/02 05:42 PHST- 2025/09/24 00:00 [received] PHST- 2025/11/13 00:00 [accepted] PHST- 2026/01/22 07:43 [medline] PHST- 2025/12/02 07:36 [pubmed] PHST- 2025/12/02 05:42 [entrez] PHST- 2026/01/22 00:00 [pmc-release] AID - ECI70156 [pii] AID - 10.1111/eci.70156 [doi] PST - ppublish SO - Eur J Clin Invest. 2026 Jan;56(1):e70156. doi: 10.1111/eci.70156. Epub 2025 Dec 2. PMID- 41321776 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251201 LR - 20251203 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 9 IP - 12 DP - 2025 Dec TI - Managing Hostile Aortic Anatomies Using an Extended-Length Introducer Sheath During Transfemoral Transcatheter Aortic Valve Replacement: Rationale and Clinical Outcomes. PG - 100737 LID - 10.1016/j.shj.2025.100737 [doi] LID - 100737 AB - BACKGROUND: Transfemoral (TF) access is the safest and guideline-recommended approach for transcatheter aortic valve replacement (TAVR). However, in patients with hostile aortic anatomies, the procedure may carry increased risks of vascular or cerebrovascular complications. The objective of this article is, therefore, to evaluate the safety and efficacy of using the extended-length DrySeal Flex introducer sheath (Gore, USA) for TF-TAVR in high-risk patients with challenging aortic anatomies. METHODS: We conducted a retrospective, single-center cohort study including all consecutive patients who underwent TF-TAVR with the 65-cm DrySeal sheath between 2021 and 2025. We analyzed the indications for sheath use and the following clinical outcomes: all-cause mortality, stroke, and major vascular complications as defined by Valve Academic Research Consortium-3 criteria. RESULTS: The 65-cm DrySeal sheath was used in 200 patients (median age 80 years; median Society of Thoracic Surgeons score 5.4%) out of 2430 (8.2%) TF-TAVR procedures performed. This approach was selected to address challenges posed by aortic arch calcification (28%), heavily atheromatous or shaggy aorta (20%), acute aortic angulation (26%), tortuosity (36%), and aortic coarctation (8%). In this high-risk cohort, all-cause mortality was 0.5%, stroke occurred in 1.5% (including 0.5% with disabling stroke), and major vascular complications were observed in 1.0%. These outcomes were comparable to those seen in lower-risk patients undergoing TF-TAVR using conventional approaches. CONCLUSIONS: In patients with hostile aortic anatomies, the extended-length DrySeal Flex introducer sheath facilitated safe and effective TAV delivery and was associated with a low rate of periprocedural complications, including cerebrovascular events. Its use may help mitigate the risks traditionally associated with hostile aortic anatomies. CI - (c) 2025 The Author(s). FAU - Kobari, Yusuke AU - Kobari Y AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Lulic, Davorka AU - Lulic D AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Khokhar, Arif A AU - Khokhar AA AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Lim, Yinghao AU - Lim Y AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Hartikainen, Tau Sarra AU - Hartikainen TS AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Campens, Laurence AU - Campens L AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Willemen, Yannick AU - Willemen Y AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Bieliauskas, Gintautas AU - Bieliauskas G AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - De Backer, Ole AU - De Backer O AD - Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark. AD - Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. LA - eng PT - Journal Article DEP - 20251008 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC12664507 OTO - NOTNLM OT - Aortic stenosis OT - Extended length introducer sheath OT - Stroke OT - Transcatheter aortic valve replacement OT - Vascular complication COIS- Y. Kobari has received financial support from the 10.13039/501100013642Japan Heart Foundation for his fellowship, and speaker fees from Abbott Structural Heart and 10.13039/100008497Boston Scientific. A. Khokhar received honoraria from 10.13039/100000046Abbott, 10.13039/100008497Boston Scientific, and 10.13039/100004374Medtronic. G. Bieliauskas received institutional research grants and consulting fees from 10.13039/100008497Boston Scientific. O. De Backer received institutional research grants and consulting fees from 10.13039/100000046Abbott, 10.13039/100008497Boston Scientific, and 10.13039/100004374Medtronic. The other authors had no conflicts to declare. EDAT- 2025/12/01 12:28 MHDA- 2025/12/01 12:29 PMCR- 2025/10/08 CRDT- 2025/12/01 06:18 PHST- 2025/08/20 00:00 [received] PHST- 2025/09/25 00:00 [revised] PHST- 2025/09/29 00:00 [accepted] PHST- 2025/12/01 12:29 [medline] PHST- 2025/12/01 12:28 [pubmed] PHST- 2025/12/01 06:18 [entrez] PHST- 2025/10/08 00:00 [pmc-release] AID - S2474-8706(25)00329-X [pii] AID - 100737 [pii] AID - 10.1016/j.shj.2025.100737 [doi] PST - epublish SO - Struct Heart. 2025 Oct 8;9(12):100737. doi: 10.1016/j.shj.2025.100737. eCollection 2025 Dec. PMID- 41319141 OWN - NLM STAT- MEDLINE DCOM- 20260203 LR - 20260203 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 2 DP - 2026 Feb TI - Transradial Secondary Access Transcaval Transcatheter Aortic Valve Intervention: A Single-Center Experience. PG - 593-599 LID - 10.1002/ccd.70378 [doi] AB - BACKGROUND: Transcaval transcatheter aortic valve implantation (TAVI) is well described for patients with severe peripheral arterial disease. Conventionally, secondary arterial access via the femoral artery is used to allow bail-out stenting of the aortotomy site in case of complications. Transradial access may reduce the risk of complications related to the secondary access itself but prevents effective bail-out. We use the transradial approach for secondary access, accepting this risk. AIM: We aim to report the feasibility and acute outcomes following transcaval TAVI with transradial secondary access. METHODS: All patients with transcaval TAVI performed from November 2016 to March 2024 at our center were identified. Patients with secondary access via the radial artery were included. The primary outcome was postprocedural mortality to hospital discharge. Secondary outcomes were the incidence of major vascular complications, bleeding, and stroke up to 72 h after the procedure. RESULTS: A total of 20 patients were included. Procedural success was achieved in all the patients. Ten (50%) patients received cerebral protection via the right radial artery in addition to left radial secondary access. All 20 patients had successful closure of the aortotomy with a 10/8 or 8/6 mm Amplatzer ductal occluder (Abbott, USA). No patient had major complications of the aortocaval shunt either during or after the procedure. No patient needed a bailout aortic intervention. There was one death (5%) secondary to peri-procedural stroke. Patients were usually discharged on the first postprocedural day. CONCLUSIONS: Transcaval TAVI with transradial secondary access appeared to be safe. Bailout stenting is not possible but is rarely needed. Overall, procedural vascular risks are reduced. CI - (c) 2025 Wiley Periodicals LLC. FAU - Wong, Siu-Fung AU - Wong SF AUID- ORCID: 0000-0001-9326-2648 AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. FAU - Cockburn, James AU - Cockburn J AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. FAU - Broyd, Christopher AU - Broyd C AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. FAU - Michail, Michael AU - Michail M AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. FAU - Ferreira-Martins, Joao AU - Ferreira-Martins J AUID- ORCID: 0000-0002-5491-9421 AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. FAU - Arunothayaraj, Sandeep AU - Arunothayaraj S AD - St Vincent's Heart Centre, St Vincent's Hospital Melbourne, Melbourne, Australia. FAU - Bagnall, Timothy AU - Bagnall T AUID- ORCID: 0009-0007-8703-851X AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. FAU - Hildick-Smith, David AU - Hildick-Smith D AD - Department of Cardiology, Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK. LA - eng GR - The authors received no specific funding for this work./ PT - Journal Article DEP - 20251130 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Radial Artery/diagnostic imaging MH - Male MH - Female MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation MH - Aged, 80 and over MH - *Catheterization, Peripheral/adverse effects/mortality/methods MH - Time Factors MH - Aged MH - Risk Factors MH - Feasibility Studies MH - *Aortic Valve Stenosis/diagnostic imaging/mortality/surgery/physiopathology MH - Retrospective Studies MH - Punctures MH - *Aortic Valve/diagnostic imaging/surgery/physiopathology MH - *Peripheral Arterial Disease/mortality/diagnostic imaging/complications OTO - NOTNLM OT - aortic intervention OT - transcaval TAVI OT - transradial secondary access EDAT- 2025/11/30 13:39 MHDA- 2026/02/03 14:59 CRDT- 2025/11/30 07:03 PHST- 2025/11/09 00:00 [revised] PHST- 2025/06/22 00:00 [received] PHST- 2025/11/22 00:00 [accepted] PHST- 2026/02/03 14:59 [medline] PHST- 2025/11/30 13:39 [pubmed] PHST- 2025/11/30 07:03 [entrez] AID - 10.1002/ccd.70378 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Feb;107(2):593-599. doi: 10.1002/ccd.70378. Epub 2025 Nov 30. PMID- 41308164 OWN - NLM STAT- MEDLINE DCOM- 20251210 LR - 20261009 IS - 2753-670X (Electronic) IS - 2753-670X (Linking) VI - 40 IP - 12 DP - 2025 Dec 1 TI - Increased Aortic Angulation in Transcatheter Aortic Valve Implantation-Still a Challenging Anatomy? LID - 10.1093/icvts/ivaf281 [doi] LID - ivaf281 AB - OBJECTIVES: Increased aortic angulation (AA) is anatomically challenging during transcatheter aortic valve implantation (TAVI) and may affect procedural outcomes. This study evaluates the clinical and procedural impact of AA in contemporary TAVI procedures. METHODS: This retrospective single-centre observational study included 509 consecutive patients undergoing transfemoral TAVI between January 2021 and December 2024. The primary end-point was device success according to VARC-3 criteria. Secondary endpoints included technical success, early safety at 30 days, procedural time, fluoroscopy time, contrast volume, paravalvular regurgitation (PVR), and permanent pacemaker implantation (PPI). Multivariable logistic and linear regression models were used to assess the association between AA (in degrees) and clinical outcomes. Receiver operating characteristic (ROC) and spline regression analyses were used to evaluate potential threshold effects. RESULTS: Device success at discharge was achieved in 89.4% (455/509) of patients, technical success in 96.3% (490/509), and early safety at 30 days in 75.6% (385/509). Aortic angulation did not significantly influence device success (adjusted odds ratio [aOR]: 0.974, 95% CI: 0.938-1.012, P = .175), technical success (aOR 1.034; 95% CI 0.980-1.091; P = .22), or early safety (aOR: 0.994, 95% CI: 0.968-1.020, P = .633). Similarly, no association was observed between AA and PPI (aOR 1.016; 95% CI 0.984-1.050; P = .34) and PVR. However, AA significantly correlated with increased fluoroscopy times (coefficient: 0.073, SE: 0.026; P = .006) and greater contrast usage (coefficient: 0.406, SE: 0.194; P = .037). CONCLUSIONS: While higher AA increased procedural imaging demand, it did not adversely affect device performance or clinical safety outcomes after TAVI. Importantly, outcomes remained consistent across prosthesis types. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Polat, Emre AU - Polat E AUID- ORCID: 0009-0006-9810-0860 AD - Department of Cardiothoracic Surgery, Augsburg University Hospital, 86156 Augsburg, Germany. FAU - Fortunato, Arianna AU - Fortunato A AD - Department of Cardiothoracic Surgery, Augsburg University Hospital, 86156 Augsburg, Germany. FAU - Schemet, Lena AU - Schemet L AD - Department of Mathematical Statistics and Artificial Intelligence in Medicine, University of Augsburg, 86156 Augsburg, Germany. AD - Center for Advanced Analytics and Predictive Sciences (CAAPS), University of Augsburg, 86156 Augsburg, Germany. FAU - Friedrich-Welz, Sarah AU - Friedrich-Welz S AD - Department of Mathematical Statistics and Artificial Intelligence in Medicine, University of Augsburg, 86156 Augsburg, Germany. AD - Center for Advanced Analytics and Predictive Sciences (CAAPS), University of Augsburg, 86156 Augsburg, Germany. FAU - Tomsic, Anton AU - Tomsic A AD - Department of Cardiothoracic Surgery, Augsburg University Hospital, 86156 Augsburg, Germany. FAU - Amer, Mohamed AU - Amer M AD - Department of Cardiac Surgery, Heart Center Helios Wuppertal, University of Witten/Herdecke, 42117 Wuppertal, Germany. FAU - Girdauskas, Evaldas AU - Girdauskas E AUID- ORCID: 0000-0003-1571-4244 AD - Department of Cardiothoracic Surgery, Augsburg University Hospital, 86156 Augsburg, Germany. FAU - Owais, Tamer AU - Owais T AD - Department of Cardiac Surgery, Heart Center Helios Wuppertal, University of Witten/Herdecke, 42117 Wuppertal, Germany. LA - eng PT - Journal Article PT - Observational Study PL - England TA - Interdiscip Cardiovasc Thorac Surg JT - Interdisciplinary cardiovascular and thoracic surgery JID - 9918540787006676 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Male MH - Female MH - Retrospective Studies MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - *Aortic Valve/diagnostic imaging/surgery MH - Treatment Outcome MH - Heart Valve Prosthesis MH - Risk Factors MH - Postoperative Complications/etiology PMC - PMC12782728 OTO - NOTNLM OT - aortic valve OT - aortic valve stenosis OT - heart valve OT - transcatheter aortic valve implantation COIS- None declared. EDAT- 2025/11/27 18:28 MHDA- 2025/12/10 13:51 PMCR- 2025/11/27 CRDT- 2025/11/27 14:43 PHST- 2025/10/17 00:00 [received] PHST- 2025/11/07 00:00 [accepted] PHST- 2025/12/10 13:51 [medline] PHST- 2025/11/27 18:28 [pubmed] PHST- 2025/11/27 14:43 [entrez] PHST- 2025/11/27 00:00 [pmc-release] AID - 8346369 [pii] AID - ivaf281 [pii] AID - 10.1093/icvts/ivaf281 [doi] PST - ppublish SO - Interdiscip Cardiovasc Thorac Surg. 2025 Dec 1;40(12):ivaf281. doi: 10.1093/icvts/ivaf281. PMID- 41302138 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251127 LR - 20251130 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 15 IP - 11 DP - 2025 Nov 5 TI - Advanced Haemodynamic Monitoring During Transfemoral Aortic Valve Replacement: A Prospective Pilot Study. LID - 10.3390/life15111714 [doi] LID - 1714 AB - This pilot study aims to compare advanced and standard haemodynamic monitoring during TAVI in terms of predicting and avoiding hypotension. Intraoperative hypotension influences postoperative outcomes by increasing mortality, renal failure, and cardiac complications. In TAVI (transaortic valve implantation), haemodynamic stability is essential because the patients are usually old and vulnerable. Fifty patients underwent transfemoral TAVI under standard anaesthetic care. Blood pressure was measured invasively, using Edwards Acumen sensors connected to a HemoSphere monitor. The signal was simultaneously fed to anaesthesia monitors. Patients were randomly divided into two groups: in the test group, the Edwards monitor with the HPI (hypotension prediction index) values was available to the anaesthetist, whereas in the control group, the HemoSphere monitor was covered. The primary endpoint of the study was the time-weighted average of intraoperative hypotension, which is calculated from the intensity and duration of hypotension, adjusted for the duration of surgery (TWA(65)). Secondary endpoints were the cumulative time of hypotensive episodes adjusted for the duration of the procedure (TWA(total)). No difference in intraoperative hypotension in terms of TWA(65) between control and intervention group could be detected, the overall duration of intraoperative hypotension was reduced in the intervention group, and the administration of intraoperative volume was higher in the intervention group when compared to controls. The use of HPI during TAVI leads to improved haemodynamic stability, and this is particularly important in these extremely vulnerable patients. Not only is it possible to reduce overall intraoperative hypotension with HPI, but postoperative complications associated with intraoperative hypotension that might occur will also be diminished. FAU - Bergmann, Astrid AU - Bergmann A AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - Woldt, Philip AU - Woldt P AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - Steins, Lena AU - Steins L AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - Hulde, Nikolai AU - Hulde N AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - Fliegenschmidt, Janis AU - Fliegenschmidt J AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - Piper, Cornelia AU - Piper C AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - Rudolph, Tanja AU - Rudolph T AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. FAU - von Dossow, Vera AU - von Dossow V AUID- ORCID: 0000-0001-7281-2137 AD - Heart- and Diabetes-Center Bad Oeynhausen, Ruhr-University Bochum, 44801 Bochum, Germany. AD - Heart- and Diabetes-Center Bad Oeynhausen, Medical Center East Westphalia-Lippe, University Bielefeld, 33615 Bielefeld, Germany. LA - eng PT - Journal Article DEP - 20251105 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC12653725 OTO - NOTNLM OT - TAVI OT - advanced haemodynamic monitoring OT - intraoperative hypotension OT - intraoperative volume OT - pilot study OT - time-weighted average COIS- The authors declare no conflicts of interest. EDAT- 2025/11/27 06:28 MHDA- 2025/11/27 06:29 PMCR- 2025/11/05 CRDT- 2025/11/27 01:09 PHST- 2025/09/02 00:00 [received] PHST- 2025/10/18 00:00 [revised] PHST- 2025/11/03 00:00 [accepted] PHST- 2025/11/27 06:29 [medline] PHST- 2025/11/27 06:28 [pubmed] PHST- 2025/11/27 01:09 [entrez] PHST- 2025/11/05 00:00 [pmc-release] AID - life15111714 [pii] AID - life-15-01714 [pii] AID - 10.3390/life15111714 [doi] PST - epublish SO - Life (Basel). 2025 Nov 5;15(11):1714. doi: 10.3390/life15111714. PMID- 41293620 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251126 LR - 20251128 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 12 DP - 2025 TI - Changes in patient characteristics and procedural measures over a 10-year period in aortic valve-in-valve procedures for degenerated surgical bioprostheses. PG - 1680733 LID - 10.3389/fcvm.2025.1680733 [doi] LID - 1680733 AB - OBJECTIVES: Aortic valve-in-valve procedures for treatment of degenerated surgical bioprostheses are an established therapy. In this study, we evaluated how the risk profiles, procedural approaches, and early outcomes for patients in these procedures changed over a period of 10 years. METHODS: Baseline, procedural, early outcome, and echocardiographic parameters were retrospectively compared between three time periods (period 1: 2013-2016, period 2: 2017-2020, and period 3: 2021-2023). RESULTS: Between 2013 and 2023, a total of 256 patients underwent valve-in-valve implantation in degenerated aortic bioprostheses at our center with a steady increase of patient numbers. The median age of the patients was 78.0 (interquartile range 72.2-82.4) years and remained unchanged over time. EuroSCORE II presented lower risk profiles in later periods (p = 0.001). Access proportions changed with transfemoral access in 100% of patients in period 3 (p < 0.001). Rates of BASILICA procedures (0% vs. 17.5% vs. 19.4%; p < 0.001) and valve fracturing steadily increased (0% vs. 6.3% vs. 7.8%; p = 0.058). Cerebral protection device use presented a distinct decline to 18.4% in period 3 (p < 0.001). Procedure time and length of intensive care unit stay decreased significantly over time. Early outcome parameters such as rates of permanent pacemaker implantation, bleeding, acute kidney injury, disabling stroke (0.0% vs. 1.3% vs. 1.0%; p = 0.653), and device success (91.8% vs. 92.5% vs. 98.1%; p = 0.123) showed no significant changes over time. The rate of 30-day mortality decreased to 0% in period 3 (p = 0.069). CONCLUSION: Advancements in technical approaches have expanded eligibility for patients previously considered unsuitable for aortic valve-in-valve procedures. In this study, it was found that early outcomes for patients were excellent, with improvement over time, highlighting the clinical efficacy and safety of the procedures. CI - (c) 2025 Knochenhauer, Demal, Bhadra, Ludwig, Sorensen, von der Heide, Hannen, Grundmann, Voigtlander-Buschmann, Waldschmidt, Schirmer, Pecha, Girdauskas, Blankenberg, Reichenspurner, Schofer and Schaefer. FAU - Knochenhauer, Tim AU - Knochenhauer T AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Demal, Till J AU - Demal TJ AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Ludwig, Sebastian AU - Ludwig S AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Sorensen, Nils Arne AU - Sorensen NA AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - von der Heide, Ina AU - von der Heide I AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Hannen, Laura AU - Hannen L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Voigtlander-Buschmann, Lisa AU - Voigtlander-Buschmann L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Waldschmidt, Lara AU - Waldschmidt L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Schirmer, Johannes AU - Schirmer J AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Pecha, Simon AU - Pecha S AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Girdauskas, Evaldas AU - Girdauskas E AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. AD - Department of Cardiothoracic Surgery, Augsburg University Medical Center, Augsburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AD - DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. LA - eng PT - Journal Article DEP - 20251110 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC12640918 OTO - NOTNLM OT - TAVI OT - TAVR OT - aortic valve OT - bioprosthesis OT - lifetime management OT - valve-in-valve COIS- NS received travel compensation from Edwards Lifesciencesand St Jude Medical, and speaking and lecture fees and travelcompensation from Boston Scientific. AS received lecture fees/travel compensation from Abbott, Boston Scientific, andEdwards Lifesciences Inc. AS is a proctor for Abbott. MBreceived travel compensation from Abbott. SL received travelcompensation from Edwards Lifesciences Inc. HR received travelcompensation and lecture fees from Edwards Lifesciences Inc.and Medtronic Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/11/26 06:29 MHDA- 2025/11/26 06:30 PMCR- 2025/11/10 CRDT- 2025/11/26 04:50 PHST- 2025/08/06 00:00 [received] PHST- 2025/10/20 00:00 [accepted] PHST- 2025/11/26 06:30 [medline] PHST- 2025/11/26 06:29 [pubmed] PHST- 2025/11/26 04:50 [entrez] PHST- 2025/11/10 00:00 [pmc-release] AID - 10.3389/fcvm.2025.1680733 [doi] PST - epublish SO - Front Cardiovasc Med. 2025 Nov 10;12:1680733. doi: 10.3389/fcvm.2025.1680733. eCollection 2025. PMID- 41286135 OWN - NLM STAT- MEDLINE DCOM- 20260731 LR - 20261008 IS - 1438-8359 (Electronic) IS - 0913-8668 (Linking) VI - 40 IP - 4 DP - 2026 Aug TI - Incidence and predictors of activities of daily living decline after transcatheter aortic valve implantation. PG - 549-556 LID - 10.1007/s00540-025-03633-4 [doi] AB - PURPOSE: To clarify the incidence of activities of daily living (ADL) decline following transcatheter aortic valve implantation (TAVI) and to investigate its contributing factors, including anesthesia methods and sedative drugs. METHODS: This retrospective study included 128 patients who underwent transfemoral TAVI between December 2018 and June 2023. ADL was assessed using the Katz Index preoperatively and one week postoperatively. Patients with decreased scores were assigned to the ADL-decline group. Clinical, physical, cognitive, and perioperative data were analyzed. Multivariate logistic regression analysis was performed to identify predictors of ADL decline. RESULTS: ADL decline occurred in 25 patients (20%), who were significantly older (87.9 vs. 85.1 years, p = 0.004), had lower preoperative Short Physical Performance Battery (SPPB) scores (7.2 vs. 9.7, p = 0.001), and lower preoperative grip strength (14.6 vs. 17.4, p = 0.04). All three patients of with postoperative cerebral infarction experienced ADL decline. No significant differences in anesthesia methods (general anesthesia vs. monitored anesthesia care) or sedative drugs (propofol vs. remimazolam) were noted. Multivariate analysis revealed that older age (adjusted odds ratio [OR]: 1.15; 95% confidence interval [CI]: 1.01-1.31; p = 0.03) and lower preoperative SPPB score (adjusted OR: 0.83; 95% CI: 0.69-0.98; p = 0.03) were independent predictors of ADL decline. CONCLUSION: Older age and reduced preoperative physical function were associated with ADL decline after TAVI. In contrast, anesthesia methods and sedative drug choices did not influence postoperative ADL. These findings may help guide patient selection and inform perioperative rehabilitation strategies to preserve independence after TAVI. CI - (c) 2025. The Author(s), under exclusive licence to Japanese Society of Anesthesiologists. FAU - Yamada, Yasutaka AU - Yamada Y AUID- ORCID: 0000-0003-2792-5516 AD - National Hospital Organization Ureshino Medical Center, 4760-1, Shimojyuku kou, Ureshino chou, Ureshino City, Saga, 843-0393, Japan. yasu-taka.0418@outlook.jp. FAU - Amamoto, Keisuke AU - Amamoto K AD - Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga City, Saga, Japan. FAU - Noguchi, Hiroshi AU - Noguchi H AD - Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga City, Saga, Japan. FAU - Tashiro, Taku AU - Tashiro T AD - Department of Anesthesia, Saga Medical Center KOSEIKAN, Saga City, Saga, Japan. FAU - Kusaba, Shinichiro AU - Kusaba S AD - Department of Anesthesia, Saga Medical Center KOSEIKAN, Saga City, Saga, Japan. FAU - Sakaguchi, Yoshiro AU - Sakaguchi Y AD - Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga City, Saga, Japan. LA - eng PT - Journal Article DEP - 20251125 PL - Japan TA - J Anesth JT - Journal of anesthesia JID - 8905667 RN - 0 (Hypnotics and Sedatives) SB - IM CIN - J Anesth. 2026 Feb 4. doi: 10.1007/s00540-026-03673-4. PMID: 41639427 MH - Humans MH - *Activities of Daily Living MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Aged, 80 and over MH - Retrospective Studies MH - Incidence MH - *Postoperative Complications/epidemiology/etiology MH - Risk Factors MH - Aortic Valve Stenosis/surgery MH - Hypnotics and Sedatives MH - Age Factors OTO - NOTNLM OT - Activities of daily living OT - Aortic stenosis OT - Geriatrics OT - Sedative drugs OT - Transcatheter aortic valve implantation COIS- Declarations. Conflict of interest: The authors declare that they have no competing interests. EDAT- 2025/11/25 06:26 MHDA- 2026/07/31 12:39 CRDT- 2025/11/25 01:21 PHST- 2025/08/28 00:00 [received] PHST- 2025/11/20 00:00 [accepted] PHST- 2026/07/31 12:39 [medline] PHST- 2025/11/25 06:26 [pubmed] PHST- 2025/11/25 01:21 [entrez] AID - 10.1007/s00540-025-03633-4 [pii] AID - 10.1007/s00540-025-03633-4 [doi] PST - ppublish SO - J Anesth. 2026 Aug;40(4):549-556. doi: 10.1007/s00540-025-03633-4. Epub 2025 Nov 25. PMID- 41281667 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251124 LR - 20251126 IS - 0353-8109 (Print) IS - 1986-5988 (Electronic) IS - 0353-8109 (Linking) VI - 33 IP - 3 DP - 2025 TI - Access Site and Pacemaker Outcomes After TAVR in HFrEF Patients: Axillary vs Femoral Approach. PG - 209-214 LID - 10.5455/aim.2025.33.209-214 [doi] AB - BACKGROUND: Aortic stenosis is a prevalent disease affecting approximately 10% of the population by the eighth decade, it is a fatal disease without treatment, with an annual mortality rate reaching 25%. Valve replacement, either through surgical or transcatheter approach, is the only therapeutic option. Over the last 15 years, the indications for transcatheter aortic valve replacement (TAVR) have spread to include young and low surgical risk patients. OBJECTIVE: Our study aims to address this gap in the literature by comparing the adverse outcome after TAVR through axillary versus femoral access in heart failure reduce ejection fraction (HFrEF) patients who underwent TAVR within 30 days of the procedure. METHODS: We used data from TriNetX US collaborative network database, including HFrEF patients who had TAVR through axillary or femoral access between 2015 and 2025. Propensity score matching was done to minimize the difference in baseline characteristics between the two cohorts. Outcomes were observed within the first 30 days of TAVR. RESULTS: A total of 206 patients in each cohort (axillary vs. femoral) were studied after propensity score matching. The incidence of permanent pacemaker (PPM) insertion was comparable between groups (5.0% vs. 5.1%; OR: 0.984, 95% CI: 0.400-2.419; HR: 0.365, 95% CI: 0.097-1.376; p = 0.157). Secondary outcomes showed no significant differences between the axillary and femoral approaches, including major vascular complications (OR: 0.542, 95% CI: 0.238-1.231; HR: 0.448, 95% CI: 0.192-1.046), acute kidney injury (OR: 0.922, 95% CI: 0.430-1.976; HR: 0.940, 95% CI: 0.459-1.922), all-cause mortality (OR: 1.010, 95% CI: 0.411-2.482; HR: 1.040, 95% CI: 0.433-2.498), cerebrovascular accident (OR: 0.980, 95% CI: 0.390-2.460; HR: 1.142, 95% CI: 0.384-3.399), and acute coronary syndrome (OR: 0.885, 95% CI: 0.355-2.208; HR: 1.211, 95% CI: 0.271-5.412). CONCLUSION: Our study finding showed no difference in the permanent pacemaker insertion or secondary outcomes (Major vascular complications, Acute Kidney Injury, Cerebrovascular accident, Acute coronary syndrome, and All-cause mortality) within the first 30 days of TAVR in patients with HFrEF, whether the access axillary or femoral. CI - (c) 2025 Laith Rhabneh, Raed Ababneh, Emad Algorani, Jamil Wafi, Mohammed Alkhanafsa, Huthaifa Ababneh, Abdel Rahman Alwardat, Mohammed Aloqaily. FAU - Rhabneh, Laith AU - Rhabneh L AD - Internal Medicine Department, HMH Ocean University Medical Center, Brick, NJ, USA. FAU - Ababneh, Raed AU - Ababneh R AD - Internal Medicine Department, HMH Ocean University Medical Center, Brick, NJ, USA. FAU - Algorani, Emad AU - Algorani E AD - Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar. FAU - Wafi, Jamil AU - Wafi J AD - Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar. FAU - Alkhanafsa, Mohammed AU - Alkhanafsa M AD - Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar. FAU - Ababneh, Huthaifa AU - Ababneh H AD - Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar. FAU - Alwardat, Abdel Rahman AU - Alwardat AR AD - Internal Medicine Department, King Abdullah University Hospital, Irbid, Jordan. FAU - Aloqaily, Mohammed AU - Aloqaily M AD - Internal Medicine Department, King Abdullah University Hospital, Irbid, Jordan. LA - eng PT - Journal Article PL - Bosnia and Herzegovina TA - Acta Inform Med JT - Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH JID - 101147064 PMC - PMC12634094 OTO - NOTNLM OT - Aortic Stenosis OT - Heart Failure Reduce Ejection Fraction OT - Permanent Pacemaker Insertion OT - Transcatheter Aortic Valve Replacement COIS- The authors declare that there are no conflicts of interest for this study. EDAT- 2025/11/24 12:38 MHDA- 2025/11/24 12:39 PMCR- 2025/01/01 CRDT- 2025/11/24 09:06 PHST- 2025/08/16 00:00 [received] PHST- 2025/09/28 00:00 [accepted] PHST- 2025/11/24 12:39 [medline] PHST- 2025/11/24 12:38 [pubmed] PHST- 2025/11/24 09:06 [entrez] PHST- 2025/01/01 00:00 [pmc-release] AID - AIM-33-3-209 [pii] AID - 10.5455/aim.2025.33.209-214 [doi] PST - ppublish SO - Acta Inform Med. 2025;33(3):209-214. doi: 10.5455/aim.2025.33.209-214. PMID- 41273923 OWN - NLM STAT- MEDLINE DCOM- 20251201 LR - 20260128 IS - 1872-7727 (Electronic) IS - 0720-048X (Linking) VI - 194 DP - 2026 Jan TI - Predicting pacemaker dependency after transcatheter aortic valve replacement: Analysis of ECG, clinical, and CT-imaging parameters. PG - 112534 LID - S0720-048X(25)00620-5 [pii] LID - 10.1016/j.ejrad.2025.112534 [doi] AB - OBJECTIVES: Conduction disturbances necessitating permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR) have been observed. However, limited data exist on ECG, clinical, and CT-imaging factors predicting PPM dependency after TAVR. This study aimed to identify predictors of pacemaker dependency in selected patients who required PPM implantation after TAVR with SAPIEN 3 prostheses. MATERIALS AND METHODS: This study included consecutive patients who underwent transfemoral TAVR with SAPIEN 3 prostheses at our institution between May 2012 and December 2019. Exclusion criteria were incomplete or non-diagnostic data, valve-in-valve procedures, TAVR in mitral position, previous surgical repair, and pre-implanted PPM. The primary endpoint was PPM dependency, defined as ventricular pacing percentage >/= 1 % at the first outpatient follow-up after PPM implantation post-TAVR. Regression analysis was performed to compare a limited prediction model for PPM dependency using only selected variables to a full model with all available variables. RESULTS: Out of 2105 patients who received TAVR, 350 (16.6 %) required pacemaker implantation post-TAVR. After exclusions, 301 patients remained, with 168 (55.8 %) PPM-dependent and 133 (44.2 %) non-dependent patients. Multivariate analysis identified prosthesis oversizing (OR: 1.09, p < 0.001), calcification below the left coronary cusp (LCC) (OR: 1.02, p < 0.001), and right bundle branch block (RBBB) prior to TAVR (OR: 2.20, p = 0.025) as significant predictors. A limited regression model predicted PPM dependency with an AUC of 0.752, significantly outperforming the full model (AUC: 0.660, p = 0.037). CONCLUSION: RBBB prior to TAVR was the strongest predictor of PPM dependency post-TAVR, followed by prosthesis oversizing and calcification below the LCC. A limited prediction model with these variables demonstrated moderate predictive accuracy. CI - Copyright (c) 2025 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Klambauer, Konstantin AU - Klambauer K AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Rizas, Konstantinos D AU - Rizas KD AD - Department of Internal Medicine I, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Fabritius, Matthias P AU - Fabritius MP AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Fink, Nicola AU - Fink N AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Schafer, Verena AU - Schafer V AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Mansour, Nabeel AU - Mansour N AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Utz, Christina AU - Utz C AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Grathwohl, Fabian AU - Grathwohl F AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Kunz, Wolgang G AU - Kunz WG AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Spiro, Judith AU - Spiro J AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Ricke, Jens AU - Ricke J AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Curta, Adrian AU - Curta A AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. FAU - Puhr-Westerheide, Daniel AU - Puhr-Westerheide D AD - Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. Electronic address: Daniel.Puhr-Westerheide@med.uni-muenchen.de. LA - eng PT - Journal Article DEP - 20251117 PL - Ireland TA - Eur J Radiol JT - European journal of radiology JID - 8106411 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Female MH - Male MH - *Pacemaker, Artificial/statistics & numerical data MH - Aged, 80 and over MH - *Electrocardiography MH - *Tomography, X-Ray Computed/methods MH - *Postoperative Complications/therapy MH - Aged MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - Heart Valve Prosthesis OTO - NOTNLM OT - CT-imaging OT - ECG OT - Pacemaker dependency OT - Prediction OT - TAVR COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/11/23 00:58 MHDA- 2025/12/02 01:00 CRDT- 2025/11/22 18:10 PHST- 2025/05/22 00:00 [received] PHST- 2025/10/21 00:00 [revised] PHST- 2025/11/16 00:00 [accepted] PHST- 2025/12/02 01:00 [medline] PHST- 2025/11/23 00:58 [pubmed] PHST- 2025/11/22 18:10 [entrez] AID - S0720-048X(25)00620-5 [pii] AID - 10.1016/j.ejrad.2025.112534 [doi] PST - ppublish SO - Eur J Radiol. 2026 Jan;194:112534. doi: 10.1016/j.ejrad.2025.112534. Epub 2025 Nov 17. PMID- 41243772 OWN - NLM STAT- MEDLINE DCOM- 20251117 LR - 20251212 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 22 DP - 2025 Nov 14 TI - Assessment of coronary cannulation after TAVI with the Evolut FX valve: the CANNULATE TAVR EXPANDED study. PG - 1364-1375 LID - EIJ-D-24-01050 [pii] LID - 10.4244/EIJ-D-24-01050 [doi] AB - BACKGROUND: The new-generation supra-annular, self-expanding Evolut FX system has the potential to facilitate commissural alignment. AIMS: We sought to assess the feasibility of coronary cannulation (CC) and the impact of commissural and coronary alignment on CC execution, as confirmed by post-transcatheter aortic valve implantation (TAVI) computed tomography (CT). METHODS: The CANNULATE TAVR EXPANDED study is a multicentre, prospective study which included consecutive patients who underwent transfemoral TAVI with the Evolut FX, CC, and angiography after valve deployment. Post-TAVI CT was performed to assess commissural and coronary alignment. Moderate-to-severe commissural and coronary misalignments based on the ALIGN-TAVR Consortium definition were categorised as the misalignment group. The primary endpoint was the rate of successful CC after Evolut FX implantation. RESULTS: A total of 126 patients were included. CC was successful in 100% of cases for the left coronary artery (LCA) and 96.7% for the right coronary artery (RCA). Moderate-to-severe commissural misalignment was observed in 13.5%, and moderate-to-severe coronary misalignment was observed in 20.6% (LCA) and 22.2% (RCA). Misaligned LCA and RCA required significantly longer CC times. In multivariable analysis, factors associated with suboptimal LCA cannulation were coronary height (odds ratio [OR] 0.73, 95% confidence interval [CI]: 0.57-0.90; p=0.006) and coronary misalignment (OR 4.58, 95% CI: 1.45-14.47; p=0.009), whereas right coronary cusp width (OR 0.63, 95% CI: 0.44-0.90; p=0.007) and coronary misalignment (OR 4.64, 95% CI: 1.29-16.74; p=0.019) were identified for the RCA. CONCLUSIONS: High rates of CC, and commissural and coronary alignment post-TAVI with the Evolut FX were observed in this prospective, multicentre study. Coronary misalignment was identified as the strongest predictor of suboptimal CC for both the LCA and the RCA. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Kamioka, Norihiko AU - Kamioka N AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Miyamoto, Junichi AU - Miyamoto J AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Omura, Ryosuke AU - Omura R AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Horinouchi, Hitomi AU - Horinouchi H AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Hashimoto, Kaho AU - Hashimoto K AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Noda, Satoshi AU - Noda S AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Murakami, Tsutomu AU - Murakami T AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Ikari, Yuji AU - Ikari Y AD - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan. FAU - Okada, Kimiaki AU - Okada K AD - Department of Cardiovascular Surgery, Tokai University School of Medicine, Isehara, Japan. FAU - Frazzetto, Marco AU - Frazzetto M AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Raheja, Hitesh AU - Raheja H AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Lodi, Hamza AU - Lodi H AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Rushing, Gregory AU - Rushing G AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Ukaigwe, Anene AU - Ukaigwe A AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Filby, Steven AU - Filby S AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Yoon, Sunghan AU - Yoon S AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Feroze, Rafey AU - Feroze R AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Palma Dallan, Luis Augusto AU - Palma Dallan LA AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. FAU - Attizzani, Guilherme F AU - Attizzani GF AD - Department of Cardiology, University Hospitals, Cleveland, OH, USA. AD - Department of Cardiology, Osaka University, Osaka, Japan. FAU - Tavr Expanded Investigators, On Behalf Of The Cannulate AU - Tavr Expanded Investigators OBOTC LA - eng PT - Journal Article PT - Multicenter Study PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation MH - Prospective Studies MH - Aged MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/diagnostic imaging MH - *Aortic Valve/surgery/diagnostic imaging MH - *Coronary Vessels/diagnostic imaging/surgery MH - Coronary Angiography/methods MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Cardiac Catheterization/methods PMC - PMC12593821 COIS- Y. Ohno is a clinical proctor for Medtronic and Abbott. N. Kamioka is a clinical proctor for Edwards Lifesciences. G.F. Attizzani is a consultant, serves on the advisory board, and has research grants with Medtronic, Boston Scientific, and Dasi Simulations. A. Ukaigwe is a consultant for Medtronic. S. Filby is a consultant for Boston Scientific. The other authors have no conflicts of interest relevant to the contents of this paper to declare. EDAT- 2025/11/17 09:07 MHDA- 2025/11/17 09:08 PMCR- 2026/11/14 CRDT- 2025/11/17 04:43 PHST- 2025/11/17 09:08 [medline] PHST- 2025/11/17 09:07 [pubmed] PHST- 2025/11/17 04:43 [entrez] PHST- 2026/11/14 00:00 [pmc-release] AID - EIJ-D-24-01050 [pii] AID - 10.4244/EIJ-D-24-01050 [doi] PST - ppublish SO - EuroIntervention. 2025 Nov 14;21(22):1364-1375. doi: 10.4244/EIJ-D-24-01050. PMID- 41240026 OWN - NLM STAT- MEDLINE DCOM- 20251224 LR - 20260724 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 24 DP - 2025 Dec 22 TI - Real-Time Fluoroscopic Assessment of Underexpansion Predicts Hemodynamic Valve Deterioration Following TAVR With Balloon-Expandable Device. PG - 3024-3035 LID - S1936-8798(25)02577-4 [pii] LID - 10.1016/j.jcin.2025.10.005 [doi] AB - BACKGROUND: The clinical sequelae of transcatheter heart valve (THV) underexpansion following transcatheter aortic valve replacement (TAVR) with balloon-expandable devices remain incompletely understood. OBJECTIVES: The aim of this study was to investigate the impact of THV underexpansion on clinical outcomes among patients treated with balloon-expandable TAVR. METHODS: Consecutive patients undergoing transfemoral TAVR with the SAPIEN 3 and SAPIEN 3 Ultra systems in the prospective Bern TAVI registry were retrospectively evaluated. THV underexpansion was assessed on postimplantation fluoroscopic images and quantified using the validated commissural post height method. Significant THV underexpansion was defined as a reduction in stent frame midportion diameter >/=20% compared with the nominal diameter, using an optimal cutoff value determined by maximizing the log-rank statistic. The outcomes of interest were moderate or severe hemodynamic valve deterioration (HVD) according to the Valve Academic Research Consortium 3 and all-cause and cardiovascular mortality at 5-year follow-up. RESULTS: Among 1,043 patients (median age 81 years; Q1-Q3: 76-85 years; 34.6% women) undergoing TAVR with SAPIEN 3 or SAPIEN 3 Ultra valves between 2014 and 2022, 57 (5.4%) exhibited THV underexpansion. THV underexpansion >/= 20% was associated with an increased risk for HVD at 5-year follow-up (subdistribution HR: 4.88; 95% CI: 2.18-10.97). The risk for HVD gradually increased with increasing degree of underexpansion (subdistribution HR: 1.94 per 5% increase; 95% CI: 1.42-2.79), with consistent findings across all valve sizes. Total aortic valve calcium volume, bicuspid anatomy, and valve iteration were significant predictors of THV underexpansion. At 862-day follow-up (Q1-Q3: 366-1,812 days), underexpansion was not associated with mortality. CONCLUSIONS: Underexpansion of balloon-expandable THVs is associated with an increased risk for HVD at mid-term follow-up. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Angellotti, Domenico AU - Angellotti D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy. FAU - Elamin, Nadir AU - Elamin N AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Ferro, Cyril AU - Ferro C AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Alaour, Bashir AU - Alaour B AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Bartkowiak, Joanna AU - Bartkowiak J AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Samim, Daryoush AU - Samim D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Praz, Fabien AU - Praz F AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Reineke, David AU - Reineke D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Meier, David AU - Meier D AD - Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address: david.meier@chuv.ch. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20251114 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Female MH - Male MH - Aged MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Aged, 80 and over MH - *Heart Valve Prosthesis MH - Retrospective Studies MH - *Hemodynamics MH - *Aortic Valve/physiopathology/diagnostic imaging/surgery MH - Treatment Outcome MH - Time Factors MH - *Aortic Valve Stenosis/physiopathology/diagnostic imaging/mortality/surgery MH - Risk Factors MH - Prosthesis Design MH - Registries MH - Predictive Value of Tests MH - *Balloon Valvuloplasty/adverse effects/instrumentation/mortality MH - Fluoroscopy MH - Risk Assessment MH - *Prosthesis Failure OTO - NOTNLM OT - TAVR OT - hemodynamic valve deterioration OT - underexpansion COIS- Funding Support and Author Disclosures Dr Angellotti is supported by a research grant provided by the CardioPath PhD program. Dr Lanz has received speaker fees to the institution from Edwards Lifesciences and Abbott Laboratories. Dr Samim has received funding for an online course from Edwards Lifesciences. Dr Praz has received travel expenses from Edwards Lifesciences, Abbott Cardiovascular, Medira, Siemens Healthineers, and InQB8 Medical Technologies; and has received a research grant to the institution from Abbott Cardiovascular. Dr Windecker has received research, travel, and/or educational grants to the institution from Abbott Laboratories, Abiomed, Alnylam, Amicus Therapeutics, Amgen, AstraZeneca, Bayer, B. Braun, BioAnalytica, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cordis Medical, CorFlow Therapeutics, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Fumedica, GE Healthcare, Guerbet, IACULIS, Inari Medical, Janssen AI, Johnson & Johnson, Medalliance, Medtronic, Merck Sharp & Dohme, Neovii Pharmaceutica, Neutromedics, Novartis, Novo Nordisk, OM Pharma, Optimapharm, Orchestra BioMed, Pfizer, Philips, Sanofi, Servier, Shockwave Medical, Siemens Healthcare, Sinomed, SMT Sahajanand Medical Technologies, Vascular Medical, and V-Wave. Dr Windecker serves as an advisory board member and/or a member of the steering and executive groups of trials funded by Abbott Laboratories, Amgen, Abiomed, Edwards Lifesciences, EnCarda, Medtronic, Novartis, and Sinomed, with payments to the institution but no personal payments; and is a member of the steering and executive committee groups of several investigator-initiated trials that receive funding from industry, without impact on his personal remuneration. Dr Meier has received an institutional grant from Edwards Lifesciences; and is a consultant for Abbott Laboratories. Dr Pilgrim has received research, travel, and educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; and has received speaker fees and consulting fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott Laboratories, Medtronic, Biosensors, and Highlife. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/11/15 12:31 MHDA- 2025/12/25 00:30 CRDT- 2025/11/15 10:27 PHST- 2025/06/19 00:00 [received] PHST- 2025/09/10 00:00 [revised] PHST- 2025/10/02 00:00 [accepted] PHST- 2025/12/25 00:30 [medline] PHST- 2025/11/15 12:31 [pubmed] PHST- 2025/11/15 10:27 [entrez] AID - S1936-8798(25)02577-4 [pii] AID - 10.1016/j.jcin.2025.10.005 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Dec 22;18(24):3024-3035. doi: 10.1016/j.jcin.2025.10.005. Epub 2025 Nov 14. PMID- 41232807 OWN - NLM STAT- MEDLINE DCOM- 20251130 LR - 20261019 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 444 DP - 2026 Feb 1 TI - Single perclose escalation technique: A novel approach for vascular closure following Transcatheter Aortic Valve Replacement. PG - 134012 LID - S0167-5273(25)01055-1 [pii] LID - 10.1016/j.ijcard.2025.134012 [doi] AB - BACKGROUND: Suture-based vascular closure devices (VCDs) are commonly used for large-bore arteriotomy closure, but real-world comparisons of different closure strategies remain limited. We aimed to evaluate the safety and efficacy of the Single Perclose ProGlide Escalation Technique (SPET) and compare it with Double Perclose ProGlide Technique (DPT). METHODS: This is an observational, single-center, retrospective study of all consecutive patients who underwent transfemoral transcatheter aortic valve replacement (TAVR) between January 2017 and January 2023. The SPET group used a single initial Perclose ProGlide, followed by post-TAVR angiography to assess the need for additional VCDs. After propensity score matching, we compared SPET with the standard DPT. The primary endpoint was a composite of major vascular complications or bleeding >/=2 per VARC 3 criteria, occurring either in-hospital or within 30 days post-procedure. Minor vascular complications, and the number of VCDs used was assessed as secondary endpoints. RESULTS: From an initial cohort of 671, 446 patients were selected through propensity score matching, resulting in two well-balanced groups of 223 each (median age 81 +/- 7, 53.6 % female). No significant differences in the primary endpoint were observed (4 % vs. 5.8 %, p = 0.38). The SPET group had significantly fewer minor vascular complications (0.9 % vs. 4.9 %, p = 0.011) and reduced use of VCDs (1.96 vs. 2.09, p = 0.006), with up to 22 % of patients not requiring any additional devices. CONCLUSIONS: The SPET technique appears to be safe and effective after transfemoral TAVR, reducing minor vascular complications without increasing the risk of major vascular complications or bleeding compared to DPT. CI - Copyright (c) 2025 Elsevier B.V. All rights reserved. FAU - Monastyrski, Andrea Virginia AU - Monastyrski AV AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Serra Garcia, Vicenc AU - Serra Garcia V AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. FAU - Palma Carbajal, Ricardo AU - Palma Carbajal R AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Munoz, Juan Manuel AU - Munoz JM AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Gutierrez Guadarrama, Dulce AU - Gutierrez Guadarrama D AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Diaz Pockels, Pedro AU - Diaz Pockels P AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Moscoso Ramirez, Josh AU - Moscoso Ramirez J AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Calabuig Goena, Alvaro AU - Calabuig Goena A AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. FAU - Marti Aguasca, Gerard AU - Marti Aguasca G AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Serra Creus, Bernat AU - Serra Creus B AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Bellera Gotarda, Neus AU - Bellera Gotarda N AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. FAU - Otaegui Irurueta, Imanol AU - Otaegui Irurueta I AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. FAU - Sao-Aviles, Augusto AU - Sao-Aviles A AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. FAU - Rodenas-Alesina, Eduard AU - Rodenas-Alesina E AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. FAU - Belahnech, Yassin AU - Belahnech Y AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain. Electronic address: yassin.belahnech@gmail.com. FAU - Garcia Del Blanco, Bruno AU - Garcia Del Blanco B AD - Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20251111 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods/trends MH - Female MH - Male MH - Retrospective Studies MH - Aged, 80 and over MH - *Vascular Closure Devices/trends MH - Aged MH - Femoral Artery/surgery MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - *Suture Techniques/instrumentation OTO - NOTNLM OT - Access site closure OT - Transcatheter aortic valve replacement OT - Transfemoral OT - Vascular closure OT - Vascular complications COIS- Declaration of competing interest All authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/11/14 00:27 MHDA- 2025/12/01 00:30 CRDT- 2025/11/13 19:14 PHST- 2025/08/26 00:00 [received] PHST- 2025/10/21 00:00 [revised] PHST- 2025/11/04 00:00 [accepted] PHST- 2025/12/01 00:30 [medline] PHST- 2025/11/14 00:27 [pubmed] PHST- 2025/11/13 19:14 [entrez] AID - S0167-5273(25)01055-1 [pii] AID - 10.1016/j.ijcard.2025.134012 [doi] PST - ppublish SO - Int J Cardiol. 2026 Feb 1;444:134012. doi: 10.1016/j.ijcard.2025.134012. Epub 2025 Nov 11. PMID- 41227283 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251113 LR - 20251115 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 21 DP - 2025 Nov 6 TI - Managing Complex Anatomical Scenarios in Tavi: Evidence and an Institutional Perspective. LID - 10.3390/jcm14217888 [doi] LID - 7888 AB - Transcatheter aortic valve implantation (TAVI) is the default therapy for most elderly patients with severe aortic stenosis, but outcomes in complex anatomy depend on imaging-guided planning and disciplined technique. This article aims to present our institutional approach, supported by the current literature, in managing several challenging anatomical scenarios. We focus on seven high-impact scenarios-bicuspid aortic valve (BAV), hostile transfemoral access, iliofemoral/aortic tortuosity, adverse aortic angulation, heavy annulus/Left Ventricular Outflow Tract (LVOT) calcification, small annulus, and risk of coronary obstruction-and propose a practical approach to minimize the risk of complications. In BAV, current generation transcatheter heart valves (THV) achieve favorable early outcomes when sizing accounts for supra-annular constraints and implantation depth is tailored. Transfemoral access remains dominant in contemporary registries, yet a meaningful minority of cases require adjunctive peripheral vascular intervention to enable THV delivery-system passage. In case of annulus or LVOT calcification, small annuli, complex aortic anatomy, high risk for coronary obstruction, and pre-procedural Computed Tomography (CT) allow for an accurate sizing of THV and tailored procedural planning. A structured, CT-driven pathway that links anatomic findings to specific facilitation and bailout steps can standardize decision-making and improve safety across these challenging scenarios. We strongly highlight the importance to build a network where most complex procedures are carried out in Valve Centers where expert operators are trained to manage high volume, high complexity, and difficult complications. FAU - Piro, Orlando AU - Piro O AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Granato, Mattia AU - Granato M AUID- ORCID: 0009-0009-5169-1570 AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Covino, Simona AU - Covino S AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Cigala, Emanuele AU - Cigala E AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Crisci, Mario AU - Crisci M AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Granata, Riccardo AU - Granata R AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Monteforte, Ida AU - Monteforte I AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Mocavero, Paola AU - Mocavero P AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Sordelli, Chiara AU - Sordelli C AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. FAU - Di Lorenzo, Emilio AU - Di Lorenzo E AD - Division of Cardiology, Monaldi Hospital, 80131 Naples, Italy. LA - eng PT - Journal Article PT - Review DEP - 20251106 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12608379 OTO - NOTNLM OT - aortic tortuosity and angulation OT - bicuspid aortic valve (BAV) OT - complex aortic anatomy OT - hostile transfemoral access OT - transcatheter aortic valve implantation (TAVI) COIS- The authors declare no conflicts of interest. EDAT- 2025/11/13 06:30 MHDA- 2025/11/13 06:31 PMCR- 2025/11/06 CRDT- 2025/11/13 01:07 PHST- 2025/09/25 00:00 [received] PHST- 2025/10/26 00:00 [revised] PHST- 2025/10/31 00:00 [accepted] PHST- 2025/11/13 06:31 [medline] PHST- 2025/11/13 06:30 [pubmed] PHST- 2025/11/13 01:07 [entrez] PHST- 2025/11/06 00:00 [pmc-release] AID - jcm14217888 [pii] AID - jcm-14-07888 [pii] AID - 10.3390/jcm14217888 [doi] PST - epublish SO - J Clin Med. 2025 Nov 6;14(21):7888. doi: 10.3390/jcm14217888. PMID- 41203918 OWN - NLM STAT- MEDLINE DCOM- 20260221 LR - 20260813 IS - 1179-1896 (Electronic) IS - 1175-5652 (Print) IS - 1175-5652 (Linking) VI - 24 IP - 2 DP - 2026 Mar TI - Cost-Utility Analysis of TAVI Versus Surgery in Low-Risk Patients with Severe Aortic Stenosis in the UK. PG - 365-378 LID - 10.1007/s40258-025-01012-4 [doi] AB - BACKGROUND AND OBJECTIVE: European guidelines recommend transcatheter aortic valve implantation (TAVI; class IA) for symptomatic severe aortic stenosis (sSAS) in patients aged >/= 75 years, if a transfemoral approach is possible. Recent cost-utility analyses based on the PARTNER 3 trial have suggested that TAVI with the SAPIEN 3 device is cost effective versus surgical aortic valve replacement (SAVR) in patients at low risk of surgical mortality in several European countries. This cost-utility analysis compares TAVI with SAPIEN 3 versus SAVR in patients with sSAS at low risk of surgical mortality from the UK healthcare system perspective, using 5-year PARTNER 3 trial data. METHODS: A two-stage, Markov-based, cost-utility analysis was performed using published and validated methodology to estimate changes in both direct healthcare costs and health-related quality of life for TAVI with SAPIEN 3 versus SAVR in patients with sSAS at low surgical risk from the perspective of the UK healthcare system. The model used a lifetime horizon with a 3.5% yearly discounting factor. Uncertainty was addressed using deterministic and probabilistic sensitivity analyses. RESULTS: Transcatheter aortic valve implantation with SAPIEN 3 generated an incremental health benefit of 0.47 (90% credible interval 0.35-0.60) quality-adjusted life-years per patient compared with SAVR, at an increased cost of pound7999 ( pound852- pound15,035 90% credible interval) per patient over a lifetime horizon (incremental cost-effectiveness ratio: pound16,979 per quality-adjusted life-year gained). Transcatheter aortic valve implantation has a 63-90% probability of cost effectiveness based on a pound20,000- pound30,000 willingness-to-pay threshold. Transcatheter aortic valve implantation remained cost effective across most deterministic sensitivity analyses, confirming the relative robustness of the results. CONCLUSIONS: Transcatheter aortic valve implantation with SAPIEN 3 has a 63-90% probability of being cost effective compared with SAVR for low-surgical-risk patients with sSAS. These findings may inform policy decision making in the management of this patient group. CI - (c) 2025. The Author(s). FAU - Curzen, Nick AU - Curzen N AD - Faculty of Medicine, University of Southampton, Southampton, UK. AD - Cardiothoracic Unit, University Hospital Southampton NHS Trust, Southampton, UK. FAU - Candolfi, Pascal AU - Candolfi P AUID- ORCID: 0000-0001-6728-451X AD - Edwards Lifesciences Sarl, Route de l'Etraz 70, 1260, Nyon, Switzerland. pascal_candolfi@edwards.com. FAU - MacCarthy, Philip AU - MacCarthy P AD - King's College Hospital, London, UK. FAU - Lloyd, Clinton T AU - Lloyd CT AD - University Hospitals Plymouth NHS Trust, Plymouth, UK. FAU - Aetesam-Ur-Rahman, Muhammad AU - Aetesam-Ur-Rahman M AD - Sheffield Teaching Hospitals NHS FT, Sheffield, UK. FAU - Bromilow, Tom AU - Bromilow T AD - York Health Economics Consortium, University of York, York, UK. FAU - Sellitto, Valentina AU - Sellitto V AD - Edwards Lifesciences, Milan, Italy. FAU - Blackman, Daniel J AU - Blackman DJ AD - Leeds Teaching Hospitals NHS Trust, Leeds, UK. LA - eng PT - Journal Article DEP - 20251107 PL - New Zealand TA - Appl Health Econ Health Policy JT - Applied health economics and health policy JID - 101150314 SB - IM MH - Humans MH - Cost-Benefit Analysis MH - *Transcatheter Aortic Valve Replacement/economics MH - *Aortic Valve Stenosis/surgery/economics MH - United Kingdom MH - Aged MH - Aged, 80 and over MH - Quality-Adjusted Life Years MH - Markov Chains MH - Male MH - Female MH - *Heart Valve Prosthesis Implantation/economics/methods MH - Quality of Life PMC - PMC12924842 COIS- Declarations. Conflicts of interest/competing interests: Nick Curzen received research grants from Boston, HeartFlow, Haemonetics and Beckman Coulter; speaker fees/consultancy from Abbott, HeartFlow, Shockwave and Boston; and travel sponsorship from HeartFlow, Biosensors and Shockwave. Pascal Candolfi is an employee at Edwards Lifesciences, Nyon, Switzerland. Philip MacCarthy has no conflicts of interest that are directly relevant to the content of this article. Clinton T. Lloyd has been a speaker for Edwards Lifesciences. Muhammad Aetesam-Ur-Rahman has been a consultant and received speaker fees from Medtronic and SMT. Tom Bromilow has been a consultant for Edwards Lifesciences. Valentina Sellitto is an employee at Edwards Lifesciences, Milan, Italy. Daniel J. Blackman received an institutional research grant from Medtronic and is a consultant and speaker for Medtronic, Abbott Vascular, JenaValve and Edwards Lifesciences. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and material: Input parameters values used and data generated during this cost-utility study are wholly included within this article and the associated Electronic Supplementary Material. Code availability: Input parameters values used and data generated during this cost-utility study are wholly included within this article and the associated Electronic Supplementary Material. The code was only used in the model to run a probabilistic and deterministic sensitivity analysis and so will not be made available. Authors' contributions: PC led the project and contributed to the methodology, data analysis and manuscript drafting, and serves as the guarantor, ensuring the integrity and accuracy of the work. VS assisted with model adaptation and manuscript drafting. TB adapted the model, ensured the use of the best methodology and provided a health economics opinion. PMC, DB, CL, MAR and NC provided expert clinical opinion and economic guidance, contributing to the interpretation of results and critical review of the manuscript. All authors reviewed and approved the final version. EDAT- 2025/11/08 00:28 MHDA- 2026/02/21 12:29 PMCR- 2025/11/07 CRDT- 2025/11/07 23:35 PHST- 2025/04/25 00:00 [received] PHST- 2025/10/12 00:00 [accepted] PHST- 2026/02/21 12:29 [medline] PHST- 2025/11/08 00:28 [pubmed] PHST- 2025/11/07 23:35 [entrez] PHST- 2025/11/07 00:00 [pmc-release] AID - 10.1007/s40258-025-01012-4 [pii] AID - 1012 [pii] AID - 10.1007/s40258-025-01012-4 [doi] PST - ppublish SO - Appl Health Econ Health Policy. 2026 Mar;24(2):365-378. doi: 10.1007/s40258-025-01012-4. Epub 2025 Nov 7. PMID- 41198188 OWN - NLM STAT- MEDLINE DCOM- 20251106 LR - 20260103 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 12 IP - 2 DP - 2025 Nov 5 TI - Trends and risk factors of stroke and mortality after transcatheter aortic valve implantation in the Netherlands. LID - 10.1136/openhrt-2025-003630 [doi] LID - e003630 AB - BACKGROUND: Stroke after transcatheter aortic valve implantation (TAVI) is an infrequent but serious complication with important impact on morbidity and mortality. Contemporary real-world evidence on the risk factors of early stroke after TAVI is scarce. We aimed to evaluate the incidence, temporal trends and predictors of in-hospital stroke after TAVI and to assess its association with mortality. METHODS: We conducted a retrospective, observational cohort study using data from the Netherlands Heart Registration of all TAVI procedures performed in the Netherlands between 2013 and 2023. The primary endpoint was the incidence of in-hospital stroke. The secondary endpoints were trends, mortality and risk factors associated with in-hospital stroke and early mortality as identified by logistic regression. RESULTS: Among 23 593 TAVI procedures, the overall incidence of in-hospital stroke was 2.0% and remained stable after an initial decline. Independent covariates associated with in-hospital stroke included female gender (OR 1.29; 95% CI 1.07 to 1.56), peripheral arterial disease (OR 1.55; 95% CI 1.24 to 1.93), non-transfemoral access (OR 1.54; 95% CI 1.21 to 1.93) and postdilation (OR 1.40; 95% CI 1.10 to 1.76). In-hospital stroke was strongly associated with an increased risk of mortality at 30 days (OR 8.54; 95% CI 6.56 to 11.02), and 1 year (OR 4.38; 95% CI 3.55 to 5.40). CONCLUSIONS: In-hospital stroke remains an important complication after TAVI with a strong impact on mortality. Identification of high-risk patients and procedural optimisation is essential in optimisation of outcome. CI - (c) Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - van Putten, Simon E AU - van Putten SE AUID- ORCID: 0000-0002-9755-5859 AD - Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands s.van.putten@antoniusziekenhuis.nl. AD - Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands. FAU - Hegeman, Romy R M J J AU - Hegeman RRMJJ AD - Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands. AD - Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands. FAU - Timmers, Leo AU - Timmers L AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands. FAU - Overduin, Daniel C AU - Overduin DC AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands. FAU - Nieuwkerk, Pythia T AU - Nieuwkerk PT AD - Department of Medical Psychology, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands. AD - Public Health, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands. FAU - Peper, Joyce AU - Peper J AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands. FAU - Roefs, Maaike M AU - Roefs MM AD - Netherlands Heart Registration, Utrecht, Netherlands. FAU - Sonker, Uday AU - Sonker U AD - Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands. FAU - Rensing, Benno J W M AU - Rensing BJWM AD - Department of Cardiothoracic Surgery, Leiden Universitair Medisch Centrum, Leiden, ZH, Netherlands. FAU - Swaans, Martin J AU - Swaans MJ AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands. FAU - Klautz, Robert J M AU - Klautz RJM AD - Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands. AD - Department of Cardiothoracic Surgery, Leiden Universitair Medisch Centrum, Leiden, ZH, Netherlands. FAU - Ten Berg, Jurrien AU - Ten Berg J AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands. FAU - Klein, Patrick AU - Klein P AD - Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands. AD - Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands. CN - THI Registration Committee of the Netherlands Heart Registration LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20251105 PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Humans MH - Netherlands/epidemiology MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Male MH - Female MH - Retrospective Studies MH - Risk Factors MH - *Stroke/epidemiology/mortality/etiology/diagnosis MH - Aged, 80 and over MH - Incidence MH - *Aortic Valve Stenosis/surgery/mortality MH - Hospital Mortality/trends MH - Risk Assessment/methods MH - Aged MH - Time Factors MH - *Postoperative Complications/epidemiology MH - Survival Rate/trends MH - Follow-Up Studies MH - Registries PMC - PMC12593453 OTO - NOTNLM OT - Aortic Valve Stenosis OT - Heart Valve Prosthesis Implantation OT - Risk Factors OT - Stroke OT - Transcatheter Aortic Valve Replacement COIS- Competing interests: Romy R.M.J.J. Hegeman has received speaker fees and travel grants from Edwards Lifesciences. Martin J. Swaans has received consulting fees from Abbott Vascular, Bioventrix Inc., Boston Scientific, Cardiac Dimensions, Edwards Lifesciences, GE Healthcare, Medtronic, Philips Healthcare and Siemens Healthcare. Robert J.M. Klautz has received research support, and consulting and speaker fees from Medtronic. Jur M. ten Berg has received institutional research grants from Daiichi Sankyo and ZonMW, consulting fees from CeleCor, and speaker fees from CeleCor and Daiichi Sankyo. Patrick Klein received proctor, speaking and consulting fees from AMT Medical, Edwards Lifesciences and Medtronic, and received institutional research grants from ZonMW. Simon E. van Putten, Leo Timmers, Daniel C. Overduin, Pythia T. Nieuwkerk, Joyce Peper, Maaike M. Roefs, Uday Sonker and Benno J.W.M. Rensing have no conflicts of interest to declare. FIR - van den Branden, B J L IR - van den Branden BJL FIR - Vis, M M IR - Vis MM FIR - Tonino, W A L IR - Tonino WAL FIR - Mieghem, N M D A van IR - Mieghem NMDAV FIR - Schotborgh, C E IR - Schotborgh CE FIR - Hermanides, R S IR - Hermanides RS FIR - van der Kley, F IR - van der Kley F FIR - Vriesendorp, P IR - Vriesendorp P FIR - Porta, F IR - Porta F FIR - van Houwelingen, K G IR - van Houwelingen KG FIR - Amoroso, G IR - Amoroso G FIR - van Wely, M IR - van Wely M FIR - Timmers, L IR - Timmers L FIR - Voskuil, M IR - Voskuil M FIR - van der Werf, H W IR - van der Werf HW EDAT- 2025/11/07 00:27 MHDA- 2025/11/07 00:28 PMCR- 2025/11/05 CRDT- 2025/11/06 21:03 PHST- 2025/08/03 00:00 [received] PHST- 2025/10/22 00:00 [accepted] PHST- 2025/11/07 00:28 [medline] PHST- 2025/11/07 00:27 [pubmed] PHST- 2025/11/06 21:03 [entrez] PHST- 2025/11/05 00:00 [pmc-release] AID - openhrt-2025-003630 [pii] AID - 10.1136/openhrt-2025-003630 [doi] PST - epublish SO - Open Heart. 2025 Nov 5;12(2):e003630. doi: 10.1136/openhrt-2025-003630. PMID- 41196360 OWN - NLM STAT- Publisher LR - 20251106 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) DP - 2025 Nov 6 TI - Intravascular lithotripsy enables safe and effective transfemoral aortic valve replacement. LID - 10.1007/s00392-025-02779-1 [doi] AB - BACKGROUND: In patients with severe peripheral artery disease (PAD), transfemoral transcatheter aortic valve replacement (TAVR) is often not feasible. OBJECTIVES: Iliofemoral calcium modification by intravascular lithotripsy (IVL) may enable transfemoral access in PAD patients. METHODS: Between June 2022 and February 2024, all consecutive TAVR patients at our institution were prospectively screened for use of IVL according to the predefined TREATABLE classification, involving parameters such as calcification, vessel kinking and stenosis. Endpoints comprised successful TAVR, safety, and three-month outcomes (DRKS00034681). In an independent retrospective approach, all TAVR patients treated between February 2020 and June 2022 were evaluated with the TREATABLE classification towards complication rates without use of IVL (DRKS00029242). RESULTS: Two hundred twenty-nine prospective patients were included and after application of the TREATABLE classification, 26 patients (11.4%) received IVL-supported transfemoral TAVR. According to the TREATABLE classification, there was a similar extent of kinking (p = 0.468), but a significantly higher severity of calcification in the IVL-treated group (p < 0.001). In the retrospective analysis of the additional 1000 patients, 966 (96.6%) received transfemoral and 34 alternative access TAVR. 154 transfemoral and all alternative access TAVR were identified as high-risk according to the TREATABLE classification. Comparing the retrospective and prospective TREATABEL cohorts, transfemoral high-risk patients in the retrospective cohort without IVL showed a higher rate of post-interventional stenosis or occlusion (12.3% vs. 0%, p = 0.049). CONCLUSION: This observational study shows a favourable success and safety level of IVL-supported transfemoral TAVR despite severe PAD, based on the TREATABLE classification. Therefore, the newly developed classification provides a suitable tool for identifying patients who would benefit from facilitating transfemoral TAVR by IVL. CI - (c) 2025. The Author(s). FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Valina, Christian AU - Valina C AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Vagner, Laura AU - Vagner L AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Mack, Lara AU - Mack L AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Asmussen, Alexander AU - Asmussen A AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Lindau, Alexandra AU - Lindau A AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Ruile, Philipp AU - Ruile P AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Hein, Manuel AU - Hein M AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Moser, Martin AU - Moser M AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Stachon, Peter AU - Stachon P AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AD - Faculty of Medicine, Institute of Medical Biometry and Statistics, Medical Center, University of Freiburg, Freiburg, Germany. FAU - Hartikainen, Tau AU - Hartikainen T AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Maier, Alexander AU - Maier A AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Jackel, Markus AU - Jackel M AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Czerny, Martin AU - Czerny M AD - Department of Cardiovascular Surgery, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Oettinger, Vera AU - Oettinger V AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Rilinger, Jonathan AU - Rilinger J AUID- ORCID: 0000-0001-9333-3629 AD - Department of Cardiology and Angiology, Medical Center, Faculty of Medicine, University Heart Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. jonathan.rilinger@uniklinik-freiburg.de. LA - eng PT - Journal Article DEP - 20251106 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM OTO - NOTNLM OT - Aortic valve stenosis OT - Lithotripsy OT - Peripheral artery disease OT - TAVR OT - Transfemoral transcatheter aortic valve replacement COIS- Declarations. Ethics approval and consent to participate: The study was approved by the local ethics committee of the University of Freiburg (EK-Freiburg 22-1453-S1; 21-1358). All prospective patients signed written informed consent. Written informed consent for retrospective patients was waived by the ethics committee. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00029242 and DRKS00034681). Consent for publication: Not applicable. Competing interests: JR received speaker's honoraria from AstraZeneca and research grants from Abbott and Philips, independent from this work. TH received speaker's honoraria from AstraZeneca, Amgen and Novartis and travel fees from Boston Scientific, Philips and Novartis. EDAT- 2025/11/06 12:33 MHDA- 2025/11/06 12:33 CRDT- 2025/11/06 11:14 PHST- 2025/07/24 00:00 [received] PHST- 2025/10/03 00:00 [accepted] PHST- 2025/11/06 12:33 [medline] PHST- 2025/11/06 12:33 [pubmed] PHST- 2025/11/06 11:14 [entrez] AID - 10.1007/s00392-025-02779-1 [pii] AID - 10.1007/s00392-025-02779-1 [doi] PST - aheadofprint SO - Clin Res Cardiol. 2025 Nov 6. doi: 10.1007/s00392-025-02779-1. PMID- 41194410 OWN - NLM STAT- MEDLINE DCOM- 20260107 LR - 20260115 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 107 IP - 1 DP - 2026 Jan TI - A Streamline Strategy for Indication and Length of Telemetry Monitoring After TAVR. PG - 142-152 LID - 10.1002/ccd.70299 [doi] AB - BACKGROUND: Both indication and length of ECG telemetry monitoring (TM) after transcatheter aortic valve replacement (TAVR) are not well defined. AIMS: We hypothesize that a targeted strategy for monitoring conductive disorders (CD) post-TAVR can reduce the need and duration of in-hospital TM without compromising safety. METHODS: We prospectively evaluated consecutive patients undergoing transfemoral TAVR between February 2023 and September 2024. Intensive care unit (ICU) transfer for TM was considered when previous right bundle branch block or when new or worsening CD. TM duration was standardized, from 24 to 48 h. The primary endpoint was incidence of severe CD, defined as symptomatic or requiring medical intervention, occurring outside the ICU, at 1-month follow-up. RESULTS: Among 250 patients included (mean age: 80.53 +/- 6.86 years), 138 (55.20%) required TM, mainly due to new left bundle branch block (n = 64, 44.80%). By respecting the protocol, the primary endpoint was achieved for three patients (1.20%, 95% CI: 0.31; 3.77), all related to post-discharge CD occurring after Day 6 and requiring permanent pacemaker implantation (PPI). There were no deaths and no severe in-hospital CD outside the ICU. The PPI rate was 16.80%. The mean ICU length of stay was 1.34 days. Absence of TM was associated with shorter mean global hospitalization duration (1.43 vs. 2.93 days, p < 0.001). CONCLUSION: Selective indication and length of TM after TAVR is possible with no in-hospital events, no deaths, and a low rate of rhythmic events after hospital discharge, confirming the safety of this in-hospital strategy. Nearly half of the patients did not require TM, and very short global and ICU lengths were observed. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Fournier, Antonin AU - Fournier A AUID- ORCID: 0009-0004-6925-0398 AD - Department of Cardiology, CHU Montpellier, Montpellier, France. FAU - Robert, Pierre AU - Robert P AD - Department of Cardiology, CHU Nimes, Nimes, France. FAU - Lattuca, Benoit AU - Lattuca B AUID- ORCID: 0000-0001-6167-500X AD - Department of Cardiology, CHU Nimes, Nimes, France. FAU - Duflos, Claire AU - Duflos C AD - Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France. FAU - Duroyon, Mael-Morvan AU - Duroyon MM AD - Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, Montpellier, France. FAU - Macia, Jean-Christophe AU - Macia JC AUID- ORCID: 0009-0002-7725-0529 AD - Department of Cardiology, CHU Montpellier, Montpellier, France. FAU - Schmutz, Laurent AU - Schmutz L AD - Department of Cardiology, CHU Nimes, Nimes, France. FAU - Steinecker, Matthieu AU - Steinecker M AD - Department of Cardiology, CHU Montpellier, Montpellier, France. FAU - Berdeu, Jean-Michel AU - Berdeu JM AD - Department of Cardiology, CHU Montpellier, Montpellier, France. FAU - Gandet, Thomas AU - Gandet T AD - Department of Cardiac Surgery, CHU Montpellier, Montpellier, France. FAU - Pasquie, Jean Luc AU - Pasquie JL AD - Department of Cardiology, CHU Montpellier, Montpellier, France. FAU - Roubille, Francois AU - Roubille F AUID- ORCID: 0000-0002-5288-9687 AD - Department of Cardiology, CHU Montpellier, Montpellier, France. FAU - Cayla, Guillaume AU - Cayla G AD - Department of Cardiology, CHU Nimes, Nimes, France. FAU - Leclercq, Florence AU - Leclercq F AUID- ORCID: 0000-0001-5936-5184 AD - Department of Cardiology, CHU Montpellier, Montpellier, France. LA - eng PT - Journal Article PT - Observational Study DEP - 20251105 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Female MH - *Telemetry MH - Aged, 80 and over MH - Time Factors MH - Prospective Studies MH - Aged MH - Treatment Outcome MH - Predictive Value of Tests MH - Risk Factors MH - *Arrhythmias, Cardiac/diagnosis/therapy/physiopathology/etiology MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging MH - Action Potentials MH - Pacemaker, Artificial PMC - PMC12775202 OTO - NOTNLM OT - ECG telemetry monitoring (TM) OT - conductive disorder (CD) OT - intensive care OT - length of stay OT - pacemaker OT - transcatheter aortic valve replacement (TAVR) COIS- The authors declare no conflicts of interest. EDAT- 2025/11/06 06:29 MHDA- 2026/01/07 06:30 PMCR- 2026/01/07 CRDT- 2025/11/06 00:43 PHST- 2025/10/20 00:00 [revised] PHST- 2025/08/26 00:00 [received] PHST- 2025/10/28 00:00 [accepted] PHST- 2026/01/07 06:30 [medline] PHST- 2025/11/06 06:29 [pubmed] PHST- 2025/11/06 00:43 [entrez] PHST- 2026/01/07 00:00 [pmc-release] AID - CCD70299 [pii] AID - 10.1002/ccd.70299 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Jan;107(1):142-152. doi: 10.1002/ccd.70299. Epub 2025 Nov 5. PMID- 41190634 OWN - NLM STAT- MEDLINE DCOM- 20260504 LR - 20260813 IS - 1724-6032 (Electronic) IS - 1129-7298 (Print) IS - 1129-7298 (Linking) VI - 27 IP - 3 DP - 2026 May TI - Percutaneous femoral access closure and prognosis following transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 906-913 LID - 10.1177/11297298251389645 [doi] AB - BACKGROUND: The impact of different percutaneous femoral access closure strategies on mortality and bleeding after transcatheter aortic valve replacement (TAVR) has been less studied. The aim of this study is to investigate whether different percutaneous femoral access closure strategies might affect systemic outcomes in patients undergoing TAVR. METHODS: In this systematic review and meta-analysis, randomized trials comparing a suture-based closure (suture group) with a plug-based or suture/plug-based closure (control group) for hemostasis of the femoral access in patients undergoing TAVR were included. The primary endpoint of the study was all-cause death. Secondary endpoints included any bleeding (defined according Valve Academic Research Consortium (VARC) criteria) and unplanned endovascular or surgical repair at the access site. All endpoints were calculated at the longest available follow-up. RESULTS: Four studies with a total of 1429 TAVR patients (suture-based group, n = 707; control group, n = 722) were available for quantitative synthesis. There was no statistically significant difference in all-cause death in patients who underwent TAVR with suture-based closure compared to the control group (risk ratio-RR = 1.04, 95% confidence interval-CI 0.60-1.82; p = 0.83). Similarly, there was no statistically significant difference between treatment groups for any bleeding and unplanned endovascular or surgical repair at the access site. However, there was a significant treatment effect for VARC bleeding type ⩾2 associated with the use of a plug-based or suture/plug-based closure in the control group (p for interaction = 0.01). CONCLUSIONS: In the context of contemporary TAVR procedures, percutaneous closure of the femoral access using any suture or plug-based strategy has no impact on hard clinical outcomes such as death from any cause. FAU - Simonetti, Fiorenzo AU - Simonetti F AUID- ORCID: 0000-0001-6897-9807 AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. AD - Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. FAU - Cassese, Salvatore AU - Cassese S AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. FAU - Rheude, Tobias AU - Rheude T AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. FAU - Alvarez-Covarrubias, Hector AU - Alvarez-Covarrubias H AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. AD - DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. FAU - Joner, Michael AU - Joner M AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. AD - DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AUID- ORCID: 0000-0002-0728-2819 AD - Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20251105 PL - United States TA - J Vasc Access JT - The journal of vascular access JID - 100940729 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - *Femoral Artery MH - Treatment Outcome MH - Risk Factors MH - Punctures MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Hemostatic Techniques/adverse effects/mortality/instrumentation MH - Time Factors MH - Male MH - Aged MH - *Suture Techniques/adverse effects/mortality MH - Aged, 80 and over MH - Randomized Controlled Trials as Topic MH - Female MH - Vascular Closure Devices MH - Risk Assessment MH - *Hemorrhage/prevention & control/etiology/mortality MH - *Postoperative Hemorrhage/prevention & control/mortality/etiology PMC - PMC13135637 OTO - NOTNLM OT - Transcatheter aortic valve replacement OT - complications OT - death OT - femoral artery OT - hemorrhage OT - vascular closure devices COIS- Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Simonetti is supported by a research grant provided by the CardioPath PhD program. Dr Rheude has received speaker fees from AstraZeneca and SIS Medical AG. Dr Joner reports institutional grant support from Boston Scientific, Cardiac Dimensions, Edwards Lifesciences and Infraredx; consulting fees from Biotronik, TriCares, Veryan, and Shockwave; speaker fees from Abbott Vascular, AstraZeneca, Biotronik, Boston Scientific, Cardiac Dimensions, Edwards Lifesciences, Recor Medical and Shockwave; participation on a Steering Committee of Biotronik and Edwards Lifesciences; travel support from Boston Scientific, Cardiac Dimensions, Edwards Lifesciences, and SIS Medical AG. Dr Xhepa has received lecture fees/honoraria from AstraZeneca, Boston Scientific, and SIS Medical AG; and proctoring honoraria from Abbott Vascular; and institutional grant support from Abbott Vascular. Dr Cassese has received lectures/proctoring honoraria from Abbott Vascular, Shockwave Medical, SIS Medical AG, and Translumina GmbH; and institutional grant support from Abbott Vascular and SIS Medical AG. The other authors declare no potential conflict of interest. EDAT- 2025/11/05 12:33 MHDA- 2026/05/04 12:34 PMCR- 2026/05/03 CRDT- 2025/11/05 07:14 PHST- 2026/05/04 12:34 [medline] PHST- 2025/11/05 12:33 [pubmed] PHST- 2025/11/05 07:14 [entrez] PHST- 2026/05/03 00:00 [pmc-release] AID - 10.1177_11297298251389645 [pii] AID - 10.1177/11297298251389645 [doi] PST - ppublish SO - J Vasc Access. 2026 May;27(3):906-913. doi: 10.1177/11297298251389645. Epub 2025 Nov 5. PMID- 41170017 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251031 LR - 20251102 IS - 1923-2829 (Print) IS - 1923-2837 (Electronic) IS - 1923-2829 (Linking) VI - 16 IP - 5 DP - 2025 Oct TI - Comparative Outcomes of Alternative Access Site Versus Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Replacement: A Single-Center Retrospective Study. PG - 413-420 LID - 10.14740/cr2115 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as a primary therapeutic option for patients with severe aortic stenosis across all surgical risk categories. Alternative access site (AAS) routes are often used in patients unsuitable for standard transfemoral (TF) approach, though intravascular lithotripsy (IVL) provides novel remedies to traditionally "unsuitable" patients. The objectives of our study were to compare outcomes between AAS TAVR placement and lithotripsy-assisted TF TAVR. METHODS: The authors analyzed 60 patients who underwent TAVR between 2019 and 2022 (41 with alternative access, 19 with lithotripsy) at a single US site. Primary outcomes included procedural success, adverse events at 1 month and 1 year, length of stay, and 3-year mortality. RESULTS: The data trended towards higher 1-month adverse outcomes in the alternative access patients compared to TF lithotripsy patients (17.1% (95% confidence interval (CI): 8.5% - 31.3%) vs. 0% (95% CI: 0.0% - 16.8%); P = 0.09), while 1-year adverse outcomes were similar (AAS 12.2% (95% CI: 5.3% - 25.5%) vs. IVL 15.8% (95% CI: 5.5% - 37.6%); P = 0.70), and 3-year mortality (19.5% vs. 21.1%) were similar between groups. Median length of stay was 3 days for both groups. CONCLUSIONS: Lithotripsy-assisted TF TAVR demonstrated a statistically insignificant trend toward short-term major adverse events with comparable 1-year morbidity and 3-year mortality to alternative access approaches. These findings may support lithotripsy as a viable option for patients with challenging vascular anatomy rather than the more traditional use of AAS in these settings. However, more extensive research is necessary for appropriate statistical power to prove superiority rather than equivocality alone. CI - Copyright 2025 Authors. FAU - Ramos, Gabriel AU - Ramos G AD - Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA. FAU - DeLozier, Grant AU - DeLozier G AD - Department of Medicine, Geisinger Medical System, Scranton, PA, USA. FAU - Ullibarri, Ryan AU - Ullibarri R AD - Department of Medicine, Geisinger Medical System, Scranton, PA, USA. FAU - Mileto, Alden AU - Mileto A AD - Department of Medicine, Geisinger Medical System, Scranton, PA, USA. FAU - Ierovante, Nicholas AU - Ierovante N AD - Department of Cardiology, Geisinger Medical System, Scranton, PA, USA. FAU - Nawaz, Yassir AU - Nawaz Y AD - Department of Cardiology, Geisinger Medical System, Scranton, PA, USA. LA - eng PT - Journal Article DEP - 20251010 PL - Canada TA - Cardiol Res JT - Cardiology research JID - 101557543 PMC - PMC12571132 OTO - NOTNLM OT - Alternative access OT - Lithotripsy OT - Structural heart intervention OT - TAVR OT - Vascular complications COIS- The authors declare no conflict of interest. EDAT- 2025/10/31 06:26 MHDA- 2025/10/31 06:27 PMCR- 2025/10/10 CRDT- 2025/10/31 04:52 PHST- 2025/07/15 00:00 [received] PHST- 2025/09/10 00:00 [accepted] PHST- 2025/10/31 06:27 [medline] PHST- 2025/10/31 06:26 [pubmed] PHST- 2025/10/31 04:52 [entrez] PHST- 2025/10/10 00:00 [pmc-release] AID - 10.14740/cr2115 [doi] PST - epublish SO - Cardiol Res. 2025 Oct 10;16(5):413-420. doi: 10.14740/cr2115. eCollection 2025 Oct. PMID- 41170013 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251031 LR - 20251102 IS - 1923-2829 (Print) IS - 1923-2837 (Electronic) IS - 1923-2829 (Linking) VI - 16 IP - 5 DP - 2025 Oct TI - Evaluation of Gold Marker Orientation in the Three-Cusp Coplanar View After Evolut FX Transcatheter Aortic Valve Implantation. PG - 394-402 LID - 10.14740/cr2124 [doi] AB - BACKGROUND: Obtaining commissural alignment in transcatheter aortic valve replacement (TAVR) is important for ensuring coronary access and coronary artery filling, reducing the risk of central leaks, and minimizing leaflet stress. The Evolut FX system has the gold markers placed at the neo-commissures and has demonstrated favorable outcomes. We investigated whether evaluating the orientation of the gold markers in a three-cusp coplanar view (3-CV) after Evolut FX implantation was useful for assessing commissural misalignment (CMA). METHODS: Between April 2023 and December 2024, we included 25 patients who underwent transfemoral TAVR using the Evolut FX for symptomatic severe aortic stenosis. All patients underwent multidetector computed tomography (CT) after TAVR. The native-prosthetic gap (NPG) was defined as the distance between the center of the transcatheter heart valve stent frame and the central gold marker in a 3-CV. We evaluated the association between the NPG and CMA, which was derived from the average misalignment deviation on post-TAVR CT. RESULTS: The median age was 84 years, 36% were male, and 8% had coronary artery disease. The implanting view was the cusp overlap view (COV) in 11 patients, the near-COV in 11 patients, and the left anterior oblique view in three patients. Of the 22 patients implanted using the COV or near-COV, the gold markers were positioned at "2 left-1 right" in 17 patients. The average misalignment deviation was 18.0 degrees (commissural alignment: eight patients, mild CMA: 13 patients, moderate CMA: two patients, and severe CMA: two patients) and the median NPG was 0.11. In cases with commissural alignment and mild CMA, NPG showed a significant positive correlation with the average misalignment deviation (r = 0.68, P < 0.01), whereas in cases with moderate and severe CMA, the relationship was inverse (r = -0.38, P = 0.62). Further, in cases with commissural alignment and mild CMA, a clockwise misalignment occurred when the central marker was positioned closer to the non-coronary cusp side, while a counterclockwise misalignment was observed when positioned closer to the left-coronary cusp side. CONCLUSIONS: Evaluating the orientation of the gold markers in a 3-CV after Evolut FX implantation is useful for assessing CMA. CI - Copyright 2025 Authors. FAU - Kudo, Yusuke AU - Kudo Y AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. FAU - Kato, Yuta AU - Kato Y AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. FAU - Kawahira, Yuto AU - Kawahira Y AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. FAU - Miyazaki, Midori AU - Miyazaki M AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. AD - Department of Clinical Laboratory and Transfusion, Fukuoka University Hospital, Fukuoka, Japan. FAU - Hirata, Tetsuo AU - Hirata T AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. FAU - Teratani, Hiromitsu AU - Teratani H AD - Department of Cardiovascular Surgery, Fukuoka University Hospital, Fukuoka, Japan. FAU - Kuwahara, Go AU - Kuwahara G AD - Department of Cardiovascular Surgery, Fukuoka University Hospital, Fukuoka, Japan. FAU - Sugihara, Makoto AU - Sugihara M AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. FAU - Wada, Hideichi AU - Wada H AD - Department of Cardiovascular Surgery, Fukuoka University Hospital, Fukuoka, Japan. FAU - Ogawa, Masahiro AU - Ogawa M AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. AD - Department of Clinical Laboratory and Transfusion, Fukuoka University Hospital, Fukuoka, Japan. FAU - Miura, Shin-Ichiro AU - Miura SI AD - Department of Cardiology, Fukuoka University School of Medicine, Jyonan-ku, Fukuoka 814-0180, Japan. LA - eng PT - Journal Article DEP - 20251010 PL - Canada TA - Cardiol Res JT - Cardiology research JID - 101557543 PMC - PMC12571125 OTO - NOTNLM OT - Aortic stenosis OT - Commissure alignment OT - Gold marker OT - Transcatheter aortic valve replacement COIS- There is no conflict of interest to declare. EDAT- 2025/10/31 06:26 MHDA- 2025/10/31 06:27 PMCR- 2025/10/10 CRDT- 2025/10/31 04:52 PHST- 2025/07/25 00:00 [received] PHST- 2025/09/16 00:00 [accepted] PHST- 2025/10/31 06:27 [medline] PHST- 2025/10/31 06:26 [pubmed] PHST- 2025/10/31 04:52 [entrez] PHST- 2025/10/10 00:00 [pmc-release] AID - 10.14740/cr2124 [doi] PST - epublish SO - Cardiol Res. 2025 Oct 10;16(5):394-402. doi: 10.14740/cr2124. eCollection 2025 Oct. PMID- 41163865 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251030 LR - 20251101 IS - 2772-9931 (Electronic) IS - 2772-9931 (Linking) VI - 3 IP - 3 DP - 2025 Sep TI - Influence of Failure to Rescue on Mortality After Transcatheter Aortic Valve Replacement. PG - 617-623 LID - 10.1016/j.atssr.2025.03.011 [doi] AB - BACKGROUND: Mortality after transcatheter aortic valve replacement (TAVR) varies among centers. "Failure to rescue" (FTR) patients from post-TAVR complications may represent an unexplored opportunity for TAVR process improvement. METHODS: The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy registry was queried for patients undergoing transfemoral TAVR between 2011 and 2016. Hospital FTR rate was derived from the ratio of observed-to-expected procedural mortality. Multivariable logistic regression models assessed the association between FTR and hospital mortality. Adjusted FTR rates were compared across tertiles of hospital mortality. RESULTS: The analysis included 61,804 patients (429 sites). Post-TAVR mortality at low-, middle-, and high-mortality hospitals was 1.8%, 3.3%, and 5.6% (P < .01), respectively. Risk-adjusted complication rates differed only slightly between tertiles (22.2% vs 24.5% vs 27.0%, P < .001). However, adjusted FTR rates were significantly worse in high- and medium-mortality hospitals than in low-mortality centers (14.6% vs 9.5% vs 5.4%, P < .001). This was true for all investigated complications, including conversion to open surgery (high-mortality: odds ratio [OR], 9.04 [95% CI, 4.12-19.83], P < .001; medium-mortality: OR 2.99 [95% CI, 1.48-6.07], P < .003), stroke (high-mortality: OR, 3.15 [95% CI, 1.97-5.04], P < .001; medium-mortality: OR, 1.67 [95% CI, 1.05-2.67], P < .032), and cardiac arrest (high-mortality: OR, 3.54 [95% CI, 2.57-4.87], P < .001; medium-mortality: OR, 1.67 [95% CI, 1.24-2.24], P < .001). CONCLUSIONS: National TAVR mortality rates vary significantly across centers, despite comparable rates of postoperative complications. Patients at medium- and high-mortality centers face a disproportionately higher risk of death due to FTR. These findings highlight the need for a closer evaluation of post-TAVR care processes to address this disparity. CI - (c) 2025 The Authors. FAU - Bishawi, Muath AU - Bishawi M AD - Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina. FAU - Jensen, Christopher AU - Jensen C AD - Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina. FAU - Vekstein, Andrew AU - Vekstein A AD - Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina. AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. FAU - Kosinski, Andrzej S AU - Kosinski AS AD - Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina. FAU - Grover, Fred L AU - Grover FL AD - University of Colorado School of Medicine, Denver, Colorado. FAU - Harrison, J Kevin AU - Harrison JK AD - Division of Cardiology, Duke University Medical Center, Durham, North Carolina. FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, Georgia. FAU - Kirtane, Ajay J AU - Kirtane AJ AD - Division of Cardiology and the Cardiovascular Research Foundation, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Bavaria, Joseph E AU - Bavaria JE AD - Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. FAU - Vemulapalli, Sreekanth AU - Vemulapalli S AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. AD - Division of Cardiology, Duke University Medical Center, Durham, North Carolina. FAU - Hughes, G Chad AU - Hughes GC AD - Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina. LA - eng PT - Journal Article DEP - 20250403 PL - United States TA - Ann Thorac Surg Short Rep JT - Annals of thoracic surgery short reports JID - 9918506088006676 PMC - PMC12559580 EDAT- 2025/10/30 06:29 MHDA- 2025/10/30 06:30 PMCR- 2025/04/03 CRDT- 2025/10/30 04:56 PHST- 2025/03/24 00:00 [accepted] PHST- 2025/10/30 06:30 [medline] PHST- 2025/10/30 06:29 [pubmed] PHST- 2025/10/30 04:56 [entrez] PHST- 2025/04/03 00:00 [pmc-release] AID - S2772-9931(25)00114-7 [pii] AID - 10.1016/j.atssr.2025.03.011 [doi] PST - epublish SO - Ann Thorac Surg Short Rep. 2025 Apr 3;3(3):617-623. doi: 10.1016/j.atssr.2025.03.011. eCollection 2025 Sep. PMID- 41156021 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251029 LR - 20251101 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 20 DP - 2025 Oct 10 TI - Definition, Incidence, Prediction, and Prevention of Bleeding Events After Transcatheter Aortic Valve Implantation. LID - 10.3390/jcm14207154 [doi] LID - 7154 AB - Bleeding remains the most common complication following transcatheter aortic valve implantation (TAVI), despite a decline in its incidence over time. Periprocedural (/=30% reduction from baseline for at least 5 min. Clinical, laboratory, and procedural predictors were assessed using multivariate logistic regression, and model performance was evaluated by ROC curve analysis. RESULTS: Perioperative hypotension occurred in 57% of patients. Independent predictors were diabetes mellitus (OR 2.79, 95% CI 1.03-7.56, p = 0.044), reduced EF (<50%) (OR 2.87, 95% CI 1.13-7.31, p = 0.027), lower baseline diastolic blood pressure (OR 0.935 per mmHg, 95% CI 0.893-0.978, p = 0.004), and longer procedural duration (OR 1.038 per minute, 95% CI 1.001-1.076, p = 0.044). The predictive model demonstrated good calibration and discrimination (AUC 0.844). Patients with hypotension had significantly higher in-hospital mortality (12.9% vs. 1.9%, p = 0.027) and longer ICU stay. An exploratory finding suggested less frequent use of sugammadex among hypotensive patients (11.4% vs. 32.1%, p = 0.005). CONCLUSIONS: Perioperative hypotension is common during TAVI and strongly associated with early mortality. Our study uniquely identifies diabetes mellitus as an independent predictor, alongside ventricular dysfunction, baseline blood pressure, and procedural duration. These findings suggest that careful preprocedural risk stratification, hemodynamic vigilance, and optimization of anesthetic management may improve outcomes in vulnerable patients. FAU - Demirbas, Zeynep Ece AU - Demirbas ZE AUID- ORCID: 0000-0002-2009-4505 AD - Department of Internal Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul 34668, Turkey. FAU - Yilmaz, Sahin AU - Yilmaz S AD - Department of Anesthesiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul 34668, Turkey. FAU - Can, Fatma AU - Can F AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul 34668, Turkey. FAU - Zeren, Gonul AU - Zeren G AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul 34668, Turkey. FAU - Karabay, Can Yucel AU - Karabay CY AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul 34668, Turkey. LA - eng PT - Journal Article DEP - 20251009 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC12564241 OTO - NOTNLM OT - anesthesia management OT - diabetes mellitus OT - left ventricular ejection fraction OT - mortality OT - perioperative hypotension OT - transcatheter aortic valve implantation (TAVI) COIS- The authors declare no conflicts of interest. EDAT- 2025/10/28 18:27 MHDA- 2025/10/28 18:28 PMCR- 2025/10/09 CRDT- 2025/10/28 12:36 PHST- 2025/08/21 00:00 [received] PHST- 2025/10/01 00:00 [revised] PHST- 2025/10/07 00:00 [accepted] PHST- 2025/10/28 18:28 [medline] PHST- 2025/10/28 18:27 [pubmed] PHST- 2025/10/28 12:36 [entrez] PHST- 2025/10/09 00:00 [pmc-release] AID - jcdd12100398 [pii] AID - jcdd-12-00398 [pii] AID - 10.3390/jcdd12100398 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2025 Oct 9;12(10):398. doi: 10.3390/jcdd12100398. PMID- 41149248 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251028 LR - 20251030 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 12 IP - 10 DP - 2025 Sep 24 TI - Beyond Conventional Meta-Analysis: A Meta-Learning Model to Predict Cohort-Level Mortality After Transcatheter Aortic Valve Replacement (TAVR). LID - 10.3390/jcdd12100376 [doi] LID - 376 AB - CONTEXT AND OBJECTIVE: Post-Transcatheter Aortic Valve Replacement (TAVR) mortality exhibits extreme heterogeneity that conventional meta-analyses fail to explain, limiting the clinical utility of evidence synthesis and hindering accurate prognostic assessment. This study evaluated whether meta-learning, using aggregate data from the literature, can predict cohort-level mortality and identify its determinants, overcoming the limitations of traditional methods to provide a clearer understanding of the factors driving TAVR outcomes. METHODS: A systematic review following PRISMA guidelines was conducted across five databases. Methodological quality was assessed with standardized tools (Risk of Bias 2, Newcastle-Ottawa Scale, Risk of Bias in Non-randomized Studies of Exposure). After performing conventional meta-analyses and meta-regressions, multiple machine learning models were trained using study-level characteristics as predictors. Advanced optimization with regularization and ensemble techniques was applied to develop a final, optimized model. RESULTS: Fifty-eight studies, encompassing over 533,000 patients, were included. Traditional meta-analysis confirmed extreme heterogeneity (I(2) = 76.7% in Random Clinical Trials, 96.8% in observational studies), with no explanatory power via meta-regression. The initial AdaBoost model achieved R(2) = 0.191, outperforming 17 alternative algorithms. Advanced optimization developed a Blend_Optimized model that explained 65.3% of the variability (R(2) = 0.653), marking a substantial 46 percentage-point increase. Interpretability analysis identified four dominant predictors: Society of Thoracic Surgeons Predicted Risk of Operative Mortality (R(2) = 0.300), Recruitment Year (R(2) = 0.212), % Transfemoral (R(2) = 0.201), and % Diabetes (R(2) = 0.175), revealing a potent temporal gradient reflecting the evolution of medical practice. CONCLUSIONS: Meta-learning significantly surpasses traditional methods in extracting systematic signals from heterogeneous evidence. This study demonstrates that, in addition to patient risk factors, a significant temporal gradient models technological evolution and learning curves. The methodology transforms seemingly unexplained heterogeneity into clinically interpretable patterns, demonstrating the potential of meta-learning as a complementary tool for evidence synthesis in interventional cardiology and opening avenues for applications in other complex cardiovascular fields. Important Limitation: This model predicts cohort-level outcomes and should not be used for individual risk assessment. FAU - Liscano, Yamil AU - Liscano Y AUID- ORCID: 0000-0002-2674-8725 AD - Grupo de Investigacion en Salud Integral (GISI), Department of Health, Universidad Santiago de Cali, 760035 Cali, Colombia. FAU - Martinez Guevara, Darly AU - Martinez Guevara D AD - Grupo de Investigacion en Salud Integral (GISI), Department of Health, Universidad Santiago de Cali, 760035 Cali, Colombia. FAU - Urriago-Osorio, Gustavo Andres AU - Urriago-Osorio GA AUID- ORCID: 0000-0002-4627-7908 AD - Internal Medicine Specialization Program, Department of Health, Universidad Santiago de Cali, 760035 Cali, Colombia. FAU - Quintana, John AU - Quintana J AD - Internal Medicine Specialization Program, Department of Health, Universidad Santiago de Cali, 760035 Cali, Colombia. LA - eng GR - call No. DGI-01-2025/Universidad Santiago de Cali/ GR - project DGI-445-621124-760 Fortalecimiento de grupo GISI/Universidad Santiago de Cali/ PT - Journal Article PT - Review DEP - 20250924 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC12565431 OTO - NOTNLM OT - aortic stenosis OT - machine learning OT - meta-learning OT - mortality OT - systematic review OT - transcatheter aortic valve replacement (TAVR) COIS- The authors declare no conflicts of interest. EDAT- 2025/10/28 18:27 MHDA- 2025/10/28 18:28 PMCR- 2025/09/24 CRDT- 2025/10/28 12:36 PHST- 2025/07/13 00:00 [received] PHST- 2025/08/26 00:00 [revised] PHST- 2025/08/28 00:00 [accepted] PHST- 2025/10/28 18:28 [medline] PHST- 2025/10/28 18:27 [pubmed] PHST- 2025/10/28 12:36 [entrez] PHST- 2025/09/24 00:00 [pmc-release] AID - jcdd12100376 [pii] AID - jcdd-12-00376 [pii] AID - 10.3390/jcdd12100376 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2025 Sep 24;12(10):376. doi: 10.3390/jcdd12100376. PMID- 41147311 OWN - NLM STAT- In-Process LR - 20260511 IS - 1784-973X (Electronic) IS - 0001-5385 (Linking) VI - 81 IP - 3 DP - 2026 May TI - 'All vessels lead to the heart': a transcaval TAVR through an aortic aneurysm. PG - 295-296 LID - 10.1080/00015385.2025.2576454 [doi] FAU - De Cock, Emmanuel AU - De Cock E AUID- ORCID: 0000-0002-6487-6306 AD - Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium. AD - Ghent University Hospital, Ghent, Belgium. FAU - Van der Heyden, Jan AU - Van der Heyden J AD - Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium. FAU - Geerts, Bert AU - Geerts B AD - Department of Radiology, AZ Sint-Jan Brugge AV, Bruges, Belgium. FAU - Buysschaert, Ian AU - Buysschaert I AD - Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges, Belgium. LA - eng PT - Journal Article DEP - 20251028 PL - England TA - Acta Cardiol JT - Acta cardiologica JID - 0370570 SB - IM EDAT- 2025/10/28 12:28 MHDA- 2025/10/28 12:28 CRDT- 2025/10/28 06:04 PHST- 2025/10/28 12:28 [pubmed] PHST- 2025/10/28 12:28 [medline] PHST- 2025/10/28 06:04 [entrez] AID - 10.1080/00015385.2025.2576454 [doi] PST - ppublish SO - Acta Cardiol. 2026 May;81(3):295-296. doi: 10.1080/00015385.2025.2576454. Epub 2025 Oct 28. PMID- 41144631 OWN - NLM STAT- MEDLINE DCOM- 20260218 LR - 20261013 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 394 IP - 8 DP - 2026 Feb 19 TI - Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years. PG - 773-783 LID - 10.1056/NEJMoa2509766 [doi] AB - BACKGROUND: Five-year data from the PARTNER 3 trial showed that among low-risk patients with severe, symptomatic aortic stenosis, outcomes were similar among patients who had undergone transcatheter aortic-valve replacement (TAVR) and those who had undergone surgical aortic-valve replacement. Longer-term assessments of clinical outcomes and valve durability are needed. METHODS: Patients were randomly assigned in a 1:1 ratio to undergo transfemoral TAVR or surgery. The first primary end point was a nonhierarchical composite of death, stroke, or rehospitalization related to the procedure, the valve, or heart failure. The second primary end point was a hierarchical composite of death, disabling stroke, nondisabling stroke, and the number of rehospitalization days related to the procedure, the valve, or heart failure, analyzed with the use of a win ratio analysis. Clinical, echocardiographic, valve-durability, and health-status end points were assessed through 7 years. RESULTS: A total of 1000 patients underwent randomization. In the analysis of the first primary end point, the Kaplan-Meier estimate of the incidence of an end-point event was 34.6% with TAVR and 37.2% with surgery (difference, -2.6 percentage points; 95% confidence interval [CI], -9.0 to 3.7). The win ratio for the second primary end point was 1.04 (95% CI, 0.84 to 1.30). In the TAVR and surgery groups, respectively, the Kaplan-Meier estimates for the incidence of components of the first primary end point were as follows: death, 19.5% and 16.8%; stroke, 8.5% and 8.1%; and rehospitalization, 20.6% and 23.5%. The mean (+/-SD) aortic-valve gradients assessed by echocardiography at 7 years were 13.1+/-8.5 mm Hg after TAVR and 12.1+/-6.3 mm Hg after surgery. The percentage of bioprosthetic valves that failed was 6.9% in the TAVR group and 7.5% in the surgery group. Patient-reported outcomes were similar in the two groups. CONCLUSIONS: Among low-risk patients with severe, symptomatic aortic stenosis, no significant differences with respect to two primary composite end points involving death, stroke, and rehospitalization were observed at 7 years between those who had undergone TAVR and those who had undergone surgery. (Funded by Edwards Lifesciences; PARTNER 3 ClinicalTrials.gov number, NCT02675114.). CI - Copyright (c) 2025 Massachusetts Medical Society. FAU - Leon, Martin B AU - Leon MB AD - Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York. AD - Cardiovascular Research Foundation, New York. FAU - Mack, Michael J AU - Mack MJ AD - Baylor Scott and White the Heart Hospital Plano, Plano, TX. FAU - Pibarot, Philippe AU - Pibarot P AD - Laval University, Quebec, QC, Canada. FAU - Hahn, Rebecca T AU - Hahn RT AUID- ORCID: 0000-0003-1342-9191 AD - Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York. AD - Cardiovascular Research Foundation, New York. FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta. FAU - Kodali, S H AU - Kodali SH AD - Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York. AD - Cardiovascular Research Foundation, New York. FAU - Genereux, Philippe AU - Genereux P AD - Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Cleveland Clinic, Cleveland. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York. AD - St. Francis Hospital and Heart Center, Roslyn, NY. FAU - Pocock, Stuart J AU - Pocock SJ AD - Cardiovascular Research Foundation, New York. AD - London School of Hygiene and Tropical Medicine, London. FAU - Zhang, Yiran AU - Zhang Y AD - Edwards Lifesciences, Irvine, CA. FAU - Szerlip, Molly AU - Szerlip M AD - Baylor Scott and White the Heart Hospital Plano, Plano, TX. FAU - Ternacle, Julien AU - Ternacle J AD - Unite Medico-Chirurgicale des Valvulopathies, Hopital Haut-Leveque, CHU Bordeaux, Pessac, France. FAU - Malaisrie, S Chris AU - Malaisrie SC AD - Northwestern University, Chicago. FAU - Herrmann, Howard C AU - Herrmann HC AD - University of Pennsylvania, Philadelphia. FAU - Szeto, Wilson Y AU - Szeto WY AD - University of Pennsylvania, Philadelphia. FAU - Russo, Mark J AU - Russo MJ AD - Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ. FAU - Babaliaros, Vasilis AU - Babaliaros V AD - Emory University, Atlanta. FAU - Nazif, Tamim AU - Nazif T AD - Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York. AD - Cardiovascular Research Foundation, New York. FAU - Webb, John G AU - Webb JG AD - St. Paul's Hospital, University of British Columbia, Vancouver, Canada. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars-Sinai Medical Center, Los Angeles. CN - PARTNER 3 Investigators LA - eng SI - ClinicalTrials.gov/NCT02675114 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20251027 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2026 May 28;394(20):2066. doi: 10.1056/NEJMc2604007. PMID: 42202333 CIN - N Engl J Med. 2026 May 28;394(20):2066-2067. doi: 10.1056/NEJMc2604007. PMID: 42202334 CIN - N Engl J Med. 2026 May 28;394(20):2067-2068. doi: 10.1056/NEJMc2604007. PMID: 42202335 CIN - N Engl J Med. 2026 May 28;394(20):2068. doi: 10.1056/NEJMc2604007. PMID: 42202336 CIN - N Engl J Med. 2026 May 28;394(20):2068-2070. doi: 10.1056/NEJMc2604007. PMID: 42202337 CIN - J Thorac Dis. 2026 Jun 30;18(6):694. doi: 10.21037/jtd-2026-0929. PMID: 42444856 CIN - J Thorac Dis. 2026 Aug 31;18(8):979. doi: 10.21037/jtd-2026-1724. PMID: 42724608 CIN - J Thorac Dis. 2026 Sep 30;18(9):1081. doi: 10.21037/jtd-2026-2404. PMID: 42866302 MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve/surgery/diagnostic imaging MH - *Aortic Valve Stenosis/complications/mortality/surgery MH - Follow-Up Studies MH - Heart Failure/epidemiology/etiology MH - Heart Valve Prosthesis/adverse effects MH - *Heart Valve Prosthesis Implantation/adverse effects/methods MH - Kaplan-Meier Estimate MH - Patient Readmission/statistics & numerical data MH - *Postoperative Complications/epidemiology/etiology MH - Risk MH - Stroke/epidemiology/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Prospective Studies MH - Incidence MH - Treatment Outcome FIR - El-Hajjar, Mohammad IR - El-Hajjar M FIR - Bailey, Stephen IR - Bailey S FIR - Brown, John IR - Brown J FIR - Kipperman, Robert IR - Kipperman R FIR - Webster, Mark IR - Webster M FIR - Zidar, Frank IR - Zidar F FIR - Kerendi, Faraz IR - Kerendi F FIR - Eng, Marvin IR - Eng M FIR - Fang, Kenith IR - Fang K FIR - Paulus, Basil IR - Paulus B FIR - Shah, Pinak IR - Shah P FIR - Kaneko, Tsuyoshi IR - Kaneko T FIR - Chehab, Bassem IR - Chehab B FIR - Grizzell, Brett IR - Grizzell B FIR - Rinaldi, Michael IR - Rinaldi M FIR - Skipper, Eric IR - Skipper E FIR - Makkar, Raj IR - Makkar R FIR - Trento, Alfredo IR - Trento A FIR - Eisenhauer, Andrew IR - Eisenhauer A FIR - Kodali, Susheel IR - Kodali S FIR - George, Isaac IR - George I FIR - Nazif, Tamim IR - Nazif T FIR - Bergman, Geoffrey IR - Bergman G FIR - Wong, Shing Chiu IR - Wong SC FIR - Salemi, Arash IR - Salemi A FIR - Mick, Stephanie IR - Mick S FIR - DeVries, James IR - DeVries J FIR - DeSimone, Joseph IR - DeSimone J FIR - Thourani, Vinod IR - Thourani V FIR - Guyton, Robert IR - Guyton R FIR - Grubb, Kendra IR - Grubb K FIR - Babaliaros, Vasilis IR - Babaliaros V FIR - Accola, Kevin IR - Accola K FIR - McKay, Raymond IR - McKay R FIR - Hagberg, Robert IR - Hagberg R FIR - O'Neill, William IR - O'Neill W FIR - Paone, Gaetano IR - Paone G FIR - Apostolou, Dimitrios IR - Apostolou D FIR - Engel, Pedro IR - Engel P FIR - Castellanos, Jorge IR - Castellanos J FIR - Caffarelli, Anthony IR - Caffarelli A FIR - Yazdani, Shahram IR - Yazdani S FIR - Sarin, Eric IR - Sarin E FIR - Whisenant, Brian IR - Whisenant B FIR - Jones, Kent IR - Jones K FIR - Nores, Marcos IR - Nores M FIR - Rothenberg, Mark IR - Rothenberg M FIR - McNulty, Edward IR - McNulty E FIR - Richter, Richard IR - Richter R FIR - Hayashida, Kentaro IR - Hayashida K FIR - Coady, Paul IR - Coady P FIR - Gnall, Eric IR - Gnall E FIR - Goldman, Scott IR - Goldman S FIR - Holmes, David IR - Holmes D FIR - Alkhouli, Mohammad IR - Alkhouli M FIR - Greason, Kevin IR - Greason K FIR - Bowers, Bruce IR - Bowers B FIR - Dewey, Todd IR - Dewey T FIR - Daniels, David IR - Daniels D FIR - Vial, Conrad IR - Vial C FIR - Jones, Noah IR - Jones N FIR - Wells, Patrick IR - Wells P FIR - Xydas, Steve IR - Xydas S FIR - Beohar, Nirat IR - Beohar N FIR - Wu, Willis IR - Wu W FIR - Anderson, Curtis IR - Anderson C FIR - Nass, Omar IR - Nass O FIR - Martin, Steven IR - Martin S FIR - Williams, Mathew IR - Williams M FIR - Russo, Mark IR - Russo M FIR - Waxman, Sergio IR - Waxman S FIR - Haik, Bruce IR - Haik B FIR - Levisay, Justin IR - Levisay J FIR - Russell, Hyde IR - Russell H FIR - Malaisrie, Chris IR - Malaisrie C FIR - Davidson, Charles IR - Davidson C FIR - Ramee, Stephen IR - Ramee S FIR - Tafur, Jose IR - Tafur J FIR - Parrino, Patrick IR - Parrino P FIR - Ghani, Mohammad IR - Ghani M FIR - Bodenhamer, Mark IR - Bodenhamer M FIR - Sakata, Yasushi IR - Sakata Y FIR - Christy, Jeffrey IR - Christy J FIR - Goldstein, Jeffery IR - Goldstein J FIR - Badr, Salem IR - Badr S FIR - Korngold, Ethan IR - Korngold E FIR - Swanson, Jeffrey IR - Swanson J FIR - Vincent, Logan IR - Vincent L FIR - Montarello, Joseph IR - Montarello J FIR - Collado, Fareed IR - Collado F FIR - Chhatriwalla, Adnan IR - Chhatriwalla A FIR - Rodriguez, Evelio IR - Rodriguez E FIR - Morse, Andrew IR - Morse A FIR - Mahoney, Paul IR - Mahoney P FIR - Newton, Joseph IR - Newton J FIR - Kemp, Clinton IR - Kemp C FIR - Webb, John IR - Webb J FIR - Fischebin, Michael IR - Fischebin M FIR - Yeung, Alan IR - Yeung A FIR - Ingram, Michael IR - Ingram M FIR - Huang, Pei-Hsiu IR - Huang PH FIR - Kozuma, Ken IR - Kozuma K FIR - Kereiakes, Dean IR - Kereiakes D FIR - Answini, Geoffrey IR - Answini G FIR - Kapadia, Samir IR - Kapadia S FIR - Unai, Shinya IR - Unai S FIR - Mack, Michael IR - Mack M FIR - Szerlip, Molly IR - Szerlip M FIR - Spies, Christian IR - Spies C FIR - Plank, Benjamin IR - Plank B FIR - Lau, Jeffrey IR - Lau J FIR - Smalling, Richard IR - Smalling R FIR - Nguyen, Tuyen Tom IR - Nguyen TT FIR - Oldemeyer, Brad IR - Oldemeyer B FIR - Guadagnoli, Mark IR - Guadagnoli M FIR - Iyer, Vijay IR - Iyer V FIR - Grosner, Gary IR - Grosner G FIR - Davies, James IR - Davies J FIR - Shemin, Richard IR - Shemin R FIR - Suh, William IR - Suh W FIR - Beaver, Thomas IR - Beaver T FIR - Anderson, David IR - Anderson D FIR - Horwitz, Phillip IR - Horwitz P FIR - Helmer, Gregory IR - Helmer G FIR - John, Ranjit IR - John R FIR - Bavaria, Joseph IR - Bavaria J FIR - Desai, Nimesh IR - Desai N FIR - Herrmann, Howard IR - Herrmann H FIR - Ailawadi, Gorav IR - Ailawadi G FIR - Yount, Kenan IR - Yount K FIR - Kern, John IR - Kern J FIR - McCabe, James IR - McCabe J FIR - Chung, Christine IR - Chung C FIR - Aldea, Gabriel IR - Aldea G FIR - Gimelli, Giorgio IR - Gimelli G FIR - Lozonschi, Lucian IR - Lozonschi L FIR - Osaki, Satoru IR - Osaki S FIR - Zajarias, Alan IR - Zajarias A FIR - Maniar, Hersh IR - Maniar H FIR - Abbas, Amr IR - Abbas A FIR - Schwartz, Richard IR - Schwartz R FIR - Tolerico, Paul IR - Tolerico P FIR - Burlingame, Mark IR - Burlingame M EDAT- 2025/10/27 18:26 MHDA- 2026/02/18 19:07 CRDT- 2025/10/27 14:33 PHST- 2026/02/18 19:07 [medline] PHST- 2025/10/27 18:26 [pubmed] PHST- 2025/10/27 14:33 [entrez] AID - 10.1056/NEJMoa2509766 [doi] PST - ppublish SO - N Engl J Med. 2026 Feb 19;394(8):773-783. doi: 10.1056/NEJMoa2509766. Epub 2025 Oct 27. PMID- 41136030 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251024 LR - 20260113 IS - 2666-0849 (Electronic) IS - 2666-0849 (Linking) VI - 30 IP - 33 DP - 2025 Oct 22 TI - 30-Day Outcomes of a Controlled-Bending Delivery System for TAVR in Severe Aortic Stenosis. PG - 105542 LID - S2666-0849(25)02325-3 [pii] LID - 10.1016/j.jaccas.2025.105542 [doi] LID - 105542 AB - This report presents the first-in-human experience with a 3-dimensional controlled-bending, fully retrievable delivery system for transfemoral transcatheter aortic valve replacement in severe aortic stenosis with anatomical challenge. In a prospective single-center series (September-December 2023) of 6 high-risk patients (mean age: 68.0 +/- 3.9 years, 84% bicuspid valve, all with complex features such as horizontal heart or dilated ascending aorta), the device success rate was 100%, implantation was coaxial (implantation depth difference: 2.32 +/- 1.53 mm), and postprocedural paravalvular leak was none to trivial. Hemodynamics improved substantially (gradient decreased from 75.5 +/- 12.3 to 7.9 +/- 2.1 mm Hg, effective orifice area increased from 0.61 +/- 0.15 to 2.26 +/- 0.34 cm(2); P < 0.001). There were no deaths or strokes at 30 days postprocedure, and all patients reached NYHA functional class I or II. These early results suggest that controlled-bending delivery may enhance the precision and safety of transcatheter aortic valve replacement in complex anatomy, particularly with respect to the bicuspid valve. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Chen, Yang AU - Chen Y AD - Coronary Heart Disease Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiology, Peking University People's Hospital, Beijing, China. FAU - Wang, Zhongyu AU - Wang Z AD - Department of Medicine, Qingdao University, Qingdao, Shandong, China. FAU - Sun, Baihua AU - Sun B AD - Department of Radiology, Linyi People's Hospital, Linyi, Shandong, China. FAU - Chen, Guoliang AU - Chen G AD - Department of Cardiac Surgery, Shanxi Cardiovascular Hospital, Taiyuan, China. FAU - Zhang, Pinghai AU - Zhang P AD - Shanghai MicroPort CardioFlow Medtech Co Ltd, Shanghai, China. FAU - Xi, Jicheng AU - Xi J AD - Department of Cardiac Surgery, Shanxi Cardiovascular Hospital, Taiyuan, China. Electronic address: 3452893059@qq.com. FAU - Wu, Yongjian AU - Wu Y AD - Coronary Heart Disease Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: wuyongjian@fuwai.com. LA - eng PT - Journal Article PL - Netherlands TA - JACC Case Rep JT - JACC. Case reports JID - 101757292 PMC - PMC12789823 OTO - NOTNLM OT - aortic valve OT - bicuspid aortic valve OT - treatment OT - valve replacement COIS- Funding Support and Author Disclosures Support was received from the Peking University People's Hospital Scientific Research Development Fund (RDJP2024-12). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/10/25 00:30 MHDA- 2025/10/25 00:31 PMCR- 2025/10/22 CRDT- 2025/10/24 20:54 PHST- 2025/06/03 00:00 [received] PHST- 2025/08/04 00:00 [revised] PHST- 2025/08/11 00:00 [accepted] PHST- 2025/10/25 00:31 [medline] PHST- 2025/10/25 00:30 [pubmed] PHST- 2025/10/24 20:54 [entrez] PHST- 2025/10/22 00:00 [pmc-release] AID - S2666-0849(25)02325-3 [pii] AID - 105542 [pii] AID - 10.1016/j.jaccas.2025.105542 [doi] PST - ppublish SO - JACC Case Rep. 2025 Oct 22;30(33):105542. doi: 10.1016/j.jaccas.2025.105542. PMID- 41123239 OWN - NLM STAT- Publisher LR - 20251022 IS - 2724-5772 (Electronic) IS - 2724-5683 (Linking) DP - 2025 Oct 22 TI - Single or double suture-based devices with additional endovascular plug for vascular closure after transfemoral transcatheter aortic valve implantation. LID - 10.23736/S2724-5683.25.06859-0 [doi] AB - BACKGROUND: Procedure-related vascular and bleeding complications after transcatheter aortic valve implantation (TAVI) still represents an important issue that impact on patients' mortality and morbidity. The aim of this study was to compare the effectiveness of single or double suture-based devices (SBDs) combined with a plug-based device to obtain large bore arteriotomy hemostasis after transfemoral (TF) TAVI. METHODS: Consecutive patients with available preprocedural computed tomography angiography (CTA) assessment undergoing 14Fr TF-TAVI from February 2018 to May 2023 at our Institution were considered. Patient receiving single or double SBD combined with a plug-based device were compared after propensity score matching. The primary outcomes were major vascular complications and type 2 to 4 bleeding due to endovascular closure system failure according VARC-3 criteria. RESULTS: Among a total of 490 patients, 130 matched pairs of patients were compared. At 30 days, there was no difference in major vascular complications (0.0% vs. 2.3%, P=0.25) and in type 2 to 4 bleedings (4.6% vs. 6.2%, P=0.78) between two matched groups. No difference in 30-day (1.5% vs. 3.8%, P=0.45) and one-year (12.0% vs. 9.5%, P=0.60) all-cause death was observed. CONCLUSIONS: A simpler strategy with single SBD had comparable safety and effectiveness to the use of double SBD when combined to a plug-base device after 14 Fr TF-TAVI. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Sammartino, Sofia AU - Sammartino S AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Cali, Mariachiara AU - Cali M AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - LA Rosa, Luigi AU - LA Rosa L AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Giaquinta, Alessia AU - Giaquinta A AD - Division of Cardiology, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Veroux, Pierfrancesco AU - Veroux P AD - Division of Vascular Surgery, Policlinico-San Marco Hospital, C.A.S.T., University of Catania, Catania, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Centro Cuore Morgagni, Pedara, Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Faculty of Medicine and Surgery, Kore University of Enna, Enna, Italy - mbarbanti83@gmail.com. LA - eng PT - Journal Article DEP - 20251022 PL - Italy TA - Minerva Cardiol Angiol JT - Minerva cardiology and angiology JID - 101776555 SB - IM EDAT- 2025/10/22 12:31 MHDA- 2025/10/22 12:31 CRDT- 2025/10/22 08:31 PHST- 2025/10/22 12:31 [medline] PHST- 2025/10/22 12:31 [pubmed] PHST- 2025/10/22 08:31 [entrez] AID - S2724-5683.25.06859-0 [pii] AID - 10.23736/S2724-5683.25.06859-0 [doi] PST - aheadofprint SO - Minerva Cardiol Angiol. 2025 Oct 22. doi: 10.23736/S2724-5683.25.06859-0. PMID- 41114822 OWN - NLM STAT- MEDLINE DCOM- 20260612 LR - 20261010 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 115 IP - 7 DP - 2026 Jul TI - Secondary access and routine protection wire for transfemoral transcatheter aortic valve replacement: the SURF-TAVR registry. PG - 1178-1187 LID - 10.1007/s00392-025-02730-4 [doi] AB - BACKGROUND: Vascular complications remain a challenge in transfemoral transcatheter aortic valve replacement (TF-TAVR). Evidence for routine wire protection (RP) to mitigate these complications is limited. OBJECTIVES: This study assessed the impact of RP on vascular complications in a contemporary TF-TAVR cohort. METHODS: The SURF-TAVR registry analyzed 4224 TF-TAVR patients treated between January 2020 and August 2023 at 15 centers in Italy and France. Patients were categorized into RP or no-routine protection (nRP) centers. Propensity score matching (PSM) adjusted for baseline differences. The primary endpoint was overall vascular complications (VARC-3 criteria). Secondary outcomes included major vascular complications, bleeding, acute kidney injury, and intrahospital mortality. RESULTS: Of the analyzed patients, 69.1% were treated in nRP centers and 30.9% in RP centers. Secondary access was predominantly transradial in the nRP group (82%) and contralateral femoral in the RP group (87.5%). nRP was associated with fewer overall vascular complications (8.3% vs. 12.1%, p < 0.001), but more major vascular complications (2.4% vs. 1.1%, p = 0.009). Bleeding rates were lower with nRP (6.6% vs. 9.7%, p < 0.001), while major bleedings were comparable (3.8% vs 4.8%, p = 0.111). Propensity score matching confirmed these findings. CONCLUSIONS: Routine wire protection in transfemoral TAVR is associated with increased overall vascular complications and bleeding, but appears to lower the risk of major vascular complications. These findings underscore the need to carefully weigh procedural risks and benefits to optimize vascular access management in TF-TAVR. CI - (c) 2025. Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Cozzi, Ottavia AU - Cozzi O AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy. FAU - Ratan, Prem AU - Ratan P AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Costa, Giulia AU - Costa G AD - Cardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Branca, Luca AU - Branca L AD - Civili Hospital and University of Brescia, Brescia, Italy. FAU - Boiago, Mauro AU - Boiago M AD - Clinique Pasteur, Toulouse, France. FAU - Fezzi, Simone AU - Fezzi S AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Biroli, Matteo AU - Biroli M AD - Centro Cardiologico Monzino IRCCS, Milan, Italy. FAU - Munafo, Andrea AU - Munafo A AD - Interventional Cardiology, Cardiologia I-Emodinamica, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan - Dipartimento Di Medicina E Chirurgia, Universita Degli Studi Milano-Bicocca, Milan, Italy. FAU - Montalto, Claudio AU - Montalto C AD - Interventional Cardiology, Cardiologia I-Emodinamica, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan - Dipartimento Di Medicina E Chirurgia, Universita Degli Studi Milano-Bicocca, Milan, Italy. AD - School of Medicine and Surgery, University of Milano-Bicocca, Piazza Dell'Ateneo Nuovo 1, 20126, Milan, Italy. FAU - Colombo, Francesco AU - Colombo F AD - Department of Cardiology, Ospedale San Giovanni Bosco, Torino, Italy. FAU - Gallo, Francesco AU - Gallo F AD - Cardiology Unit, Ospedale Dell'Angelo, AULSS 3 Serenissima, Mestre, Italy. FAU - Pellegrini, Dario AU - Pellegrini D AD - IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy. FAU - Casenghi, Matteo AU - Casenghi M AD - Sant'Andrea Hospital, Rome, Italy. FAU - Giacomin, Enrico AU - Giacomin E AD - Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy. FAU - Regazzoli, Damiano AU - Regazzoli D AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Sticchi, Alessandro AU - Sticchi A AD - Cardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy. FAU - De Biase, Chiara AU - De Biase C AD - Clinique Pasteur, Toulouse, France. FAU - Chiarito, Mauro AU - Chiarito M AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy. FAU - De Carlo, Marco AU - De Carlo M AD - Cardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Adamo, Marianna AU - Adamo M AD - Civili Hospital and University of Brescia, Brescia, Italy. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. FAU - Cernetti, Carlo AU - Cernetti C AD - Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy. FAU - Barbato, Emanuele AU - Barbato E AD - Sant'Andrea Hospital, Rome, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy. FAU - Tumminello, Gabriele AU - Tumminello G AD - Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. FAU - Azzano, Alessia AU - Azzano A AD - Cardiovascular Department, Humanitas Gavazzeni Hospital, Bergamo, Italy. FAU - Brscic, Elvis AU - Brscic E AD - Cardiovascular Department, Humanitas Gavazzeni Hospital, Bergamo, Italy. FAU - Vercellino, Matteo AU - Vercellino M AD - Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS San Martino Polyclinic University Hospital, Genoa, Italy. FAU - Busco, Marco AU - Busco M AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Barbierato, Marco AU - Barbierato M AD - Cardiology Unit, Ospedale Dell'Angelo, AULSS 3 Serenissima, Mestre, Italy. FAU - Boccuzzi, Giacomo G AU - Boccuzzi GG AD - Department of Cardiology, Ospedale San Giovanni Bosco, Torino, Italy. FAU - Ribichini, Flavio AU - Ribichini F AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - De Marco, Federico AU - De Marco F AD - Centro Cardiologico Monzino IRCCS, Milan, Italy. FAU - Oreglia, Jacopo AU - Oreglia J AD - Interventional Cardiology, Cardiologia I-Emodinamica, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan - Dipartimento Di Medicina E Chirurgia, Universita Degli Studi Milano-Bicocca, Milan, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AUID- ORCID: 0000-0002-3239-4046 AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. antonio.mangieri@gmail.com. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20251020 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Registries MH - Female MH - *Femoral Artery MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery MH - Male MH - Risk Factors MH - *Postoperative Complications/epidemiology/prevention & control MH - Italy/epidemiology MH - *Catheterization, Peripheral/methods MH - France/epidemiology MH - Treatment Outcome OTO - NOTNLM OT - Minimalistic TAVR OT - Secondary access OT - Transfemoral TAVR OT - Vascular complications COIS- Declarations. Conflict of interest: The authors declare no competing interests. EDAT- 2025/10/20 12:30 MHDA- 2026/06/12 06:39 CRDT- 2025/10/20 11:13 PHST- 2025/05/06 00:00 [received] PHST- 2025/07/11 00:00 [accepted] PHST- 2026/06/12 06:39 [medline] PHST- 2025/10/20 12:30 [pubmed] PHST- 2025/10/20 11:13 [entrez] AID - 10.1007/s00392-025-02730-4 [pii] AID - 10.1007/s00392-025-02730-4 [doi] PST - ppublish SO - Clin Res Cardiol. 2026 Jul;115(7):1178-1187. doi: 10.1007/s00392-025-02730-4. Epub 2025 Oct 20. PMID- 41096194 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251016 LR - 20251019 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 19 DP - 2025 Oct 9 TI - Femoral Closure with Single ProGlide((R)) in Transcatheter Aortic Valve Implantation: A Registry-Based Study. LID - 10.3390/jcm14197113 [doi] LID - 7113 AB - Background: Vascular closure of the femoral artery during transcatheter aortic valve implantation (TAVI) remains a critical step prone to complications, despite advancements in introducer technology. The traditional technique involves using two ProGlide((R)) suture closure devices (2P), but alternative approaches, such as employing a single ProGlide((R)) device (1P), have emerged. Aims: We sought to evaluate the efficacy and safety of the 1P strategy compared to the standard 2P closure technique during transfemoral TAVI procedures. Methods: A registry-based study was conducted at the University Hospitals of Strasbourg, France, from January 2020 to December 2023. Consecutive patients who underwent TAVI via the transfemoral approach were deemed eligible. Results: The study cohort consisted of 1303 patients, with a mean age of 81.7 years and 47% female. The 1P strategy was used in 733 cases (56.3%), while the 2P technique was employed in 570 patients (43.7%). Hemostasis was achieved in the catheterization laboratory without additional devices in 30.4% of the single-ProGlide((R)) pre-closing cases. Vascular complication rates were similar in both groups, at 11.3% for the 1P technique and 11.4% for the 2P technique (p = 0.964). However, vascular closure device failure was significantly less frequent in the 1P group (1.6%) compared to the 2P group (5.3%). Conclusions: The 1P strategy for pre-closing during TAVI is as effective and safe as the conventional 2P approach. The 1P method offers potential advantages in terms of simplicity and cost-effectiveness. FAU - Roulot, Kevin AU - Roulot K AUID- ORCID: 0009-0005-2581-577X AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Kibler, Marion AU - Kibler M AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Trimaille, Antonin AU - Trimaille A AUID- ORCID: 0000-0001-9279-4220 AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Carmona, Adrien AU - Carmona A AUID- ORCID: 0000-0002-3477-208X AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Granier, Amandine AU - Granier A AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Plastaras, Philoktimon AU - Plastaras P AD - Hopital Albert Schweitzer, 68000 Colmar, France. FAU - Rischner, Jerome AU - Rischner J AD - Hopital Albert Schweitzer, 68000 Colmar, France. FAU - Greciano, Stephane AU - Greciano S AD - Hopital Pasteur, 68024 Colmar, France. FAU - Leddet, Pierre AU - Leddet P AUID- ORCID: 0000-0002-2717-0961 AD - Centre Hospitalier d'Haguenau, 67500 Haguenau, France. FAU - De Poli, Fabien AU - De Poli F AD - Centre Hospitalier d'Haguenau, 67500 Haguenau, France. FAU - Kanso, Mohamad AU - Kanso M AUID- ORCID: 0000-0001-9604-8866 AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Crimizade, Ulun AU - Crimizade U AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Boyer, Karen AU - Boyer K AD - Centre Hospitalier d'Haguenau, 67500 Haguenau, France. FAU - Hoang, Minh AU - Hoang M AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Kindo, Michel AU - Kindo M AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Jesel, Laurence AU - Jesel L AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Morel, Olivier AU - Morel O AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. FAU - Ohlmann, Patrick AU - Ohlmann P AUID- ORCID: 0000-0002-8021-2737 AD - Service de Cardiologie and Service de Chirurgie Cardio-Vasculaire, Pole d'Activite Medico-Chirurgicale, Nouvel Hopital Civil, 67000 Strasbourg, Cedex, France. LA - eng PT - Journal Article DEP - 20251009 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12525902 OTO - NOTNLM OT - femoral procedures OT - registry OT - transcatheter aortic valve implantation OT - vascular access OT - vascular closure device COIS- The authors declare no conflicts of interest. EDAT- 2025/10/16 06:29 MHDA- 2025/10/16 06:30 PMCR- 2025/10/09 CRDT- 2025/10/16 01:10 PHST- 2025/06/27 00:00 [received] PHST- 2025/08/18 00:00 [revised] PHST- 2025/09/16 00:00 [accepted] PHST- 2025/10/16 06:30 [medline] PHST- 2025/10/16 06:29 [pubmed] PHST- 2025/10/16 01:10 [entrez] PHST- 2025/10/09 00:00 [pmc-release] AID - jcm14197113 [pii] AID - jcm-14-07113 [pii] AID - 10.3390/jcm14197113 [doi] PST - epublish SO - J Clin Med. 2025 Oct 9;14(19):7113. doi: 10.3390/jcm14197113. PMID- 41093448 OWN - NLM STAT- MEDLINE DCOM- 20260316 LR - 20260722 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 19 DP - 2025 Oct 13 TI - Alternative Access for TAVR: A State-of-the-Art Review and Practical Guide. PG - 2309-2325 LID - S1936-8798(25)02262-9 [pii] LID - 10.1016/j.jcin.2025.08.029 [doi] AB - Current guideline recommendations for transcatheter aortic valve replacement are largely confined to procedures performed via transfemoral (TF) access. Major advances in preprocedural planning, delivery system technology, and procedural technique have led to substantial growth in TF access, even in complex vascular anatomies. However, determining the threshold beyond which TF access is either not feasible or carries unacceptable risk remains controversial. Furthermore, although alternative transvascular access routes have largely replaced surgical transthoracic approaches in patients unsuitable for TF access, the optimal alternative access route is still debated. Herein, the authors provide a state-of-the-art review of alternative access for TAVR, including the decision-making process between TF and non-TF approaches and the key elements of alternative access site selection and execution. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Feistritzer, Hans-Josef AU - Feistritzer HJ AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Dumpies, Oliver AU - Dumpies O AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Rosseel, Liesbeth AU - Rosseel L AD - Hartcentrum Aalst, Azorg, Aalst, Belgium. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospital Galway, School of Medicine, University of Galway, Galway, Ireland. FAU - Rogers, Toby AU - Rogers T AD - MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Blackman, Daniel J AU - Blackman DJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. FAU - Sawaya, Fadi AU - Sawaya F AD - Cardiology Department, American University of Beirut Medical Center, Beirut, Lebanon. FAU - Modine, Thomas AU - Modine T AD - Hopital haut Leveque, Unite Medico Chirurgicale, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna Policlinico S. Orsola, Bologna, Italy. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Unbehaun, Axel AU - Unbehaun A AD - Deutsches Herzzentrum der Charite, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany. FAU - Grubb, Kendra J AU - Grubb KJ AD - Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA. FAU - de Backer, Ole AU - de Backer O AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. Electronic address: https://twitter.com/Mo_A_W. LA - eng PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Review PT - Video-Audio Media PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - *Transcatheter Aortic Valve Replacement/methods MH - Humans OTO - NOTNLM OT - TAVR OT - alternative access OT - transaxillary OT - transcarotid OT - transcaval OT - transthoracic COIS- Funding Support and Author Disclosures Dr Mylotte is a consultant for Medtronic, Microport, and Boston Scientific. Dr Rogers is a consultant for Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Laboratories, Anteris, and Transmural Systems; is an advisory board member for Medtronic and Boston Scientific; has equity interest in Transmural Systems; and is a coinventor on patents, assigned to the National Institutes of Health, for transcatheter electrosurgery devices. Dr Blackman has received honoraria from Abbott Vascular, Edwards Lifesciences, JenaValve Technologies, and Medtronic, and an institutional research grant from Medtronic. Dr Unbehaun serves as a physician proctor for Edwards Lifesciences, Medtronic, and JenaValve. Dr Grubb has received consulting fees or honoraria from Medtronic, Abbott Laboratories, Ancora, and 4C Medical; and has been a Medtronic employee. Dr Abdel-Wahab's hospital receives consulting fees and/or speaking honoraria on his behalf from Medtronic, Boston Scientific, and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/10/16 05:32 MHDA- 2025/10/16 05:33 CRDT- 2025/10/15 20:57 PHST- 2025/02/01 00:00 [received] PHST- 2025/06/30 00:00 [revised] PHST- 2025/08/06 00:00 [accepted] PHST- 2025/10/16 05:33 [medline] PHST- 2025/10/16 05:32 [pubmed] PHST- 2025/10/15 20:57 [entrez] AID - S1936-8798(25)02262-9 [pii] AID - 10.1016/j.jcin.2025.08.029 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Oct 13;18(19):2309-2325. doi: 10.1016/j.jcin.2025.08.029. PMID- 41088485 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251015 LR - 20251017 IS - 2731-6203 (Electronic) IS - 2731-6203 (Linking) VI - 4 IP - 1 DP - 2025 Oct 14 TI - Fatal outcome after self-expanding transcatheter aortic valve replacement of the bicuspid valve due to infolding: a case report. PG - 39 LID - 10.1186/s44215-025-00224-3 [doi] LID - 39 AB - BACKGROUND: Infolding is a rare but potentially life-threatening complication of self-expanding transcatheter aortic valve replacement (TAVR). CASE PRESENTATION: We describe the case of an 80-year-old man who was referred for the treatment of severe aortic stenosis complicated by heart failure. Transthoracic echocardiography revealed the following: peak velocity, 6.1 m/s; mean pressure gradient, 102 mmHg; and aortic valve area, 0.26 cm(2). Computed tomography (CT) showed a bicuspid aortic valve with a R-L raphe, an annular area of 529 mm(2), and a perimeter of 83.4 mm. Considering the patient's severe emphysema, transfemoral TAVR was performed with the patient under deep sedation. A 34-mm Evolut FX valve was implanted after predilation with a 20-mm Inoue balloon. During deployment up to the point of no recapture, hypotension occurred without improvement, and mild infolding was suspected. However, full deployment was performed, as valve optimization was considered likely to stabilize hemodynamics. Post-deployment balloon dilation was performed; however, valve under-expansion and moderate aortic regurgitation persisted. Initial hemodynamics were stabilized; however, the patient gradually developed respiratory distress. Follow-up CT confirmed substantial valve infolding. Pulmonary hypertension, alveolar hemorrhage, and disseminated intravascular coagulation developed. Surgical aortic valve replacement with a 21-mm valve was performed 15 days post-TAVR. The explanted TAVR valve exhibited marked structural deformation. Although the patient's circulatory status improved postoperatively, he died of respiratory failure due to pneumonia. CONCLUSION: This case highlights the importance of comprehensive preoperative anatomical assessment and intraoperative decision making in high-risk patients, particularly those with bicuspid valves. Valve selection (considering the valve type and size) must be meticulously tailored to the anatomical features surrounding the annulus. In addition, upon its recognition, substantial infolding should be promptly addressed by recapturing the valve, adjusting the valve size, or redeploying the valve with additional balloon aortic valvuloplasty. CI - (c) 2025. The Author(s). FAU - Hayashi, Nagi AU - Hayashi N AUID- ORCID: 0009-0005-2382-5640 AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. qywfr603@yahoo.co.jp. FAU - Yunoki, Junji AU - Yunoki J AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Shigetomi, Keijiro AU - Shigetomi K AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Baba, Kouhei AU - Baba K AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Shichijo, Masahide AU - Shichijo M AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Jinnouchi, Koki AU - Jinnouchi K AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Morokuma, Hiroyuki AU - Morokuma H AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Itoh, Manabu AU - Itoh M AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. FAU - Kamohara, Keiji AU - Kamohara K AD - Department of Thoracic and Cardiovascular Surgery, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan. LA - eng PT - Journal Article DEP - 20251014 PL - England TA - Gen Thorac Cardiovasc Surg Cases JT - General thoracic and cardiovascular surgery cases JID - 9918900337406676 PMC - PMC12522575 OTO - NOTNLM OT - Bicuspid valve OT - Infolding OT - Self-expandable valve OT - TAVR COIS- Declarations. Ethics approval and consent to participate: The need for ethical review and approval were waived by the ethics committee of our hospital, as case reports are exempt from review in accordance with institutional policy. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and accompanying images. Competing interests: The authors declare no competing interests. EDAT- 2025/10/15 06:30 MHDA- 2025/10/15 06:31 PMCR- 2025/10/14 CRDT- 2025/10/15 00:28 PHST- 2025/06/28 00:00 [received] PHST- 2025/09/09 00:00 [accepted] PHST- 2025/10/15 06:31 [medline] PHST- 2025/10/15 06:30 [pubmed] PHST- 2025/10/15 00:28 [entrez] PHST- 2025/10/14 00:00 [pmc-release] AID - 10.1186/s44215-025-00224-3 [pii] AID - 224 [pii] AID - 10.1186/s44215-025-00224-3 [doi] PST - epublish SO - Gen Thorac Cardiovasc Surg Cases. 2025 Oct 14;4(1):39. doi: 10.1186/s44215-025-00224-3. PMID- 41085855 OWN - NLM STAT- MEDLINE DCOM- 20260520 LR - 20260813 IS - 1618-7601 (Electronic) IS - 1618-7598 (Print) IS - 1618-7598 (Linking) VI - 27 IP - 3 DP - 2026 Apr TI - TF-TAVI and SAVR post-procedural complications in Germany 2021/2022 - impact on healthcare resource consumption. PG - 651-661 LID - 10.1007/s10198-025-01838-8 [doi] AB - BACKGROUND: Post-procedural complications after transfemoral transcatheter aortic valve implantation (TF-TAVI) lead to extended healthcare resource consumption. A comparison with resource consumption after surgical aortic stenosis valve replacement (SAVR) complications has not been conducted. METHODS: The impact of acute kidney injury (AKI), stroke, severe bleeding and permanent pacemaker implantation (PPI) on length of stay, mechanical ventilation > 48 h and reimbursement was analyzed by risk-adjusted linear and logistic regression analyses of all German aortic stenosis TF-TAVI and SAVR cases 2021/2022. RESULTS: 48,565 TF-TAVI and 9,803 SAVR procedures for aortic stenosis treatment were performed in Germany 2021/2022. The length of stay for TF-TAVI was shorter (10.16 +/- 7.19 vs. 13.91 +/- 9.82 days, p < 0.001), the rate of mechanical ventilation > 48 h was lower after TF-TAVI (1.3% vs. 7.0%, p < 0.001) and reimbursement was higher for TF-TAVI (26,483 +/- 4,487 vs. 20,538 +/- 11,748 euro, p < 0.001). Length of stay was increased by all investigated complications after TF-TAVI and SAVR (p < 0.001) with the highest increase after bleeding in TF-TAVI. Odds ratios for mechanical ventilation > 48 h were significantly increased for stroke, severe bleeding and AKI (p < 0.001) but not for PPI after both TF-TAVI and SAVR with the highest OR increase after bleeding in TF-TAVI. Reimbursement was significantly increased after TF-TAVI and SAVR by all investigated complications (p < 0.001) finding significantly higher increases after SAVR compared to TF-TAVI for all complications. The total hospital stay after stroke, AKI and PPM was longer for SAVR (p < 0.001), while severe bleeding led to longer total hospital stay after TF-TAVI (p < 0.001). Total reimbursement remained higher for TF-TAVI after all investigated complications (p < 0.001). CONCLUSION: Healthcare resource consumption differs between TF-TAVI and SAVR for aortic stenosis treatment also after procedural complications. SAVR is associated with longer hospitalization and more mechanical ventilation, while TF-TAVI is associated with higher reimbursement in the German healthcare system. Complications lead to increased resource use for both procedures with higher extra reimbursement for SAVR and more extra hospital days for TF-TAVI after bleeding reversing the length of stay advantage. CI - (c) 2025. The Author(s). FAU - Maier, Alexander AU - Maier A AUID- ORCID: 0000-0003-0200-7495 AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. alexander.maier@uniklinik-freiburg.de. FAU - Zientara, Alicja AU - Zientara A AD - Department of Cardiovascular Surgery, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Jackel, Markus AU - Jackel M AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Rilinger, Jonathan AU - Rilinger J AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Weber, Christian AU - Weber C AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Oettinger, Vera AU - Oettinger V AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Heger, Lukas A AU - Heger LA AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Hazard, Derek AU - Hazard D AD - Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Gottardi, Roman AU - Gottardi R AD - Department of Cardiovascular Surgery, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Czerny, Martin AU - Czerny M AD - Department of Cardiovascular Surgery, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AD - Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Freiburg, Germany. LA - eng PT - Journal Article DEP - 20251014 PL - Germany TA - Eur J Health Econ JT - The European journal of health economics : HEPAC : health economics in prevention and care JID - 101134867 SB - IM MH - Humans MH - Germany/epidemiology MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery MH - Aged MH - Length of Stay/statistics & numerical data/economics MH - *Transcatheter Aortic Valve Replacement/adverse effects/economics/methods MH - Aged, 80 and over MH - *Postoperative Complications/epidemiology/economics MH - Acute Kidney Injury/epidemiology MH - Respiration, Artificial/statistics & numerical data MH - *Heart Valve Prosthesis Implantation/adverse effects PMC - PMC13190498 OTO - NOTNLM OT - Complications OT - Healthcare resources OT - SAVR OT - TAVI COIS- Declarations. Competing interests: The authors declare that there is no conflict of interest. EDAT- 2025/10/14 12:30 MHDA- 2026/05/20 12:38 PMCR- 2025/10/14 CRDT- 2025/10/14 11:21 PHST- 2025/02/13 00:00 [received] PHST- 2025/08/18 00:00 [accepted] PHST- 2026/05/20 12:38 [medline] PHST- 2025/10/14 12:30 [pubmed] PHST- 2025/10/14 11:21 [entrez] PHST- 2025/10/14 00:00 [pmc-release] AID - 10.1007/s10198-025-01838-8 [pii] AID - 1838 [pii] AID - 10.1007/s10198-025-01838-8 [doi] PST - ppublish SO - Eur J Health Econ. 2026 Apr;27(3):651-661. doi: 10.1007/s10198-025-01838-8. Epub 2025 Oct 14. PMID- 41079586 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251013 LR - 20251015 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 12 DP - 2025 TI - The NORTh Europe HOStile access TAVI (NORTHOSTAVI) registry. PG - 1674218 LID - 10.3389/fcvm.2025.1674218 [doi] LID - 1674218 AB - BACKGROUND-AIMS: Comparisons between alternative access routes for transcatheter aortic valve implantation (TAVI) in patients with hostile vascular access are scarce. This study aimed to perform a head-to-head comparison of various techniques (percutaneous transaxillary [P-TAx], surgically-assisted transaxillary [S-TAx], transcarotid [TCar], percutaneous transluminal angioplasty-assisted transfemoral [PTA-TF], transbrachiocephalic [TBra], and transcaval [TCav]) with respect to the 30-day outcome of patients undergoing TAVI. METHODS: NORTHOSTAVI (NORTh Europe HOStile access TAVI) was an international registry that included patients undergoing TAVI via various endovascular transarterial access routes in Northern European countries. The primary endpoint was the adjusted 30-day rate of composite overall mortality, disabling stroke, main access site-related major vascular complications, and major bleeding according to VARC-3 criteria. RESULTS: In total, 531 patients were enrolled in the study across 14 centers. The main access routes were TCar (N = 183, 35%), P-TAx (N = 153, 29%), S-TAx (N = 79, 15%), and PTA-TF (N = 76, 14%), while TBra and TCav were used in 23 (4%) and 17 (3%) patients, respectively. Technical success was achieved in 95% of cases, 30-day overall and event-free survival rates were 97% and 91%, respectively, similar between groups. P-TAx, but not S-TAx or PTA-TF, was associated with an increased adjusted risk of overall stroke (adjusted OR: 4.21; 95%CI: 1.129-15.747; p = 0.003) compared to TCar. PTA-TF was associated with an increased adjusted risk of main access site-related major vascular complications (adjusted OR: 7.71; 95%CI: 1.367-43.554; p = 0.02) compared to TCar. CONCLUSIONS: The NORTHOSTAVI registry showed that in patients with hostile iliofemoral anatomy, TAVI via various endovascular transarterial access route is efficient and safe. CI - (c) 2025 Kefer, Kobari, Briki, Dubois, De Roeck, De Cock, Pirlet, Aminian, Colas-Florial, Vanhaverbeke, Guedes, Bataille, Sogorb, Van Bergeijk, Bugli, Maes, Bosmans, Buysschaert, Rosseel, Vandeloo, Wykrzykowska and De Backer. FAU - Kefer, Joelle AU - Kefer J AD - Division of Cardiology, Cliniques Universitaires Saint-Luc et Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain), Brussels, Belgium. FAU - Kobari, Yusuke AU - Kobari Y AD - The Heart Center, Righospitalet, Copenhagen, Denmark. FAU - Briki, Rachid AU - Briki R AD - CHU Saint-Pierre, Brussels, Belgium. FAU - Dubois, Christophe AU - Dubois C AD - Gasthuisberg, UZ Leuven, Leuven, Belgium. FAU - De Roeck, Frederic AU - De Roeck F AD - UZ Antwerpen, Antwerpen, Belgium. FAU - De Cock, Emmanuel AU - De Cock E AD - AZ Sint-Jan Campus, Brugge, Belgium. FAU - Pirlet, Charles AU - Pirlet C AD - CHR Citadelle, Liege, Belgium. FAU - Aminian, Adel AU - Aminian A AD - Division of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium. FAU - Colas-Florial, Julie AU - Colas-Florial J AD - Hartcentrum Aalst, AZORG, Aalst, Belgium. FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - Hartcentrum AZ Delta, Roeselare, Belgium. FAU - Guedes, Antoine AU - Guedes A AD - CHU UCL Namur- Mont Godinne, Yvoir, Belgium. FAU - Bataille, Yoann AU - Bataille Y AD - Jessa Ziekenhuis, Hasselt, Belgium. FAU - Sogorb, Amaury AU - Sogorb A AD - UZ Brussel Jette, Brussels, Belgium. FAU - Van Bergeijk, Kees AU - Van Bergeijk K AD - University Medical Center, Groningen, Netherlands. FAU - Bugli, Celine AU - Bugli C AD - SMCS (Plateforme Technologique de Support en Methodologie et Support Statistique), UCLouvain, Louvain-la-Neuve, Belgium. FAU - Maes, Frederic AU - Maes F AD - Division of Cardiology, Cliniques Universitaires Saint-Luc et Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain), Brussels, Belgium. FAU - Bosmans, Johan AU - Bosmans J AD - UZ Antwerpen, Antwerpen, Belgium. FAU - Buysschaert, Ian AU - Buysschaert I AD - AZ Sint-Jan Campus, Brugge, Belgium. FAU - Rosseel, Liesbeth AU - Rosseel L AD - Hartcentrum Aalst, AZORG, Aalst, Belgium. FAU - Vandeloo, Bert AU - Vandeloo B AD - UZ Brussel Jette, Brussels, Belgium. FAU - Wykrzykowska, Joanna AU - Wykrzykowska J AD - University Medical Center, Groningen, Netherlands. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Righospitalet, Copenhagen, Denmark. LA - eng PT - Journal Article DEP - 20250926 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC12513205 OTO - NOTNLM OT - TAVI OT - VARC-3 OT - alternative access OT - endovascular access OT - peripheral arterial disease COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/10/13 12:31 MHDA- 2025/10/13 12:32 PMCR- 2025/09/26 CRDT- 2025/10/13 07:28 PHST- 2025/07/27 00:00 [received] PHST- 2025/08/30 00:00 [accepted] PHST- 2025/10/13 12:32 [medline] PHST- 2025/10/13 12:31 [pubmed] PHST- 2025/10/13 07:28 [entrez] PHST- 2025/09/26 00:00 [pmc-release] AID - 10.3389/fcvm.2025.1674218 [doi] PST - epublish SO - Front Cardiovasc Med. 2025 Sep 26;12:1674218. doi: 10.3389/fcvm.2025.1674218. eCollection 2025. PMID- 41077517 OWN - NLM STAT- MEDLINE DCOM- 20260611 LR - 20260723 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 87 DP - 2026 Jun TI - Timing of percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation: A retrospective propensity-matched survival and safety analysis. PG - 33-41 LID - S1553-8389(25)00513-5 [pii] LID - 10.1016/j.carrev.2025.10.004 [doi] AB - BACKGROUND: The coexistence of severe aortic stenosis and coronary artery disease (CAD) in patients undergoing transcatheter aortic valve implantation (TAVI) is a common and clinically significant scenario. However, the optimal timing of percutaneous coronary intervention (PCI) in this population remains an unresolved question. This study aimed to compare the outcomes of patients undergoing PCI either prior to (Pre-TAVI) or simultaneously with (Simultaneous PCI-TAVI) transfemoral TAVI. METHODS: We retrospectively analyzed consecutive patients with severe symptomatic aortic stenosis and significant CAD who underwent transfemoral TAVI at the Interbalkan Medical Center between January 2019 and December 2024. We included 212 patients, that were categorized into two groups based on the timing of PCI: Pre-TAVI PCI and Simultaneous PCI-TAVI. A 1:1 propensity score matching (PSM) was performed based on baseline clinical and anatomical characteristics, yielding 50 matched pairs. The primary outcome was all-cause mortality at 3 years. Secondary endpoints, adjudicated per VARC-3, included in-hospital mortality, bleeding (types 1-4), major vascular complications, stroke, myocardial infarction, and unplanned rehospitalization. Transfusion >/=2 units was assessed separately as a safety/resource-use endpoint. Survival was analyzed using Kaplan-Meier and restricted mean survival time (RMST). Logistic regression was used for in-hospital composite safety events, and landmark/sensitivity analyses explored the impact of bleeding and transfusion. RESULTS: In-hospital mortality was low and comparable between groups (4.1 % vs. 2.6 % in the unmatched cohort, p = 0.62; 4.0 % vs. 2.0 % in matched pairs, p = 1.00). Simultaneous PCI-TAVI was associated with fewer VARC-3 type 2-4 bleeds (10 % vs. 4 %, p = 0.048), fewer transfusions >/=2 units (26 % vs. 12 %, p = 0.014), and numerically fewer major vascular complications. At 3 years, RMST analysis demonstrated longer survival with Simultaneous PCI-TAVI: +75 days in the unmatched cohort (95 % CI 10-140; p = 0.024) and + 68 days in matched pairs (95 % CI 5-131; p = 0.033). In a discharge-landmark analysis excluding in-hospital deaths, the survival benefit persisted in both cohorts. Logistic regression identified Pre-TAVI PCI as an independent predictor of the in-hospital composite safety endpoint (aOR 2.52, 95 % CI 1.25-5.07; p = 0.010). RMST regression adjusted for bleeding and transfusion confirmed that the survival benefit of Simultaneous PCI-TAVI was not explained solely by peri-procedural complications. CONCLUSIONS: In patients undergoing transfemoral TAVI with concomitant CAD, a strategy of Simultaneous PCI-TAVI was associated with improved survival and a lower incidence of bleeding, vascular complications, and transfusion needs compared to Pre-TAVI PCI. These findings support a tailored single-session approach in appropriately selected patients and highlight the value of procedural consolidation to minimize risk. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Papadopoulos, Georgios E AU - Papadopoulos GE AD - Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Ninios, Ilias AU - Ninios I AD - Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Evangelou, Sotirios AU - Evangelou S AD - Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Ioannides, Andreas AU - Ioannides A AD - Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Nikitopoulos, Athinodoros AU - Nikitopoulos A AD - Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Giamouzis, Grigorios AU - Giamouzis G AD - Department of Cardiology, University Hospital of Larissa, 41334, Larissa, Greece. FAU - Ninios, Vlasis AU - Ninios V AD - Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. Electronic address: vninios@gmail.com. LA - eng PT - Comparative Study PT - Journal Article DEP - 20251010 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Retrospective Studies MH - Female MH - Time Factors MH - Treatment Outcome MH - Male MH - Risk Factors MH - *Aortic Valve Stenosis/mortality/surgery/diagnostic imaging/physiopathology/complications MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Aged, 80 and over MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Risk Assessment MH - *Coronary Artery Disease/mortality/diagnostic imaging/therapy/complications MH - Hospital Mortality MH - Aged MH - *Time-to-Treatment MH - Severity of Illness Index MH - Propensity Score OTO - NOTNLM OT - Bleeding complications OT - Coronary artery disease OT - Percutaneous Coronary Intervention OT - Propensity score matching OT - Simultaneous PCI-TAVI OT - Structural Heart Disease OT - Timing of revascularization OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/10/13 00:27 MHDA- 2026/06/11 06:36 CRDT- 2025/10/12 21:58 PHST- 2025/08/25 00:00 [received] PHST- 2025/10/07 00:00 [revised] PHST- 2025/10/08 00:00 [accepted] PHST- 2026/06/11 06:36 [medline] PHST- 2025/10/13 00:27 [pubmed] PHST- 2025/10/12 21:58 [entrez] AID - S1553-8389(25)00513-5 [pii] AID - 10.1016/j.carrev.2025.10.004 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2026 Jun;87:33-41. doi: 10.1016/j.carrev.2025.10.004. Epub 2025 Oct 10. PMID- 41077218 OWN - NLM STAT- MEDLINE DCOM- 20251208 LR - 20251209 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 258 DP - 2026 Jan 1 TI - Aortic Arch Morphology and Cerebrovascular Accidents After Transfemoral Transcatheter Aortic Valve Implantation. PG - 229-233 LID - S0002-9149(25)00633-2 [pii] LID - 10.1016/j.amjcard.2025.09.066 [doi] AB - Cerebrovascular accidents (CVA) after transcatheter aortic valve implantation (TAVI) remain a major concern. However, the impact of aortic arch morphology has not been investigated in this context. To address this gap, consecutive patients undergoing transfemoral TAVI between March 2009 and January 2025 were analysed. Aortic arch morphology was assessed on preprocedural computed tomography scans, including measurements of arch angle, presence of calcification and soft plaques. Patients were classified as having an acutely angled (gothic, angle 138 degrees ) arch. The primary endpoint was the occurrence of CVA within 30 days following TAVI. A total of 1248 patients with a mean age of 81 +/- 6 years (44% female) were studied. CVA occurred in 38 patients (3.0%) within 30 days. Notably, patients who experienced CVA had a significantly higher prevalence of a round arch (89% versus 72%, p = 0.021) and soft plaques along the outer curvature (45% versus 26%, p = 0.010). Other predictors of CVA included peripheral arterial disease (29% versus 12%, p = 0.002) and implantation of more than 1 transcatheter heart valve (11% versus 2%, p < 0.001). Interestingly, use of cerebral protection devices did not reduce stroke rates. In conclusion, an acutely angled (gothic) arch was not associated with increased risk for CVA within 30 days after TAVI. Instead, a round arch and soft plaques along the outer curvature were associated with more strokes. Such patients may benefit from careful advancement of the valve catheter when crossing the aortic arch or an alternative (transapical, direct aortic) access route. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Baltruskeviciute, Laura AU - Baltruskeviciute L AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. Electronic address: laura.baltruskeviciute@gmail.com. FAU - Moccetti, Federico AU - Moccetti F AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Wolfrum, Mathias AU - Wolfrum M AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Loretz, Lucca AU - Loretz L AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Brunner, Stephanie AU - Brunner S AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Hakimi, Maani AU - Hakimi M AD - Department of Vascular Surgery, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Matt, Peter AU - Matt P AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center, University Teaching and Research Hospital Lucerne, Lucerne, Switzerland. LA - eng PT - Journal Article DEP - 20251010 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM EIN - Am J Cardiol. 2026 Jan 15;259:228. doi: 10.1016/j.amjcard.2025.11.003. PMID: 41349586 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Female MH - Male MH - Aged, 80 and over MH - *Aorta, Thoracic/diagnostic imaging/pathology MH - *Stroke/epidemiology/etiology MH - *Aortic Valve Stenosis/surgery MH - Aged MH - Retrospective Studies MH - *Postoperative Complications/epidemiology MH - Femoral Artery MH - Tomography, X-Ray Computed MH - Risk Factors OTO - NOTNLM OT - aortic angulation OT - aortic arch morphology OT - atherosclerotic plaque OT - cerebrovascular accident OT - stroke risk COIS- Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Stefan Toggweiler reports financial support was provided by Medtronic. Stefan Toggweiler reports financial support was provided by Boston Scientific Corporation. Stefan Toggweiler reports financial support was provided by Biosensors Europe SA. Stefan Toggweiler reports financial support was provided by Edwards Lifesciences Corporation. Stefan Toggweiler reports financial support was provided by Hi-D Imaging. Stefan Toggweiler reports financial support was provided by Abbott Vascular. Stefan Toggweiler reports financial support was provided by Shockwave Medical Inc. Stefan Toggweiler reports financial support was provided by Teleflex. Stefan Toggweiler reports financial support was provided by atHeart Medical. Stefan Toggweiler reports financial support was provided by Cardiac Dimensions Inc. Stefan Toggweiler reports financial support was provided by Polares Medical Inc. Stefan Toggweiler reports financial support was provided by Amarin Switzerland GmbH. Stefan Toggweiler reports financial support was provided by Sanofi. Stefan Toggweiler reports financial support was provided by AstraZeneca. Stefan Toggweiler reports financial support was provided by ReCor Medical Inc. Stefan Toggweiler reports financial support was provided by Daiichi Sankyo Inc. Stefan Toggweiler reports financial support was provided by Bayer AG. Stefan Toggweiler reports financial support was provided by Armira. Lucca Loretz reports financial support was provided by AstraZeneca. Stefan Toggweiler reports a relationship with Edwards Lifesciences Corporation that includes: funding grants. Stefan Toggweiler reports a relationship with Abbott Vascular Inc that includes: funding grants. Stefan Toggweiler reports a relationship with Boston Scientific Corporation that includes: funding grants. Stefan Toggweiler reports a relationship with Fumedica that includes: funding grants. Stefan Toggweiler reports a relationship with Novartis that includes: funding grants. Stefan Toggweiler reports a relationship with Boehringer Ingelheim GmbH that includes: funding grants. Stefan Toggweiler reports a relationship with Polares Medical that includes: funding grants. Stefan Toggweiler reports a relationship with Hi-D Imaging that includes: equity or stocks. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/10/13 00:27 MHDA- 2025/12/09 00:31 CRDT- 2025/10/12 19:32 PHST- 2025/08/11 00:00 [received] PHST- 2025/09/23 00:00 [revised] PHST- 2025/09/27 00:00 [accepted] PHST- 2025/12/09 00:31 [medline] PHST- 2025/10/13 00:27 [pubmed] PHST- 2025/10/12 19:32 [entrez] AID - S0002-9149(25)00633-2 [pii] AID - 10.1016/j.amjcard.2025.09.066 [doi] PST - ppublish SO - Am J Cardiol. 2026 Jan 1;258:229-233. doi: 10.1016/j.amjcard.2025.09.066. Epub 2025 Oct 10. PMID- 41075958 OWN - NLM STAT- MEDLINE DCOM- 20251208 LR - 20251222 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 258 DP - 2026 Jan 1 TI - Full Heparin Reversal With Protamine After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. PG - 239-246 LID - S0002-9149(25)00619-8 [pii] LID - 10.1016/j.amjcard.2025.09.057 [doi] AB - Protamine sulfate is widely used to reverse unfractionated heparin during transfemoral transcatheter aortic valve replacement (TAVR), but the optimal reversal strategy remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies comparing full heparin reversal (1 mg protamine per 100 units heparin) with partial or no reversal in transfemoral TAVR. The primary outcome was a composite of all-cause mortality, major bleeding, and major vascular complications, defined according to VARC-3 criteria, while secondary outcomes included each component of the composite and stroke. Five studies (two randomized trials, three cohort studies) involving 3,089 patients were included. Full-dose protamine significantly reduced the composite outcome (RR 0.46, 95% CI 0.36-0.60), driven by reductions in major bleeding (RR 0.41, 95% CI 0.28-0.59) and major vascular complications (RR 0.44, 95% CI 0.30-0.65). No excess risk was observed for all-cause mortality (RR 0.94, 95% CI 0.65-1.36) or stroke (RR 0.67, 95% CI 0.40-1.12). Leave-one-out and subgroup analyses confirmed the robustness of these findings, and no evidence of publication bias was identified. In conclusion, full heparin reversal with protamine during TAVR is associated with lower bleeding and vascular complications without increasing thromboembolic risk, supporting its use as a bleeding-avoidance strategy. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Silva, Joao Pedro Machado Ribeiro Jacintho AU - Silva JPMRJ AD - Department of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: jp.mrjacintho@gmail.com. FAU - Nogueira, Bruno Viruez AU - Nogueira BV AD - Department of Medicine, University of Sao Paulo, Sao Paulo, Brazil. FAU - Mussolini, Maria Carolina Bortoletto AU - Mussolini MCB AD - Department of Medicine, School of Medicine of Araraquara, Araraquara, Brazil. FAU - Bisneto, Oscar Inacio de Mendonca AU - Bisneto OIM AD - Department of Medicine, Federal University of Campina Grande, Cajazeiras, Brazil. FAU - Gomes, Wilton Francisco AU - Gomes WF AD - Department of Interventional Cardiology, INC Hospital, Curitiba, Brazil; Department of Internal Medicine, Faculdades Pequeno Principe, Curitiba, Brazil; Department of Interventional Cardiology, Irmandade da Santa Casa de Misericordia de Curitiba, Curitiba, Brazil. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20251009 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Protamines) RN - 0 (Heparin Antagonists) RN - 9005-49-6 (Heparin) RN - 0 (Anticoagulants) SB - IM MH - Humans MH - *Protamines/therapeutic use MH - *Transcatheter Aortic Valve Replacement MH - *Heparin Antagonists/therapeutic use MH - *Heparin/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Anticoagulants OTO - NOTNLM OT - TAVI OT - TAVR OT - UFH OT - heparin OT - protamine COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/10/12 00:33 MHDA- 2025/12/09 00:31 CRDT- 2025/10/11 19:31 PHST- 2025/08/28 00:00 [received] PHST- 2025/09/26 00:00 [revised] PHST- 2025/09/29 00:00 [accepted] PHST- 2025/12/09 00:31 [medline] PHST- 2025/10/12 00:33 [pubmed] PHST- 2025/10/11 19:31 [entrez] AID - S0002-9149(25)00619-8 [pii] AID - 10.1016/j.amjcard.2025.09.057 [doi] PST - ppublish SO - Am J Cardiol. 2026 Jan 1;258:239-246. doi: 10.1016/j.amjcard.2025.09.057. Epub 2025 Oct 9. PMID- 41053517 OWN - NLM STAT- MEDLINE DCOM- 20260204 LR - 20260207 IS - 1826-6983 (Electronic) IS - 0033-8362 (Print) IS - 0033-8362 (Linking) VI - 131 IP - 1 DP - 2026 Jan TI - Impact of low-energy virtual monoenergetic imaging in photon-counting CT for pre-TAVI pelvic arteries visualization. PG - 31-44 LID - 10.1007/s11547-025-02113-9 [doi] AB - PURPOSE: This study aimed to assess the impact of photon-counting computed tomography (PCCT) virtual monoenergetic images (VMI) on quantitative and qualitative parameters in abdominal and pelvic vascular imaging for transcatheter aortic valve implantation (TAVI) planning. MATERIAL AND METHODS: A retrospective analysis of 125 patients undergoing dual-source PCCT scans before TAVI procedures was conducted. Reconstructions included polychromatic (T3D) images, leveraging multiple photon energy levels and VMI series spanning 40-100 keV in 15 keV increments. Quantitative parameters (signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) were evaluated. Qualitative assessments by three radiologists used clinically relevant five-point scales for overall image quality, TAVI access site suitability, and confidence in TAVI measurements. RESULTS: VMI reconstructions, particularly at 40 and 55 keV, demonstrated significantly higher SNR and CNR than T3D reconstructions (p < 0.001). T3D reconstructions had a mean noise of 12.61 +/- 6.12, comparable to 100 keV VMI reconstructions (14.77 +/- 8.23, p > 0.05). In qualitative evaluation, 55 keV VMI images scored highest in overall image quality and TAVI access site assessability, followed by 70 keV VMI reconstructions. CONCLUSION: Low-keV PCCT VMI reconstructions provided superior quantitative and qualitative image quality for abdominal and pelvic vascular imaging in TAVI planning. Notably, 55 keV reconstructions showed an image quality reserve over T3D images, aiding confidence in TAVI-related measurements and enabling possible future reductions in contrast agent use, emphasizing the relevance of VMI techniques in optimizing TAVI imaging protocols. CI - (c) 2025. The Author(s). FAU - Alizadeh, Leona S AU - Alizadeh LS AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Department of Diagnostic and Interventional Radiology, Bundeswehr Central Hospital Koblenz, 56072, Koblenz, Germany. FAU - Booz, Christian AU - Booz C AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. FAU - Vogl, Thomas J AU - Vogl TJ AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. FAU - Lanzafame, Ludovica R M AU - Lanzafame LRM AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124, Messina, Italy. FAU - Martin, Simon S AU - Martin SS AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. FAU - Yel, Ibrahim AU - Yel I AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. FAU - Gruenewald, Leon D AU - Gruenewald LD AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. FAU - Koch, Vitali AU - Koch V AD - Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. FAU - D'Angelo, Tommaso AU - D'Angelo T AUID- ORCID: 0000-0003-0004-6378 AD - Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany. tommasodang@gmail.com. AD - Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124, Messina, Italy. tommasodang@gmail.com. AD - Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital "Policlinico G. Martino", Via Consolare Valeria 1, 98100, Messina, Italy. tommasodang@gmail.com. FAU - Mazziotti, Silvio AU - Mazziotti S AD - Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital Messina, 98124, Messina, Italy. FAU - Smolka, Kerstin AU - Smolka K AD - Department of Diagnostic and Interventional Radiology, Bundeswehr Central Hospital Koblenz, 56072, Koblenz, Germany. FAU - Braunegger, Grit AU - Braunegger G AD - Department of Diagnostic and Interventional Radiology, Bundeswehr Central Hospital Koblenz, 56072, Koblenz, Germany. FAU - Dillinger, Daniel AU - Dillinger D AD - Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital Koblenz, Rubenacher Strasse 170, 56072, Koblenz, Germany. FAU - Kaatsch, Leonhard AU - Kaatsch L AD - Department of Diagnostic and Interventional Radiology, Bundeswehr Central Hospital Koblenz, 56072, Koblenz, Germany. FAU - Overhoff, Daniel AU - Overhoff D AD - Department of Diagnostic and Interventional Radiology, Bundeswehr Central Hospital Koblenz, 56072, Koblenz, Germany. AD - Department of Diagnostic and Interventional Radiology, University Hospital Mannheim, 68167, Mannheim, Germany. FAU - Verloh, Niklas AU - Verloh N AD - Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Waldeck, Stephan S AU - Waldeck SS AD - Department of Diagnostic and Interventional Radiology, Bundeswehr Central Hospital Koblenz, 56072, Koblenz, Germany. AD - Department of Diagnostic and Interventional Radiology, University Hospital Mainz, 55131, Mainz, Germany. LA - eng PT - Journal Article DEP - 20251006 PL - Italy TA - Radiol Med JT - La Radiologia medica JID - 0177625 SB - IM MH - Humans MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement MH - Female MH - Male MH - Aged MH - *Pelvis/blood supply/diagnostic imaging MH - Aged, 80 and over MH - *Tomography, X-Ray Computed/methods MH - Signal-To-Noise Ratio MH - Photons PMC - PMC12872712 OTO - NOTNLM OT - Pelvic arteries OT - Photon-counting CT OT - Transcatheter aortic valve replacement OT - Transfemoral access OT - Virtual monoenergetic Imaging COIS- Declarations. Conflict of interest: C.B. and I.Y. have received speaking fees from Siemens Healthineers. T.D. has received speaking fees from Bracco and Philips. Ethical approval: Approval for this study was received by our institutional review board at the University Hospital Frankfurt, with a waiver for informed consent of the patients due to the retrospective nature of our study (approval number: 2023-1508). Consent to participate: A waiver for informed consent of the patients was provided by the IRB due to the retrospective and observational nature of our study. Consent for publication: All authors provided their consent for publication of this study. The authors affirm that human research participants provided informed consent for publication of the images. EDAT- 2025/10/07 00:29 MHDA- 2026/02/04 15:12 PMCR- 2025/10/06 CRDT- 2025/10/06 23:47 PHST- 2024/04/02 00:00 [received] PHST- 2025/09/22 00:00 [accepted] PHST- 2026/02/04 15:12 [medline] PHST- 2025/10/07 00:29 [pubmed] PHST- 2025/10/06 23:47 [entrez] PHST- 2025/10/06 00:00 [pmc-release] AID - 10.1007/s11547-025-02113-9 [pii] AID - 2113 [pii] AID - 10.1007/s11547-025-02113-9 [doi] PST - ppublish SO - Radiol Med. 2026 Jan;131(1):31-44. doi: 10.1007/s11547-025-02113-9. Epub 2025 Oct 6. PMID- 41040455 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251003 LR - 20251005 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 4 IP - 9 DP - 2025 Sep TI - Fluoroscopic "Lucent Line" Visualization in SAPIEN 3 TAVR Deployment: Reproducibility and Impacts on Outcomes. PG - 103856 LID - 10.1016/j.jscai.2025.103856 [doi] LID - 103856 AB - BACKGROUND: Fluoroscopic radiolucent (lucent) line (LL) visualization in SAPIEN 3 (S3) transcatheter aortic valve replacement (TAVR) has been advocated to optimize implant depth, but reproducibility and outcomes remain unknown. Our goal was to determine the incidence of LL seen at conventional deployment view during S3 TAVR and associated outcomes. METHODS: From April 2017 to September 2022, fluoroscopic images of 1130 consecutive transfemoral S3 TAVR were retrospective analyzed. LL visualization at the time of S3 positioning (+ or -) and coaxiality (coaxial [C] or noncoaxial [NC]) of the S3 valve at final implantation in the 3-cusp coplanar view were respectively evaluated. Procedural and in-hospital outcomes per Valve Academic Research Consortium 3 definitions were determined. RESULTS: LL was present in only 64.8%, and coaxial implant was achieved in only 45.6% of the cases. Three main scenarios were identified: (1) LL(+)/C implant in 44.5%, (2) LL(+)/NC implant in 20.3%, and (3) LL(-)/NC implant in 34.2%. LL deployment resulted in a deeper S3 implantation (LL[+]/C: 19.8% +/- 11.0% ventricular vs LL[+]/NC: 18.5% +/- 9.7% vs LL[-]/NC: 17.5% +/- 12.1%, at noncoronary cusp; P = .008; LL[+]/C 16.3 +/- 11.5% vs LL[+]/NC: 15.6% +/- 11.1% vs LL[-]/NC: 13.9% +/- 13.5% at left-coronary cusp; P = .02). When comparing the 3 scenarios of S3 deployment, there were no differences in outcomes including paravalvular leak, pacemaker implantation, and hemodynamic performance. CONCLUSIONS: LL visualization in S3 TAVR could not be obtained in a significant portion of cases, did not result in a coaxial valve deployment in a majority of cases, and did not achieve a higher valve implantation. However, no short-term clinical and echocardiographic impact was observed. CI - (c) 2025 The Author(s). FAU - Krishnamoorthy, Parasuram AU - Krishnamoorthy P AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Vinayak, Manish AU - Vinayak M AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Salehi, Negar AU - Salehi N AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Khera, Sahil AU - Khera S AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Goel, Sunny AU - Goel S AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Hooda, Amit AU - Hooda A AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Lerakis, Stamatios AU - Lerakis S AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Anastasius, Malcolm AU - Anastasius M AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Dangas, George D AU - Dangas GD AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Moreno, Pedro AU - Moreno P AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Sharma, Samin K AU - Sharma SK AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Kini, Annapoorna S AU - Kini AS AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Tang, Gilbert H L AU - Tang GHL AD - Department of Cardiovascular Surgery, Mount Sinai Hospital, New York, New York. LA - eng PT - Journal Article DEP - 20250819 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC12485540 OTO - NOTNLM OT - coaxiality OT - lucent line OT - transcatheter aortic valve replacement EDAT- 2025/10/03 06:31 MHDA- 2025/10/03 06:32 PMCR- 2025/08/19 CRDT- 2025/10/03 05:20 PHST- 2025/04/04 00:00 [received] PHST- 2025/05/27 00:00 [revised] PHST- 2025/06/23 00:00 [accepted] PHST- 2025/10/03 06:32 [medline] PHST- 2025/10/03 06:31 [pubmed] PHST- 2025/10/03 05:20 [entrez] PHST- 2025/08/19 00:00 [pmc-release] AID - S2772-9303(25)01298-0 [pii] AID - 103856 [pii] AID - 10.1016/j.jscai.2025.103856 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2025 Aug 19;4(9):103856. doi: 10.1016/j.jscai.2025.103856. eCollection 2025 Sep. PMID- 41040451 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251003 LR - 20251005 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 4 IP - 9 DP - 2025 Sep TI - Expected Surgical Risk and the Risk of Stroke and Brain Injury After Transcatheter Aortic Valve Replacement: A Patient-Level Pooled Analysis. PG - 103867 LID - 10.1016/j.jscai.2025.103867 [doi] LID - 103867 AB - BACKGROUND: The 30-day Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) has been used to risk-stratify patients undergoing transcatheter aortic valve replacement (TAVR). Whether surgical mortality risk predicts stroke and neurocognitive outcomes following TAVR is unknown. We evaluated the association between STS-PROM and clinical outcomes, including stroke, acute brain injury on diffusion-weighted magnetic resonance imaging (DW-MRI), and cognitive decline in patients undergoing TAVR. METHODS: Patient-level data were pooled from 4 prospective trials: (1) DEFLECT III (N = 87), (2) NeuroTAVR (N = 44), (3) REFLECT I (N = 214), and (4) REFLECT II (N = 258). All studies included patients undergoing TAVR with a protocol-mandated predischarge DW-MRI and serial cognitive and neurologic assessments. All patients were evaluated by a board-certified neurologist at baseline, postprocedure, and 30 days. Clinical outcomes, including stroke, cognitive decline (Montreal Cognitive Assessment score), death, myocardial infarction, vascular, and bleeding complications were adjudicated by the same clinical events committee. Imaging analysis was performed by a single core laboratory using identical methods. The DW-MRI measures included total lesion number, individual lesion volume, and total lesion volume. Outcomes were compared between low (STS <4), intermediate (STS 4-8), and high (STS >8) risk groups. RESULTS: In total, 537 of 603 patients with DW-MRI and complete STS assessment undergoing transfemoral TAVR were included in this pooled analysis, of which 253 (47%) were low risk, 198 (37%) intermediate risk, and 86 (16%) high risk patients. At 30 days, high risk patients had higher rates of all-cause and cardiovascular mortality, myocardial infarction, acute kidney injury, bleeding, and vascular complications. Rates of stroke, disabling stroke, DW-MRI measures of brain injury, and cognitive decline were similar across risk categories. CONCLUSIONS: This pooled analysis demonstrates that the STS score does not predict stroke, cognitive decline, or acute brain injury after TAVR. CI - (c) 2025 Society for Cardiovascular Angiography & Interventions Foundation. Published by Elsevier Inc. FAU - Messe, Steven R AU - Messe SR AD - Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. FAU - Grubman, Daniel AU - Grubman D AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Huerter, Mary E AU - Huerter ME AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Dwyer, Michael G 3rd AU - Dwyer MG 3rd AD - Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York. AD - Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York. FAU - Zivadinov, Robert AU - Zivadinov R AD - Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York. AD - Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York. FAU - Pietras, Cody AU - Pietras C AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Nazif, Tamim M AU - Nazif TM AD - Division of Cardiology, Department of Medicine, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Moses, Jeffrey W AU - Moses JW AD - Division of Cardiology, Department of Medicine, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Shah, Tayyab AU - Shah T AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Gambone, Louise AU - Gambone L AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Tripathi, Rishi AU - Tripathi R AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Forrest, John K AU - Forrest JK AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. FAU - Vora, Amit N AU - Vora AN AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. FAU - Parise, Helen AU - Parise H AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. FAU - Lansky, Alexandra J AU - Lansky AJ AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. AD - Yale Cardiovascular Research Group, New Haven, Connecticut. LA - eng PT - Journal Article DEP - 20250812 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC12485508 OTO - NOTNLM OT - embolic protection OT - imaging OT - risk score OT - stroke OT - transcatheter aortic valve replacement EDAT- 2025/10/03 06:32 MHDA- 2025/10/03 06:33 PMCR- 2025/08/12 CRDT- 2025/10/03 05:20 PHST- 2025/01/27 00:00 [received] PHST- 2025/06/24 00:00 [revised] PHST- 2025/06/29 00:00 [accepted] PHST- 2025/10/03 06:33 [medline] PHST- 2025/10/03 06:32 [pubmed] PHST- 2025/10/03 05:20 [entrez] PHST- 2025/08/12 00:00 [pmc-release] AID - S2772-9303(25)01309-2 [pii] AID - 103867 [pii] AID - 10.1016/j.jscai.2025.103867 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2025 Aug 12;4(9):103867. doi: 10.1016/j.jscai.2025.103867. eCollection 2025 Sep. PMID- 41040448 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251003 LR - 20251005 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 4 IP - 9 DP - 2025 Sep TI - First-in-Human Experience With the EnCompass F(2) Filter, a Novel Cerebral Embolic Protection Device for TAVR. PG - 103608 LID - 10.1016/j.jscai.2025.103608 [doi] LID - 103608 AB - BACKGROUND: Stroke is a feared complication of transcatheter aortic valve replacement (TAVR), and effective cerebral embolic protection devices are an important innovation target. The EnCompass F(2) system is a novel cerebral embolic protection device consisting of a cylindrical, nitinol frame and an electrospun polyurethane deflection filter with 30-mum average pore size. It is deployed across the aortic arch from femoral access to provide complete cerebral embolic protection during TAVR. METHODS: This first-in-human study investigated the feasibility and safety of F(2) filter use during TAVR. Subjects had symptomatic severe aortic stenosis and met established clinical indications for TAVR. The primary safety end point was 30-day major adverse cardiac and cerebrovascular events, defined as all-cause death, stroke, major vascular complication, type 2 to 4 bleeding, or acute kidney injury stage 3 to 4. F(2) filter technical and procedure success and new ischemic brain lesion counts and volumes on diffusion-weighted magnetic resonance imaging (DW-MRI) were evaluated. RESULTS: Twelve patients underwent transfemoral TAVR with the F(2) device. Subjects were 58% female with mean age 73.4 +/- 5.1 years and mean Society of Thoracic Surgeons score 3.2 +/- 2.0%. A balloon-expandable valve was used in 75% (n = 9). A single F(2) device was used in all cases and was delivered ipsilateral to the TAVR sheath in 41.7% (n = 5). Technical and procedure success was achieved in 100% of cases. No major adverse cardiac and cerebrovascular events occurred within 30 days of TAVR, including no strokes. DW-MRI revealed median total new lesion volume 23.4 mm(3) (IQR: 13.1-159.8 mm(3)). CONCLUSIONS: In this first-in-human series, cerebral embolic protection with the EnCompass F(2) during TAVR was feasible and safe with very low new brain DW-MRI lesion volumes and no strokes. CI - (c) 2025 The Author(s). FAU - George, Isaac AU - George I AD - Structural Heart and Valve Center, Columbia University Irving Medical Center, New York, New York. FAU - Blusztein, David AU - Blusztein D AD - Division of Cardiology, Victorian Heart Hospital, Monash Health, Melbourne, Victoria, Australia. FAU - Gogorishvili, Irakli AU - Gogorishvili I AD - Department of Interventional Cardiology, Israeli-Georgian Medical Research Clinic, Tbilisi, Georgia. FAU - Dughashvili, Gvantsa AU - Dughashvili G AD - Department of Interventional Cardiology, Israeli-Georgian Medical Research Clinic, Tbilisi, Georgia. FAU - Nour, May AU - Nour M AD - eHealth Merit Corporation, Los Angeles, California. FAU - Szeder, Viktor AU - Szeder V AD - eHealth Merit Corporation, Los Angeles, California. FAU - Woodward, Keith AU - Woodward K AD - Vista Radiology and Oculus Imaging, Knoxville, Tennessee. FAU - Nazif, Tamim M AU - Nazif TM AD - Structural Heart and Valve Center, Columbia University Irving Medical Center, New York, New York. LA - eng PT - Journal Article DEP - 20250812 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC12485541 OTO - NOTNLM OT - cerebral embolic protection OT - stroke OT - transcatheter aortic valve replacement EDAT- 2025/10/03 06:32 MHDA- 2025/10/03 06:33 PMCR- 2025/08/12 CRDT- 2025/10/03 05:20 PHST- 2025/01/06 00:00 [received] PHST- 2025/02/28 00:00 [revised] PHST- 2025/03/17 00:00 [accepted] PHST- 2025/10/03 06:33 [medline] PHST- 2025/10/03 06:32 [pubmed] PHST- 2025/10/03 05:20 [entrez] PHST- 2025/08/12 00:00 [pmc-release] AID - S2772-9303(25)01050-6 [pii] AID - 103608 [pii] AID - 10.1016/j.jscai.2025.103608 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2025 Aug 12;4(9):103608. doi: 10.1016/j.jscai.2025.103608. eCollection 2025 Sep. PMID- 41018471 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250929 LR - 20251001 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 17 IP - 8 DP - 2025 Aug TI - Effect of Ondansetron on Intra-procedural Nausea and Vomiting in Patients Undergoing Transcatheter Aortic Valve Replacement With Conscious Sedation: A Before-and-After Study. PG - e91070 LID - 10.7759/cureus.91070 [doi] LID - e91070 AB - PURPOSE: Sedation has advantages for patients receiving transcatheter aortic valve replacement (TAVR) compared with general anesthesia. However, the beneficial effect of an antiemetic agent on intra-procedural nausea and vomiting (IPNV) remains unclear. Therefore, we aimed to evaluate whether ondansetron reduces IPNV in patients undergoing transfemoral TAVR with conscious sedation. METHODS: We conducted a single-center retrospective study, analyzing outcomes of 100 patients undergoing TAVR before (Before group, n=48) and after (After group, n=52) ondansetron administration. Conscious sedation was initiated with a bolus of 0.7 mug/kg and subsequent 0.1-0.4 mug/kg/h IV dexmedetomidine, supplemented with IV remifentanil and IV propofol to achieve a bispectral index <90 with a Richmond Agitation-Sedation Scale of -2 to -1. Only the After group received ondansetron 4 mg IV at the beginning of sedation. All patients underwent an ultrasound-guided right or left fascia iliaca block using 30 mL of 0.185% ropivacaine, depending on the sheath insertion side. The primary endpoint was IPNV incidence during TAVR procedures, with statistical significance set at P<0.05. RESULTS: Groups were well balanced, with no significant differences in aortic stenosis severity, cardiac function, or comorbidities affecting heart function. The After group showed a significantly lower incidence of IPNV (0% vs. 22.9%, P<0.001 using the chi(2) test). No differences were observed in intra-operative vasopressor use, and no cases of suspected aspiration occurred. CONCLUSIONS: Ondansetron prevented IPNV in transfemoral TAVR patients with conscious sedation. These results suggest that pretreatment with ondansetron may be a useful strategy for reducing aspiration risk in procedures requiring conscious sedation, including transfemoral TAVR. CI - Copyright (c) 2025, Anezaki et al. FAU - Anezaki, Hiroki AU - Anezaki H AD - Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN. FAU - Kawashima, Shingo AU - Kawashima S AD - Department of Anesthesiology, Seirei Mikatahara General Hospital, Hamamatsu, JPN. AD - Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN. FAU - Suzuki, Kensuke AU - Suzuki K AD - Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN. FAU - Kimura, Tetsuro AU - Kimura T AD - Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN. FAU - Nakajima, Yoshiki AU - Nakajima Y AD - Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN. FAU - Kinoshita, Hiroyuki AU - Kinoshita H AD - Department of Anesthesiology, Seirei Mikatahara General Hospital, Hamamatsu, JPN. AD - Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, JPN. AD - Department of Anesthesiology, Toyohashi Heart Center, Toyohashi, JPN. LA - eng PT - Journal Article DEP - 20250826 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC12464278 OTO - NOTNLM OT - conscious sedation OT - nausea OT - ondansetron OT - transcatheter aortic valve replacement OT - vomiting COIS- Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Ethical Committee of Toyohashi Heart Center issued approval 240301. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. EDAT- 2025/09/29 13:19 MHDA- 2025/09/29 13:20 PMCR- 2025/08/26 CRDT- 2025/09/29 06:42 PHST- 2025/08/26 00:00 [accepted] PHST- 2025/09/29 13:20 [medline] PHST- 2025/09/29 13:19 [pubmed] PHST- 2025/09/29 06:42 [entrez] PHST- 2025/08/26 00:00 [pmc-release] AID - 10.7759/cureus.91070 [doi] PST - epublish SO - Cureus. 2025 Aug 26;17(8):e91070. doi: 10.7759/cureus.91070. eCollection 2025 Aug. PMID- 41003368 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250926 LR - 20260925 IS - 2313-433X (Electronic) IS - 2313-433X (Linking) VI - 11 IP - 9 DP - 2025 Sep 17 TI - Uncertainty-Guided Active Learning for Access Route Segmentation and Planning in Transcatheter Aortic Valve Implantation. LID - 10.3390/jimaging11090318 [doi] LID - 318 AB - Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure for treating severe aortic stenosis, where optimal vascular access route selection is critical to reduce complications. It requires careful selection of the iliac artery with the most favourable anatomy, specifically, one with the largest diameters and no segments narrower than 5 mm. This process is time-consuming when carried out manually. We present an active learning-based segmentation framework for contrast-enhanced Cardiac Magnetic Resonance (CMR) data, guided by probabilistic uncertainty and pseudo-labelling, enabling efficient segmentation with minimal manual annotation. The segmentations are then fed into an automated pipeline for diameter quantification, achieving a Dice score of 0.912 and a mean absolute percentage error (MAPE) of 4.92%. An ablation study using pre- and post-contrast CMR showed superior performance with post-contrast data only. Overall, the pipeline provides accurate segmentation and detailed diameter profiles of the aorto-iliac route, helping the assessment of the access route. FAU - Islam, Mahdi AU - Islam M AUID- ORCID: 0009-0009-5978-0471 AD - Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria. FAU - Tabassum, Musarrat AU - Tabassum M AUID- ORCID: 0009-0002-3115-4697 AD - Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria. FAU - Mayr, Agnes AU - Mayr A AUID- ORCID: 0000-0001-9363-873X AD - Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria. FAU - Kremser, Christian AU - Kremser C AUID- ORCID: 0000-0002-6953-935X AD - Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria. FAU - Haltmeier, Markus AU - Haltmeier M AUID- ORCID: 0000-0001-5715-0331 AD - Department of Mathematics, University of Innsbruck, 6020 Innsbruck, Austria. FAU - Almar-Munoz, Enrique AU - Almar-Munoz E AUID- ORCID: 0009-0006-0610-3520 AD - Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria. LA - eng GR - FWF DOC 110/FWF/ PT - Journal Article DEP - 20250917 PL - Switzerland TA - J Imaging JT - Journal of imaging JID - 101698819 PMC - PMC12471150 OTO - NOTNLM OT - TAVI planning OT - active learning OT - aortic segmentation OT - cardiovascular magnetic resonance OT - vessel diameter quantification COIS- The authors declare no conflicts of interest. EDAT- 2025/09/26 12:33 MHDA- 2025/09/26 12:34 PMCR- 2025/09/17 CRDT- 2025/09/26 10:26 PHST- 2025/07/23 00:00 [received] PHST- 2025/09/06 00:00 [revised] PHST- 2025/09/10 00:00 [accepted] PHST- 2025/09/26 12:34 [medline] PHST- 2025/09/26 12:33 [pubmed] PHST- 2025/09/26 10:26 [entrez] PHST- 2025/09/17 00:00 [pmc-release] AID - jimaging11090318 [pii] AID - jimaging-11-00318 [pii] AID - 10.3390/jimaging11090318 [doi] PST - epublish SO - J Imaging. 2025 Sep 17;11(9):318. doi: 10.3390/jimaging11090318. PMID- 41002606 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250926 LR - 20250928 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 12 IP - 9 DP - 2025 Aug 26 TI - Transcatheter Aortic Valve Implantation in Nonagenarians: A Comparative Analysis of Baseline Characteristics and 1-Year Outcomes. LID - 10.3390/jcdd12090327 [doi] LID - 327 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly used in elderly patients with severe aortic stenosis, yet data on nonagenarians remain limited. This study aimed to compare clinical characteristics and outcomes of patients aged >/=90 years with those aged <90 years undergoing TAVI. METHODS: We retrospectively analyzed 620 patients who underwent transfemoral TAVI. Patients were divided into two groups: <90 years (n = 545) and >/=90 years (n = 75). Baseline clinical, procedural, and outcome data were compared. RESULTS: Nonagenarians had lower body mass index (BMI) and a lower prevalence of comorbidities such as diabetes, hyperlipidemia, and prior coronary artery bypass grafting CABG (all p < 0.05). All-cause mortality was higher in nonagenarians at 1 month (8.0% vs. 5.5%, p = 0.425), 6 months (9.3% vs. 7.9%, p = 0.838), and 1 year (21.3% vs. 16.7%, p = 0.405), though these differences were not statistically significant. In-hospital stroke occurred more frequently in patients >/= 90 years (6.7% vs. 2.2%, p = 0.044). CONCLUSIONS: Despite a higher rate of in-hospital stroke, nonagenarians undergoing TAVI had comparable mortality outcomes to younger patients. These findings support the feasibility of TAVI in selected very elderly patients, while highlighting the need for tailored stroke prevention strategies. TRIAL REGISTRATION: The trial is retrospectively registered, and a clinical trial number is not applicable. FAU - Guney, Murat Can AU - Guney MC AD - Department of Cardiology, Faculty of Medicine, Medicana International Ankara Hospital, Atilim University, Sogutozu, 2176. Sk. No. 3, Cankaya 06510, Turkey. FAU - Bozkurt, Engin AU - Bozkurt E AD - Department of Cardiology, Medicana International Ankara Hospital, Sogutozu, 2176. Sk. No. 3, Cankaya 06510, Turkey. LA - eng PT - Journal Article DEP - 20250826 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC12470840 OTO - NOTNLM OT - geriatric cardiology OT - nonagenarians OT - transcatheter aortic valve implantation (TAVI) COIS- The authors declare that they have no competing interests. EDAT- 2025/09/26 12:32 MHDA- 2025/09/26 12:33 PMCR- 2025/08/26 CRDT- 2025/09/26 10:15 PHST- 2025/07/31 00:00 [received] PHST- 2025/08/21 00:00 [revised] PHST- 2025/08/25 00:00 [accepted] PHST- 2025/09/26 12:33 [medline] PHST- 2025/09/26 12:32 [pubmed] PHST- 2025/09/26 10:15 [entrez] PHST- 2025/08/26 00:00 [pmc-release] AID - jcdd12090327 [pii] AID - jcdd-12-00327 [pii] AID - 10.3390/jcdd12090327 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2025 Aug 26;12(9):327. doi: 10.3390/jcdd12090327. PMID- 40990554 OWN - NLM STAT- MEDLINE DCOM- 20251103 LR - 20260501 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 83 IP - 10 DP - 2025 TI - Predictors of long-term survival in patients undergoing TAVR: Recent advances. A narrative review. PG - 1134-1141 LID - 10.33963/v.phj.108744 [doi] AB - Transcatheter aortic valve replacement (TAVR)/intervention has fundamentally altered the management of severe aortic stenosis, expanding from inoperable patients to lower-risk populations and prompting a shift from a procedure-centric view to a lifelong management strategy. This paradigm shift necessitates a deeper understanding of factors predicting long-term survival beyond five years to guide personalized treatment decisions. This narrative review summarizes current evidence on predictors of long-term mortality following TAVR with a focus on novel predictors. Key patient-related factors include advanced age, impaired renal function, and subtle declines in ventricular function, such as reduced left ventricular global longitudinal strain and right ventricle-pulmonary artery uncoupling. Beyond traditional clinical assessments, emerging biomarkers like growth differentiation factor 15 and genetic markers of clonal hematopoiesis are showing prognostic potential. Procedural factors such as access route, paravalvular leak, and patient-prosthesis mismatch remain critical determinants of outcomes, with their long-term impact still under active investigation. Furthermore, valve-related characteristics, particularly the choice between self-expanding and balloon-expandable valves as well as supra-annular versus annular valves in specific anatomies, are increasingly recognized for their influence on valve hemodynamics and, potentially, long-term survival. As TAVR technology and patient longevity improve, future research must focus on integrating these multifaceted predictors to tailor device selection, ensuring optimal and durable outcomes for each patient. FAU - Zornitzki, Lior AU - Zornitzki L AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel. lior.zoz@gmail.com. AD - Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. lior.zoz@gmail.com. FAU - Ben-Shoshan, Jeremy AU - Ben-Shoshan J AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel. AD - Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. LA - eng PT - Journal Article PT - Review DEP - 20250924 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/mortality MH - *Aortic Valve Stenosis/surgery/mortality MH - Prognosis MH - Risk Factors MH - Treatment Outcome OTO - NOTNLM OT - bioprosthetic heart valve OT - predictors OT - survival OT - transcatheter aortic valve replacement EDAT- 2025/09/24 13:00 MHDA- 2025/11/03 13:49 CRDT- 2025/09/24 09:14 PHST- 2025/09/22 00:00 [received] PHST- 2025/09/22 00:00 [accepted] PHST- 2025/11/03 13:49 [medline] PHST- 2025/09/24 13:00 [pubmed] PHST- 2025/09/24 09:14 [entrez] AID - VM/OJS/J/108744 [pii] AID - 10.33963/v.phj.108744 [doi] PST - ppublish SO - Kardiol Pol. 2025;83(10):1134-1141. doi: 10.33963/v.phj.108744. Epub 2025 Sep 24. PMID- 40984837 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250923 LR - 20250925 IS - 0970-9134 (Print) IS - 0973-7723 (Electronic) IS - 0970-9134 (Linking) VI - 41 IP - 10 DP - 2025 Oct TI - An uncommon complication of a minimally invasive procedure. PG - 1503-1506 LID - 10.1007/s12055-025-01962-3 [doi] AB - Decision-making for intervention in symptomatic aortic stenosis should balance the risks of surgery and of transcatheter aortic valve implantation (TAVI). TAVI is a well-established technique for treating elderly and high-risk patients with aortic stenosis using a variety of different surgical approaches (a retrograde transfemoral, transaxillary, transaortic or an antegrade transapical approach). The transapical approach requires the involvement of the heart surgeon and is now limited to cases where the procedure cannot be performed by alternative approaches. We report the case of an 87-year-old patient with severe peripheral arterial disease and a history of TAVI via transapical approach, who presented with a syncopal episode 4 years post-procedure. Imaging revealed a left ventricular apex aneurysm, likely related to the previous transapical TAVI. This case underscores the importance of thorough pre-procedural assessment and long-term follow-up in patients undergoing alternative TAVI access routes, as well as the need for heightened awareness of rare but significant complications such as ventricular pseudoaneurysm. Careful patient selection and individualized procedural planning remain essential to optimize outcomes in this complex population. CI - (c) The Author(s) 2025. FAU - Magro, Valerio Massimo AU - Magro VM AUID- ORCID: 0000-0002-0850-2764 AD - Department of Internal Medicine and Geriatry, Echocardiography Unit, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80100 Naples, Italy. ROR: https://ror.org/02kqnpp86. GRID: grid.9841.4. ISNI: 0000 0001 2200 8888 AD - Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, 00133 Rome, Italy. ROR: https://ror.org/02p77k626. GRID: grid.6530.0. ISNI: 0000 0001 2300 0941 FAU - Sorbino, Andrea AU - Sorbino A AD - Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, 00133 Rome, Italy. ROR: https://ror.org/02p77k626. GRID: grid.6530.0. ISNI: 0000 0001 2300 0941 FAU - Manocchio, Nicola AU - Manocchio N AD - Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, 00133 Rome, Italy. ROR: https://ror.org/02p77k626. GRID: grid.6530.0. ISNI: 0000 0001 2300 0941 FAU - Massaro, Gianluca AU - Massaro G AD - Department of Cardiology, Tor Vergata University Hospital, 00133 Rome, Italy. ROR: https://ror.org/03z475876. GRID: grid.413009.f FAU - Chiricolo, Gaetano AU - Chiricolo G AD - Department of Cardiology, Tor Vergata University Hospital, 00133 Rome, Italy. ROR: https://ror.org/03z475876. GRID: grid.413009.f AD - Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy. ROR: https://ror.org/02p77k626. GRID: grid.6530.0. ISNI: 0000 0001 2300 0941 FAU - Ljoka, Concetta AU - Ljoka C AD - Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, 00133 Rome, Italy. ROR: https://ror.org/02p77k626. GRID: grid.6530.0. ISNI: 0000 0001 2300 0941 FAU - Foti, Calogero AU - Foti C AD - Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, 00133 Rome, Italy. ROR: https://ror.org/02p77k626. GRID: grid.6530.0. ISNI: 0000 0001 2300 0941 LA - eng PT - Journal Article DEP - 20250515 PL - India TA - Indian J Thorac Cardiovasc Surg JT - Indian journal of thoracic and cardiovascular surgery JID - 8700105 PMC - PMC12450158 OTO - NOTNLM OT - Aortic stenosis OT - Decision-making OT - Heart Aneurysm OT - TAVI COIS- Conflict of interestNil. EDAT- 2025/09/23 06:36 MHDA- 2025/09/23 06:37 PMCR- 2025/05/15 CRDT- 2025/09/23 03:53 PHST- 2025/02/27 00:00 [received] PHST- 2025/04/09 00:00 [revised] PHST- 2025/04/10 00:00 [accepted] PHST- 2025/09/23 06:37 [medline] PHST- 2025/09/23 06:36 [pubmed] PHST- 2025/09/23 03:53 [entrez] PHST- 2025/05/15 00:00 [pmc-release] AID - 1962 [pii] AID - 10.1007/s12055-025-01962-3 [doi] PST - ppublish SO - Indian J Thorac Cardiovasc Surg. 2025 Oct;41(10):1503-1506. doi: 10.1007/s12055-025-01962-3. Epub 2025 May 15. PMID- 40982007 OWN - NLM STAT- MEDLINE DCOM- 20260306 LR - 20260819 IS - 1615-2573 (Electronic) IS - 0910-8327 (Print) IS - 0910-8327 (Linking) VI - 41 IP - 3 DP - 2026 Mar TI - Feasibility of same-day discharge after transcatheter aortic valve replacement: the North Shore Day Stay pathway. PG - 192-201 LID - 10.1007/s00380-025-02598-4 [doi] AB - Transcatheter aortic valve replacement (TAVR) is an established treatment for patients with severe symptomatic aortic stenosis but expanding indications have increased strain on hospital resources. Several studies assessed same-day discharge (SDD) after TAVR during the COVID-19 pandemic and showed it to be safe in well-selected, low-risk patients. However, more studies are warranted, with no studies in an Australian population and minimal data on self-expanding valves. Patients undergoing consecutive, transfemoral TAVR procedures at two large-volume centres in Sydney, Australia between 2021 and 2023 were prospectively recruited to the CONDUCT-TAVI study cohort. A locally derived clinical pathway ('The North Shore Pathway') was retrospectively applied to identify which patients would have been suitable for SDD. In-hospital and 30-day outcomes were compared between SDD patients and the remaining, ineligible patients (standard discharge cohort). Of 182 patients, 20 (11.0%) met SDD criteria. The total cohort received both self-expanding (67.3%) and balloon-expandable valves (32.7%). The SDD cohort had a higher proportion of females (55.0% vs. 21.5%, p = 0.04) but was otherwise comparable in baseline and procedural characteristics. No significant differences were found in hospital or 30-day outcomes. One SDD patient was readmitted with complete heart block requiring pacemaker implantation (day 20), and two patients had non-cardiovascular readmissions. No other adverse outcomes occurred in the SDD cohort. The present study suggests SDD after TAVR is feasible in both balloon-expandable and self-expanding cohorts. The study also supports prospective validation of the North Shore Day Stay pathway as a tool to safely identify low-risk patients that are suitable for SDD after TAVR. CI - (c) 2025. The Author(s). FAU - Rao, Karan AU - Rao K AD - Department of Cardiology, Royal North Shore Hospital, St. Leonards, Reserve Road, Sydney, 2065, Australia. AD - University of Sydney, Sydney, Australia. AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. FAU - Litkouhi, Princess Neila AU - Litkouhi PN AUID- ORCID: 0000-0002-2616-3524 AD - Department of Cardiology, Royal North Shore Hospital, St. Leonards, Reserve Road, Sydney, 2065, Australia. AD - University of Sydney, Sydney, Australia. FAU - Baer, Alexandra AU - Baer A AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. FAU - Hansen, Peter AU - Hansen P AD - Department of Cardiology, Royal North Shore Hospital, St. Leonards, Reserve Road, Sydney, 2065, Australia. AD - University of Sydney, Sydney, Australia. AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. FAU - Bhindi, Ravinay AU - Bhindi R AD - Department of Cardiology, Royal North Shore Hospital, St. Leonards, Reserve Road, Sydney, 2065, Australia. ravinay.bhindi@sydney.edu.au. AD - University of Sydney, Sydney, Australia. ravinay.bhindi@sydney.edu.au. AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. ravinay.bhindi@sydney.edu.au. LA - eng GR - Project Grant/Heart Research Australia/ GR - PhD Scholarship/Heart Research Australia/ PT - Journal Article PT - Multicenter Study DEP - 20250922 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 SB - IM CIN - Heart Vessels. 2026 Sep;41(9):634-635. doi: 10.1007/s00380-025-02627-2. PMID: 41249710 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Female MH - Male MH - *Aortic Valve Stenosis/surgery/diagnosis MH - *Patient Discharge MH - Aged, 80 and over MH - Feasibility Studies MH - Retrospective Studies MH - Aged MH - Australia/epidemiology MH - *COVID-19/epidemiology MH - Time Factors MH - Treatment Outcome MH - *Critical Pathways MH - Length of Stay PMC - PMC12935814 OTO - NOTNLM OT - Aortic valve replacement OT - Same-day discharge COIS- Declarations. Conflict of interest: The authors declare that they have no conflict of interest. EDAT- 2025/09/22 12:46 MHDA- 2026/03/06 19:43 PMCR- 2025/09/22 CRDT- 2025/09/22 11:13 PHST- 2025/06/23 00:00 [received] PHST- 2025/09/03 00:00 [accepted] PHST- 2026/03/06 19:43 [medline] PHST- 2025/09/22 12:46 [pubmed] PHST- 2025/09/22 11:13 [entrez] PHST- 2025/09/22 00:00 [pmc-release] AID - 10.1007/s00380-025-02598-4 [pii] AID - 2598 [pii] AID - 10.1007/s00380-025-02598-4 [doi] PST - ppublish SO - Heart Vessels. 2026 Mar;41(3):192-201. doi: 10.1007/s00380-025-02598-4. Epub 2025 Sep 22. PMID- 40972953 OWN - NLM STAT- MEDLINE DCOM- 20251114 LR - 20251212 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 256 DP - 2025 Dec 1 TI - Major Clinical Outcomes in Patients With Carotid Artery Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. PG - 145-154 LID - S0002-9149(25)00555-7 [pii] LID - 10.1016/j.amjcard.2025.09.007 [doi] AB - Data on carotid artery stenosis (CAS) prevalence in patients undergoing transcatheter aortic valve replacement (TAVR) are limited. It remains unclear whether CAS serves as a predictor of worse outcomes following TAVR. This meta-analysis aims to assess the impact of CAS on major clinical outcomes in this population. A comprehensive literature search was conducted across 3 databases to identify relevant studies. The primary endpoint was the 30-day incidence of Stroke or Transient Ischemic Attack (TIA) in patients with CAS>/=50% and CAS>/=70%, respectively. Secondary endpoints included in-hospital Stroke/TIA, in-hospital mortality, 30-day mortality, bleeding events, myocardial infarction (MI), acute kidney injury (AKI), periprocedural vascular complications, and permanent pacemaker implantation (PPM) up to 30 days. A total of 15 studies, involving 129,155 patients, were included in the meta-analysis. CAS was associated with higher rates of 30-day Stroke/TIA: 1) CAS >/=50% (Risk Ratio (RR): 1.38, 95% Confidence Intervals (CI): 1.19, 1.59), 2) CAS >/=70% (RR: 1.61, 95% CI: 1.10, 2.36). CAS comorbidity was also linked to increased risk for in-hospital stroke/TIA (RR: 1.73, 95% CI: 1.28, 2.33), 30-day mortality (RR: 1.29, 95% CI: 1.13, 1.47), and 30-day bleeding events (RR: 1.15, 95% CI: 1.08, 1.23). No differences were observed in the rest secondary endpoints. In conclusion, CAS was associated with a higher risk of 30-day and in-hospital cerebrovascular events following TAVR. Patients with CAS are at an increased risk of 30-day all-cause mortality without any impact on in-hospital mortality. Further studies are required to validate our results. CI - Crown Copyright (c) 2025. Published by Elsevier Inc. All rights reserved. FAU - Theodoropoulou, Theoni AU - Theodoropoulou T AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. Electronic address: theoni.theodoropoulou98@gmail.com. FAU - Vythoulkas-Biotis, Nikolaos AU - Vythoulkas-Biotis N AD - Third Departmnent of Cardiology, Athens School of Medicine, Sotiria Thoracic Diseases Hospital of Athens, Athens, Greece. FAU - Apostolos, Anastasios AU - Apostolos A AD - Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Ktenopoulos, Nikolaos AU - Ktenopoulos N AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Koliastasis, Leonidas AU - Koliastasis L AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Synetos, Andreas AU - Synetos A AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Drakopoulou, Maria AU - Drakopoulou M AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Tsalamandris, Sotirios AU - Tsalamandris S AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Latsios, George AU - Latsios G AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Tsioufis, Konstantinos AU - Tsioufis K AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. FAU - Toutouzas, Konstantinos AU - Toutouzas K AD - Unit for Structural Heart Diseases and Valvulopathies, First Department of Cardiology, Athens School of Medicine, Hippokration Hospital, Athens, Greece. Electronic address: ktoutouz@med.uoa.gr. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20250917 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Carotid Stenosis/complications/epidemiology MH - *Aortic Valve Stenosis/surgery/complications MH - Hospital Mortality/trends MH - *Stroke/epidemiology/etiology MH - *Postoperative Complications/epidemiology MH - Ischemic Attack, Transient/epidemiology MH - Global Health MH - Incidence MH - Risk Factors MH - Myocardial Infarction/epidemiology MH - Treatment Outcome COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/09/20 00:31 MHDA- 2025/11/15 00:29 CRDT- 2025/09/19 19:29 PHST- 2025/07/14 00:00 [received] PHST- 2025/08/10 00:00 [revised] PHST- 2025/09/04 00:00 [accepted] PHST- 2025/11/15 00:29 [medline] PHST- 2025/09/20 00:31 [pubmed] PHST- 2025/09/19 19:29 [entrez] AID - S0002-9149(25)00555-7 [pii] AID - 10.1016/j.amjcard.2025.09.007 [doi] PST - ppublish SO - Am J Cardiol. 2025 Dec 1;256:145-154. doi: 10.1016/j.amjcard.2025.09.007. Epub 2025 Sep 17. PMID- 40969679 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250919 LR - 20250921 IS - 2666-6685 (Electronic) IS - 2666-6685 (Linking) VI - 20 DP - 2025 Jun TI - Reflections on transfemoral TAVI in dextrocardia with severe aortic regurgitation: Navigating anatomical complexity, off-label innovation, and future directions. PG - 100583 LID - 10.1016/j.ijcchd.2025.100583 [doi] LID - 100583 AB - This reflective article explores the first reported case in literature of a transfemoral transcatheter aortic valve implantation (TAVI) in a dextrocardiac patient with severe aortic regurgitation (AR), left-sided superior vena cava (LSVC), and prohibitive surgical risk. It provides an overview of off-label TAVI for pure AR, aortic regurgitation without annular calcification, and in patients with rare congenital anomalies such as dextrocardia. The article discusses the technical, ethical, and procedural challenges, including device oversizing, the use of new-generation valves, and the risk of paravalvular leaks. The review also highlights recent advances in TAVI devices, procedural planning, and outcomes from multicenter studies and registries. The case underscores the importance of innovation, multidisciplinary collaboration, and the evolution of ethical frameworks to guide the safe expansion of TAVI into complex scenarios. CI - (c) 2025 The Authors. FAU - Athauda Arachchi, Pandula AU - Athauda Arachchi P AD - General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka. AD - Durdans Heart Centre, Colombo, Sri Lanka. FAU - De Silva, Sulakkana AU - De Silva S AD - Durdans Heart Centre, Colombo, Sri Lanka. LA - eng PT - Journal Article DEP - 20250408 PL - Netherlands TA - Int J Cardiol Congenit Heart Dis JT - International journal of cardiology. Congenital heart disease JID - 9918367981006676 PMC - PMC12442313 OTO - NOTNLM OT - Aortic regurgitation OT - Congenital anomalies OT - Dextrocardia OT - Off-label use OT - Paravalvular leak OT - Transcatheter aortic valve implantation COIS- The authors declare no conflicts of interest. EDAT- 2025/09/19 06:32 MHDA- 2025/09/19 06:33 PMCR- 2025/04/08 CRDT- 2025/09/19 05:05 PHST- 2025/04/02 00:00 [received] PHST- 2025/04/03 00:00 [revised] PHST- 2025/04/03 00:00 [accepted] PHST- 2025/09/19 06:33 [medline] PHST- 2025/09/19 06:32 [pubmed] PHST- 2025/09/19 05:05 [entrez] PHST- 2025/04/08 00:00 [pmc-release] AID - S2666-6685(25)00019-9 [pii] AID - 100583 [pii] AID - 10.1016/j.ijcchd.2025.100583 [doi] PST - epublish SO - Int J Cardiol Congenit Heart Dis. 2025 Apr 8;20:100583. doi: 10.1016/j.ijcchd.2025.100583. eCollection 2025 Jun. PMID- 40962389 OWN - NLM STAT- MEDLINE DCOM- 20250917 LR - 20250917 IS - 2211-7466 (Electronic) IS - 2211-7458 (Linking) VI - 14 IP - 4 DP - 2025 Oct TI - Upper Extremity Vascular Access for Structural Interventions. PG - 521-534 LID - S2211-7458(25)00048-3 [pii] LID - 10.1016/j.iccl.2025.07.004 [doi] AB - Upper extremity vascular access has become an essential alternative to transfemoral access for structural and congenital cardiac interventions. This section outlines the expanding role of radial and subclavian/axillary approaches across procedures such as TAVR, aortic balloon valvuloplasty, aortic paravalvular leak closure, adult congenital defect interventions, and cardiac mechanical circulatory support placement. Compared with femoral access, upper extremity approaches offer lower complication rates, enhanced safety, and earlier ambulation, but present unique anatomic and technical challenges. With accumulating evidence and operator experience, these strategies are increasingly favored in selected patients and procedural contexts for optimized outcomes in structural heart disease management. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Neicheril, Radhika AU - Neicheril R AD - Department of Cardiology, Section of Interventional Cardiology, Cleveland Clinic Florida, Weston, FL 33331, USA. FAU - Abdelghaffar, Bahaa AU - Abdelghaffar B AD - Department of Cardiology, Section of Interventional Cardiology, Cleveland Clinic Florida, Weston, FL 33331, USA. FAU - Cohen, Mauricio G AU - Cohen MG AD - Department of Cardiology, Section of Interventional Cardiology, Cleveland Clinic Florida, Weston, FL 33331, USA. Electronic address: cohenm10@ccf.org. LA - eng PT - Journal Article PT - Review DEP - 20250819 PL - Netherlands TA - Interv Cardiol Clin JT - Interventional cardiology clinics JID - 101615153 SB - IM MH - Humans MH - *Upper Extremity/blood supply MH - *Catheterization, Peripheral/methods MH - *Cardiac Catheterization/methods MH - Radial Artery MH - *Heart Defects, Congenital/surgery OTO - NOTNLM OT - Adult congenital heart disease OT - Axillary artery OT - Paravalvular leak closure OT - Percutaneous left ventricular assist device OT - Structural heart interventions OT - Subclavian artery OT - Transcatheter aortic valve replacement OT - Transradial access EDAT- 2025/09/18 00:30 MHDA- 2025/09/18 00:31 CRDT- 2025/09/17 20:53 PHST- 2025/09/18 00:31 [medline] PHST- 2025/09/18 00:30 [pubmed] PHST- 2025/09/17 20:53 [entrez] AID - S2211-7458(25)00048-3 [pii] AID - 10.1016/j.iccl.2025.07.004 [doi] PST - ppublish SO - Interv Cardiol Clin. 2025 Oct;14(4):521-534. doi: 10.1016/j.iccl.2025.07.004. Epub 2025 Aug 19. PMID- 40954938 OWN - NLM STAT- MEDLINE DCOM- 20251114 LR - 20260502 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 106 IP - 6 DP - 2025 Nov TI - Noncoronary Sinus Pivot Implantation (NCPI) Strategy for Transcatheter Aortic Valve Replacement With Self-Expanding Valve in Pure Native Aortic Regurgitation: A Multicenter, Registry Study From the CCA Database-NTCVR. PG - 3230-3238 LID - 10.1002/ccd.70183 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) for pure native aortic regurgitation (PNAR) remains challenging. While the noncoronary sinus pivot implantation (NCPI) strategy showed promise with VitaFlow valve, its efficacy with other valves needs validation. AIMS: This study aims to evaluate the real-world efficacy of the TaurusElite valve in patients with PNAR and to assess the impact of the NCPI strategy on procedural outcomes. METHODS: This registry-based analysis included 121 PNAR patients from the prospective CCA Database-NTCVR who underwent transfemoral TAVR with TaurusElite valve at seven Chinese centers (April 2022 to October 2024). A core laboratory assessed procedural imaging to classify patients into NCPI (n = 81) and non-NCPI (n = 37) groups. Outcomes were evaluated per VARC-3 criteria. RESULTS: The TaurusElite valve demonstrated good effectiveness (overall device success 90.9%). NCPI strategy showed superior outcomes: higher success rate (98.8% vs. 81.1%, p < 0.001), no valve-in-valve implantation (0% vs. 16.2%, p < 0.001), and lower permanent pacemaker requirement (3.7% vs. 18.9%, p = 0.006). NCPI (OR:6.08, 95% CI: 3.27-28.68) independently predicted success. CONCLUSIONS: The TaurusElite valve is an effective treatment for PNAR, and the NCPI strategy provides significant additional benefits in improving procedural success and reducing complications compared to conventional approaches. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Xia, Feng AU - Xia F AD - Department of Cardiology, Wuhan Asia General Hospital, Wuhan, China. FAU - Chen, XinJing AU - Chen X AD - Department of Cardiology, Provincial Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China. FAU - Weng, ZiLong AU - Weng Z AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. FAU - Pan, Xin AU - Pan X AD - Department of Cardiology, Shanghai Chest Hospital Affiliated With Shanghai Jiao Tong University, Shanghai, China. FAU - Liu, JinJun AU - Liu J AD - Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China. FAU - Zhou, Hao AU - Zhou H AD - Department of Cardiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China. FAU - Wu, LianPin AU - Wu L AD - Department of Cardiology, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China. FAU - Guo, YanSong AU - Guo Y AD - Department of Cardiology, Provincial Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China. FAU - Zhang, LongYan AU - Zhang L AD - Department of Cardiology, Wuhan Asia General Hospital, Wuhan, China. FAU - Pan, WenZhi AU - Pan W AUID- ORCID: 0000-0002-0530-261X AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. FAU - Zhou, DaXin AU - Zhou D AUID- ORCID: 0009-0007-9814-3630 AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. FAU - Ge, JunBo AU - Ge J AUID- ORCID: 0000-0002-9360-7332 AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai, China. LA - eng GR - This study was supported by the National Natural Science Foundation of China (No. NSFC 82270377), Fujian Science and Technology Innovation Joint Funding Project Plan (No. 2024Y9010), and Fujian Provincial Natural Science Funding Project (No. 2025J01068)./ PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20250915 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Male MH - *Aortic Valve Insufficiency/physiopathology/diagnostic imaging/surgery MH - Registries MH - Female MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Aged MH - Aged, 80 and over MH - Prosthesis Design MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - Databases, Factual MH - Time Factors MH - China MH - Recovery of Function MH - Risk Factors MH - Prospective Studies PMC - PMC12617326 OTO - NOTNLM OT - aortic regurgitation OT - clinical outcomes OT - implantation technique OT - self-expanding valve OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2025/09/16 06:38 MHDA- 2025/11/14 12:33 PMCR- 2025/11/14 CRDT- 2025/09/16 01:08 PHST- 2025/07/13 00:00 [revised] PHST- 2025/04/18 00:00 [received] PHST- 2025/09/08 00:00 [accepted] PHST- 2025/11/14 12:33 [medline] PHST- 2025/09/16 06:38 [pubmed] PHST- 2025/09/16 01:08 [entrez] PHST- 2025/11/14 00:00 [pmc-release] AID - CCD70183 [pii] AID - 10.1002/ccd.70183 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Nov;106(6):3230-3238. doi: 10.1002/ccd.70183. Epub 2025 Sep 15. PMID- 40944093 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250915 LR - 20250916 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 17 DP - 2025 Sep 8 TI - Standard Percutaneous Transluminal Angioplasty Versus Intravascular Lithotripsy to Facilitate Trans-Femoral Transcatheter Aortic Valve Implantation in Patients with Aortic Stenosis and Severe Peripheral Arterial Disease. LID - 10.3390/jcm14176335 [doi] LID - 6335 AB - Background/Objectives: The optimal method to facilitate femoral access in patients with aortic stenosis and severe peripheral arterial disease (PAD) undergoing transcatheter aortic valve implantation (TAVI) remains unclear. This study compared the safety and efficacy of percutaneous transluminal angioplasty (PTA) versus Shockwave((R)) intravascular lithotripsy (IVL) in patients with severe PAD undergoing TAVI via the trans-femoral route enrolled in the Hostile TAVI registry trial. Methods: Patients with severe PAD from 28 international centers were enrolled in the registry. This sub-study analyzed patients who underwent transfemoral TAVI facilitated by PTA (n = 352) or IVL (n = 166). Primary endpoints included rates of survival, major vascular complications, and major bleeding. Outcomes were also stratified according to the severity of PAD using the novel Hostile risk score. Results: Patients in the PTA group were older and had lower rates of prior stroke/TIA. All-cause mortality at 3 years was similar between PTA and IVL groups (34.9% vs. 38.6%; p = 0.27, respectively). However, IVL was associated with fewer major vascular complications (21.7% vs. 13.3%; p = 0.033, respectively), less major bleeding (14.0% vs. 7.0%; p = 0.024, respectively), and shorter hospital stays (7.06 +/- 6.69 vs. 4.29 +/- 4.78 days; p < 0.001; 95% CI: 1.63-3.91, respectively). Cox regression analysis showed that at low ( 0.050), abdominal aorta (p = 0.276), and femoral segment (p = 0.816). The image noise in A was found to be 21%-55% lower, leading to a significant increase in contrast-to-noise ratio (CNR) by 63%-114% (p < 0.050). CONCLUSION: Reduced-dose TAVI planning CT is feasible on 8-cm detector scanners by using deep-learning reconstruction algorithms, showing promise of implementing the examination in imaging settings that are more commonly accessible. CI - (c) 2025 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine. FAU - Shao, Qiang AU - Shao Q AD - State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China. FAU - Zhou, Yongxia AU - Zhou Y AD - Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China. FAU - Li, Jing AU - Li J AD - United Imaging Healthcare, Shanghai, China. FAU - Zhang, Guozhi AU - Zhang G AUID- ORCID: 0000-0002-4819-3580 AD - United Imaging Healthcare, Shanghai, China. FAU - Li, Kunyao AU - Li K AD - Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China. FAU - Ding, Zhaojun AU - Ding Z AD - Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China. FAU - Zhou, Rong AU - Zhou R AD - Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China. FAU - Zhang, Jiamo AU - Zhang J AD - Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China. FAU - Zheng, Xiaohong AU - Zheng X AD - Chongqing Medical and Pharmaceutical College, Chongqing, China. FAU - Du, Yonghong AU - Du Y AD - State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China. LA - eng GR - 2024MSXM112/Chongqing Science and Health Joint Medical Research Project/ GR - 2022MSXM108/Chongqing Science and Health Joint Medical Research Project/ GR - 2022yc-jckx20054/Yongchuan Natural Science Foundation Project/ PT - Journal Article PL - United States TA - J Appl Clin Med Phys JT - Journal of applied clinical medical physics JID - 101089176 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Algorithms MH - *Deep Learning MH - *Image Processing, Computer-Assisted/methods MH - *Radiotherapy Planning, Computer-Assisted/methods MH - Male MH - Female MH - *Tomography, X-Ray Computed/methods MH - Radiation Dosage MH - Radiotherapy, Intensity-Modulated/methods MH - Aged MH - Computed Tomography Angiography/methods MH - Aged, 80 and over MH - Aortic Valve Stenosis/surgery PMC - PMC12396921 OTO - NOTNLM OT - computed tomography angiography OT - deep learning reconstruction OT - radiation dose OT - transcatheter aortic valve implantation COIS- Two of the authors (J.L. and G.Z.) are scientific researchers with the United Imaging Healthcare. The remaining authors declare no relationships with any companies. EDAT- 2025/08/31 22:22 MHDA- 2025/08/31 22:23 PMCR- 2025/08/29 CRDT- 2025/08/29 21:43 PHST- 2025/07/25 00:00 [revised] PHST- 2024/10/29 00:00 [received] PHST- 2025/07/30 00:00 [accepted] PHST- 2025/08/31 22:23 [medline] PHST- 2025/08/31 22:22 [pubmed] PHST- 2025/08/29 21:43 [entrez] PHST- 2025/08/29 00:00 [pmc-release] AID - ACM270224 [pii] AID - 10.1002/acm2.70224 [doi] PST - ppublish SO - J Appl Clin Med Phys. 2025 Sep;26(9):e70224. doi: 10.1002/acm2.70224. PMID- 40869716 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250914 LR - 20250914 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 16 DP - 2025 Aug 21 TI - A Comparison of Short-Term Clinical Outcomes Between the Navitor and Evolut Transcatheter Aortic Valve Prostheses. LID - 10.3390/jcm14165890 [doi] LID - 5890 AB - Background: The novel Navitor intra-annular self-expandable transcatheter aortic valve prosthesis is designed to improve coronary access, reduce paravalvular leaks, and enhance hemodynamic performance. Comparative data with the established Evolut platform (R, Pro, FX) are still lacking. This study aimed to evaluate the short-term clinical outcomes of Navitor (NAV) versus Evolut transcatheter heart valves. Methods: We conducted a single-center analysis of patients undergoing transfemoral TAVR between January 2015 and May 2024. A propensity score matching protocol including 18 baseline variables was used to balance baseline characteristics. Clinical outcomes were assessed using VARC-3 criteria. Results: Of 1067 TAVR patients, 210 were analyzed after matching-70 with the Nav valve and 140 with the Evolut valve. Baseline characteristics were comparable between groups, with a mean age of 80.9 +/- 6.5 years in the NAV group and 80.7 +/- 6.7 years in the Evolut group (p = 0.9). Both groups had an intermediate STS predicted risk of mortality, 3.9 +/- 3.4% for NAV and 3.9 +/- 3.2% for Evolut (p = 1.0). The effective aortic annulus diameter was comparable between the NAV (23.9 +/- 1.5 mm) and Evolut group (23.9 +/- 2.4 mm, p = 0.8). Hemodynamic performance at discharge was similar, with mean gradients of 7.5 +/- 2.8 mmHg (NAV) vs. 7.4 +/- 3.7 mmHg (Evolut, p = 0.9). Valve orifice areas and paravalvular leak rates showed no difference between the groups. Device success rates at discharge were good for both THVs: 89.3% for Evolut and 91.4% for NAV (p = 0.8). Disabling stroke occurred less frequently in the NAV group (0.0% vs. 7.1%, p = 0.033), while other early safety outcomes and 30-day mortalities were similar. Conclusions: The Navitor valve offers comparable hemodynamic performance, paravalvular leak rates, and procedural success to the Evolut platform. While early safety outcomes were largely similar, the Navitor valve was associated with a lower 30-day disabling stroke rate. FAU - Campanella, Caterina AU - Campanella C AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Kaiser, Katherine AU - Kaiser K AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Voss, Stephanie AU - Voss S AUID- ORCID: 0000-0002-8685-532X AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Burri, Melchior AU - Burri M AUID- ORCID: 0000-0002-8540-7090 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Erlebach, Magdalena AU - Erlebach M AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Puluca, Nazan AU - Puluca N AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Wirth, Felix AU - Wirth F AUID- ORCID: 0000-0002-0682-9990 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. FAU - Krane, Markus AU - Krane M AUID- ORCID: 0000-0002-5466-9290 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. AD - DZHK (German Centre for Cardiovascular Research)-Partner Site Munich Heart Alliance, 10785 Berlin, Germany. AD - Division of Cardiac Sugery, Department of Surgery, Yale School of Medicine, New Haven, CT 06510, USA. FAU - Ruge, Hendrik AU - Ruge H AUID- ORCID: 0000-0001-6886-3660 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, Germany. LA - eng PT - Journal Article DEP - 20250821 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12387559 OTO - NOTNLM OT - TAVR OT - hemodynamic outcomes OT - intra-annular OT - self-expandable OT - supra-annular COIS- Hendrik Ruge is a physician proctor for Abbott and Edwards Lifesciences, a consultant for Medtronic, Abbott, and Edwards Lifesciences, and a member of the Abbott Advisory Board. Markus Krane is a physician proctor and a member of the medical advisory board for Sanamedi and has received speakers' honoraria from EDWARDS, AtriCure, Medtronic, and Terumo. All other authors have no conflicts of interest to declare. EDAT- 2025/08/30 04:51 MHDA- 2025/08/30 04:52 PMCR- 2025/08/21 CRDT- 2025/08/28 01:13 PHST- 2025/07/14 00:00 [received] PHST- 2025/08/01 00:00 [revised] PHST- 2025/08/07 00:00 [accepted] PHST- 2025/08/30 04:52 [medline] PHST- 2025/08/30 04:51 [pubmed] PHST- 2025/08/28 01:13 [entrez] PHST- 2025/08/21 00:00 [pmc-release] AID - jcm14165890 [pii] AID - jcm-14-05890 [pii] AID - 10.3390/jcm14165890 [doi] PST - epublish SO - J Clin Med. 2025 Aug 21;14(16):5890. doi: 10.3390/jcm14165890. PMID- 40878766 OWN - NLM STAT- MEDLINE DCOM- 20251201 LR - 20260127 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 152 IP - 22 DP - 2025 Dec 2 TI - Peri-Interventional Anesthesia Strategies for Transcatheter Aortic Valve Implantation: A Multicenter, Randomized, Controlled, Noninferiority Trial. PG - 1526-1537 LID - 10.1161/CIRCULATIONAHA.125.076557 [doi] AB - BACKGROUND: Minimalist treatment strategies for transcatheter aortic valve implantation have been widely adopted because of continued procedural evolution, but large randomized trials are lacking. The DOUBLE-CHOICE trial (Randomized Study Comparing Both Latest Generation Self-Expanding Valves and a Minimalist Approach Versus Standard of Care in Transcatheter Aortic Valve Implantation) evaluated the safety and efficacy of a minimalist approach (MA) compared with the standard of care (SoC) for transfemoral transcatheter aortic valve implantation. METHODS: In this investigator-initiated, 2x2 factorial, open-label, randomized, multicenter, noninferiority trial, patients with symptomatic aortic stenosis were included at 10 German sites. Patients were randomly assigned to the MA, including isolated local anesthesia, versus the SoC using conscious sedation. The primary end point was a composite of all-cause mortality, vascular and bleeding complications, infection requiring antibiotic therapy, and neurological events at 30 days. The noninferiority of the MA compared with the SoC was tested in the intention-to-treat population with an absolute noninferiority margin of -6% at an alpha level of 0.05. RESULTS: Between July 11, 2022, and January 14, 2025, 752 patients were randomly assigned to the MA (n=377) and SoC (n=375). The median age was 83 (interquartile range, 79-86) years, 439 (58.5%) patients were women, and the median Society of Thoracic Surgeons risk score was 4.6% (interquartile range, 2.9-8.0). The primary end point occurred in 80 (22.9%) of 350 patients in the MA group and in 91 (25.8%) of 353 patients in the SoC group (rate difference, 2.9%; lower boundary of the 1-sided 95% CI, -2.4%; P for noninferiority=0.003; 2-sided 95% CI, -3.4 to 9.3; P for difference=0.37). Patient-reported anxiety and stress levels during the procedure were higher in the MA group. CONCLUSIONS: The MA including isolated local anesthesia was noninferior to the SoC with conscious sedation, highlighting the safety and efficacy of the MA for transcatheter aortic valve implantation. The burden of intraprocedural pain and discomfort is potentially higher in the MA group. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05036018. FAU - Feistritzer, Hans-Josef AU - Feistritzer HJ AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Ender, Joerg AU - Ender J AUID- ORCID: 0000-0002-8507-5321 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Lauten, Philipp AU - Lauten P AUID- ORCID: 0000-0001-9997-9201 AD - Zentralklinik Bad Berka, Bad Berka, Germany (P.L., S.B.). FAU - Rudolph, Tanja K AU - Rudolph TK AUID- ORCID: 0000-0001-8839-7476 AD - Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (T.K.R., V.R., V.v.D., S.B.). FAU - Rudolph, Volker AU - Rudolph V AUID- ORCID: 0000-0001-5385-6839 AD - Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (T.K.R., V.R., V.v.D., S.B.). FAU - Geisler, Tobias AU - Geisler T AUID- ORCID: 0000-0002-8864-6038 AD - University Hospital Tubingen, Tubingen, Germany (T.G., H.M.). FAU - Massberg, Steffen AU - Massberg S AUID- ORCID: 0000-0001-7387-3986 AD - Department of Medicine I, Ludwig Maximilian University Munich, Munich, Germany (S.M., M.F.). FAU - Adam, Matti AU - Adam M AUID- ORCID: 0000-0002-6990-8135 AD - Heart Center, University of Cologne, Cologne, Germany (M.A., S.B.). FAU - Baldus, Stephan AU - Baldus S AUID- ORCID: 0000-0001-8259-1737 AD - Zentralklinik Bad Berka, Bad Berka, Germany (P.L., S.B.). AD - Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (T.K.R., V.R., V.v.D., S.B.). FAU - Sossalla, Samuel AU - Sossalla S AUID- ORCID: 0000-0001-8034-2673 AD - University Hospital Giessen, Giessen, Germany (S.S., W.-K.K., M.S., U.V.-R., A.B.). FAU - Joner, Michael AU - Joner M AUID- ORCID: 0000-0002-2971-8310 AD - Department of Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany (M.J.). FAU - Mollmann, Helge AU - Mollmann H AUID- ORCID: 0000-0002-6047-0990 AD - University Hospital Tubingen, Tubingen, Germany (T.G., H.M.). FAU - Wolf, Alexander AU - Wolf A AUID- ORCID: 0000-0003-1541-6351 AD - Heart Center Wuppertal, Witten-Herdecke University, Wuppertal, Germany (A.W.). FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - University Hospital Giessen, Giessen, Germany (S.S., W.-K.K., M.S., U.V.-R., A.B.). FAU - Borger, Michael A AU - Borger MA AUID- ORCID: 0000-0003-1046-1364 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Noack, Thilo AU - Noack T AUID- ORCID: 0000-0003-0245-0147 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Magunia, Harry AU - Magunia H AD - Department of Cardiology, St.-Johannes Hospital Dortmund, Dortmund, Germany (H.M.). FAU - von Dossow, Vera AU - von Dossow V AUID- ORCID: 0000-0001-7281-2137 AD - Heart and Diabetes Center NRW, Bad Oeynhausen, Germany (T.K.R., V.R., V.v.D., S.B.). FAU - Sander, Michael AU - Sander M AD - University Hospital Giessen, Giessen, Germany (S.S., W.-K.K., M.S., U.V.-R., A.B.). FAU - Vigelius-Rauch, Ursula AU - Vigelius-Rauch U AD - University Hospital Giessen, Giessen, Germany (S.S., W.-K.K., M.S., U.V.-R., A.B.). FAU - Feuerecker, Matthias AU - Feuerecker M AUID- ORCID: 0000-0002-9773-083X AD - Department of Medicine I, Ludwig Maximilian University Munich, Munich, Germany (S.M., M.F.). FAU - Zakhary, Waseem AU - Zakhary W AUID- ORCID: 0000-0001-8014-6031 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Boening, Andreas AU - Boening A AUID- ORCID: 0000-0002-4404-510X AD - University Hospital Giessen, Giessen, Germany (S.S., W.-K.K., M.S., U.V.-R., A.B.). FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Heart Center, University of Cologne, Cologne, Germany (M.A., S.B.). FAU - Hohenstein, Sven AU - Hohenstein S AUID- ORCID: 0000-0002-9708-1593 AD - Helios Health Institute, Leipzig, Germany (S.H.). FAU - Hoesler, Nadine AU - Hoesler N AUID- ORCID: 0009-0000-7555-7055 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Buske, Maria AU - Buske M AUID- ORCID: 0009-0000-9612-4486 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Desch, Steffen AU - Desch S AUID- ORCID: 0000-0002-1349-9969 AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AUID- ORCID: 0000-0002-9596-558X AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). FAU - Thiele, Holger AU - Thiele H AUID- ORCID: 0000-0002-0169-998X AD - Heart Center Leipzig at Leipzig University, Leipzig, Germany (H.-J.F., J.E., M.A.B., T.N., W.Z., N.H., M.B., S.D., M.A.-W., H.T.). AD - Leipzig Heart Science, Leipzig, Germany (H.T.). CN - DOUBLE-CHOICE Investigators LA - eng SI - ClinicalTrials.gov/NCT05036018 PT - Equivalence Trial PT - Journal Article PT - Multicenter Study DEP - 20250829 PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM CIN - Circulation. 2025 Dec 2;152(22):1538-1540. doi: 10.1161/CIRCULATIONAHA.125.077345. PMID: 41325447 MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Anesthesia, Local/adverse effects/methods/mortality MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery/mortality MH - Procedural Sedation MH - Germany MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects/mortality MH - Treatment Outcome OTO - NOTNLM OT - anesthesia OT - aortic stenosis OT - fast-track OT - minimalist approach OT - transcatheter aortic valve implantation OT - transcatheter aortic valve replacement COIS- Dr Rudolph discloses that her hospital received speaker honoraria or consultancy fees from Boston Scientific, Medtronic, JenaValve, and Edwards Lifesciences. Dr Kim received personal fees from Abbott, Anteris, Boston Scientific, Edwards Lifesciences, Emboline, HID Imaging, JenaValve, Meril Life Sciences, and P & F and an institutional grant from Boston Scientific. Dr Borger discloses that his hospital receives speaker honoraria or consulting fees on his behalf from Edwards Lifesciences, Medtronic, Abbott, and Artivion. Dr Abdel-Wahab discloses that his hospital received speaker honoraria or consultancy fees on his behalf from Boston Scientific, Medtronic, and Edwards Lifesciences. EDAT- 2025/08/29 08:45 MHDA- 2025/12/01 18:50 CRDT- 2025/08/29 05:52 PHST- 2025/12/01 18:50 [medline] PHST- 2025/08/29 08:45 [pubmed] PHST- 2025/08/29 05:52 [entrez] AID - 10.1161/CIRCULATIONAHA.125.076557 [doi] PST - ppublish SO - Circulation. 2025 Dec 2;152(22):1526-1537. doi: 10.1161/CIRCULATIONAHA.125.076557. Epub 2025 Aug 29. PMID- 40857132 OWN - NLM STAT- MEDLINE DCOM- 20250922 LR - 20260616 IS - 1522-1539 (Electronic) IS - 0363-6135 (Linking) VI - 329 IP - 4 DP - 2025 Oct 1 TI - Clinical significance and correlation of microRNA-21 expression in patients undergoing transcatheter aortic valve replacement. PG - H867-H872 LID - 10.1152/ajpheart.00506.2025 [doi] AB - Transcatheter aortic valve replacement (TAVR) is an increasingly common procedure for treating severe aortic stenosis. Although cardiac biomarker elevation post-TAVR is common, its correlation with outcomes remains controversial. MicroRNAs (miRNAs) have emerged as potential biomarkers in cardiovascular diseases. This study aimed to assess the prognostic significance of various miRNAs on outcomes after TAVR to stratify high-risk patients for adverse outcomes. Consecutive patients undergoing transfemoral TAVR were prospectively enrolled. Blood samples were collected at baseline and 6 h postprocedure. MiRNA levels, including miR-21, miR-1, and miR-210, were quantified using polymerase chain reaction (PCR). The relative quantification (RQ) was analyzed by the DeltaDeltaCt method. The primary outcome was major adverse cardiovascular or cerebrovascular events (MACCE). Receiver-operating characteristic curve analysis was performed to assess the correlation between miRNAs and MACCE. Seventy-six patients were included in the study, with a mean age of 80.8 yr. Nearly a quarter of patients experienced MACCE. RQ analysis of miR-21 showed moderate-prognostic accuracy for predicting freedom from MACCE (R = 0.61). An RQ of miR-21 cutoff value of 0.709 yielded a sensitivity of 71% and specificity of 56%. Patients experiencing a significant decrease in miR-21 levels (RQ < 0.709) had significantly higher MACCE rates and 30-day mortality compared with those with a nonsignificant change in miR-21 levels (40% vs. 16%, P = 0.025 and 12% vs. 0%, P = 0.033, respectively). A significant decrease in miR-21 levels at 6 h post-TAVR is associated with poor patient outcomes. MiR-21 may serve as a potential biomarker for risk stratification and personalized post-TAVR management.NEW & NOTEWORTHY A significant drop in circulating microRNA-21 levels 6 h after transcatheter aortic valve replacement (TAVR) was associated with a fourfold increased risk of major adverse cardiovascular or cerebrovascular events (MACCE). This prospective study identifies microRNA-21 as a promising early biomarker for risk stratification and prognosis after TAVR, offering potential for more personalized postprocedural care. FAU - Berkovitch, Anat AU - Berkovitch A AUID- ORCID: 0000-0002-4589-5296 AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Sirotkin, Zvi AU - Sirotkin Z AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Grossman, Yoni AU - Grossman Y AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Guetta, Victor AU - Guetta V AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Fefer, Paul AU - Fefer P AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Segev, Amit AU - Segev A AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Maor, Elad AU - Maor E AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Paret, Gidi AU - Paret G AD - Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Matetzky, Shlomi AU - Matetzky S AUID- ORCID: 0009-0008-6489-8127 AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Nevo-Caspi, Yael AU - Nevo-Caspi Y AD - Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. FAU - Barbash, Israel Moshe AU - Barbash IM AUID- ORCID: 0000-0002-7416-5989 AD - Division of Cardiology, Leviev Cardiovascular and Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - School of Medicine, Tel Aviv University, Tel aviv, Israel. LA - eng PT - Journal Article DEP - 20250826 PL - United States TA - Am J Physiol Heart Circ Physiol JT - American journal of physiology. Heart and circulatory physiology JID - 100901228 RN - 0 (MicroRNAs) RN - 0 (MIRN21 microRNA, human) RN - 0 (Biomarkers) SB - IM MH - Humans MH - *MicroRNAs/blood/genetics MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery/blood/mortality/genetics MH - Aged, 80 and over MH - Aged MH - Prospective Studies MH - Treatment Outcome MH - Risk Assessment MH - Risk Factors MH - Biomarkers/blood MH - Time Factors MH - *Aortic Valve/surgery MH - Clinical Relevance OTO - NOTNLM OT - MicroRNA-21 OT - cardiac biomarkers OT - transcatheter aortic valve replacement EDAT- 2025/08/26 20:45 MHDA- 2025/09/22 18:38 CRDT- 2025/08/26 12:23 PHST- 2025/09/22 18:38 [medline] PHST- 2025/08/26 20:45 [pubmed] PHST- 2025/08/26 12:23 [entrez] AID - 10.1152/ajpheart.00506.2025 [doi] PST - ppublish SO - Am J Physiol Heart Circ Physiol. 2025 Oct 1;329(4):H867-H872. doi: 10.1152/ajpheart.00506.2025. Epub 2025 Aug 26. PMID- 40853882 OWN - NLM STAT- MEDLINE DCOM- 20250827 LR - 20260410 IS - 1940-087X (Electronic) IS - 1940-087X (Linking) IP - 222 DP - 2025 Aug 8 TI - Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation. LID - 10.3791/68470 [doi] AB - Transcatheter aortic valve implantation (TAVI) requires multiple access sites, each with a potential risk of access site-related bleeding complications. While most bleeding events occur at the primary TAVI access site, a significant number of bleeding events originate from the secondary access sites. Additionally, a temporary pacing lead prevents early mobilization after TAVI, while prolonged immobilization is associated with an increased rate of post-procedural complications such as delirium and infection. Using alternative secondary access sites may reduce the incidence of access site-related complications and facilitate early mobilization after TAVI. This protocol describes an upper-extremity approach, as recently investigated in the TAVI XS trial, and aims to provide a comprehensive overview of the methodology. For this approach, the radial artery is used for diagnostic access, and the upper arm veins (basilic, cephalic, or brachial vein) are used for temporary pacing lead insertion. To enhance reproducibility, a step-by-step protocol was created on how to perform an upper-extremity secondary access approach during transfemoral TAVI. It was previously demonstrated that an upper-extremity approach for secondary access results in significantly fewer clinically relevant secondary access site-related bleeding complications. Additionally, the approach reduces the time to mobilization for patients who require a pacing lead for an extended period of time. Due to the pragmatic nature of the aforementioned study, the protocol presented here is readily applicable to the majority of transfemoral TAVI patients. The upper-extremity approach reduces periprocedural complications in TAVI patients and may facilitate early mobilization. The presented approach is the next step in minimizing the invasiveness of transfemoral TAVI and should be considered in all eligible TAVI patients. FAU - Versteeg, Geert A A AU - Versteeg GAA AD - Department of Cardiology, Radboud University Medical Center; Geert.versteeg@radboudumc.nl. FAU - Rooijakkers, Maxim J P AU - Rooijakkers MJP AD - Department of Cardiology, Radboud University Medical Center. FAU - Stens, Niels A AU - Stens NA AD - Department of Cardiology, Radboud University Medical Center; Department of Medical BioSciences, Radboud University Medical Center. FAU - van Wely, Marleen H AU - van Wely MH AD - Department of Cardiology, Radboud University Medical Center. FAU - van Geuns, Robert-Jan M AU - van Geuns RM AD - Department of Cardiology, Radboud University Medical Center. FAU - van Garsse, Leen A F M AU - van Garsse LAFM AD - Department of Cardiothoracic Surgery, Radboud University Medical Center. FAU - Geuzebroek, Guillaume S C AU - Geuzebroek GSC AD - Department of Cardiothoracic Surgery, Radboud University Medical Center. FAU - Verkroost, Michel W A AU - Verkroost MWA AD - Department of Cardiothoracic Surgery, Radboud University Medical Center. FAU - Thijssen, Dick H J AU - Thijssen DHJ AD - Department of Medical BioSciences, Radboud University Medical Center; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University. FAU - Heijmen, Robin H AU - Heijmen RH AD - Department of Cardiothoracic Surgery, Radboud University Medical Center. FAU - van Nunen, Lokien X AU - van Nunen LX AD - Department of Cardiology, Radboud University Medical Center. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, Radboud University Medical Center. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Video-Audio Media DEP - 20250808 PL - United States TA - J Vis Exp JT - Journal of visualized experiments : JoVE JID - 101313252 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Femoral Artery/surgery MH - *Upper Extremity/blood supply/surgery EDAT- 2025/08/25 20:45 MHDA- 2025/08/27 08:45 CRDT- 2025/08/25 13:23 PHST- 2025/08/27 08:45 [medline] PHST- 2025/08/25 20:45 [pubmed] PHST- 2025/08/25 13:23 [entrez] AID - 10.3791/68470 [doi] PST - epublish SO - J Vis Exp. 2025 Aug 8;(222). doi: 10.3791/68470. PMID- 40853010 OWN - NLM STAT- MEDLINE DCOM- 20251007 LR - 20260803 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 4 DP - 2025 Oct TI - Impact of Aortic Atherosclerosis on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement. PG - 2661-2667 LID - 10.1002/ccd.70125 [doi] AB - BACKGROUND: Aortic atherothrombotic lesions can cause systemic embolization and adverse outcomes after interventional procedures. AIMS: This study aimed to assess the association between the degree of aortic atherosclerosis and clinical outcomes after transfemoral transcatheter aortic valve replacement (TAVR). METHODS: This single-center observational study included data from 278 patients who underwent transfemoral TAVR. The degree of aortic atherosclerosis in the ascending aorta, aortic arch, descending aorta, and abdominal aorta according to preoperative enhanced computed tomography was evaluated, and extensive intimal thickening >/= 4 mm or mobile-looking, ulcerated or protruding atheroma were considered to be atherothrombotic lesions. Patients were classified into two groups: those with and without atherothrombotic lesions. Clinical outcomes, including all-cause death, stroke, systemic embolization, and worsening renal function, were investigated. RESULTS: Of 278 patients, 116 (41.4%) exhibited atherothrombotic lesions. Baseline renal function was significantly worse in patients with atherothrombotic lesions. There were no significant differences in the occurrence of all-cause death (0% vs. 0.6%; p > 0.99), stroke (3.5% vs. 2.5%; p = 0.72), systemic embolism (0.9% vs. 0%; p = 0.42), and worsening renal function (increase in serum creatinine >/= 0.3 mg/dL or >/= 1.5-fold from baseline; 5.4% vs. 5.2%; p = 0.93) within 1-month. During a median follow-up of 3.0 years (interquartile range 2.0-4.0 years), the occurrence of all-cause death was numerically higher in patients with atherothrombotic lesions compared to those without. CONCLUSIONS: Atherothrombotic lesions were commonly observed in patients undergoing transfemoral TAVR. No significant clinical effect of aortic atherosclerosis on short-term adverse outcomes was observed, although long-term mortality was numerically higher in patients who exhibited atherothrombotic lesions. CI - (c) 2025 Wiley Periodicals LLC. FAU - Shirai, Yoshinori AU - Shirai Y AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Tanaka, Akihito AU - Tanaka A AUID- ORCID: 0000-0003-2260-1942 AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Tokuda, Yoshiyuki AU - Tokuda Y AD - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Kondo, Hiroki AU - Kondo H AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Mizutani, Koji AU - Mizutani K AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Uemura, Tomonari AU - Uemura T AUID- ORCID: 0009-0007-9729-3020 AD - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Furusawa, Kenji AU - Furusawa K AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Mutsuga, Masato AU - Mutsuga M AD - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Murohara, Toyoaki AU - Murohara T AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. LA - eng PT - Journal Article PT - Observational Study DEP - 20250825 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Treatment Outcome MH - *Femoral Artery/diagnostic imaging MH - Aged, 80 and over MH - Risk Factors MH - Aged MH - Time Factors MH - *Aortic Diseases/mortality/diagnostic imaging/complications MH - *Atherosclerosis/mortality/diagnostic imaging/complications MH - *Aortic Valve Stenosis/mortality/diagnostic imaging/surgery/physiopathology MH - Risk Assessment MH - Severity of Illness Index MH - *Catheterization, Peripheral/adverse effects/mortality MH - Retrospective Studies MH - Aortography/methods MH - Computed Tomography Angiography MH - Punctures MH - *Aortic Valve/diagnostic imaging/surgery/physiopathology MH - Plaque, Atherosclerotic MH - Embolism/etiology/mortality OTO - NOTNLM OT - TAVI OT - TAVR OT - adverse outcomes OT - aortic atherosclerosis OT - aortic atherothrombotic lesions EDAT- 2025/08/25 12:47 MHDA- 2025/10/07 12:30 CRDT- 2025/08/25 08:03 PHST- 2025/07/21 00:00 [revised] PHST- 2025/05/01 00:00 [received] PHST- 2025/08/19 00:00 [accepted] PHST- 2025/10/07 12:30 [medline] PHST- 2025/08/25 12:47 [pubmed] PHST- 2025/08/25 08:03 [entrez] AID - 10.1002/ccd.70125 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Oct;106(4):2661-2667. doi: 10.1002/ccd.70125. Epub 2025 Aug 25. PMID- 40845744 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250926 LR - 20250926 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 4 IP - 9 DP - 2025 Sep TI - Single- Versus Dual-Access Transcatheter Aortic Valve Implantation Using Balloon-Expandable Platform: A Propensity Score Matching Study. PG - 102086 LID - S2772-963X(25)00511-3 [pii] LID - 10.1016/j.jacadv.2025.102086 [doi] LID - 102086 AB - BACKGROUND: Vascular complications are more frequently encountered in patients undergoing transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement. Single access (SA) TAVI may reduce access-site complications, but this approach has not been widely studied. OBJECTIVES: The aim of the study was to compare clinical outcomes of SA vs dual access (DA) TAVI using balloon-expandable valve Sapien 3 Ultra. METHODS: This was a retrospective analysis of consecutive patients who underwent TAVI using balloon-expandable valve. Data were prospectively entered into a dedicated web-based database. The co-primary endpoints were device success and 30-day safety endpoints, defined according to the Valve Academic Research Consortium 3. A propensity score matching with a 1:1 ratio was performed comparing SA vs DA TAVI. RESULTS: Of 532 patients who had transfemoral TAVI, 117 (22%) underwent the SA approach. Propensity score matching analysis yielded a well-balanced 204 patients (102 in each group). SA was associated with a significant reduction in contrast use, fluoroscopy time, radiation exposure, and total procedure time. Device success was comparable between the 2 groups (3.9% vs 3.9%; OR: 1.00; 95% CI: 0.24-4.11; P > 0.99). The 30-day safety profile of the Valve Academic Research Consortium 3 was significantly better in patients who underwent SA vs DA TAVI (15.0% vs 28.9%; OR: 0.44; 95% CI: 0.22-0.88; P = 0.02). This was derived from a lower incidence of severe paravalvular regurgitation and new pacemaker implantation. CONCLUSIONS: SA is a feasible and safe strategy compared to DA TAVI. It was associated with quicker procedure times, lower contrast and radiation exposure, and a better 30-day safety profile than the DA strategy. Future randomized studies are needed to further assess this strategy. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Omari, Muntaser AU - Omari M AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom; Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom. FAU - Diaz Nuila, Mario E AU - Diaz Nuila ME AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Abdalwahab, Ahmed AU - Abdalwahab A AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Stewart, Debbie AU - Stewart D AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Edwards, Richard AU - Edwards R AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Das, Rajiv AU - Das R AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Zaman, Azfar AU - Zaman A AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Farag, Mohamed AU - Farag M AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom. FAU - Alkhalil, Mohammad AU - Alkhalil M AD - Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom; Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom. Electronic address: mohammad.alkhalil@nhs.net. LA - eng PT - Journal Article DEP - 20250821 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC12398850 OTO - NOTNLM OT - TAVI OT - VARC-3 OT - pacemaker OT - paravalvular regurgitation OT - single access OT - vascular complication COIS- Funding support and author disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/08/23 00:44 MHDA- 2025/08/23 00:45 PMCR- 2025/08/21 CRDT- 2025/08/22 18:20 PHST- 2025/05/14 00:00 [received] PHST- 2025/07/14 00:00 [revised] PHST- 2025/07/19 00:00 [accepted] PHST- 2025/08/23 00:45 [medline] PHST- 2025/08/23 00:44 [pubmed] PHST- 2025/08/22 18:20 [entrez] PHST- 2025/08/21 00:00 [pmc-release] AID - S2772-963X(25)00511-3 [pii] AID - 102086 [pii] AID - 10.1016/j.jacadv.2025.102086 [doi] PST - ppublish SO - JACC Adv. 2025 Sep;4(9):102086. doi: 10.1016/j.jacadv.2025.102086. Epub 2025 Aug 21. PMID- 40827109 OWN - NLM STAT- MEDLINE DCOM- 20251007 LR - 20260803 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 106 IP - 4 DP - 2025 Oct TI - Transcaval Transcatheter Aortic Valve Replacement: Clinical Outcomes From a TAVI Program Without Prior Transcaval Experience. PG - 2592-2600 LID - 10.1002/ccd.70015 [doi] AB - BACKGROUND: Despite the emergence of the transcaval (TCv) access route for transcatheter aortic valve implantation (TAVI) in the treatment of patients with hostile iliofemoral anatomy, the number of patients reported in clinical series of TCv TAVI has been relatively small (< 500 published cases). We assessed procedural and clinical outcomes in a prospective cohort of patients undergoing TAVI using TCv access at a clinical site without prior TCv TAVI experience. METHODS: A prospective TAVI database was used to identify all patients treated with TCv TAVI at our center. Baseline clinical and procedural data, and clinical outcomes at follow-up were assessed. The Valve Academic Research Consortium (VARC) consensus document for standardized endpoints was used. RESULTS: Between February 2020 and July 2024, a total of 21 patients underwent TCv TAVI. The mean age of the cohort age was 76 +/- 6 years, most were female (N = 13, 62%), and the mean STS score was 7.4 +/- 5.8%. We achieved a technical and clinical success rate of 100% and 95%, respectively. The mean duration of in-hospital stay was 3.4 +/- 1.5 days. There was one central aortic complication in a patient who required balloon tamponade to treat bleeding into the retroperitoneum from the aorto-caval tract and one peripheral vascular complication in a patient who required a direct thrombin injection to treat a femoral artery pseudoaneurysm. The rate of permanent pacemaker implantation was 20% (N = 4) and the incidence of stroke and/or death at 30 days was 0%. The mean follow-up time of the cohort was 2.5 +/- 1.4 years with a 1-year Kaplan-Meier survival estimate of 89.6% (95% confidence interval of 64.3%-97.3%). CONCLUSIONS: When performed by an experienced TAVI operator with peripheral vascular and structural training, with limited up-front proctoring for procedures and input from imaging specialists, this series supports that TCv TAVI can achieve a high rate of procedural success with low risk of mortality and stroke. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Doyle, Conor J AU - Doyle CJ AUID- ORCID: 0000-0001-9124-5297 AD - Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. FAU - McGrath, Brian AU - McGrath B AD - Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. FAU - Margey, Ronan AU - Margey R AD - Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. FAU - Sharp, Andrew AU - Sharp A AD - Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. FAU - Mitchell, Andrew J AU - Mitchell AJ AUID- ORCID: 0000-0002-4756-292X AD - Department of Cardiology, University of Edinburgh, Edinburgh, UK. FAU - Beirne, Ellen AU - Beirne E AD - Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. FAU - Casserly, Ivan P AU - Casserly IP AD - Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland. LA - eng GR - The authors received no specific funding for this work./ PT - Journal Article DEP - 20250819 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Male MH - Aged MH - Treatment Outcome MH - Aged, 80 and over MH - Time Factors MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/physiopathology/mortality MH - Risk Factors MH - Databases, Factual MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Prospective Studies MH - Risk Assessment MH - Postoperative Complications/mortality/therapy/etiology MH - Punctures MH - Length of Stay PMC - PMC12502014 COIS- The authors declare no conflicts of interest. EDAT- 2025/08/19 06:28 MHDA- 2025/10/07 12:30 PMCR- 2025/10/07 CRDT- 2025/08/19 03:43 PHST- 2025/06/18 00:00 [revised] PHST- 2025/01/27 00:00 [received] PHST- 2025/07/10 00:00 [accepted] PHST- 2025/10/07 12:30 [medline] PHST- 2025/08/19 06:28 [pubmed] PHST- 2025/08/19 03:43 [entrez] PHST- 2025/10/07 00:00 [pmc-release] AID - CCD70015 [pii] AID - 10.1002/ccd.70015 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Oct;106(4):2592-2600. doi: 10.1002/ccd.70015. Epub 2025 Aug 19. PMID- 40826137 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250914 LR - 20250914 IS - 2731-6203 (Electronic) IS - 2731-6203 (Linking) VI - 4 IP - 1 DP - 2025 Aug 18 TI - Usefulness of somatosensory-evoked potentials for monitoring cerebral perfusion during transcarotid transcatheter aortic valve replacement: a case report. PG - 36 LID - 10.1186/s44215-025-00219-0 [doi] LID - 36 AB - BACKGROUND: Transcarotid transcatheter aortic valve replacement (TAVR) is a safe procedure with a low incidence of cerebral infarction and has recently become the first-choice alternative approach. This procedure requires temporary occlusion of the common carotid artery (CCA). CCA clamping during surgery may help reduce the risk of embolism caused by debris; however, the risk of hemodynamic stroke cannot be entirely ruled out. Therefore, intraoperative monitoring of cerebral ischemia is essential. Regional oxygen saturation (rSO(2)) monitoring is commonly used, but can only measure local mixed venous oxygen saturation in the frontal lobes. During carotid endarterectomy (CEA), a combination of multiple monitoring methods for intraoperative cerebral ischemia is recommended. Similarly, we used somatosensory-evoked potentials (SEPs) in conjunction with rSO(2) monitoring. CASE PRESENTATION: A 92-year-old male patient with a history of dyspnea on exertion was diagnosed with severe aortic valve stenosis (AS) using transthoracic echocardiography (TTE). Contrast-enhanced computed tomography (CT) revealed a shaggy aorta extending from the aortic arch to the descending aorta. Preoperative magnetic resonance angiography (MRA) of the head showed slight narrowing of the anterior communicating artery. Considering the patient's age, frailty, and vascular pathology, we performed transcarotid TAVR while monitoring rSO(2) and SEPs for intraoperative cerebral ischemia. No significant decreases in rSO(2) values or SEPs amplitudes due to occlusion of the left CCA. The procedure was successful, with no postoperative stroke, and the patient had an uneventful recovery. CONCLUSIONS: In transcarotid TAVR requiring CCA occlusion, monitoring cerebral ischemia with both rSO(2) and SEPs may help prevent perioperative hemodynamic cerebral infarction. CI - (c) 2025. The Author(s). FAU - Okamoto, Koji AU - Okamoto K AUID- ORCID: 0009-0000-9313-0549 AD - Department of Cardiovascular Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyohama, Chuoku, Fukuoka, 810-0065, Japan. okamo333@gmail.com. FAU - Motomatsu, Yuma AU - Motomatsu Y AD - Department of Cardiovascular Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyohama, Chuoku, Fukuoka, 810-0065, Japan. FAU - Kano, Meikun AU - Kano M AD - Department of Cardiovascular Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyohama, Chuoku, Fukuoka, 810-0065, Japan. FAU - Meno, Kyohei AU - Meno K AD - Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. FAU - Ura, Yujiro AU - Ura Y AD - Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. FAU - Mori, Takahiro AU - Mori T AD - Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. FAU - Otani, Kisho AU - Otani K AD - Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. FAU - Inoue, Shujiro AU - Inoue S AD - Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. FAU - Sonoda, Hiromichi AU - Sonoda H AD - Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan. FAU - Shiose, Akira AU - Shiose A AD - Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan. LA - eng PT - Journal Article DEP - 20250818 PL - England TA - Gen Thorac Cardiovasc Surg Cases JT - General thoracic and cardiovascular surgery cases JID - 9918900337406676 PMC - PMC12363108 OTO - NOTNLM OT - Intraoperative monitoring of cerebral ischemia OT - Somatosensory-evoked potentials OT - Transcarotid transcatheter aortic valve replacement COIS- Declarations. Ethics approval and consent to participate: Ethics approval and consent to participate were obtained. Consent for publication: A written informed consent was obtained from the patient for the publication of this case report and accompanying images. Competing interests: The authors declare that they have no competing interests. EDAT- 2025/08/19 00:28 MHDA- 2025/08/19 00:29 PMCR- 2025/08/18 CRDT- 2025/08/18 23:40 PHST- 2025/03/10 00:00 [received] PHST- 2025/07/25 00:00 [accepted] PHST- 2025/08/19 00:29 [medline] PHST- 2025/08/19 00:28 [pubmed] PHST- 2025/08/18 23:40 [entrez] PHST- 2025/08/18 00:00 [pmc-release] AID - 10.1186/s44215-025-00219-0 [pii] AID - 219 [pii] AID - 10.1186/s44215-025-00219-0 [doi] PST - epublish SO - Gen Thorac Cardiovasc Surg Cases. 2025 Aug 18;4(1):36. doi: 10.1186/s44215-025-00219-0. PMID- 40820615 OWN - NLM STAT- MEDLINE DCOM- 20251007 LR - 20260803 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 106 IP - 4 DP - 2025 Oct TI - Three-Cusp View Orientation in TAVI: Evaluating LOA Versus Non-LOA Impact on Outcomes With Contemporary Valve Prostheses. PG - 2567-2578 LID - 10.1002/ccd.70087 [doi] AB - BACKGROUND: Optimal projection views during transcatheter aortic valve implantation (TAVI) procedures are critical for procedural success and patient outcomes. AIMS: This study investigated the influence of 3-cusp view orientation-line of alignment (LOA) versus non-LOA-on procedural outcomes in patients undergoing TAVI with contemporary transcatheter heart valves. METHODS: This retrospective analysis included 421 consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI at a single center between March 2019 and December 2023. Patients received either SAPIEN 3 (n = 140) or CoreValve Evolut R/PRO (n = 281) prostheses and were classified as having either LOA (n = 312, 74.1%) or non-LOA (n = 109, 25.9%) projection based on pre-procedural computed tomography. Primary endpoints included device success according to VARC-2 criteria, post-procedural aortic regurgitation, and 30-day clinical outcomes. Multivariate logistic regression analyses were performed to identify independent predictors of device success, post-procedural hemodynamics, and the need for permanent pacemaker implantation. RESULTS: Non-LOA patients had larger annulus dimensions (461.37 +/- 83.52 vs. 441.16 +/- 80.83 mm(2), p = 0.03), higher calcium burden (3072.26 +/- 1524.36 vs. 2646.0 +/- 1189.11 AU, p = 0.01), and required more contrast (179.99 +/- 67.12 vs. 161.94 +/- 64.7 ml, p = 0.01). Multivariate analysis revealed that aortic valve calcium score was the only independent predictor of device success (p = 0.018), while LOA orientation showed no significant association (p = 0.971). Valve type was the primary determinant of post-procedural hemodynamics (SAPIEN 3 superior, p = 0.025), and prior bundle branch block was the strongest pacemaker predictor (p = 0.005). Device success (94.81% vs. 95.88%, p = 0.86) and safety outcomes were comparable between groups. CONCLUSIONS: While LOA orientation creates anatomical differences, it doesn't change fundamental treatment decisions-calcium burden and valve type remain the primary determinants of outcomes. LOA status should inform procedural planning through enhanced contrast management and risk-stratified surveillance, without compromising fundamental treatment decisions. Contemporary TAVI procedures demonstrate excellent safety and efficacy across both types of projections. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Kasem Ali Sliman, Rim AU - Kasem Ali Sliman R AD - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. FAU - Eitan, Amnon AU - Eitan A AUID- ORCID: 0000-0002-6710-9057 AD - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. AD - Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel. FAU - Zisman, Keren AU - Zisman K AD - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. AD - Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel. FAU - Avidan, Yuval AU - Avidan Y AD - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. AD - Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel. FAU - Aker, Amir AU - Aker A AD - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. AD - Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel. FAU - Sliman, Hussein AU - Sliman H AD - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. AD - Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel. LA - eng GR - The authors received no specific funding for this work./ PT - Comparative Study PT - Journal Article DEP - 20250817 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Female MH - *Aortic Valve Stenosis/diagnostic imaging/physiopathology/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - *Aortic Valve/diagnostic imaging/physiopathology/surgery MH - Aged, 80 and over MH - Prosthesis Design MH - Aged MH - Risk Factors MH - Predictive Value of Tests MH - Time Factors MH - Hemodynamics MH - Severity of Illness Index MH - Aortic Valve Insufficiency/etiology/physiopathology MH - Risk Assessment MH - Recovery of Function PMC - PMC12502009 OTO - NOTNLM OT - 3-cusp view OT - aortic root anatomy OT - aortic stenosis OT - computed tomography OT - transcatheter aortic valve implantation (TAVI) OT - valve deployment, anatomical variation COIS- The authors declare no conflicts of interest. EDAT- 2025/08/18 06:28 MHDA- 2025/10/07 12:30 PMCR- 2025/10/07 CRDT- 2025/08/18 04:12 PHST- 2025/07/27 00:00 [revised] PHST- 2025/04/16 00:00 [received] PHST- 2025/08/01 00:00 [accepted] PHST- 2025/10/07 12:30 [medline] PHST- 2025/08/18 06:28 [pubmed] PHST- 2025/08/18 04:12 [entrez] PHST- 2025/10/07 00:00 [pmc-release] AID - CCD70087 [pii] AID - 10.1002/ccd.70087 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Oct;106(4):2567-2578. doi: 10.1002/ccd.70087. Epub 2025 Aug 17. PMID- 40816554 OWN - NLM STAT- MEDLINE DCOM- 20251009 LR - 20260723 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 291 DP - 2026 Jan TI - Effect of cerebral embolic protection device on new cerebral embolism during transcatheter aortic valve replacement: A prospective sentinel registry. PG - 44-52 LID - S0002-8703(25)00296-0 [pii] LID - 10.1016/j.ahj.2025.08.006 [doi] AB - BACKGROUND: Cerebral embolization is a common complication following transcatheter aortic valve replacement (TAVR). Cerebral embolic protection (CEP) devices have the potential to reduce embolic burden to the cerebral circulation; however, their effectiveness in real-world patients at high risk of stroke remains insufficiently studied. METHODS: As part of imaging study of the prospective Sentinel registry (NCT05217888), we evaluated the effect of CEP on new cerebral embolism as determined by brain magnetic resonance imaging (MRI) in patients undergoing transfemoral TAVR who were considered at high risk for stroke. The primary endpoint was the number and volume of new cerebral lesions on brain MRI at postprocedure (2 to 7 days) compared to baseline in protected brain territories. The control group consists of enrolled patients in the ADAPT-TAVR trial (NCT03284827), in which TAVR was performed without the use of a CEP device. RESULTS: A total of 219 patients was included (49 in the SENTINEL registry and 170 patients in the ADAPT-TAVR trial). For the primary endpoint, the number and volume of new cerebral lesions was significantly lower in the CEP group than in the control group: the median no. of lesions; 1 (interquartile range [IQR], 1 to 2) vs 6 (IQR, 3 to 10), respectively; difference, -4 [IQR, -6 to -3]; P < .001, and the median volume of lesions; 113.5 mm(3) (IQR, 42.4-206.9) vs 283.5 mm(3) (IQR, 129.7-682.4), respectively; difference, -145.9 [IQR, -296.7 to -67.1]; P < .001). Strokes at 30 days occurred in 1 patient (2.0%) in the CEP group and 2 patients (1.2%) in the control group (P = .64). CONCLUSIONS: Among patients who are at high risk for stroke undergoing TAVR, the use of CEP was associated with a significant reduction of new cerebral embolism in protected brain territories. Because the study was underpowered to detect clinically relevant events, the results cannot be considered clinically directive. CLINICAL TRAIL REGISTRATION: http://ClinicalTrials.gov (Identifier: NCT05217888). CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Park, Han-Su AU - Park HS AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Suh, Chong Hyun AU - Suh CH AD - Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Ahn, Jung-Min AU - Ahn JM AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Kang, Do-Yoon AU - Kang DY AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Ahn, Soo-Yeon AU - Ahn SY AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Wee, Sung-Bong AU - Wee SB AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Lee, Seung-Han AU - Lee SH AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Seo, Kyeong-Won AU - Seo KW AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Kim, Min-Ju AU - Kim MJ AD - Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Park, Seung-Jung AU - Park SJ AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Park, Duk-Woo AU - Park DW AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: dwpark@amc.seoul.kr. LA - eng SI - ClinicalTrials.gov/NCT05217888 SI - ClinicalTrials.gov/NCT03284827 SI - ClinicalTrials.gov/NCT05217888 SI - ClinicalTrials.gov/NCT03284827 PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20250814 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve Stenosis/surgery MH - *Embolic Protection Devices MH - *Intracranial Embolism/diagnostic imaging/epidemiology/etiology/prevention & control MH - Magnetic Resonance Imaging/methods MH - *Postoperative Complications/diagnostic imaging/epidemiology/prevention & control MH - Prospective Studies MH - Registries/statistics & numerical data MH - *Transcatheter Aortic Valve Replacement/adverse effects COIS- Disclosures S-J Park has received research grants or speaker's fees from Abott Vascular, Medtronic, Daiichi-Sankyo, ChongKunDang Pharm, Daewoong Pharm, and Edwards. D-W Park has received research grants or speaker's fees from Abott Vascular, Medtronic, Daiichi-Sankyo, 3 grants from ChongKunDang Pharm, grants from Daewoong Pharm. There were no potential competing interests among the other authors. EDAT- 2025/08/16 00:29 MHDA- 2025/10/10 00:30 CRDT- 2025/08/15 19:36 PHST- 2025/04/18 00:00 [received] PHST- 2025/08/08 00:00 [revised] PHST- 2025/08/11 00:00 [accepted] PHST- 2025/10/10 00:30 [medline] PHST- 2025/08/16 00:29 [pubmed] PHST- 2025/08/15 19:36 [entrez] AID - S0002-8703(25)00296-0 [pii] AID - 10.1016/j.ahj.2025.08.006 [doi] PST - ppublish SO - Am Heart J. 2026 Jan;291:44-52. doi: 10.1016/j.ahj.2025.08.006. Epub 2025 Aug 14. PMID- 40807070 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250817 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 15 DP - 2025 Aug 2 TI - A TAVI Programme Without an On-Site Cardiac Surgery Department: A Single-Center Retrospective Study. LID - 10.3390/jcm14155449 [doi] LID - 5449 AB - Background: Aortic stenosis (AS) is the most common valvular heart disease, associated with poor outcomes if left untreated. Current guidelines recommend that transcatheter aortic valve implantation (TAVI) procedures be performed in hospitals with an on-site cardiac surgery unit due to potential complications requiring surgical intervention. Objective: Based on our experience, we evaluated the feasibility and outcomes of implementing a TAVI program in a cardiology department without an on-site cardiac surgery unit, in collaboration with a remote hospital for surgical backup. Methods: The TAVI program involved pre- and post-procedural evaluations conducted at Meir Medical Center (Kfar Saba, Israel) with a remote surgical team available. The study population included 149 consecutive patients with severe aortic stenosis treated at the Meir valve clinic between November 2019 and December 2023. Procedures were performed by the center's interventional cardiology team. Results: The mean age of the 149 patients was 80 +/- 6 years, and 75 (50%) were female. The average STS score was 4.3, and the EuroSCORE II was 3.1. Among the patients, 68 (45%) were classified as New York Heart Association (NYHA) class III-IV. The valve types used included ACURATE neo2 (57 patients, 38%), Edwards SAPIEN 3 (43 patients, 28%), Evolut-PRO (41 patients, 27%), and Navitor (7 patients, 4%). There were no cases of moderate to severe paravalvular leak and no elevated post-implantation gradients, and there was no need for urgent cardiac surgery. One case of valve embolization was successfully managed percutaneously during the procedure. In-hospital follow-up revealed no deaths and only one major vascular complication. At one-year follow-up, six patients had died, with only one death attributed to cardiac causes. Conclusions: Our findings support the safe and effective performance of transfemoral TAVI in cardiology departments without on-site cardiac surgery, in collaboration with a remote surgical team. Further prospective, multicenter studies are warranted to confirm these results and guide broader clinical implementation of this practice. FAU - Barashi, Rami AU - Barashi R AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Gabarin, Mustafa AU - Gabarin M AUID- ORCID: 0000-0003-4081-2727 AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Arow, Ziad AU - Arow Z AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Hilu, Ranin AU - Hilu R AUID- ORCID: 0009-0005-9559-719X AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Losin, Ilya AU - Losin I AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Novikov, Ivan AU - Novikov I AUID- ORCID: 0000-0002-0716-728X AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Abd El Hai, Karam AU - Abd El Hai K AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Arnson, Yoav AU - Arnson Y AUID- ORCID: 0000-0002-0397-1756 AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Neuman, Yoram AU - Neuman Y AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Pesis, Koby AU - Pesis K AD - Herzliya Medical Center, Herzliya 4685107, Israel. FAU - Jebara, Ziyad AU - Jebara Z AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Pereg, David AU - Pereg D AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Koifman, Edward AU - Koifman E AUID- ORCID: 0000-0002-7907-6002 AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Assali, Abid AU - Assali A AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. FAU - Vaknin-Assa, Hana AU - Vaknin-Assa H AUID- ORCID: 0000-0001-6935-9765 AD - Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel. AD - School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel. LA - eng PT - Journal Article DEP - 20250802 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12347660 OTO - NOTNLM OT - aortic stenosis OT - on-site cardiac surgery OT - remote surgical backup OT - transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2025/08/14 06:27 MHDA- 2025/08/14 06:28 PMCR- 2025/08/02 CRDT- 2025/08/14 01:16 PHST- 2025/04/11 00:00 [received] PHST- 2025/05/16 00:00 [revised] PHST- 2025/07/31 00:00 [accepted] PHST- 2025/08/14 06:28 [medline] PHST- 2025/08/14 06:27 [pubmed] PHST- 2025/08/14 01:16 [entrez] PHST- 2025/08/02 00:00 [pmc-release] AID - jcm14155449 [pii] AID - jcm-14-05449 [pii] AID - 10.3390/jcm14155449 [doi] PST - epublish SO - J Clin Med. 2025 Aug 2;14(15):5449. doi: 10.3390/jcm14155449. PMID- 40802215 OWN - NLM STAT- MEDLINE DCOM- 20251203 LR - 20261010 IS - 1573-2614 (Electronic) IS - 1387-1307 (Linking) VI - 39 IP - 6 DP - 2025 Dec TI - Association of renal regional tissue oxygen saturation and post-procedural acute kidney injury following transcatheter aortic valve implantation. PG - 1203-1213 LID - 10.1007/s10877-025-01339-2 [doi] AB - PURPOSE: Acute kidney injury (AKI) is a common complication and a strong risk factor for adverse outcomes after transcatheter aortic valve implantation (TAVI). Renal regional tissue oxygen saturation (rSO(2)) reflects tissue perfusion and can be measured using near-infrared spectroscopy. We hypothesized that decrease in renal rSO(2) during TAVI would predict post-procedural AKI. METHODS: Patients with severe aortic stenosis who scheduled for transfemoral TAVI were enrolled. Patients undergoing emergent procedures, those with severe renal impairment, those with a distance from skin to renal capsule > 4 cm, those on mechanical ventilation, or those who refused to participate were excluded. The primary outcome was the relationship between changes in renal rSO(2) during TAVI and post-procedural AKI. AKI was determined according to the Valve Academic Research Consortium-2 criteria. RESULTS: Sixty-four patients were included and analyzed. The mean (standard deviation [SD]) age of patients was 82 (4) years, and the median [interquartile range] procedure time was 75 [65-90] min. The incidence of post-procedural AKI was 33% (21/64). There was no difference in the mean (SD) time-weighted renal rSO(2) (70% [13%] and 73% [11%]), changes in renal rSO(2) (-14% [10%] and - 15% [13%]), or nadir rSO(2) (55% [17%] and 60% [17%]) during TAVI between patients who developed post-TAVI AKI and those who did not (p = 0.227, 0.157, and 0.333, respectively). In multivariable regression analysis, renal rSO(2) variables were not predictors of post-TAVI AKI. CONCLUSION: Procedural changes in renal rSO(2) measured using near-infrared spectroscopy did not predict the development of post-TAVI AKI. Further studies are needed to investigate more effective strategies to predict and prevent AKI following TAVI. TRIAL REGISTRATION: This study was registered on cinicaltrials.gov (identifier, NCT04921475, registered on June 10, 2021). CI - (c) 2025. The Author(s), under exclusive licence to Springer Nature B.V. FAU - Lee, Hoo Seung AU - Lee HS AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Cho, Youn Joung AU - Cho YJ AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. mingming7@gmail.com. FAU - Yoo, Seungho AU - Yoo S AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Lee, Seohee AU - Lee S AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Ju, Jae-Woo AU - Ju JW AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Nam, Karam AU - Nam K AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Jeon, Yunseok AU - Jeon Y AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. LA - eng SI - ClinicalTrials.gov/NCT04921475 PT - Journal Article PT - Observational Study DEP - 20250813 PL - Netherlands TA - J Clin Monit Comput JT - Journal of clinical monitoring and computing JID - 9806357 RN - S88TT14065 (Oxygen) SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Acute Kidney Injury/etiology MH - Aortic Valve Stenosis/surgery MH - *Kidney/metabolism MH - *Oxygen/metabolism MH - *Oxygen Saturation MH - Postoperative Complications/etiology MH - Risk Factors MH - Spectroscopy, Near-Infrared MH - *Transcatheter Aortic Valve Replacement/adverse effects OTO - NOTNLM OT - Acute kidney injury OT - Aortic stenosis OT - Near-infrared spectroscopy OT - Regional tissue oxygen saturation OT - Transcatheter aortic valve implantation COIS- Declarations. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the by the Institutional Review Board of Seoul National University Hospital (approval #2105-159-1221, approved on June 7, 2021). Consent to participate: Informed consent was obtained from all individual participants included in the study. EDAT- 2025/08/13 12:31 MHDA- 2025/12/04 02:11 CRDT- 2025/08/13 11:35 PHST- 2025/04/20 00:00 [received] PHST- 2025/07/27 00:00 [accepted] PHST- 2025/12/04 02:11 [medline] PHST- 2025/08/13 12:31 [pubmed] PHST- 2025/08/13 11:35 [entrez] AID - 10.1007/s10877-025-01339-2 [pii] AID - 10.1007/s10877-025-01339-2 [doi] PST - ppublish SO - J Clin Monit Comput. 2025 Dec;39(6):1203-1213. doi: 10.1007/s10877-025-01339-2. Epub 2025 Aug 13. PMID- 40786196 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250813 IS - 2668-0572 (Electronic) IS - 2602-0807 (Print) IS - 2602-0807 (Linking) VI - 98 IP - 3 DP - 2025 Jul TI - Early cognitive and quality of life changes after transfemoral transcatheter aortic valve replacement. PG - 311-319 LID - 10.15386/mpr-2885 [doi] AB - BACKGROUND AND AIMS: Cognitive impairment has been associated with the presence of severe aortic stenosis (AS). Our study evaluated the early changes in cognitive function and quality of life in patients with severe AS who underwent transfemoral transcatheter aortic valve replacement (TAVR). METHODS: The cognitive function and quality of life of patients with severe symptomatic AS who underwent transfemoral TAVR were assessed with the Montreal Cognitive Assessment (MoCA) and the EQ-5D-3L questionnaire, respectively. The tests were performed at the time of admission and at 48 to 72 h after TAVR. RESULTS: The study group included 37 patients with a mean age of 78 years. Cognitive improvement was observed in 72.9% of patients. A higher MoCA score at baseline was correlated with a better functional outcome after TAVR (r=0.49, p=0.02). Patients with an early post-procedural increase in MoCA scores had a smaller aortic valve area at baseline as compared to patients without cognitive improvement (0.5+/-0.2 vs. 0.7+/-0.1 sq.cm, p=0.02). The baseline aortic valve area was associated with an increase in MoCA scores at an optimal cutoff value 3 g/dL as a bleeding event. Chronic kidney disease, thoracotomy access, dual antiplatelet therapy (P<0.001 for all), and female sex (P=0.023) were variables associated with VARC-3 bleedings. Type 3 bleeding (VARC-3) was associated with an increased 30-day mortality (hazard ratio [HR], 2.89 [95% CI, 1.35-6.19], P=0.006). VARC-2 major and life-threatening bleeding events were associated with increased 30-day mortality as well (HR, 2.74 [95% CI, 1.26-5.95], P=0.011 and HR, 29.60 [95% CI, 17.42-50.30], P<0.001). CONCLUSIONS: The VARC-3 criteria present a refined classification for bleeding with prognostic relevance. However, the VARC-2 criteria demonstrate precision and clear correlation with increasing mortality risk proportional to the severity of bleeding too, showing even greater predictive accuracy in the transfemoral cohort. These findings require further validation with similar or even larger patient cohorts. FAU - Nienaber, Stephan AU - Nienaber S AUID- ORCID: 0000-0001-5779-7549 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Himken, Janosch AU - Himken J AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Meertens, Max AU - Meertens M AD - Department for Cardiology III-Angiology University Medical Center of the Johannes Gutenberg-University Mainz Mainz Germany. FAU - Mauri, Victor AU - Mauri V AUID- ORCID: 0000-0003-2678-3501 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Lee, Samuel AU - Lee S AUID- ORCID: 0000-0001-6768-7079 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Curio, Jonathan AU - Curio J AUID- ORCID: 0000-0002-3437-7450 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Kuhn, Elmar AU - Kuhn E AUID- ORCID: 0000-0001-6301-7422 AD - Department of Cardiothoracic Surgery, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Nies, Richard AU - Nies R AUID- ORCID: 0000-0002-1336-6031 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Eghbalzadeh, Kaveh AU - Eghbalzadeh K AUID- ORCID: 0000-0001-6941-7785 AD - Department of Cardiothoracic Surgery, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. AD - Department of Cardiac Surgery University Hospital Bonn Bonn Germany. FAU - Dohr, Johannes AU - Dohr J AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Baldus, Stephan AU - Baldus S AUID- ORCID: 0000-0001-8259-1737 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Wienemann, Hendrik AU - Wienemann H AUID- ORCID: 0000-0001-5810-2868 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. FAU - Adam, Matti AU - Adam M AUID- ORCID: 0000-0002-6990-8135 AD - Department of Cardiology, Heart Center Cologne Faculty of Medicine and University Hospital, University of Cologne Cologne Germany. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20250717 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Female MH - Male MH - *Aortic Valve Stenosis/surgery/mortality MH - *Postoperative Hemorrhage/epidemiology/diagnosis/mortality MH - Aged, 80 and over MH - Aged MH - Risk Factors MH - Incidence MH - Risk Assessment MH - Severity of Illness Index PMC - PMC12449918 OTO - NOTNLM OT - VARC-2 OT - VARC-3 OT - bleeding complications after TAVR OT - prognostic relevance of bleeding COIS- J. Curio has received research grant support from Boston Scientific. H. Wienemann has received travel grants from JenaValve. M. Adam has received personal fees from Medtronic and personal fees from JenaValve, Edwards Lifesciences, Meril Life Sciences, and Boston Scientific. S. Baldus received research grants and lecture honoraria from Edwards Lifesciences, Abbott Vascular, Boston Scientific and JenaValve. The other authors have no conflicts of interest to declare. EDAT- 2025/07/17 12:31 MHDA- 2025/08/06 06:28 PMCR- 2025/07/17 CRDT- 2025/07/17 08:24 PHST- 2025/08/06 06:28 [medline] PHST- 2025/07/17 12:31 [pubmed] PHST- 2025/07/17 08:24 [entrez] PHST- 2025/07/17 00:00 [pmc-release] AID - JAH311151 [pii] AID - 10.1161/JAHA.124.039342 [doi] PST - ppublish SO - J Am Heart Assoc. 2025 Aug 5;14(15):e039342. doi: 10.1161/JAHA.124.039342. Epub 2025 Jul 17. PMID- 40666607 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250718 IS - 2352-9067 (Print) IS - 2352-9067 (Electronic) IS - 2352-9067 (Linking) VI - 59 DP - 2025 Aug TI - Can TAVI be performed without on-site cardiac surgery? PG - 101736 LID - 10.1016/j.ijcha.2025.101736 [doi] LID - 101736 AB - INTRODUCTION: Aim of this analysis in to assess the prevalence and post-procedural outcomes of surgical bailout during transcatheter aortic valve implantation (TAVI). METHODS: Patients undergoing TAVI from September 2017 to March 2023 were enrolled from two high volume centers. All the procedures were performed with on-site cardiac surgery, but especially the scrubbed cardiac surgeon. The primary endpoint was in-hospital mortality of TAVI patients after emergent cardiac surgery (ECS). Secondary endpoints were intra-operative and 1-year mortality, and post-procedural complications such as acute kidney injury (AKI), stroke, myocardial infarction (MI), conduction abnormalities, need for inotropic support and intensive care unit (ICU) and in- hospital length of stay. RESULTS: A total of 1347 consecutive patients underwent transfemoral TAVI. Ten patients (0.74 %), representing the study population, reported intra-procedural complications requiring ECS: seven patients received a self-expandable prosthesis; three patients received a balloon expandable prosthesis. Indications for ECS included: type A dissection (n = 2), aortic annulus rupture (n = 1), left(n = 1) and right (n = 2) ventricle perforation, mitral valve apparatus damage (n = 2), prosthesis embolization (n = 2). Four patients required post-operative inotropic support. One case of minor stroke and one case of AKI (grade III) were reported. Three patients developed a post procedural left bundle branch block (LBBB). Median ICU and hospital length-of-stay were 4.5 (2-7.75) days and 14 (8-22) days, respectively. One case of in-hospital mortality was reported. CONCLUSIONS: The on-site cardiac surgery, with the scrubbed heart surgeon, represents a life-saving resource for TAVI centers in case of ECS, and it is essential to achieve low-rate in-hospital mortality. CI - (c) 2025 The Authors. FAU - Lodo, V AU - Lodo V AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy. FAU - Barbero, C AU - Barbero C AD - Cardiac Surgery, Citta della Salute e della Scienza Hospital, Turin, Italy. FAU - Salizzoni, S AU - Salizzoni S AD - University of Turin, Department of Cardiovascular and Thoracic Surgery, Turin, Italy. FAU - Zingarelli, E AU - Zingarelli E AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy. FAU - Torre, M La AU - Torre M AD - Cardiac Surgery, Citta della Salute e della Scienza Hospital, Turin, Italy. FAU - Enrico, Italiano G AU - Enrico IG AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy. FAU - Centofanti, P AU - Centofanti P AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy. FAU - Rinaldi, M AU - Rinaldi M AD - University of Turin, Department of Cardiovascular and Thoracic Surgery, Turin, Italy. LA - eng PT - Journal Article DEP - 20250707 PL - Ireland TA - Int J Cardiol Heart Vasc JT - International journal of cardiology. Heart & vasculature JID - 101649525 PMC - PMC12260410 OTO - NOTNLM OT - Emergent cardiac surgery OT - On-site cardiac surgery OT - TAVI COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/07/16 11:57 MHDA- 2025/07/16 11:58 PMCR- 2025/07/07 CRDT- 2025/07/16 05:31 PHST- 2025/03/25 00:00 [received] PHST- 2025/06/13 00:00 [revised] PHST- 2025/06/26 00:00 [accepted] PHST- 2025/07/16 11:58 [medline] PHST- 2025/07/16 11:57 [pubmed] PHST- 2025/07/16 05:31 [entrez] PHST- 2025/07/07 00:00 [pmc-release] AID - S2352-9067(25)00139-3 [pii] AID - 101736 [pii] AID - 10.1016/j.ijcha.2025.101736 [doi] PST - epublish SO - Int J Cardiol Heart Vasc. 2025 Jul 7;59:101736. doi: 10.1016/j.ijcha.2025.101736. eCollection 2025 Aug. PMID- 40659499 OWN - NLM STAT- MEDLINE DCOM- 20250922 LR - 20260611 IS - 2055-6845 (Electronic) IS - 2055-6837 (Print) VI - 11 IP - 6 DP - 2025 Sep 22 TI - Single vs. dual antiplatelet therapy in patients with severe peripheral arterial disease undergoing transcatheter aortic valve implantation: insights from the Hostile registry. PG - 524-531 LID - 10.1093/ehjcvp/pvaf049 [doi] AB - AIMS: Single antiplatelet therapy (SAPT) has been shown to be a safer alternative to dual antiplatelet therapy (DAPT) in patients without atrial fibrillation (AF) undergoing transcatheter aortic valve implantation (TAVI). However, antithrombotic therapy for TAVI patients with severe peripheral artery disease (PAD) remains an underexplored area. This study aimed to evaluate and compare the outcomes of SAPT and DAPT in this high-risk patient population. METHODS AND RESULTS: The HOSTILE registry was a multicentre, international, observational study including 1707 consecutive patients with hostile femoral access undergoing TAVI in 28 international centres. Among 573 patients without AF treated through transfemoral or non-thoracic alternative approach, 144 received SAPT and 429 DAPT after TAVI. The primary efficacy endpoint was the propensity-adjusted rate of major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, stroke, or transient ischaemic attack. The primary safety endpoint was the propensity-adjusted rate of major bleeding. Outcomes were reported at 30 days and 12 months. Dual antiplatelet therapy was associated with a non-significant reduction in MACE at 30 days [hazard ratio (HR) 0.74, 95% confidence interval (CI) 0.25-2.18; P = 0.59] and at 12 months (HR 0.89, 95% CI 0.35-2.24; P = 0.80) compared with SAPT, but with a significant interaction between antiplatelet strategy and PAD severity (P = 0.01), suggesting a greater benefit of DAPT in patients with a high PAD severity. Dual antiplatelet therapy was associated with reduced all-cause death at 12 months (HR 0.22, 95% CI 0.10-0.47; P < 0.001) but not at 30 days (HR 0.26, 95% CI 0.05-1.22; P = 0.09) compared with SAPT. There was no difference in major bleeding at 30 days (P = 0.13) or 12 months (P = 0.10) between groups. There were no differences between groups in any bleeding at 30 days (P = 0.16) or 12 months (P = 0.17). CONCLUSION: In TAVI patients with severe PAD, DAPT was associated with a trend towards improved outcomes compared with SAPT, particularly in those with higher PAD severity. These findings, including the observed reduction in 1-year mortality with DAPT, warrant further investigation in prospective studies. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of European Society of Cardiology. FAU - Galli, Mattia AU - Galli M AUID- ORCID: 0000-0003-3909-182X AD - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina 04100, Italy. AD - Maria Cecilia Hospital, GVM Care and Research, Cotignola 48033, Italy. FAU - Nerla, Roberto AU - Nerla R AUID- ORCID: 0000-0002-9065-3261 AD - Maria Cecilia Hospital, GVM Care and Research, Cotignola 48033, Italy. FAU - Castriota, Fausto AU - Castriota F AD - Maria Cecilia Hospital, GVM Care and Research, Cotignola 48033, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna. AD - Cardiac Thoracic and Vascular Department, Universita di Bologna. FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - Leiter interventionelle Herzklappentherapie Kerckhoff-Klinik GmbH Herz und Thorax Zentrum, Bad Nauheim, Germany. FAU - Iadanza, Alessandro AU - Iadanza A AD - UOSA Cardiologia Interventistica Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Burzotta, Francesco AU - Burzotta F AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. AD - Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Netherlands. FAU - Pilgrim, Thomas AU - Pilgrim T AUID- ORCID: 0000-0001-8721-4068 AD - Inselspital, Bern University Hospital, University of Bern, Switzerland. FAU - Musumeci, Giuseppe AU - Musumeci G AD - A.O. Mauriziano Umberto I Hospital, Turin, Italy. FAU - Meertens, Max M AU - Meertens MM AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und Internistische Intensivmedizin, Cologne, Germany. FAU - Joner, Michael AU - Joner M AUID- ORCID: 0000-0001-6836-2559 AD - German Heart Centre Munich/Deutsches Herzzentrzum Munchen-Munich, Germany. FAU - Meucci, Francesco AU - Meucci F AUID- ORCID: 0000-0003-2719-5146 AD - Department of Clinical and Experimental Medicine, Structural Interventional Cardiology, University Hospital Careggi, Florence, Italy. FAU - Toggweiler, Stefan AU - Toggweiler S AUID- ORCID: 0000-0002-7860-0298 AD - Heart Center Lucerne, Cardiology, Luzerner, Switzerland. FAU - Testa, Luca AU - Testa L AUID- ORCID: 0000-0003-4687-3686 AD - Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, San Donato Milanese, Italy. FAU - Berti, Sergio AU - Berti S AD - Unit of Diagnostic and Interventional Cardiology, C.N.R. Reg. Toscana G. Monasterio Foundation, Ospedale del Cuore, Massa, Italy. FAU - Montorfano, Matteo AU - Montorfano M AUID- ORCID: 0000-0001-9732-9459 AD - School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. AD - Interventional Cardiology Unit-IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Braun, Daniel AU - Braun D AUID- ORCID: 0000-0002-6355-3222 AD - Department of Medicine I, University Hospital Munich, Medical Faculty-LMU, Munich, Germany. FAU - De Carlo, Marco AU - De Carlo M AUID- ORCID: 0000-0002-5763-9804 AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Barbanti, Marco AU - Barbanti M AUID- ORCID: 0000-0002-4903-5437 AD - Universita Degli Studi di Enna 'Kore,' Enna, Italy. AD - Division of Cardiology, Ospedale Umberto I, ASP 4 di Enna, Enna, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milan, Italy. AD - IRCSS Humanitas Research Hospital, Rozzano - Milan, Italy. FAU - Nickenig, Georg AU - Nickenig G AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn-Universitatsklinikum Bonn, Bonn, Germany. FAU - Piva, Tommaso AU - Piva T AD - Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi, Torette, Ancona, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Porto, Italo AU - Porto I AUID- ORCID: 0000-0002-9854-5046 AD - Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy. AD - Department of Internal Medicine, University of Genoa, Genova. FAU - Kornowski, Ran AU - Kornowski R AD - Rabin Medical Center, Petah Tikva, Israel. FAU - Bartorelli, Antonio L AU - Bartorelli AL AD - IRCCS Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna. AD - Cardiac Thoracic and Vascular Department, Universita di Bologna. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study PL - England TA - Eur Heart J Cardiovasc Pharmacother JT - European heart journal. Cardiovascular pharmacotherapy JID - 101669491 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Registries MH - Male MH - Female MH - *Platelet Aggregation Inhibitors/adverse effects/administration & dosage MH - Treatment Outcome MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/complications MH - Aged MH - *Peripheral Arterial Disease/mortality/drug therapy/diagnosis/complications MH - *Dual Anti-Platelet Therapy/adverse effects/mortality MH - Severity of Illness Index MH - Time Factors MH - Hemorrhage/chemically induced MH - Risk Factors MH - Risk Assessment PMC - PMC12450595 OTO - NOTNLM OT - Dual antiplatelet therapy OT - Peripheral artery disease OT - Single antiplatelet therapy OT - Transcatheter aortic valve implantation COIS- Conflict of interest: M.G. declares that he has received consulting fees from Werfen and Genomadix; He is the PI of the following active grant: Sapienza University of Rome (Grant protocol n. 3 RG1241910F5A1A50). A.L. received consultant and or advisory board for Medtronic, Abbott, Edwards, Boston Scientific, Philipps, and Anteris. I.P. reports consultant or speaker fees (minor) from Medtronic, Siemens, GE, ABIOMED, Philips, Sanofi, Amgen, Daiichi-Sankyo, Astra Zeneca, Bayer, and PIAM, not related to this work. F.B. discloses to have received speaker's fees from Abbott, Abiomed, Edwards, Medtronic, Terumo. R.N. has received honoraria from Medtronic. F.C. has received honoraria from Medtronic, Abbott, Terumo, and Boston Scientific. S.T. has received honoraria from Medtronic, Boston Scientific, Biosensors, Edwards Lifesciences, Hi-D Imaging, Abbott Vascular, Medira, Shockwave, Teleflex, atHeart Medical, Cardiac Dimensions, Polares Medical, Amarin, Sanofi, AstraZeneca, ReCor Medical, Daiichi Sankyo, Bayer, and Armira, has received institutional research grants from Edwards Lifesciences, Abbott Vascular, Boston Scientific, Fumedica, Novartis, Boehringer Ingelheim, and Polares Medical, holds equity in Hi-D Imaging, and serves as a steering committee group member for Boston Scientific. D.B. has received institutional research grants and consulting fees from Abbott, Boston Scientific, and Medtronic. M.D.C. has received speaker fees from Medtronic and Meril and advisory board fees from Sanofi. M.B. has worked as consultant for Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott. The remaining authors have nothing to declare. EDAT- 2025/07/15 00:30 MHDA- 2025/09/22 06:31 PMCR- 2025/07/15 CRDT- 2025/07/14 21:22 PHST- 2025/04/14 00:00 [received] PHST- 2025/05/22 00:00 [revised] PHST- 2025/06/13 00:00 [accepted] PHST- 2025/09/22 06:31 [medline] PHST- 2025/07/15 00:30 [pubmed] PHST- 2025/07/14 21:22 [entrez] PHST- 2025/07/15 00:00 [pmc-release] AID - 8200995 [pii] AID - pvaf049 [pii] AID - 10.1093/ehjcvp/pvaf049 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Pharmacother. 2025 Sep 22;11(6):524-531. doi: 10.1093/ehjcvp/pvaf049. PMID- 40640212 OWN - NLM STAT- MEDLINE DCOM- 20250710 LR - 20250713 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 15 IP - 1 DP - 2025 Jul 10 TI - In-hospital outcomes of non-elective transapical transcatheter versus surgical aortic valve replacement. PG - 24972 LID - 10.1038/s41598-025-07859-w [doi] LID - 24972 AB - When transfemoral (TF) access is not available during transcatheter aortic valve replacement (TAVR), transapical (TA)-TAVR can be performed. However, TA-TAVR is associated with significantly higher risk, and it is unclear whether it provides more benefit than surgical aortic valve replacement (SAVR) in non-elective cases. This study aimed to compare the in-hospital outcomes of non-elective TA-TAVR and SAVR by conducting a population-based analysis using a national registry. Patients who underwent non-elective TA-TAVR and SAVR were selected from National Inpatient Sample from Q4 2015 to 2021. Exclusion criteria included age < 18 years and concomitant procedures. Demographics, socioeconomic status, comorbidities, relevant diagnosis, transfer-in status, and hospital characteristics were matched between patients who underwent TA-TAVR and SAVR using a 1:3 propensity-score matching. In-hospital outcomes were compared. There were 130 and 10,487 patients who underwent TA-TAVR and SAVR, respectively. After the propensity-score matching, all TA-TAVR patients were matched to 341 SAVR patients. TA-TAVR and SAVR patients had comparable in-hospital mortality (7.69% vs. 7.33%, p = 0.85), myocardial infarction (3.85% vs. 4.4%, p = 1.00), stroke (0.77% vs. 1.76%, p = 0.69), respiratory complications (15.38% vs. 17.6%, p = 0.68), cardiogenic shock (14.62% vs. 12.61%, p = 0.55), and pacemaker implantation (10% vs. 7.33%, p = 0.35). However, TA-TAVR patients had lower hemorrhage/hematoma (38.46% vs. 68.33%, p < 0.01), lower transfer out rate (33.08% vs. 44.87%, p = 0.02), and shorter length of stay (p = 0.04). All other in-hospital outcomes were comparable. Among eligible TAVR candidates in non-elective cases and when TF access is not available, both TA-TAVR and SAVR may be equally alternative approaches considering their comparable in-hospital outcomes. Further studies should compare the long-term outcomes between TA-TAVR and SAVR. CI - (c) 2025. The Author(s). FAU - Li, Renxi AU - Li R AUID- ORCID: 0000-0003-1691-6278 AD - The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA. renxili@gwu.edu. FAU - Prastein, Deyanira J AU - Prastein DJ AD - Department of Surgery, The George Washington University Hospital, Washington, D.C, USA. FAU - Boyce, Steven W AU - Boyce SW AD - Department of Surgery, The George Washington University Hospital, Washington, D.C, USA. FAU - Choi, Brian G AU - Choi BG AD - The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA. LA - eng PT - Comparative Study PT - Journal Article DEP - 20250710 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Humans MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects/mortality MH - Aged MH - Aged, 80 and over MH - Hospital Mortality MH - *Aortic Valve Stenosis/surgery/mortality MH - Treatment Outcome MH - *Heart Valve Prosthesis Implantation/methods/adverse effects MH - *Aortic Valve/surgery MH - Postoperative Complications/epidemiology MH - Propensity Score MH - Registries PMC - PMC12246065 OTO - NOTNLM OT - Aortic stenosis OT - Surgical aortic valve replacement OT - Transapical OT - Transcatheter aortic valve replacement OT - Transfemoral COIS- Declarations. Competing interests: The authors declare no competing interests. Ethics approval: This study was exempt from the IRB approval by The George Washington University as it analyzed retrospective, deidentified NIS data. EDAT- 2025/07/11 00:26 MHDA- 2025/07/11 00:27 PMCR- 2025/07/10 CRDT- 2025/07/10 23:18 PHST- 2025/03/01 00:00 [received] PHST- 2025/06/17 00:00 [accepted] PHST- 2025/07/11 00:27 [medline] PHST- 2025/07/11 00:26 [pubmed] PHST- 2025/07/10 23:18 [entrez] PHST- 2025/07/10 00:00 [pmc-release] AID - 10.1038/s41598-025-07859-w [pii] AID - 7859 [pii] AID - 10.1038/s41598-025-07859-w [doi] PST - epublish SO - Sci Rep. 2025 Jul 10;15(1):24972. doi: 10.1038/s41598-025-07859-w. PMID- 40622621 OWN - NLM STAT- MEDLINE DCOM- 20251021 LR - 20251124 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 114 IP - 11 DP - 2025 Nov TI - Patient risk evaluation for transcatheter aortic valve replacement (PRE-TAVR) - identification of real-time predictors of short- and long-term mortality. PG - 1574-1584 LID - 10.1007/s00392-025-02704-6 [doi] AB - BACKGROUND: The steadily increasing number of transcatheter aortic valve replacement (TAVR) procedures being performed on a heterogeneous patient population highlights the need for robust risk assessment. While EuroSCORE II is well established for surgical risks, it is less effective for TAVR, and the newer STS/ACC TAVR score has so far been validated mainly for in-hospital and 30-day mortality. AIMS: This study aims to improve risk stratification for TAVR patients by identifying real-time predictors of 30-day and 1-year mortality that incorporate comprehensive, procedure-specific factors. METHODS: Five-year data from 2256 transfemoral TAVR procedures performed at two German Heart Centers (2017-2022) were retrospectively analyzed. Predictors of 1-year and 30-day mortality were assessed using multivariable logistic and LASSO regression, considering a broad spectrum of patient demographics, comorbidities, and peri-procedural factors. RESULTS: The analyses revealed a predictor model (PRE-TAVR predictors) for 1-year mortality (AUC 0.770; 95% CI 0.731-0.809), including age (> 81.5 years), NYHA stage IV, COPD (GOLD >/= 2), atrial fibrillation, previous stroke or malignancy, elevated C-reactive protein (>/= 9.5 mg/L), aortic valve DeltaP mean >/= 48.5 mmHg, peripheral arterial disease (> stage 2) and low platelet count (/= 3) and pre-TAVR sodium levels as further significant predictors. The AUC was 0.699 (95% CI 0.611-0.788) compared to an AUC of 0.680 (95% CI 0.604-0.756) for EuroSCORE II and 0.7129 (95% CI 0.633-0.793) for the STS/ACC TAVR score. CONCLUSION: The PRE-TAVR study developed a robust model, particularly for predicting 1-year mortality. This model outperformed the EuroSCORE II and STS/ACC TAVR scores, despite requiring fewer variables. It provides a solid basis for future risk scores and enables more precise patient selection. CI - (c) 2025. The Author(s). FAU - Kreutz, Julian AU - Kreutz J AUID- ORCID: 0000-0001-9498-9558 AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. kreutzj@staff.uni-marburg.de. FAU - Lauten, Philipp AU - Lauten P AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. AD - Department of Cardiology, Central Hospital of Bad Berka, Robert-Koch Allee 9, 99438, Bad Berka, Germany. FAU - Chatzis, Georgios AU - Chatzis G AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. FAU - Nabrotzki, Marie AU - Nabrotzki M AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. FAU - Patsalis, Nikolaos AU - Patsalis N AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. FAU - Syntila, Styliani AU - Syntila S AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. FAU - Lapp, Harald AU - Lapp H AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. AD - Department of Cardiology, Central Hospital of Bad Berka, Robert-Koch Allee 9, 99438, Bad Berka, Germany. FAU - Schieffer, Bernhard AU - Schieffer B AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. FAU - Markus, Birgit AU - Markus B AD - Department of Cardiology, Angiology, and Intensive Care Medicine, Philipps-Universitat Marburg, Baldingerstrasse, 35043, Marburg, Germany. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250707 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/mortality/adverse effects MH - Male MH - Female MH - Risk Assessment/methods MH - Retrospective Studies MH - *Aortic Valve Stenosis/surgery/mortality MH - Aged, 80 and over MH - Germany/epidemiology MH - Risk Factors MH - Aged MH - Time Factors MH - Survival Rate/trends MH - Follow-Up Studies PMC - PMC12540637 OTO - NOTNLM OT - 1-year mortality OT - 30-day mortality OT - LASSO regression analysis OT - Predictors of mortality OT - Transcatheter aortic valve replacement (TAVR) COIS- Declarations. Competing interests: JK, GC, BS, and BM receive speakers' honoraria from Abiomed; JK and BM received speakers' honoraria from Astra Zeneca, BS received speakers' honoraria from Bayer and GSK; BM received research funding from Abiomed; PL receive speakers' honoraria from Medtronic, Edwards, and Boston plus Shockwave Medical. No other authors reported disclosures. EDAT- 2025/07/07 12:28 MHDA- 2025/10/21 12:35 PMCR- 2025/07/07 CRDT- 2025/07/07 11:16 PHST- 2025/04/08 00:00 [received] PHST- 2025/06/10 00:00 [accepted] PHST- 2025/10/21 12:35 [medline] PHST- 2025/07/07 12:28 [pubmed] PHST- 2025/07/07 11:16 [entrez] PHST- 2025/07/07 00:00 [pmc-release] AID - 10.1007/s00392-025-02704-6 [pii] AID - 2704 [pii] AID - 10.1007/s00392-025-02704-6 [doi] PST - ppublish SO - Clin Res Cardiol. 2025 Nov;114(11):1574-1584. doi: 10.1007/s00392-025-02704-6. Epub 2025 Jul 7. PMID- 40602604 OWN - NLM STAT- MEDLINE DCOM- 20250923 LR - 20250924 IS - 2405-4577 (Electronic) IS - 2405-4577 (Linking) VI - 69 DP - 2025 Oct TI - Association between nutritional intake and 1-year all-cause mortality in patients with aortic stenosis undergoing transcatheter aortic valve implantation. PG - 45-53 LID - S2405-4577(25)00394-8 [pii] LID - 10.1016/j.clnesp.2025.06.047 [doi] AB - BACKGROUND & AIMS: The relationship between energy intake and the long-term prognosis of patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis is poorly understood. We aimed to investigate the impact of energy intake before hospital discharge on the long-term prognosis of patients undergoing TAVI. METHODS: This single-centre retrospective observational study included patients who underwent TAVI for aortic stenosis. Patients on haemodialysis, on protein-restricted diets, with no oral intake before discharge, and those who experienced in-hospital death were excluded. Energy intake during the 3 days prior to discharge was assessed by a nutritionist based on a visual assessment by a nurse. Patients were classified into two groups with a cutoff value of 25 kcal/kg/day energy intake. Propensity score matching was performed to adjust for age, sex, and body mass index between the two groups. The primary endpoint was all-cause mortality within 1 year. RESULTS: Out of 312 consecutive patients, the study population included 132 patients (median age, 85 years; 68 % women) following propensity score matching. The all-cause mortality within 1 year was 10 % (13 of 132 patients). No significant differences in baseline patient characteristics were noted between patients with energy intake >/=25 and <25 kcal/kg/day, except for diabetes. Compared to patients with energy intake >/=25 kcal/kg/day, those with energy intake <25 kcal/kg/day had a significantly higher 1-year mortality rate (16.7 % vs. 3.0 %, log-rank test p < 0.01). In multivariate analysis using a Cox proportional hazards model adjusted for age, diabetes mellitus, serum creatinine, and transfemoral approach, energy intake <25 kcal/kg/day was independently associated with 1-year mortality (hazard ratio, 7.11; 95 % confidence interval 1.53-33.03, p = 0.01). CONCLUSION: Low energy intake during the predischarge phase is associated with long-term prognosis in patients undergoing TAVI. Nutritional support for patients with a low energy intake and careful follow-up after discharge should be considered. CI - Copyright (c) 2025 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. FAU - Miyata, Hiroyo AU - Miyata H AD - Department of Clinical Nutrition, Kindai University Hospital, Osakasayama, Japan. FAU - Matsumura, Koichiro AU - Matsumura K AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. Electronic address: kmatsumura1980@yahoo.co.jp. FAU - Hamamura, Kazue AU - Hamamura K AD - Department of Rehabilitation, Kindai University Hospital, Osakasayama, Japan. FAU - Yasuda, Masakazu AU - Yasuda M AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan; Department of Cardiology, Sakurabashi Watanabe Mirai Medical Hospital, Osaka, Japan. FAU - Hakozaki, Shohei AU - Hakozaki S AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. FAU - Onishi, Kyohei AU - Onishi K AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. FAU - Yagi, Eijiro AU - Yagi E AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. FAU - Fujita, Kosuke AU - Fujita K AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. FAU - Kajihara, Katsumi AU - Kajihara K AD - Department of Clinical Nutrition, Kindai University Hospital, Osakasayama, Japan. FAU - Amagai, Teruyoshi AU - Amagai T AD - Faculty of Health Care Sciences, Department of Clinical Engineering, Jikei University of Health Care Sciences, Osaka, Japan. FAU - Ueno, Masafumi AU - Ueno M AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. FAU - Nakazawa, Gaku AU - Nakazawa G AD - Department of Cardiology, Kindai University Faculty of Medicine, Osakasayama, Japan. LA - eng PT - Journal Article PT - Observational Study DEP - 20250630 PL - England TA - Clin Nutr ESPEN JT - Clinical nutrition ESPEN JID - 101654592 SB - IM MH - Humans MH - Male MH - Female MH - Aged, 80 and over MH - *Aortic Valve Stenosis/mortality/surgery MH - *Transcatheter Aortic Valve Replacement/mortality MH - Retrospective Studies MH - *Energy Intake MH - Aged MH - Nutritional Status MH - Propensity Score MH - Risk Factors MH - Body Mass Index MH - Prognosis OTO - NOTNLM OT - Aortic stenosis OT - Energy intake OT - Malnutrition OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest The authors declare no conflicts of interest. EDAT- 2025/07/03 00:27 MHDA- 2025/09/23 06:36 CRDT- 2025/07/02 19:14 PHST- 2025/03/25 00:00 [received] PHST- 2025/06/25 00:00 [revised] PHST- 2025/06/27 00:00 [accepted] PHST- 2025/09/23 06:36 [medline] PHST- 2025/07/03 00:27 [pubmed] PHST- 2025/07/02 19:14 [entrez] AID - S2405-4577(25)00394-8 [pii] AID - 10.1016/j.clnesp.2025.06.047 [doi] PST - ppublish SO - Clin Nutr ESPEN. 2025 Oct;69:45-53. doi: 10.1016/j.clnesp.2025.06.047. Epub 2025 Jun 30. PMID- 40598776 OWN - NLM STAT- MEDLINE DCOM- 20250905 LR - 20260818 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 106 IP - 3 DP - 2025 Sep TI - Balloon Aortic Valvuloplasty Prior to Self-Expanding TAVI: The BAVSE-TAVI Registry. PG - 1674-1681 LID - 10.1002/ccd.31731 [doi] AB - BACKGROUND: Direct transcatheter aortic valve implantation (TAVI) approach is feasible and safe compared to predilatation-TAVI. Certain clinical and computerized tomography (CT)-based characteristics might indicate the need for balloon aortic valvuloplasty (BAV) before TAVI, especially with self-expanding valves. AIMS: We aimed to identify patients who require predilatation before TAVI. METHODS AND RESULTS: We performed a retrospective, single-center study between 2020 and 2024, enrolling 315 patients (predilatation = 158 vs. direct = 157) aged 81 +/- 6 years, 43.5% male, with EuroSCORE II of 3.7 +/- 2.9. The rate of predilatation increased over the study period and was performed more often in patients with higher velocity and pressure gradients on echocardiography, higher aortic valve calcium score on CT, bicuspid morphology, bigger aortic annulus anatomy, severe aortic cusp calcification, tortuous descending aorta (bend > 60 degrees ), and horizontal ascending aorta (angle > 50 degrees ). Direct implantation was performed more frequently in patients with permanent pacemaker, ischemic heart disease, concomitant significant aortic regurgitation, or alternative-access TAVI. Regression analysis demonstrated that only the horizontal aorta was an independent predictor of predilatation (p = 0.037). The rates of valve recapture, embolization, contrast use, procedure duration, hospital stay, inpatient death, stroke, significant paravalvular leak on postprocedural echocardiography, and new pacemaker implantation were not different between the groups. The rate of BARC >/= 3 bleeding, mainly due to access-site complications, was more frequent with direct-TAVI compared to predilatation (6.4% vs. 0.6%; p = 0.005). CONCLUSIONS: Both predilatation and direct-TAVI approaches can be safely performed in routine practice. Upfront selection of either approach based on the patient characteristics, echocardiography gradients, and CT anatomical features is recommended. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Ibrahem, Abdalazeem AU - Ibrahem A AUID- ORCID: 0000-0003-2688-6295 AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. AD - Centre for Health Services Research, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK. FAU - Abdalwahab, Ahmed AU - Abdalwahab A AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. AD - Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt. FAU - Gorog, Diana A AU - Gorog DA AD - Centre for Health Services Research, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK. AD - National Heart and Lung Institute, Imperial College, London, UK. FAU - Stewart, Debbie AU - Stewart D AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Das, Rajiv AU - Das R AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Edwards, Richard AU - Edwards R AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Egred, Mohaned AU - Egred M AUID- ORCID: 0000-0003-3642-318X AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Zaman, Azfar AU - Zaman A AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Alkhalil, Mohammad AU - Alkhalil M AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. FAU - Farag, Mohamed AU - Farag M AUID- ORCID: 0000-0003-0811-7679 AD - Cardiothoracic Department, Freeman Hospital, Newcastle Upon Tyne, UK. AD - Centre for Health Services Research, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK. LA - eng PT - Journal Article DEP - 20250701 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Balloon Valvuloplasty/adverse effects/mortality MH - Male MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation MH - Female MH - *Aortic Valve Stenosis/diagnostic imaging/physiopathology/surgery/mortality/therapy MH - Aged, 80 and over MH - Treatment Outcome MH - Registries MH - Aged MH - *Aortic Valve/diagnostic imaging/physiopathology/surgery MH - *Heart Valve Prosthesis MH - Risk Factors MH - Time Factors MH - Prosthesis Design MH - Risk Assessment MH - Hemodynamics MH - Recovery of Function PMC - PMC12412352 OTO - NOTNLM OT - TAVI OT - balloon aortic valvuloplasty OT - outcome OT - predilatation OT - transcatheter heart valve COIS- The authors declare no conflicts of interest. EDAT- 2025/07/02 06:27 MHDA- 2025/09/05 12:40 PMCR- 2025/09/05 CRDT- 2025/07/02 04:56 PHST- 2025/05/26 00:00 [revised] PHST- 2024/11/10 00:00 [received] PHST- 2025/06/24 00:00 [accepted] PHST- 2025/09/05 12:40 [medline] PHST- 2025/07/02 06:27 [pubmed] PHST- 2025/07/02 04:56 [entrez] PHST- 2025/09/05 00:00 [pmc-release] AID - CCD31731 [pii] AID - 10.1002/ccd.31731 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Sep;106(3):1674-1681. doi: 10.1002/ccd.31731. Epub 2025 Jul 1. PMID- 40597136 OWN - NLM STAT- MEDLINE DCOM- 20250702 LR - 20250704 IS - 1472-6963 (Electronic) IS - 1472-6963 (Linking) VI - 25 IP - 1 DP - 2025 Jul 1 TI - Economic impact of TAVI pathway optimisation: the experience of the University Hospital of Parma. PG - 835 LID - 10.1186/s12913-025-13021-z [doi] LID - 835 AB - BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) has emerged as a standard of care for patients suffering from symptomatic severe aortic stenosis. However, organisational analyses and investigations of this intervention's economic impact are lacking. This study aims to assess the potential impact of implementing a process designed to optimise the TAVI pathway regarding organisational, human, material, and economic resources. METHODS: The research is conducted through a case study. The methodology consisted of three stages: (1) mapping of the current TAVI pathway; (2) identification of the organisational changes necessary to optimise it and implementation of the identified action with a multidisciplinary teamwork; (3) simulations of the organisational and economic impact of the optimisation process. Data related to costs, revenues, and activities were provided by the hospital's Management Control office. The data analysed refer to a 12-month period. The TAVI pathway optimisation presented in this analysis is aligned with the best practices described in the BENCHMARK study. RESULTS: The analysis of the current TAVI pathway in the studied hospital highlighted several critical points during the three phases of the course (pre-procedure, peri-procedure, and post-procedure). The working groups identified five areas for TAVI pathway improvement: patient and family education, coronary risk stratification, conduction disorders management, fast-track discharge eligibility, nurse-led rapid mobilisation and early discharge. The organisational solutions highlighted by the working groups outline a new TAVI pathway capable of generating a significant impact not only from an organisational point of view, but also from an economic point of view. We estimated that in our cohort TAVI optimisation would have saved approximately 112 ICCU bed-days and have led to an average cost reduction of about euro3,900 per patient. CONCLUSIONS: This study showed a process of optimisation of the TAVI pathway highlighting the positive impacts for patients, caregivers, healthcare workers, and the hospital. A Clinical Valve Coordinator may help to manage the procedural programme for individual patients while maintaining seamless communication with the Heart Team throughout the patient care journey, making the process even more streamlined. The case study analysed can be useful to all hospitals wishing to undertake processes aimed at improving the TAVI pathway. CI - (c) 2025. The Author(s). FAU - Fanelli, Simone AU - Fanelli S AD - Department of Economics and Management, University of Parma, Parma, 43125, Italy. simone.fanelli@unipr.it. FAU - Lanza, Gianluca AU - Lanza G AD - Department of Economics and Management, University of Parma, Parma, 43125, Italy. FAU - Pratici, Lorenzo AU - Pratici L AD - Department of Economics and Management, University of Parma, Parma, 43125, Italy. FAU - Benatti, Giorgio AU - Benatti G AD - Division of Cardiology, Parma University Hospital, Parma, 43126, Italy. FAU - Vignali, Luigi AU - Vignali L AD - Division of Cardiology, Parma University Hospital, Parma, 43126, Italy. LA - eng PT - Journal Article DEP - 20250701 PL - England TA - BMC Health Serv Res JT - BMC health services research JID - 101088677 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/economics MH - *Hospitals, University/economics/organization & administration MH - *Aortic Valve Stenosis/surgery/economics MH - *Critical Pathways/economics MH - Italy MH - Organizational Case Studies PMC - PMC12211903 OTO - NOTNLM OT - Capacity enhancing innovation OT - Clinical valve coordinator OT - Economic impact OT - Healthcare management OT - Management control OT - Organisational process OT - Transfemoral TAVI COIS- Declarations. Ethics approval and consent to participate: The AVEN Territorial Ethics Committee, with prot. n. 43459 of 10/31/202, approved this study. The General Director of the Parma Hospital, with resolution DELI0000896_2023, authorised this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2025/07/02 06:27 MHDA- 2025/07/02 06:28 PMCR- 2025/07/01 CRDT- 2025/07/02 03:54 PHST- 2024/07/15 00:00 [received] PHST- 2025/06/06 00:00 [accepted] PHST- 2025/07/02 06:28 [medline] PHST- 2025/07/02 06:27 [pubmed] PHST- 2025/07/02 03:54 [entrez] PHST- 2025/07/01 00:00 [pmc-release] AID - 10.1186/s12913-025-13021-z [pii] AID - 13021 [pii] AID - 10.1186/s12913-025-13021-z [doi] PST - epublish SO - BMC Health Serv Res. 2025 Jul 1;25(1):835. doi: 10.1186/s12913-025-13021-z. PMID- 40589215 OWN - NLM STAT- MEDLINE DCOM- 20250905 LR - 20260818 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 3 DP - 2025 Sep TI - Comparative Study of Single- Versus Double-ProGlide Device Strategy for Access Site Closure of Transfemoral Transcatheter Aortic Valve Replacement. PG - 1639-1649 LID - 10.1002/ccd.31725 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a first-line treatment for severe symptomatic aortic stenosis (AS) patients, and the preferred approach for TAVR is transfemoral. The double-ProGlide preclose technique offers an effective and safe method for closure of transfemoral access site after TAVR. However, the debate is still ongoing whether a single-ProGlide strategy is equal or even superior to a double one in terms of hemostasis and vascular complications. AIMS: The aim of this study is to examine the safety and efficacy of a single- versus double-ProGlide strategy for vascular closure during transfemoral TAVR. METHODS: Patients with severe AS who underwent transfemoral TAVR in the second affiliated hospital Zhejiang university school of medicine in the period from June 2021 to December 2023 were included and divided by the number of ProGlide device. The primary outcome of this study was a composite of in-hospital main access route related vascular complications, main access route related bleeding, and vascular closure device failure in accordance with Valve Academic Research Consortium-3 (VARC-3) criteria. The propensity-score matched (PSM) analysis was used to account for differences in baseline characteristics, and binary logistic regression was used to determine the predictive factors for the primary outcome. RESULTS: A total of 347 patients were included, of which 154 (44.0%) had a single ProGlide device used for arteriotomy closure, and 193 (56.0%) had a double one. After PSM, the incidence of primary composite outcome was significantly lower in the single-ProGlide group (7.7% vs. 17.9%, p = 0.023), while the incidence of in-hospital vascular complications (6.0% vs. 11.1%, p = 0.210) and bleeding (1.7% vs. 6.8%, p = 0.109) related to the main access route was lower but not significant. Multivariate logistic regression showed that single-ProGlide (for double-ProGlide, OR = 0.408, 95% CI = 0.182-0.914, p = 0.029) and an increase in the minimal lumen diameter of main access route (per 1.0 mm, OR = 0.618, 95% CI = 0.416-0.919, p = 0.017) were protective factors for the primary outcome. CONCLUSIONS: A single-ProGlide device is a safe and effective mean of vascular closure after transfemoral TAVR and may have important clinical benefits compared to the commonly used double-ProGlide technique. CI - (c) 2025 Wiley Periodicals LLC. FAU - Li, Ranxi AU - Li R AUID- ORCID: 0009-0008-4355-0586 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Wang, Lihan AU - Wang L AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Liu, Qiong AU - Liu Q AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Hu, Haochang AU - Hu H AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Zhu, Qifeng AU - Zhu Q AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Hu, Po AU - Hu P AUID- ORCID: 0000-0003-1647-2072 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Jiang, Jubo AU - Jiang J AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Ren, Kaida AU - Ren K AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - He, Yuxin AU - He Y AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Guo, Yuchao AU - Guo Y AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Fan, Jiaqi AU - Fan J AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Liu, Xianbao AU - Liu X AUID- ORCID: 0000-0003-1556-9198 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. FAU - Wang, Jian'an AU - Wang J AUID- ORCID: 0000-0002-4583-3204 AD - Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China. AD - Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China. AD - Transvascular Implantation Devices Research Institute, Hangzhou, China. LA - eng GR - The grants from The Key R & D projects of Zhejiang Province (2024C03024 for JW)./ PT - Comparative Study PT - Journal Article DEP - 20250630 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Femoral Artery/diagnostic imaging MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Female MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Aged, 80 and over MH - *Catheterization, Peripheral/adverse effects MH - *Hemostatic Techniques/adverse effects/instrumentation MH - *Vascular Closure Devices MH - Punctures MH - Aged MH - Risk Factors MH - *Hemorrhage/prevention & control/etiology MH - Time Factors MH - Retrospective Studies MH - Risk Assessment MH - China MH - Equipment Design OTO - NOTNLM OT - bleeding complications OT - transcatheter aortic valve replacement OT - vascular closure OT - vascular complications EDAT- 2025/07/01 09:30 MHDA- 2025/09/05 12:41 CRDT- 2025/07/01 03:03 PHST- 2025/06/11 00:00 [revised] PHST- 2025/04/10 00:00 [received] PHST- 2025/06/20 00:00 [accepted] PHST- 2025/09/05 12:41 [medline] PHST- 2025/07/01 09:30 [pubmed] PHST- 2025/07/01 03:03 [entrez] AID - 10.1002/ccd.31725 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Sep;106(3):1639-1649. doi: 10.1002/ccd.31725. Epub 2025 Jun 30. PMID- 40586008 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250702 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 7 IP - 6 DP - 2025 Jun TI - Review of Transcatheter Aortic Valve Insertion (TAVI) Clinician Opinions on the Canadian Cardiovascular Society Post-TAVI Driving Guidelines. PG - 843-850 LID - 10.1016/j.cjco.2025.04.004 [doi] AB - BACKGROUND: As compared to surgical aortic valve replacement, transcatheter aortic valve insertion (TAVI) has a lower perioperative risk and an abbreviated recovery. In the absence of robust clinical data to guide decision-making, the Canadian Cardiovascular Society has now recommended the same 1-month driving restriction for both procedures. METHODS: In April 2024, a 15-question survey was circulated to all 31 Canadian TAVI centres to explore opinions on the current driving recommendations and the safety of driving post TAVI, with the goal of informing updated expert-informed guidelines. RESULTS: Of 31 TAVI centres, 29 individuals from 25 centres (80.6%) provided responses. The majority (79.3%) expressed that a 1-month driving prohibition was "too long," and 20.7% stated that this restriction was appropriate. When asked to suggest a new post-TAVI driving recommendation for successful, uncomplicated, transfemoral TAVI patients, 41.4% proposed that patients be prohibited from driving for 2 weeks, 24.1% suggested 1 week, 13.8% were supportive of 1 month, and 6.9% were supportive of either 3 weeks, 72 hours, or 48 hours. The predominant driving-related concern was the development of conduction abnormalities (89.7%). A longer driving prohibition (>/= 1 month) was suggested in cases of alternative-access TAVI (transapical: 67.7%; alternative arterial: 51.6%), access-site and/or vascular complications (48.4%), and conduction abnormalities without a pacemaker (45.2%). CONCLUSIONS: The majority of Canadian TAVI programs expressed that a 1-month driving restriction period was overly cautious and that shorter restriction periods would be more appropriate. Ultimately, before any change to post-TAVI driving restrictions may be considered, a clinical assessment of patient recovery post TAVI is needed. CI - (c) 2025 The Authors. FAU - Jarvis, Catherine R AU - Jarvis CR AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. FAU - Gouda, Pishoy AU - Gouda P AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. AD - Mazankowski Alberta Heart Institute and University of Alberta, Edmonton, Alberta, Canada. FAU - Ezekowitz, Justin AU - Ezekowitz J AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. AD - Mazankowski Alberta Heart Institute and University of Alberta, Edmonton, Alberta, Canada. FAU - Van Spall, Harriette G C AU - Van Spall HGC AD - McMaster University, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada. AD - Baim Institute for Clinical Research, Boston, Massachusetts, USA. FAU - Tyrrell, Benjamin AU - Tyrrell B AD - Mazankowski Alberta Heart Institute and University of Alberta, Edmonton, Alberta, Canada. AD - CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, Alberta, Canada. FAU - Welsh, Robert C AU - Welsh RC AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. AD - Mazankowski Alberta Heart Institute and University of Alberta, Edmonton, Alberta, Canada. LA - eng PT - Journal Article DEP - 20250410 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC12198631 EDAT- 2025/07/01 04:07 MHDA- 2025/07/01 04:08 PMCR- 2025/04/10 CRDT- 2025/06/30 06:30 PHST- 2025/03/15 00:00 [received] PHST- 2025/04/03 00:00 [accepted] PHST- 2025/07/01 04:08 [medline] PHST- 2025/07/01 04:07 [pubmed] PHST- 2025/06/30 06:30 [entrez] PHST- 2025/04/10 00:00 [pmc-release] AID - S2589-790X(25)00186-6 [pii] AID - 10.1016/j.cjco.2025.04.004 [doi] PST - epublish SO - CJC Open. 2025 Apr 10;7(6):843-850. doi: 10.1016/j.cjco.2025.04.004. eCollection 2025 Jun. PMID- 40562472 OWN - NLM STAT- MEDLINE DCOM- 20250625 LR - 20260918 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 12 DP - 2025 Jun 23 TI - The Coronary Access After TAVI (CAvEAT) Study: A Prospective Registry of CA After TAVR. PG - 1571-1583 LID - S1936-8798(25)01349-4 [pii] LID - 10.1016/j.jcin.2025.05.002 [doi] AB - BACKGROUND: As transcatheter aortic valve replacement (TAVR) is now performed in patients with longer life expectancy, the need for coronary access (CA) after TAVR is expected to rise. OBJECTIVES: The aim of this study was to evaluate the feasibility of CA after TAVR with 4 different types of transcatheter heart valves (THVs). METHODS: In the multicenter, prospective CAvEAT (Coronary Access After TAVI; NCT04647864) registry, coronary angiography was performed immediately following transfemoral TAVR using short-frame SAPIEN 3 or SAPIEN 3 Ultra (SAPIEN 3/Ultra) and tall-frame ACURATE neo or ACURATE neo2 (ACURATE neo/neo2), Portico or Navitor, and Evolut Pro or Evolut Pro+ (Evolut Pro/Pro+) THVs. The primary endpoint was defined as selective CA of both coronary arteries. RESULTS: In total, 632 patients were enrolled (mean age 82 years, 59% women). Selective CA of both coronary arteries was achieved in 89% of SAPIEN 3/Ultra, 63% of ACURATE neo/neo2, 62% of Portico or Navitor, and 45% of Evolut Pro/Pro+ THVs (P < 0.001). Unfeasible CA of at least 1 coronary artery occurred in 2%, 6%, 6%, and 9% of cases, respectively (P = 0.06). In pairwise comparisons, the incidence of the primary endpoint was significantly higher for the SAPIEN 3/Ultra compared with all tall-frame THVs (P < 0.001). Among tall-frame devices, no significant difference was observed between the ACURATE neo/neo2 and the Portico or Navitor (P = 0.9), but both devices demonstrated higher rates of the primary endpoint than the Evolut Pro/Pro+ (P = 0.005 and P = 0.002, respectively). Multivariate analysis identified implantation depth, moderate or severe commissural misalignment, and use of a tall-frame THV as independent predictors of unfeasible or nonselective CA. CONCLUSIONS: The short-frame SAPIEN 3/Ultra THV demonstrated the highest rate of selective CA following TAVR. Among tall-frame THVs, the large-cell designs of the Portico or Navitor and ACURATE neo/neo2 outperformed the closed-cell Evolut Pro/Pro+ in terms of selective CA. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. Electronic address: giuseppe.tarantini.1@gmail.com. FAU - Nai Fovino, Luca AU - Nai Fovino L AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Belloni, Flavia AU - Belloni F AD - S. Spirito Hospital, Rome, Italy. FAU - Barbierato, Marco AU - Barbierato M AD - Department of Cardiology, Ospedale dell'Angelo, AULSS3 Serenissima, Mestre, Venice, Italy. FAU - Gallo, Francesco AU - Gallo F AD - Department of Cardiology, Ospedale dell'Angelo, AULSS3 Serenissima, Mestre, Venice, Italy. FAU - Vercellino, Matteo AU - Vercellino M AD - Department of Cardiovascular Sciences, Ospedale San Martino, Genoa, Italy. FAU - Trani, Carlo AU - Trani C AD - Fondazione Policlinico A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - Fondazione Policlinico A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy. FAU - Asmarats Serra, Lluis AU - Asmarats Serra L AD - Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain. FAU - Petronio, Anna Sonia AU - Petronio AS AD - Cardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Department of Clinical Cardiology, San Donato Hospital, Milan, Italy. FAU - Berti, Sergio AU - Berti S AD - Fondazione Toscana G. Monasterio, Ospedale Del Cuore, Massa, Italy. FAU - Bertolini, Andrea AU - Bertolini A AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Fabris, Tommaso AU - Fabris T AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Tito, Antonio AU - Tito A AD - Interventional Cardiology Unit, Ospedale S. Maria, GVM Care & Research, Bari, Italy. FAU - Musto, Carmine AU - Musto C AD - Department of Cardiosciences, A.O. San Camillo-Forlanini Hospital, Rome, Italy. FAU - Giordano, Arturo AU - Giordano A AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Corcione, Nicola AU - Corcione N AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Maisano, Francesco AU - Maisano F AD - Heart Valve Center, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Medda, Massimo AU - Medda M AD - U.O. Cardiologia Ospedaliera, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy. FAU - Loi, Bruno AU - Loi B AD - Interventional Cardiology Unit, Brotzu Hospital, Cagliari, Italy. FAU - Cernetti, Carlo AU - Cernetti C AD - Cardio-Neurovascular Department, Ca Foncello and San Giacomo Hospital Azienda, Treviso, Italy. FAU - Favero, Luca AU - Favero L AD - Cardio-Neurovascular Department, Ca Foncello and San Giacomo Hospital Azienda, Treviso, Italy. FAU - Di Lorenzo, Emilio AU - Di Lorenzo E AD - Department of Cardiology, AORN dei Colli-Monaldi Hospital, Naples, Italy. FAU - Gregori, Dario AU - Gregori D AD - Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Lorenzoni, Giulia AU - Lorenzoni G AD - Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Orzalkiewicz, Mateusz AU - Orzalkiewicz M AD - Unit of Cardiology, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, IRCCS, University of Bologna, Bologna, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy. FAU - Saia, Francesco AU - Saia F AD - Unit of Cardiology, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, IRCCS, University of Bologna, Bologna, Italy. FAU - Cardaioli, Francesco AU - Cardaioli F AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Marchese, Alfredo AU - Marchese A AD - Interventional Cardiology Unit, Ospedale S. Maria, GVM Care & Research, Bari, Italy. CN - CAvEAT Investigators and the Italian Society of Interventional Cardiology LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Female MH - Registries MH - Male MH - Prospective Studies MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Aged MH - Treatment Outcome MH - Heart Valve Prosthesis MH - *Aortic Valve/diagnostic imaging/surgery/physiopathology MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/physiopathology MH - *Coronary Angiography MH - Feasibility Studies MH - Prosthesis Design MH - Risk Factors MH - Time Factors MH - *Cardiac Catheterization/adverse effects/instrumentation MH - *Coronary Vessels/diagnostic imaging MH - Punctures OTO - NOTNLM OT - aortic stenosis OT - coronary access OT - coronary artery disease OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures This study was sponsored by the Italian Society of Interventional Cardiology. Dr Tarantini has received honoraria for lectures and consulting from Abbott Laboratories, Boston Scientific, Edwards Lifesciences, Medtronic, and GADA. Dr Burzotta has received speaker fees from Abiomed, Abbott Laboratories, Medtronic, and Terumo. Dr Serra is a proctor for Abbott Laboratories. Dr Berti is a proctor for Boston Scientific and Edwards Lifesciences. Dr Maisano has received grants and/or institutional research support from Abbott Laboratories, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific, NVT, Terumo, Venus, and Roche; has received consulting fees and personal and institutional honoraria from Abbott Laboratories, Boston Scientific, Medtronic, Edwards Lifesciences, Xeltis, Cardiovalve, Occlufit, Simulands, Mtex, Venus, Squadra, Valgen, and CroiValve; has received royalty income from and holds intellectual property rights with Edwards Lifesciences; and is shareholder (including share options) of Magenta, Transseptal Solutions, and 4Tech. Dr Fovino has received consulting fees from Edwards Lifesciences; and has received institutional research grant from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/06/26 00:27 MHDA- 2025/06/26 00:28 CRDT- 2025/06/25 20:53 PHST- 2025/01/02 00:00 [received] PHST- 2025/04/15 00:00 [revised] PHST- 2025/05/01 00:00 [accepted] PHST- 2025/06/26 00:28 [medline] PHST- 2025/06/26 00:27 [pubmed] PHST- 2025/06/25 20:53 [entrez] AID - S1936-8798(25)01349-4 [pii] AID - 10.1016/j.jcin.2025.05.002 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Jun 23;18(12):1571-1583. doi: 10.1016/j.jcin.2025.05.002. PMID- 40560008 OWN - NLM STAT- MEDLINE DCOM- 20250625 LR - 20250627 IS - 2379-139X (Electronic) IS - 2379-1381 (Print) IS - 2379-1381 (Linking) VI - 11 IP - 6 DP - 2025 May 28 TI - Development of Cardiac Computed Tomography for Evaluation of Aortic Valve Stenosis. LID - 10.3390/tomography11060062 [doi] LID - 62 AB - Aortic valve stenosis (AS) is a valvular heart disease that imposes a high afterload on the left ventricle (LV) due to restricted opening of the aortic valve, resulting in LV hypertrophy. Severe AS can lead to syncope, angina pectoris, and heart failure. The number of patients with AS has been increasing due to aging populations, the growing prevalence of lifestyle-related diseases, and advances in diagnostic technologies. Therefore, accurate diagnosis and appropriate treatment of AS are essential. In recent years, transcatheter aortic valve implantation (TAVI) has become feasible, and the number of procedures has rapidly increased, particularly among elderly patients. As treatment options for AS expand and diversify, detailed pre-procedural evaluation has become increasingly important. In particular, diagnostic imaging modalities such as computed tomography (CT) have advanced significantly, with notable improvements in image quality. With recent advancements in CT technology-such as increased detector rows, faster gantry rotation speeds, new image reconstruction methods, and the introduction of dual-energy imaging-the scope of cardiac assessment has expanded beyond the coronary arteries to include valves, myocardium, and the entire heart. This includes evaluating restricted AV opening and cardiac function using four-dimensional imaging, assessing AV annulus diameter and AS severity via calcium scoring with a novel motion correction algorithm, and detecting myocardial damage through late-phase contrast imaging using new reconstruction techniques. In cases of pre-TAVI evaluation or congenital bicuspid valves, CT is also valuable for assessing extracardiac structures, such as access routes and associated congenital heart anomalies. In addition, recent advancements in CT technology have made it possible to significantly reduce radiation exposure during cardiac imaging. CT has become an extremely useful tool for comprehensive cardiac evaluation in patients with aortic stenosis, especially those being considered for surgical treatment. FAU - Takaoka, Hiroyuki AU - Takaoka H AUID- ORCID: 0000-0001-8745-2162 AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Sasaki, Haruka AU - Sasaki H AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Ota, Joji AU - Ota J AD - Department of Radiology, Chiba University Hospital, Chiba 260-8677, Japan. FAU - Noguchi, Yoshitada AU - Noguchi Y AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Matsumoto, Moe AU - Matsumoto M AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Yoshida, Kazuki AU - Yoshida K AUID- ORCID: 0000-0002-1692-4107 AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Suzuki, Katsuya AU - Suzuki K AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Aoki, Shuhei AU - Aoki S AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Yashima, Satomi AU - Yashima S AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Kinoshita, Makiko AU - Kinoshita M AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Suzuki-Eguchi, Noriko AU - Suzuki-Eguchi N AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. FAU - Kobayashi, Yoshio AU - Kobayashi Y AD - Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. LA - eng GR - Grant Number: JP24K21117, JP23K11891, and JP23K11824/Japan Society for the Promotion of Science/ PT - Journal Article PT - Review DEP - 20250528 PL - Switzerland TA - Tomography JT - Tomography (Ann Arbor, Mich.) JID - 101671170 SB - IM MH - Humans MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Tomography, X-Ray Computed/methods MH - Transcatheter Aortic Valve Replacement/methods MH - Aortic Valve/diagnostic imaging PMC - PMC12196544 OTO - NOTNLM OT - aortic stenosis OT - computed tomography OT - coronary artery COIS- The authors declare no conflicts of interest related to the contents of this article. EDAT- 2025/06/25 12:28 MHDA- 2025/06/25 12:29 PMCR- 2025/05/28 CRDT- 2025/06/25 09:55 PHST- 2025/04/21 00:00 [received] PHST- 2025/05/21 00:00 [revised] PHST- 2025/05/22 00:00 [accepted] PHST- 2025/06/25 12:29 [medline] PHST- 2025/06/25 12:28 [pubmed] PHST- 2025/06/25 09:55 [entrez] PHST- 2025/05/28 00:00 [pmc-release] AID - tomography11060062 [pii] AID - tomography-11-00062 [pii] AID - 10.3390/tomography11060062 [doi] PST - epublish SO - Tomography. 2025 May 28;11(6):62. doi: 10.3390/tomography11060062. PMID- 40547427 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250625 IS - 2225-319X (Print) IS - 2304-1021 (Electronic) IS - 2225-319X (Linking) VI - 14 IP - 3 DP - 2025 May 31 TI - Lateral access fully robotic aortic valve replacement "RAVR": from novel to normal. PG - 192-201 LID - 10.21037/acs-2025-ravr-0049 [doi] AB - Right lateral access robotic aortic valve replacement (RAVR) may represent a significant advancement in minimally invasive cardiac surgery. This review examines RAVR's development, technical specifications, clinical outcomes, and future trajectory in cardiac surgery. Multicenter RAVR experiences have demonstrated promising results with low rates of operative mortality (0.9%), stroke (0.9%), and permanent pacemaker placement (2.9%). In propensity-matched comparisons with transcatheter aortic valve replacement (TAVR), RAVR had significantly lower rates of paravalvular leak (0.7% vs. 21.5%) and one-year mortality (1.4% vs. 12.5%). With a 3-cm working incision at the level of the anterior axillary line, the lateral access approach offers distinct advantages including improved surgical visualization, reduced tissue trauma, and standardization potential across various cardiac procedures. While learning curve considerations exist, these are minimal for experienced robotic mitral teams. RAVR programs have expanded to include implementation of complex procedures such as aortic root enlargement. As robotic systems become more prevalent and surgical expertise grows, RAVR shows promise to evolve from an innovative technique to a standard therapeutic option in aortic valve surgery. This evolution, supported by growing clinical evidence and technological advancement, positions RAVR as a potentially transformative development in cardiac surgery, offering patients the benefits of minimally invasive approaches while maintaining the durability of traditional surgical valve replacement. CI - Copyright (c) 2025 AME Publishing Company. All rights reserved. FAU - Murtaza, Ghulam AU - Murtaza G AD - Division of Cardiac Surgery, SSM Health Heart & Vascular Care Center, Madison, WI, USA. FAU - Wei, Lawrence AU - Wei L AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA. LA - eng PT - Journal Article PT - Review DEP - 20250529 PL - China TA - Ann Cardiothorac Surg JT - Annals of cardiothoracic surgery JID - 101605877 PMC - PMC12177761 OTO - NOTNLM OT - Robotic aortic valve replacement (RAVR) OT - aortic valve replacement (AVR) OT - right lateral access OT - robotic cardiac surgery COIS- Conflicts of Interest: The authors have no conflicts of interest to declare. EDAT- 2025/06/24 10:57 MHDA- 2025/06/24 10:58 PMCR- 2025/05/31 CRDT- 2025/06/23 06:11 PHST- 2025/03/09 00:00 [received] PHST- 2025/03/30 00:00 [accepted] PHST- 2025/06/24 10:58 [medline] PHST- 2025/06/24 10:57 [pubmed] PHST- 2025/06/23 06:11 [entrez] PHST- 2025/05/31 00:00 [pmc-release] AID - acs-14-03-192 [pii] AID - 10.21037/acs-2025-ravr-0049 [doi] PST - ppublish SO - Ann Cardiothorac Surg. 2025 May 31;14(3):192-201. doi: 10.21037/acs-2025-ravr-0049. Epub 2025 May 29. PMID- 40547421 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250625 IS - 2225-319X (Print) IS - 2304-1021 (Electronic) IS - 2225-319X (Linking) VI - 14 IP - 3 DP - 2025 May 31 TI - Surgical versus transcatheter aortic valve replacement: the future role of robotic aortic valve replacement. PG - 182-191 LID - 10.21037/acs-2024-ravr-0181 [doi] AB - Patients desire a minimally invasive option for management of their valve disease. As transcatheter aortic valve replacement (TAVR) remains a straightforward short-term solution, it is incumbent upon surgeons to provide an alternative, and preferably non-sternotomy or anterior chest option with the longitudinal benefits of surgical aortic valve replacement (SAVR). The present review will focus on the novel use of robotic aortic valve replacement (RAVR) via right lateral transaxillary mini-thoracotomy to perform standard SAVR, which permits the additional ability to perform concomitant procedures using the standard lateral approach popularized in mitral and atrial fibrillation surgery. We will define a role for RAVR in the current landscape of TAVR to provide a minimally invasive and durable operation, allowing for performance of concomitant procedures. Furthermore, we will focus on current literature supporting the safe and stepwise expansion of RAVR worldwide to provide patients requiring aortic valve replacement another option. CI - Copyright (c) 2025 AME Publishing Company. All rights reserved. FAU - Jagadeesan, Vikrant AU - Jagadeesan V AD - Department of Cardiology, West Virginia University, Morgantown, WV, USA. FAU - Mehaffey, J Hunter AU - Mehaffey JH AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA. FAU - Darehzereshki, Ali AU - Darehzereshki A AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA. FAU - Daggubati, Ramesh AU - Daggubati R AD - Department of Cardiology, West Virginia University, Morgantown, WV, USA. FAU - Raikar, Goya AU - Raikar G AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA. FAU - Wei, Lawrence AU - Wei L AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA. FAU - Badhwar, Vinay AU - Badhwar V AD - Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA. LA - eng PT - Journal Article PT - Review DEP - 20250529 PL - China TA - Ann Cardiothorac Surg JT - Annals of cardiothoracic surgery JID - 101605877 PMC - PMC12177767 OTO - NOTNLM OT - Robotic aortic valve replacement (RAVR) OT - surgical aortic valve replacement (SAVR) OT - transcatheter aortic valve replacement (TAVR) COIS- Conflicts of Interest: The authors have no conflicts of interest to declare. EDAT- 2025/06/24 10:56 MHDA- 2025/06/24 10:57 PMCR- 2025/05/31 CRDT- 2025/06/23 06:11 PHST- 2024/11/28 00:00 [received] PHST- 2025/04/10 00:00 [accepted] PHST- 2025/06/24 10:57 [medline] PHST- 2025/06/24 10:56 [pubmed] PHST- 2025/06/23 06:11 [entrez] PHST- 2025/05/31 00:00 [pmc-release] AID - acs-14-03-182 [pii] AID - 10.21037/acs-2024-ravr-0181 [doi] PST - ppublish SO - Ann Cardiothorac Surg. 2025 May 31;14(3):182-191. doi: 10.21037/acs-2024-ravr-0181. Epub 2025 May 29. PMID- 40541657 OWN - NLM STAT- MEDLINE DCOM- 20251015 LR - 20251210 IS - 1532-2165 (Electronic) IS - 1078-5884 (Linking) VI - 70 IP - 4 DP - 2025 Oct TI - Ultrasound Guided Versus Conventional Closure Device Deployment Following Transfemoral Endovascular Procedures: A Systematic Review and Meta-analysis. PG - 469-479 LID - S1078-5884(25)00550-7 [pii] LID - 10.1016/j.ejvs.2025.06.023 [doi] AB - OBJECTIVE: Femoral access site complications influence short term survival and outcomes in patients undergoing endovascular procedures. While ultrasound guided puncture is a reliable method to reduce such complications, ultrasound guidance is rarely used for closure device deployment. DATA SOURCES: Web of Science, PubMed, and the Cochrane Library. REVIEW METHODS: A systematic literature search was conducted to assess the safety and efficacy of ultrasound guided vascular closure device deployment compared with vascular closure device deployment without ultrasound guidance, referred to as conventional closure. All studies reporting on ultrasound guided closure in transfemoral arterial interventions were eligible, and those directly comparing ultrasound guided with conventional closure were included in the meta-analysis. RESULTS: Overall, 2 738 patients receiving ultrasound guided closure were included: 1 025 for introducer sheaths measuring 12 F or larger and 1 713 for introducer sheaths smaller than 12 F. The incidence of access complications was 5.7% (range 0.8 - 21.6%) for large sheath procedures and 2.6% (range 0.9 - 4.7%) for small sheath procedures. The meta-analysis, which included 2 339 patients who received ultrasound guided closure and 1 175 who underwent conventional closure, showed that ultrasound guided closure was associated with reduced access site complications compared with conventional closure (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.37 - 0.65; p < .001). This was consistently seen both for small sheath (OR 0.45, 95% CI 0.28 - 0.75; p = .002) and large sheath procedures (OR 0.50, 95% CI 0.37 - 0.71; p < .001), but with a low certainty of evidence in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) analysis. CONCLUSION: Ultrasound guided vessel closure of the femoral artery appeared to be associated with a lower rate of overall access site complications compared with conventional closure techniques. Therefore, ultrasound guided closure might offer the potential to increase procedural and patient safety in percutaneous arterial access. CI - Copyright (c) 2025 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Kalaja, Igli AU - Kalaja I AD - Department for Cardiology III - Angiology, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. FAU - Smeets, Reinier R AU - Smeets RR AD - Department of Vascular Surgery, Slingeland Hospital, Doetinchem, the Netherlands; Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. FAU - Wegner, Moritz AU - Wegner M AD - Department of Vascular and Endovascular Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Macherey-Meyer, Sascha AU - Macherey-Meyer S AD - Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Heyne, Sebastian AU - Heyne S AD - Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Espinola-Klein, Christine AU - Espinola-Klein C AD - Department for Cardiology III - Angiology, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. FAU - Mees, Barend M E AU - Mees BME AD - Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. FAU - Meertens, Max M AU - Meertens MM AD - Department for Cardiology III - Angiology, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany; Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Electronic address: max.meertens@me.com. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20250618 PL - England TA - Eur J Vasc Endovasc Surg JT - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JID - 9512728 SB - IM MH - Humans MH - *Femoral Artery/diagnostic imaging/surgery MH - *Ultrasonography, Interventional/adverse effects MH - *Endovascular Procedures/adverse effects/methods MH - *Vascular Closure Devices MH - Punctures MH - *Catheterization, Peripheral/adverse effects/methods MH - *Hemostatic Techniques/instrumentation/adverse effects MH - Treatment Outcome MH - *Hemorrhage/prevention & control/etiology OTO - NOTNLM OT - PTA OT - Percutaneous OT - TAVI OT - Transfemoral OT - Ultrasound guidance EDAT- 2025/06/21 00:31 MHDA- 2025/10/16 05:31 CRDT- 2025/06/20 23:08 PHST- 2024/08/07 00:00 [received] PHST- 2025/04/06 00:00 [revised] PHST- 2025/06/10 00:00 [accepted] PHST- 2025/10/16 05:31 [medline] PHST- 2025/06/21 00:31 [pubmed] PHST- 2025/06/20 23:08 [entrez] AID - S1078-5884(25)00550-7 [pii] AID - 10.1016/j.ejvs.2025.06.023 [doi] PST - ppublish SO - Eur J Vasc Endovasc Surg. 2025 Oct;70(4):469-479. doi: 10.1016/j.ejvs.2025.06.023. Epub 2025 Jun 18. PMID- 40535149 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260420 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 12 DP - 2025 TI - Transcatheter aortic valve replacement in quadricuspid aortic valve: a systematic review and meta-analysis. PG - 1572251 LID - 10.3389/fcvm.2025.1572251 [doi] LID - 1572251 AB - BACKGROUND: While Transcatheter Aortic Valve Replacement (TAVR) is now a standard treatment for severe aortic stenosis, its use in patients with quadricuspid aortic valves (QAV) presents unique challenges. This review analyzes current evidence to guide clinicians in managing aortic stenosis in this complex valve morphology. METHOD: Following PRISMA guidelines, a comprehensive literature search was conducted across multiple databases up to August 15, 2024. A random-effects model was used for meta-analysis, focusing on 30-day mortality and procedural success, with secondary outcomes including paravalvular leak incidence, pacemaker insertion, hemodynamic changes, and NYHA functional class improvement. RESULTS: A total of 11 case reports/series were analyzed, involving 17 adult patients with QAV. Participants had a mean age of 73.80 +/- 5.07 years. The mean left ventricular ejection fraction was 41.6%, and the mean annulus area was 595.5 mm(2). Most patients (64.7%) underwent transfemoral procedures, with nearly 70% receiving a J-valve or Edwards SAPIEN 3 device. All procedures were largely successful, though 29.4% experienced leakage or regurgitation. Aortic pre-dilation was done in 41.2% of cases. The mean procedural duration was 102 min, with a fluoroscopic duration of 15 min. No patients experienced aortic post-dilation, and one (5.8%) had an atrioventricular block within 30 days post-procedure. CONCLUSION: TAVR is an effective and growing treatment for high-risk patients with aortic valve disease, including those with QAV. While it has high success rates and challenges (i.e., post-operatively). Future studies should focus on long-term valve durability. CI - (c) 2025 Khalifa, Hashim, Shimal, Riyas Mohamed, Ragunathan, Al Sakini, Elbadawi, Irfan, Moqbel, Almualed, Al-Ghuraibawi and Al-Aboudi. FAU - Khalifa, Mostafa A AU - Khalifa MA AD - Faculty of Medicine, Cairo University, Cairo, Egypt. FAU - Hashim, Hashim Talib AU - Hashim HT AD - College of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq. FAU - Shimal, Aya Ahmed AU - Shimal AA AD - College of Medicine, University of Baghdad, Baghdad, Iraq. FAU - Riyas Mohamed, Fathima Raahima AU - Riyas Mohamed FR AD - College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. FAU - Ragunathan, Srinithi AU - Ragunathan S AD - Panimalar Medical College and Research Institute, Chennai, India. FAU - Al Sakini, Ahmed Sermed AU - Al Sakini AS AD - College of Medicine, University of Baghdad, Baghdad, Iraq. FAU - Elbadawi, Mohamed H AU - Elbadawi MH AD - Faculty of Medicine, University of Khartoum, Khartoum, Sudan. FAU - Irfan, Mohammed Rushdhi AU - Irfan MR AD - College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. FAU - Moqbel, Ibrahim AU - Moqbel I AD - Faculty of Medicine, Cairo University, Cairo, Egypt. FAU - Almualed, Marwah Mohammed AU - Almualed MM AD - College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Al-Ghuraibawi, Mohammedbaqer AU - Al-Ghuraibawi M AD - College of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq. FAU - Al-Aboudi, Batool S AU - Al-Aboudi BS AD - Faculty of Medicine, University of Kufa, Najaf, Iraq. LA - eng PT - Journal Article PT - Systematic Review DEP - 20250530 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 CIN - Front Cardiovasc Med. 2026 Jan 27;12:1660716. doi: 10.3389/fcvm.2025.1660716. PMID: 41674866 EIN - Front Cardiovasc Med. 2026 Apr 02;13:1816950. doi: 10.3389/fcvm.2026.1816950. PMID: 42006619 PMC - PMC12175154 OTO - NOTNLM OT - QVA OT - aortic stenosis OT - procedural success OT - quadricuspid aortic valves OT - transcatheter aortic valve replacement COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/06/19 07:52 MHDA- 2025/06/19 07:53 PMCR- 2025/05/30 CRDT- 2025/06/19 05:21 PHST- 2025/02/06 00:00 [received] PHST- 2025/05/08 00:00 [accepted] PHST- 2025/06/19 07:53 [medline] PHST- 2025/06/19 07:52 [pubmed] PHST- 2025/06/19 05:21 [entrez] PHST- 2025/05/30 00:00 [pmc-release] AID - 10.3389/fcvm.2025.1572251 [doi] PST - epublish SO - Front Cardiovasc Med. 2025 May 30;12:1572251. doi: 10.3389/fcvm.2025.1572251. eCollection 2025. PMID- 40530488 OWN - NLM STAT- MEDLINE DCOM- 20250701 LR - 20260824 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 14 IP - 13 DP - 2025 Jul TI - Natural History of Tricuspid Regurgitation After Transcatheter Aortic Valve Implantation. PG - e040955 LID - 10.1161/JAHA.125.040955 [doi] LID - e040955 AB - BACKGROUND: To determine the impact of tricuspid regurgitation (TR) on outcomes after transcatheter aortic valve implantation (TAVI), and to determine the evolution of TR severity after TAVI. METHODS: This was an observational study of TAVIs for aortic stenosis from November 2012 to December 2021. Patients were dichotomized according to the severity of pre-TAVI TR: less than moderate versus moderate or greater. Logistic regression was used to determine the risk factors for progression or persistence of moderate or greater TR at 1 year after TAVI. RESULTS: A total of 2250 patients were included for analysis, of which 301 (13.4%) had moderate or greater TR before TAVI. Baseline moderate or greater TR was associated with reduced survival and a higher incidence of heart failure readmission at 5 years after TAVI. Twelve percent of patients had progression or persistence of moderate or greater TR at 1 year after TAVI. On multivariable logistic regression, increasing age, female sex, lower mean pre-TAVI aortic transvalvular pressure gradient, pulmonary artery systolic pressure >/=40 mm Hg, pulmonary vascular disease, and transfemoral vascular access were associated with progression or persistence of moderate or greater TR at 1 year after TAVI, while periprocedural variables related to valve implantation were not. CONCLUSIONS: Significant TR before TAVI was associated with poor outcomes after TAVI. The incidence of moderate or greater TR at 1 year after TAVI was reasonable at 12%. Periprocedural factors, such as valve size, type of implanted valve, and paravalvular leak, were not associated with the development of TR. Evolution of TR and heart failure symptoms must be carefully surveilled after TAVI. FAU - Brown, James A AU - Brown JA AUID- ORCID: 0000-0002-2263-8318 AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. FAU - Donohue, Jack AU - Donohue J AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. FAU - Yousef, Sarah AU - Yousef S AUID- ORCID: 0000-0002-2333-1086 AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. FAU - Iyanna, Nidhi AU - Iyanna N AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. FAU - Ahmad, Danial AU - Ahmad D AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. FAU - Kliner, Dustin AU - Kliner D AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. AD - Division of Cardiology, Department of Medicine University of Pittsburgh PA USA. FAU - Toma, Catalin AU - Toma C AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. AD - Division of Cardiology, Department of Medicine University of Pittsburgh PA USA. FAU - Serna-Gallegos, Derek AU - Serna-Gallegos D AUID- ORCID: 0000-0002-5991-6385 AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. FAU - Makani, Amber AU - Makani A AUID- ORCID: 0000-0002-1896-4540 AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. AD - Division of Cardiology, Department of Medicine University of Pittsburgh PA USA. FAU - West, David AU - West D AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. FAU - Hasan, Irsa AU - Hasan I AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. FAU - Ogami, Takuya AU - Ogami T AUID- ORCID: 0000-0001-6659-2617 AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. FAU - Sultan, Ibrahim AU - Sultan I AUID- ORCID: 0000-0002-1737-4012 AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery University of Pittsburgh PA USA. AD - Heart and Vascular Institute, University of Pittsburgh Medical Center Pittsburgh PA USA. LA - eng GR - T32 HL160526/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural DEP - 20250618 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Humans MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Tricuspid Valve Insufficiency/epidemiology/etiology/diagnosis/physiopathology MH - *Aortic Valve Stenosis/surgery MH - Aged, 80 and over MH - Risk Factors MH - Aged MH - Disease Progression MH - Severity of Illness Index MH - Retrospective Studies MH - Time Factors MH - *Postoperative Complications/epidemiology MH - Incidence MH - Treatment Outcome PMC - PMC12450012 OTO - NOTNLM OT - aortic stenosis OT - transcatheter aortic valve implantation OT - tricuspid regurgitation COIS- None. EDAT- 2025/06/18 06:25 MHDA- 2025/07/01 21:17 PMCR- 2025/06/18 CRDT- 2025/06/18 05:53 PHST- 2025/07/01 21:17 [medline] PHST- 2025/06/18 06:25 [pubmed] PHST- 2025/06/18 05:53 [entrez] PHST- 2025/06/18 00:00 [pmc-release] AID - JAH311083 [pii] AID - 10.1161/JAHA.125.040955 [doi] PST - ppublish SO - J Am Heart Assoc. 2025 Jul;14(13):e040955. doi: 10.1161/JAHA.125.040955. Epub 2025 Jun 18. PMID- 40522304 OWN - NLM STAT- MEDLINE DCOM- 20250616 LR - 20260813 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 12 DP - 2025 Jun 16 TI - Predictors of pacemaker implantation in aortic regurgitation patients treated with a dedicated transcatheter heart valve. PG - e681-e691 LID - EIJ-D-24-01117 [pii] LID - 10.4244/EIJ-D-24-01117 [doi] AB - BACKGROUND: The JenaValve Trilogy System (JVTS) is the only dedicated transcatheter heart valve system approved for treating patients with aortic regurgitation (AR). Recently, several studies have revealed high rates of permanent pacemaker implantation (PPI) exceeding 20% in patients with AR. AIMS: The aim of this study was to evaluate the incidence and risk factors for new PPI after transcatheter aortic valve implantation (TAVI) with the JVTS. METHODS: This retrospective multicentre registry included 141 patients without prior PPI who underwent transfemoral TAVI with the JVTS. Comparative analyses were performed regarding baseline and procedural parameters between patients with and without new PPI at discharge. Logistic regression models were fitted to identify predictors of PPI. RESULTS: The median age of patients was 81 (interquartile range [IQR] 76-85) years, 41% were female, and the median European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 3.6% (IQR 2.0-6.4). All patients presented with >/=moderate AR. At discharge, 34 patients (24.1%) required a new PPI. Pre-existing first-degree atrioventricular block and right bundle branch block were identified as independent predictors of new PPI. Anatomical characteristics, including annular and left ventricular outflow tract perimeters, were not predictive. Procedural factors such as implantation depth and valve oversizing were also not statistically different between patients with or without new PPI. CONCLUSIONS: Overall, 24.1% of patients undergoing TAVI with the JVTS required a new PPI. While rates of new PPI were strongly associated with pre-existing first-degree atrioventricular block and right bundle branch block using the JVTS, no modifiable risk factors were identified. FAU - Wienemann, Hendrik AU - Wienemann H AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Geyer, Martin AU - Geyer M AD - Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany. FAU - Stukenberg, Malte AU - Stukenberg M AD - JenaValve Technology GmbH, Munich, Germany. FAU - Waezsada, Sara AU - Waezsada S AD - Clinic for General and Interventional Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Patel, Kush P AU - Patel KP AD - Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom. AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom. FAU - Kuhn, Elmar W AU - Kuhn EW AD - Department of Cardiac Surgery, University Hospital Cologne, Cologne, Germany. FAU - Rogmann, Marc Adrian AU - Rogmann MA AD - Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany. FAU - Pinto, Duane S AU - Pinto DS AD - JenaValve Technology GmbH, Munich, Germany. AD - Interventional Cardiology Section, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiac Surgery, University Hospital Cologne, Cologne, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Baumbach, Andreas AU - Baumbach A AD - Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom. AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Clinic for General and Interventional Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Adam, Matti AU - Adam M AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250616 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Female MH - Male MH - *Aortic Valve Insufficiency/surgery MH - Aged MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Aged, 80 and over MH - Retrospective Studies MH - *Pacemaker, Artificial MH - Risk Factors MH - Registries MH - Treatment Outcome MH - Heart Valve Prosthesis MH - *Cardiac Pacing, Artificial MH - Bundle-Branch Block MH - *Aortic Valve/surgery PMC - PMC12151165 COIS- H. Wienemann reports consultancy fees and travel grants from JenaValve Technology. M. Geyer received proctoring honoraria from JenaValve Technology. M. Stukenberg conducted blinded computed tomography data analysis and was an employee of JenaValve Technology at the time of this study. E.W. Kuhn reports consultancy and personal fees from Medtronic, Edwards Lifesciences, Boston Scientific, and Abbott. D.S. Pinto serves as the Chief Medical Officer of JenaValve Technology; and is a consultant for Abiomed, Abbott, Magenta, NuPulseCV, and Terumo. L. Conradi is an advisory board member for Medtronic, Abbott, and JenaValve Technology; and a consultant for Boston Scientific, Edwards Lifesciences, Venus MedTech, MicroPort, Micro Interventions, SmartCanula SARL, Neovasc, Pi-Cardia, and 4C Medical. S. Bleiziffer reports personal fees from Abbott, Edwards Lifesciences, Medtronic, and Boston Scientific. S. Baldus reports lecture fees from Abbott, Edwards Lifesciences, AstraZeneca, and JenaValve Technology; he received research grants from Abbott and AstraZeneca; and participates as a principal investigator in clinical trials sponsored by AstraZeneca and Abbott. A. Baumbach reports consultation or speaker fees from AstraZeneca, SINOMED, MicroPort, Medtronic, Faraday, Pi-Cardia, JenaValve Technology, and Meril Life Sciences. T.K. Rudolph reports institutional fees from Amgen, Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and JenaValve Technology. M. Adam reports grants and personal fees from Medtronic; and personal fees from Abbott, JenaValve Technology, Edwards Lifesciences, Boston Scientific, and Meril Life Sciences. The other authors have no conflicts of interest to declare regarding this project. EDAT- 2025/06/16 12:27 MHDA- 2025/06/16 12:28 PMCR- 2026/06/16 CRDT- 2025/06/16 10:53 PHST- 2025/06/16 12:28 [medline] PHST- 2025/06/16 12:27 [pubmed] PHST- 2025/06/16 10:53 [entrez] PHST- 2026/06/16 00:00 [pmc-release] AID - EIJ-D-24-01117 [pii] AID - 10.4244/EIJ-D-24-01117 [doi] PST - epublish SO - EuroIntervention. 2025 Jun 16;21(12):e681-e691. doi: 10.4244/EIJ-D-24-01117. PMID- 40522301 OWN - NLM STAT- In-Process LR - 20260813 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 12 DP - 2025 Jun 16 TI - Transcaval transcatheter aortic valve implantation via left-sided venous access. PG - e709-e710 LID - EIJ-D-24-00795 [pii] LID - 10.4244/EIJ-D-24-00795 [doi] FAU - Doyle, Conor J AU - Doyle CJ FAU - Casserly, Ivan P AU - Casserly IP LA - eng PT - Journal Article DEP - 20250616 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM PMC - PMC12151163 COIS- The authors have no conflicts of interest to declare. EDAT- 2025/06/16 12:28 MHDA- 2025/06/16 12:28 PMCR- 2026/06/16 CRDT- 2025/06/16 10:53 PHST- 2025/06/16 12:28 [medline] PHST- 2025/06/16 12:28 [pubmed] PHST- 2025/06/16 10:53 [entrez] PHST- 2026/06/16 00:00 [pmc-release] AID - EIJ-D-24-00795 [pii] AID - 10.4244/EIJ-D-24-00795 [doi] PST - epublish SO - EuroIntervention. 2025 Jun 16;21(12):e709-e710. doi: 10.4244/EIJ-D-24-00795. PMID- 40518735 OWN - NLM STAT- MEDLINE DCOM- 20250811 LR - 20260908 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 2 DP - 2025 Aug TI - Short-Term Feasibility of Transseptal Mitral Valve Replacement in China. PG - 1315-1323 LID - 10.1002/ccd.31685 [doi] AB - BACKGROUNDS: Significant mitral regurgitation (MR) is common worldwide, yet surgical correction rates remain low due to high-risk patient profiles. Transseptal mitral valve replacement (TSMVR) has emerged as a minimally invasive alternative, but its feasibility in Asian populations remains underexplored. AIMS: This study assessed the short-term feasibility of the HighLife TSMVR system for treating symptomatic MR in China. METHODS: This prospective study included seven centers in China, integrating data from multicenter and localized cohorts with identical inclusion criteria. Patients with symptomatic MR (>/= 3+) and high surgical risk were included, excluding those with unsuitable anatomy for the HighLife system. Preprocedural imaging was centrally adjudicated, and 30-day outcomes were analyzed using R software (version 4.4.0). RESULTS: Twenty-two patients (median age 70.5 years; 45.5% male) underwent the procedure. The predicted median mortality risk was 6.39%, with secondary MR in 81.8% of cases. Technical success was 95.5% (21/22). Median durations of valve delivery, ring closure, transseptal puncture, and looping were 4.00, 8.50, 22.25, and 42.75 min, respectively and 22.73% cases of tele-proctoring. One patient required conversion to transcatheter aortic valve replacement, and two deaths occurred within 30 days. Significant improvements were observed in New York Heart Association class (p = 0.033) and MR severity (p < 0.001). CONCLUSIONS: The HighLife TSMVR system demonstrated safety and efficacy in treating symptomatic MR in high-risk Chinese patients, supporting its potential clinical applicability. CI - (c) 2025 Wiley Periodicals LLC. FAU - Zhang, Yi AU - Zhang Y AUID- ORCID: 0000-0002-5004-2511 AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. FAU - Chen, Fei AU - Chen F AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Yao, Yijun AU - Yao Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Zhu, Zhongkai AU - Zhu Z AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Li, Xi AU - Li X AUID- ORCID: 0000-0002-3018-618X AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Zhao, Zhengang AU - Zhao Z AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Feng, Yuan AU - Feng Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Song, Guangyuan AU - Song G AUID- ORCID: 0000-0002-7868-6132 AD - Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Tao, Ling AU - Tao L AUID- ORCID: 0000-0003-2919-5641 AD - Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, China. FAU - Yu, Bo AU - Yu B AUID- ORCID: 0000-0002-5955-6332 AD - Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. FAU - Yin, Chunlin AU - Yin C AD - Department of Cardiology, Xuanwu Hospital, National Clinical Research Centre for Geriatric Diseases, Capital Medical University, Beijing, China. FAU - Wang, Yan AU - Wang Y AUID- ORCID: 0000-0001-9976-848X AD - Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, Xiamen, Fujian, China. FAU - Wang, Jianan AU - Wang J AUID- ORCID: 0000-0003-0409-8941 AD - Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. FAU - Piazza, Nicolo AU - Piazza N AD - Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada. FAU - Chen, Mao AU - Chen M AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. AD - Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China. LA - eng GR - This work was supported by the National Natural Science Foundation of China (U23A20395, 82170375, and 82300570); Sichuan Science and Technology Program (2024NSFSC1714, 2023NSFSC1657); and 1. 3. 5 project for disciplines of excellence-Clinical Research Fund, West China Hospital, Sichuan University (ZYGD23021)./ PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20250615 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - Female MH - Feasibility Studies MH - Prospective Studies MH - China MH - *Mitral Valve Insufficiency/surgery/diagnostic imaging/physiopathology/mortality MH - Aged MH - Treatment Outcome MH - *Heart Valve Prosthesis Implantation/adverse effects/instrumentation/mortality/methods MH - *Mitral Valve/surgery/diagnostic imaging/physiopathology MH - Time Factors MH - Middle Aged MH - Heart Valve Prosthesis MH - *Cardiac Catheterization/adverse effects/mortality/instrumentation MH - Risk Factors MH - Recovery of Function MH - Aged, 80 and over MH - Prosthesis Design OTO - NOTNLM OT - bioprosthetic mitral valve OT - mitral regurgitation OT - transfemoral mitral valve replacement OT - transseptal mitral valve replacement EDAT- 2025/06/16 11:11 MHDA- 2025/08/11 06:27 CRDT- 2025/06/16 02:33 PHST- 2025/04/25 00:00 [revised] PHST- 2025/02/01 00:00 [received] PHST- 2025/06/02 00:00 [accepted] PHST- 2025/08/11 06:27 [medline] PHST- 2025/06/16 11:11 [pubmed] PHST- 2025/06/16 02:33 [entrez] AID - 10.1002/ccd.31685 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Aug;106(2):1315-1323. doi: 10.1002/ccd.31685. Epub 2025 Jun 15. PMID- 40500116 OWN - NLM STAT- MEDLINE DCOM- 20250925 LR - 20260912 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) VI - 111 IP - 20 DP - 2025 Sep 25 TI - When absence of evidence equates to evidence of absence: the case of routine use of cerebral embolic protection devices in transcatheter aortic valve implantation. PG - 947-951 LID - 10.1136/heartjnl-2025-326208 [doi] AB - OBJECTIVES: This updated hierarchical Bayesian meta-analysis aims to integrate the latest randomised controlled trials (RCTs) on the use of cerebral embolic protection (CEP) in transcatheter aortic valve implantation (TAVI) into previously available data, providing a definite answer to the clinical effectiveness of CEP in TAVI patients. METHODS: A systematic search was updated on 31 March 2025. RCTs were included when comparing transfemoral TAVI with use of CEP versus transfemoral TAVI without CEP. The primary outcome was all stroke, while the secondary outcome was disabling stroke. A hierarchical Bayesian meta-analysis was performed on the (log) relative risk (RR) scale and transformed to absolute risk differences (ARDs) and numbers needed to treat (NNTs). The threshold for clinical relevance was based on published expert consensus and established on 1.1% ARD (NNT 91). RESULTS: The study was updated with one new RCT, totalling a number of eight RCTs (n=11 590, CEP n=5921 patients, control n=5669 patients). The prevalence of all stroke and disabling stroke was 2.9% and 1.4% in the control group. The median RR for all stroke was 0.94 (95% credible interval (CrI) 0.72-1.25), translating to a mean of -0.17% ARD (NNT 588), and a posterior probability of a clinically relevant CEP effect of <1%. The median RR for disabling stroke was 0.76 (95% CrI 0.44-1.23), translating to a mean of -0.36% ARD (NNT 278), and a posterior probability of a clinically relevant CEP effect of <1%. CONCLUSION: Current-generation CEP devices are ineffective in reducing periprocedural TAVI-stroke risk to a clinically relevant degree, rendering future trials with these devices futile. PROSPERO REGISTRATION NUMBER: CRD42023407006. CI - (c) Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Heuts, Samuel AU - Heuts S AUID- ORCID: 0000-0002-4409-6206 AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands sam.heuts@mumc.nl. AD - Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands. FAU - Kawczynski, Michal J AU - Kawczynski MJ AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands. FAU - Maesen, Bart AU - Maesen B AUID- ORCID: 0000-0001-8622-1450 AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands. FAU - Vriesendorp, Pieter A AU - Vriesendorp PA AD - Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands. AD - Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20250925 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Embolic Protection Devices MH - *Intracranial Embolism/prevention & control/etiology/epidemiology MH - *Aortic Valve Stenosis/surgery MH - Randomized Controlled Trials as Topic MH - *Stroke/prevention & control/etiology/epidemiology MH - Bayes Theorem MH - Risk Factors COIS- Competing interests: None declared. EDAT- 2025/06/12 00:38 MHDA- 2025/09/26 00:30 CRDT- 2025/06/11 21:12 PHST- 2025/04/02 00:00 [received] PHST- 2025/05/25 00:00 [accepted] PHST- 2025/09/26 00:30 [medline] PHST- 2025/06/12 00:38 [pubmed] PHST- 2025/06/11 21:12 [entrez] AID - heartjnl-2025-326208 [pii] AID - 10.1136/heartjnl-2025-326208 [doi] PST - epublish SO - Heart. 2025 Sep 25;111(20):947-951. doi: 10.1136/heartjnl-2025-326208. PMID- 40490129 OWN - NLM STAT- MEDLINE DCOM- 20250924 LR - 20250924 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 253 DP - 2025 Oct 15 TI - 6 Year Follow-Up of Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valves: A Propensity-Matched Analysis. PG - 78-85 LID - S0002-9149(25)00359-5 [pii] LID - 10.1016/j.amjcard.2025.06.002 [doi] AB - Prior reports comparing long-term outcomes of balloon-expandable (BE) versus self-expanding (SE) transcatheter aortic valve implantation (TAVI) have been limited. We compared in-hospital, 1-year, and 6-year outcomes in 1,685 BE (S3, Ultra) versus 776 SE (Evolut R, PRO, PRO+) patients undergoing transfemoral TAVI at a single center. Valve-in-valve and nontransfemoral access cases were excluded. Propensity-score matched BE (n = 683) and SE (n = 680) cohorts did not differ with respect to age (82.2 +/- 8.0 vs 82.1 +/- 7.8 years, p = 0.407), baseline demographics and comorbidities, pre-TAVI echo and cardiac catheterization results, and STS Risk Score (7.9 +/- 5.9 vs 7.9 +/- 5.5%, p = 0.481). BE vs SE patients had similar in-hospital mortality (0.9 vs 0.6%, p = 0.0.072), stroke (1.3 vs 1.8%, p = 0.503), major vascular complications (2.8 vs 2.2%, p = 0.495) and composite bleeding (4.7 vs 3.4%, p = 0.178), although the BE cohort required fewer permanent pacemakers (8.3 vs 13.3%, p = 0.003). At 1-year, BE and SE patients had similar all-cause mortality (10.8 vs 11.2%, p = 0.825), hospital readmission (22.5 vs 19.6%, p = 0.192), and KCCQ12 scores (83.7 +/- 25.5 vs 83.0 +/- 24.6, p = 0.606). At a median follow-up of 77.0 (72.6 to 81.5) months, Kaplan-Meier survival analysis demonstrated no difference in BE vs SE all-cause mortality (33.2 vs 40.4%, p = 0.586), with no differences in late valve-related outcomes including myocardial infarction, stroke, AV endocarditis, and AV re-intervention (balloon aortic valvuloplasty, percutaneous paravalvular leak closure, repeat TAVI, surgical AV replacement). However, BE patients more commonly required treatment for subclinical leaflet thrombosis, while SE patients had a higher incidence of transient ischemic attack during follow-up. In conclusion, BE and SE TAVI patients have similar in-hospital, 1-year and median 6-year adverse outcomes, other than higher subclinical leaflet thrombosis in BE patients and an increased transient ischemic attack rate in SE patients. CI - Copyright (c) 2025 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Bihag, Zade AU - Bihag Z AD - Department of Internal Medicine, University of Connecticut Health, Farmington, Connecticut. FAU - Patel, Jay AU - Patel J AD - Department of Internal Medicine, University of Connecticut Health, Farmington, Connecticut. FAU - Mather, Jeff F AU - Mather JF AD - Department of Research Administration, Hartford Hospital, Hartford, Connecticut. FAU - Hagberg, Robert AU - Hagberg R AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Haider, Jawad AU - Haider J AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Azemi, Talhat AU - Azemi T AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Sadiq, Immad AU - Sadiq I AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Cheema, Mohiuddin AU - Cheema M AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Piccirillo, Bryan AU - Piccirillo B AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Pousatis, Sheelagh AU - Pousatis S AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Thakurathi, Priyesh AU - Thakurathi P AD - Department of Medicine, Hartford Hospital, Hartford, Connecticut. FAU - Yaffee, David AU - Yaffee D AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - Hashim, Sabet W AU - Hashim SW AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. FAU - McKay, Raymond G AU - McKay RG AD - Hartford Healthcare Heart and Vascular Institute, Hartford Hospital Hartford, Connecticut. Electronic address: Raymond.mckay@hhchealth.org. LA - eng PT - Comparative Study PT - Journal Article DEP - 20250608 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Female MH - Male MH - *Aortic Valve Stenosis/surgery/mortality MH - Propensity Score MH - Aged, 80 and over MH - Follow-Up Studies MH - Hospital Mortality/trends MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Postoperative Complications/epidemiology MH - Treatment Outcome MH - Retrospective Studies MH - Aged MH - Time Factors MH - Survival Rate/trends OTO - NOTNLM OT - balloon-expandable valve OT - self-expanding valve OT - transcatheter aortic valve implantation COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/06/10 00:30 MHDA- 2025/09/25 00:28 CRDT- 2025/06/09 19:34 PHST- 2025/02/13 00:00 [received] PHST- 2025/06/03 00:00 [revised] PHST- 2025/06/03 00:00 [accepted] PHST- 2025/09/25 00:28 [medline] PHST- 2025/06/10 00:30 [pubmed] PHST- 2025/06/09 19:34 [entrez] AID - S0002-9149(25)00359-5 [pii] AID - 10.1016/j.amjcard.2025.06.002 [doi] PST - ppublish SO - Am J Cardiol. 2025 Oct 15;253:78-85. doi: 10.1016/j.amjcard.2025.06.002. Epub 2025 Jun 8. PMID- 40480459 OWN - NLM STAT- MEDLINE DCOM- 20251122 LR - 20251216 IS - 2213-3763 (Electronic) IS - 0019-4832 (Print) IS - 0019-4832 (Linking) VI - 77 IP - 5 DP - 2025 Sep-Oct TI - Unilateral access versus bilateral access in transfemoral transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 348-353 LID - S0019-4832(25)00127-0 [pii] LID - 10.1016/j.ihj.2025.06.001 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) procedures frequently require a second arterial access to perform aortic root angiography. In recent times, there has been an increase in the use of unilateral access, however, the outcomes data are conflicting. METHODS: A systematic database search was conducted to retrieve studies comparing unilateral to bilateral access in TAVR. Risk ratios (RR) with 95 % confidence intervals (CI) were pooled using the Mantel-Haenszel random-effects model. Outcomes of interest included minor vascular complications, major vascular complications, 30-day stroke, and 30-day all-cause mortality. RESULTS: Three studies with a total of 2,181 patients undergoing TAVR (unilateral 368, bilateral 1813) were included in this meta-analysis. Unilateral access was comparable to bilateral access for minor vascular complications (RR: 0.88; 95 % CI: 0.48-1.62), major vascular complications (RR: 0.61, 95 % CI: 0.14-2.75), stroke (RR: 0.95; 95 % CI: 0.42, 2.17) and all-cause mortality (RR: 0.52; 95 % CI: 0.04, 6.93). CONCLUSION: Unilateral access for TAVR was associated with similar short-term outcomes and safety profiles compared to bilateral access for TAVR. CI - Copyright (c) 2025 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved. FAU - Jain, Hritvik AU - Jain H AD - Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, India. FAU - Shahabi, Mariam AU - Shahabi M AD - Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan. FAU - Shafiq, Aimen AU - Shafiq A AD - Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan. FAU - Agrawal, Siddharth P AU - Agrawal SP AD - Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI, United States. FAU - Saad, Marwan S AU - Saad MS AD - Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Brown University Health Cardiovascular Institute, Providence, RI, United States. FAU - Sharaf, Barry L AU - Sharaf BL AD - Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Brown University Health Cardiovascular Institute, Providence, RI, United States. FAU - Gordon, Paul C AU - Gordon PC AD - Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Brown University Health Cardiovascular Institute, Providence, RI, United States. FAU - Abbott, J Dawn AU - Abbott JD AD - Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Brown University Health Cardiovascular Institute, Providence, RI, United States. FAU - Vallabhajosyula, Saraschandra AU - Vallabhajosyula S AD - Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Brown University Health Cardiovascular Institute, Providence, RI, United States. Electronic address: svallabhajosyula@brownhealth.org. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20250604 PL - India TA - Indian Heart J JT - Indian heart journal JID - 0374675 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - *Femoral Artery MH - Global Health MH - Postoperative Complications/epidemiology MH - *Aortic Valve/surgery PMC - PMC12675799 OTO - NOTNLM OT - Aortic stenosis OT - Bilateral access OT - Structural heart disease OT - Transcatheter aortic valve replacement OT - Unilateral access OT - Valvular heart disease COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/06/07 16:45 MHDA- 2025/11/23 00:58 PMCR- 2025/09/01 CRDT- 2025/06/06 19:39 PHST- 2025/03/15 00:00 [received] PHST- 2025/05/28 00:00 [revised] PHST- 2025/06/03 00:00 [accepted] PHST- 2025/11/23 00:58 [medline] PHST- 2025/06/07 16:45 [pubmed] PHST- 2025/06/06 19:39 [entrez] PHST- 2025/09/01 00:00 [pmc-release] AID - S0019-4832(25)00127-0 [pii] AID - 10.1016/j.ihj.2025.06.001 [doi] PST - ppublish SO - Indian Heart J. 2025 Sep-Oct;77(5):348-353. doi: 10.1016/j.ihj.2025.06.001. Epub 2025 Jun 4. PMID- 40475742 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250607 IS - 2153-8174 (Electronic) IS - 1530-6550 (Print) IS - 1530-6550 (Linking) VI - 26 IP - 5 DP - 2025 May TI - Real-World Observations in the Treatment of Aortic Stenosis With the Transfemoral SAPIEN 3 Transcatheter Heart Valve: Insights From China. PG - 28800 LID - 10.31083/RCM28800 [doi] LID - 28800 AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as the preferred treatment for symptomatic severe aortic stenosis (AS). However, China's unique patient population presents distinct challenges, including a higher prevalence of bicuspid aortic valves (BAVs) and severe valve calcification. This study used real-world clinical data from Chinese patients to assess the safety and efficacy of the SAPIEN 3 balloon-expandable transcatheter heart valve (THV) in TAVR, particularly in patients with BAVs. METHODS: This retrospective, multicenter study enrolled consecutive severe AS patients treated with SAPIEN 3 THVs via a transfemoral approach from June 2020 to March 2024. The primary endpoint was 30-day mortality, while secondary endpoints included procedural mortality, procedural success, conversion to surgery, coronary artery occlusion, THV-in-THV deployment, permanent pacemaker implantation, and paravalvular leaks (PVLs). RESULTS: Among the 1642 enrolled patients, 56.0% had BAVs, and 44.0% had tricuspid aortic valves (TAVs). The 30-day mortality rate was 0.90%. Propensity score matching revealed no statistically significant differences between patients with BAVs and TAVs in terms of 30-day mortality (odds ratio (OR): 1.51, 95% confidence interval (CI): 0.42 to 5.36; p = 0.531), immediate procedural mortality, procedural success, coronary artery occlusion, THV-in-THV deployment, permanent pacemaker implantation, or moderate to severe PVLs. However, a significant difference was found in the conversion rate to open surgery (OR: 5.07, 95% CI: 1.11 to 23.2; p = 0.036). CONCLUSIONS: This study demonstrates the safety and feasibility of SAPIEN 3 balloon-expandable THVs in TAVR for Chinese patients with severe AS, including those with BAV stenosis. These findings challenge historical relative contraindications for TAVR in BAV patients and highlight the potential of TAVR in diverse patient populations. Larger prospective studies with extended follow-ups are needed to refine patient selection and evaluate longer-term outcomes. CI - Copyright: (c) 2025 The Author(s). Published by IMR Press. FAU - Dong, Jie AU - Dong J AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Li, Ziping AU - Li Z AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Wei, Peijian AU - Wei P AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Yan, Yiming AU - Yan Y AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Zhao, Guangzhi AU - Zhao G AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Ouyang, Wenbin AU - Ouyang W AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Li, Shiguo AU - Li S AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Xie, Yongquan AU - Xie Y AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Wan, Junyi AU - Wan J AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Xu, Donghui AU - Xu D AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Zhang, Fengwen AU - Zhang F AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Zhang, Gejun AU - Zhang G AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Wang, Shouzheng AU - Wang S AUID- ORCID: 0000-0003-1856-7825 AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. FAU - Pan, Xiangbin AU - Pan X AUID- ORCID: 0009-0006-0134-4157 AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, 100037 Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, 100037 Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, 100037 Beijing, China. LA - eng PT - Journal Article DEP - 20250522 PL - Singapore TA - Rev Cardiovasc Med JT - Reviews in cardiovascular medicine JID - 100960007 PMC - PMC12135656 OTO - NOTNLM OT - SAPIEN 3 OT - aortic stenosis OT - bicuspid aortic valves OT - transcatheter aortic valve replacement COIS- The authors declare no conflict of interest. EDAT- 2025/06/06 06:31 MHDA- 2025/06/06 06:32 PMCR- 2025/05/22 CRDT- 2025/06/06 05:16 PHST- 2024/11/19 00:00 [received] PHST- 2024/12/20 00:00 [revised] PHST- 2025/01/16 00:00 [accepted] PHST- 2025/06/06 06:32 [medline] PHST- 2025/06/06 06:31 [pubmed] PHST- 2025/06/06 05:16 [entrez] PHST- 2025/05/22 00:00 [pmc-release] AID - S1530-6550(25)01758-2 [pii] AID - 10.31083/RCM28800 [doi] PST - epublish SO - Rev Cardiovasc Med. 2025 May 22;26(5):28800. doi: 10.31083/RCM28800. eCollection 2025 May. PMID- 40452622 OWN - NLM STAT- MEDLINE DCOM- 20250811 LR - 20260908 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 2 DP - 2025 Aug TI - Percutaneous Management of Vessel Occlusion Caused by Suture-Based Closure Devices: A Case Series and Benchtop Model. PG - 1078-1087 LID - 10.1002/ccd.31598 [doi] AB - BACKGROUND: Large-bore arterial access (LBAA) closure for percutaneous interventional procedures is often achieved using suture-based vascular closure devices (VCDs), most commonly Perclose ProGlide (Abbott Vascular, Santa Clara, CA). Although the rate of vascular occlusion due to suture-based VCDs is rare, there is no widely accepted percutaneous bailout treatment for this device-related complication. AIMS: This investigation sought to evaluate the percutaneous treatment of suture-based VCD-mediated closure in vivo and explain its mechanism with an ex vivo benchtop model. METHODS: This retrospective cohort study focused on patients who underwent LBAA closure complicated by vascular occlusion related to the Perclose VCD. These were managed through percutaneous endovascular interventions (PEI), in which the identified occlusions were treated using a peripheral cutting balloon. Additionally, a benchtop model utilizing silicone tubing was developed to simulate the occlusion mechanism caused by the Perclose VCD and to compare the use of non-compliant versus cutting balloons in this context. RESULTS: A 6 mm cutting balloon successfully cut the monofilament polypropylene at 3 atmospheres (ATM), whereas a 5 mm non-compliant balloon failed, even at a burst pressure of 24 ATM. In this patient cohort, seven patients were found to have common femoral artery (CFA) occlusion following the tightening of the previously deployed Perclose VCD. The median age was 87 years (interquartile range: 80-87), 71% were female, and had significant cardiovascular risk factors. All patients were diagnosed with CFA occlusion at the end of the transcatheter aortic valve replacement procedure during aortoiliac angiography, following vascular closure. PEI was performed using a combined cutting balloon and balloon angioplasty approach across the entire patient cohort with complete revascularization, minimal residual stenosis, no severe complications, no covered stents required, and no reported conversions to surgery. Long-term follow-up in six patients showed no reinterventions required or related mortalities. CONCLUSION: Based on the findings from our ex vivo model and clinical experience, peripheral cutting balloon angioplasty should be considered for the management of vessel occlusion caused by suture-based VCD. CI - (c) 2025 Wiley Periodicals LLC. FAU - Haberman, Dan AU - Haberman D AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Czulada, Evan AU - Czulada E AUID- ORCID: 0009-0008-1502-2006 AD - Georgetown University School of Medicine, Washington, USA. FAU - Lupu, Lior AU - Lupu L AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Chitturi, Kalyan R AU - Chitturi KR AUID- ORCID: 0000-0003-0602-2684 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Abusnina, Waiel AU - Abusnina W AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Chaturvedi, Abhishek AU - Chaturvedi A AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Merdler, Ilan AU - Merdler I AUID- ORCID: 0000-0003-3294-5968 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Galo, Jason AU - Galo J AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Verma, Beni R AU - Verma BR AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Wallace, Ryan AU - Wallace R AUID- ORCID: 0000-0003-3662-2832 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Rogers, Toby AU - Rogers T AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. AD - Cardiovascular Intervention Program, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Ben-Dor, Itsik AU - Ben-Dor I AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Waksman, Ron AU - Waksman R AUID- ORCID: 0000-0002-4063-9226 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. FAU - Bernardo, Nelson L AU - Bernardo NL AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, USA. LA - eng GR - The authors received no specific funding for this work./ PT - Journal Article DEP - 20250602 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Retrospective Studies MH - Female MH - Male MH - *Vascular Closure Devices MH - Treatment Outcome MH - *Hemostatic Techniques/adverse effects/instrumentation MH - Aged, 80 and over MH - Aged MH - Punctures MH - Equipment Design MH - *Catheterization, Peripheral/adverse effects/instrumentation MH - *Suture Techniques/adverse effects/instrumentation MH - *Hemorrhage/etiology/prevention & control MH - *Femoral Artery/diagnostic imaging MH - Risk Factors MH - Materials Testing MH - *Arterial Occlusive Diseases/etiology/therapy/diagnostic imaging/physiopathology OTO - NOTNLM OT - complications OT - large-bore access OT - suture-based OT - transcatheter aortic valve replacement OT - vascular closure device OT - vessel occlusion EDAT- 2025/06/02 06:28 MHDA- 2025/08/11 06:27 CRDT- 2025/06/02 05:13 PHST- 2025/02/06 00:00 [received] PHST- 2025/05/06 00:00 [accepted] PHST- 2025/08/11 06:27 [medline] PHST- 2025/06/02 06:28 [pubmed] PHST- 2025/06/02 05:13 [entrez] AID - 10.1002/ccd.31598 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Aug;106(2):1078-1087. doi: 10.1002/ccd.31598. Epub 2025 Jun 2. PMID- 40451995 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250605 IS - 2090-911X (Electronic) IS - 1110-2608 (Print) IS - 1110-2608 (Linking) VI - 77 IP - 1 DP - 2025 Jun 1 TI - Shockwave lithotripsy-assisted TAVI in a patient with severely calcified peripheral arteries and porcelain aorta. PG - 53 LID - 10.1186/s43044-025-00645-z [doi] LID - 53 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is the standard treatment for severe aortic stenosis (AS), particularly in high-risk patients. However, peripheral artery disease with extensive vascular calcification poses challenges for transfemoral access. Shockwave intravascular lithotripsy (IVL) has emerged as a promising technique to facilitate vascular access in such cases. CASE PRESENTATION: A 73-year-old male presented with non-ST elevation myocardial infarction. His condition necessitated urgent coronary revascularization and later, TAVI for severe AS. Pre-procedural computed tomography angiography revealed severe circumferential calcification of the entire aorta and both iliac and femoral arteries. Due to the extensive calcification and stenosis of the left common iliac artery, IVL was performed to optimize vessel diameter prior to TAVI. Post-IVL, optimal luminal expansion was achieved (6.8 mm), allowing safe passage of the delivery sheath. CONCLUSION: IVL-assisted transfemoral TAVI is a safe and effective strategy in patients with extensive iliofemoral calcifications. CI - (c) 2025. The Author(s). FAU - Rahimov, Uzeyir AU - Rahimov U AD - Universal Hospital, Baku, Azerbaijan. FAU - Zeynalov, Rufat AU - Zeynalov R AD - Baku Health Center, Baku, Azerbaijan. FAU - Karimli, Emin AU - Karimli E AD - Universal Hospital, Baku, Azerbaijan. dr.karimli.emin@gmail.com. FAU - Aliyev, Farid AU - Aliyev F AD - Baku Health Center, Baku, Azerbaijan. FAU - Hajiyev, Elkhan AU - Hajiyev E AD - Baku Health Center, Baku, Azerbaijan. FAU - Abdulalimova, Khatira AU - Abdulalimova K AD - Universal Hospital, Baku, Azerbaijan. FAU - Mustafaeva, Shafag AU - Mustafaeva S AD - Universal Hospital, Baku, Azerbaijan. FAU - Kilic, Teoman AU - Kilic T AD - Kocaeli University, Izmit, Turkey. LA - eng PT - Journal Article DEP - 20250601 PL - Germany TA - Egypt Heart J JT - The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology JID - 9106952 PMC - PMC12127253 OTO - NOTNLM OT - Aortic stenosis OT - Lithotripsy OT - TAVI COIS- Declarations. Ethical approval and consent to participate: Not applicable. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and accompanying images. Competing interests: The authors declare no competing interests. EDAT- 2025/06/02 03:18 MHDA- 2025/06/02 03:19 PMCR- 2025/06/01 CRDT- 2025/06/01 23:11 PHST- 2025/03/27 00:00 [received] PHST- 2025/04/28 00:00 [accepted] PHST- 2025/06/02 03:19 [medline] PHST- 2025/06/02 03:18 [pubmed] PHST- 2025/06/01 23:11 [entrez] PHST- 2025/06/01 00:00 [pmc-release] AID - 10.1186/s43044-025-00645-z [pii] AID - 645 [pii] AID - 10.1186/s43044-025-00645-z [doi] PST - epublish SO - Egypt Heart J. 2025 Jun 1;77(1):53. doi: 10.1186/s43044-025-00645-z. PMID- 40447554 OWN - NLM STAT- MEDLINE DCOM- 20260323 LR - 20260522 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 84 DP - 2026 Mar TI - Comparison between severe R-L and R-NC raphe-type bicuspid aortic valve stenosis treated with TAVI: insights from the international AD HOC Registry. PG - 71-79 LID - S1553-8389(25)00276-3 [pii] LID - 10.1016/j.carrev.2025.05.023 [doi] AB - BACKGROUND: Sievers type 1 bicuspid aortic valve (BAV) stenosis presents unique challenges for trans-catheter aortic valve implantation (TAVI), particularly when calcified raphe is present. The impact of raphe localization on TAVI outcomes remains unclear. OBJECTIVES: This study aimed to compare procedural and clinical outcomes in patients with right-left (R-L) and right-non coronary (R-NC) raphe-type BAV treated with TAVI. METHODS: Between January 2016 and October 2023, 956 consecutive patients with severe Sievers type 1 BAV stenosis underwent trans-femoral (TF)-TAVI across 24 tertiary centers. Pre-procedural computed tomography was retrospectively analyzed. To address the non-randomized study's design, 2:1 propensity score matching (PSM) was performed between R-L and R-NC groups. Primary endpoints included VARC-3 technical success, 30-day device success, early safety, and mid-term major adverse events (death, stroke, or heart failure hospitalization at the last follow-up). RESULTS: 825 had R-L raphe whereas 131 had R-NC pattern. After PSM, 251 R-L and 128 R-NC were analyzed. Baseline clinical, electrocardiographic, echocardiographic, computed tomography and procedural features were similar. Technical success was high in both groups (92.8 % vs 96.1 %; OR 0.53; 95%CI 0.19-1.45; p = 0.215), with comparable short- and mid-term outcomes. However, permanent pacemaker implantation (PPI) incidence was 3 times higher in R-L compared to R-NC (16.1 % vs. 6.7 %; OR 0.37, CI 0.16-0.89). CONCLUSIONS: Raphe localization in Sievers type 1 BAV does not affect major TAVI outcomes except for PPI risk, which is 3-fold higher in R-L patients. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Vicere, Andrea AU - Vicere A AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Kerckhoff Heart Center, Bad Nauheim, Germany; Med. Clinic I, Department of Cardiology & Angiology, Justus-Liebig University of Giessen/Marburg, Giessen, Germany. FAU - Zito, Andrea AU - Zito A AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Fabris, Tommaso AU - Fabris T AD - Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy. FAU - De Biase, Chiara AU - De Biase C AD - Groupe Cardiovasculaire Interventionnel (GCVI), Clinique Pasteur, Toulouse, France. FAU - Restivo, Attilio AU - Restivo A AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Montarello, Nicholas AU - Montarello N AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Costa, Giuliano AU - Costa G AD - U.O.C. Cardiologia, Centro Alte Specialita e Trapianti, P.O. G. Rodolico, A.O.U. Policlinico-V. Emanuele, Universita di Catania, Catania, Italy. FAU - Colucci, Michele AU - Colucci M AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Koren, Ofir AU - Koren O AD - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. FAU - Fezzi, Simone AU - Fezzi S AD - Department of Cardiology, University Hospitals Galway, Ireland. FAU - Bellini, Barbara AU - Bellini B AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Massussi, Mauro AU - Massussi M AD - Civil Hospital and University of Brescia, Brescia, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore Medical Center, New York, NY, USA. FAU - Galasso, Michele AU - Galasso M AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Costa, Giulia AU - Costa G AD - Cardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Mazzapicchi, Alessandro AU - Mazzapicchi A AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Giacomin, Enrico AU - Giacomin E AD - Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy. FAU - Gorla, Riccardo AU - Gorla R AD - Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Rheude, Tobias AU - Rheude T AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich, Munich, Germany. FAU - Bellamoli, Michele AU - Bellamoli M AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Briguori, Carlo AU - Briguori C AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Leone, Pier Pasquale AU - Leone PP AD - Montefiore Medical Center, New York, NY, USA. FAU - Villa, Emmanuel AU - Villa E AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Casamassima, Fabio AU - Casamassima F AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Aurigemma, Cristina AU - Aurigemma C AD - Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Renker, Matthias AU - Renker M AD - Kerckhoff Heart Center, Bad Nauheim, Germany; Med. Clinic I, Department of Cardiology & Angiology, Justus-Liebig University of Giessen/Marburg, Giessen, Germany. FAU - Gomez, Mario Garcia AU - Gomez MG AD - CIBERCV, Division of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Benvenuto, Ciro Pollio AU - Benvenuto CP AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Leone, Antonio Maria AU - Leone AM AD - Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Laterra, Giulia AU - Laterra G AD - Universita degli Studi di Enna "Kore", Enna, Italy. FAU - Gitto, Mauro AU - Gitto M AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Cattaneo, Greta AU - Cattaneo G AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples 'Federico II'. FAU - Ielasi, Alfonso AU - Ielasi A AD - Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, Milan, Italy. FAU - Orbach, Ady AU - Orbach A AD - Edith Wolfson Medical Center, Cardiology Department, Holon, Israel and Tel-Aviv University, Tel-Aviv, Israel. FAU - Brambilla, Nedy AU - Brambilla N AD - Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Amat-Santos, Ignacio AU - Amat-Santos I AD - CIBERCV, Division of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Mangieri, Antonio AU - Mangieri A AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Favero, Luca AU - Favero L AD - Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy. FAU - Chen, Mao AU - Chen M AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China. FAU - Adamo, Marianna AU - Adamo M AD - Civil Hospital and University of Brescia, Brescia, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore Medical Center, New York, NY, USA. FAU - De Carlo, Marco AU - De Carlo M AD - Cardiac Catheterization Laboratory, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Montorfano, Matteo AU - Montorfano M AD - School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Makkar, Raj R AU - Makkar RR AD - Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospitals Galway, Ireland. FAU - Blackman, Daniel J AU - Blackman DJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust Leeds, UK. FAU - Trani, Carlo AU - Trani C AD - Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore", Enna, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tchetche, Didier AU - Tchetche D AD - Groupe Cardiovasculaire Interventionnel (GCVI), Clinique Pasteur, Toulouse, France. FAU - Maffeo, Diego AU - Maffeo D AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy. FAU - Buono, Andrea AU - Buono A AD - Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. Electronic address: andrebuo@hotmail.com. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20250522 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Male MH - *Aortic Valve Stenosis/diagnostic imaging/mortality/surgery/physiopathology MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation MH - Treatment Outcome MH - Retrospective Studies MH - Aged MH - Registries MH - *Aortic Valve/diagnostic imaging/abnormalities/physiopathology/surgery MH - Risk Factors MH - Time Factors MH - Severity of Illness Index MH - *Bicuspid Aortic Valve Disease/diagnostic imaging/mortality/physiopathology/surgery MH - Aged, 80 and over MH - Risk Assessment OTO - NOTNLM OT - Bicuspid aortic valve OT - Pacemaker implantation OT - Raphe OT - TAVI COIS- Declaration of competing interest None. EDAT- 2025/05/31 00:37 MHDA- 2026/03/24 00:30 CRDT- 2025/05/30 22:34 PHST- 2025/04/12 00:00 [received] PHST- 2025/05/16 00:00 [revised] PHST- 2025/05/21 00:00 [accepted] PHST- 2026/03/24 00:30 [medline] PHST- 2025/05/31 00:37 [pubmed] PHST- 2025/05/30 22:34 [entrez] AID - S1553-8389(25)00276-3 [pii] AID - 10.1016/j.carrev.2025.05.023 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2026 Mar;84:71-79. doi: 10.1016/j.carrev.2025.05.023. Epub 2025 May 22. PMID- 40438925 OWN - NLM STAT- MEDLINE DCOM- 20250826 LR - 20250827 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 18 IP - 8 DP - 2025 Aug TI - Procedural and Clinical Outcomes According to Ultrasound-Guided Access in TAVI: A Propensity-Matched Comparative Subanalysis From the PULSE Registry. PG - e014771 LID - 10.1161/CIRCINTERVENTIONS.124.014771 [doi] AB - BACKGROUND: Access-related vascular and bleeding complications during transcatheter aortic valve implantation (TAVI) are associated with significant morbidity and mortality. Ultrasound-guided (USG) puncture may reduce the incidence of these adverse events, particularly in large-bore arterial access. However, large-scale data on this approach are limited, and it has not yet been fully implemented into standard clinical practice. We compared access-related vascular and bleeding complications in USG versus fluoroscopy-guided access from a large multicenter TAVI registry. METHODS: The PULSE registry (Plug- or Suture-Based Vascular Closure After TAVI) retrospectively evaluated data of 9295 patients who underwent transfemoral TAVI at 10 high-volume German heart centers (2016-2021). USG and fluoroscopy-guided access were performed in 1992 (21.4%) and 7303 (78.6%) patients, respectively. Propensity score matching (1:1) yielded 895 matched pairs. The primary end point, a composite of minor and major vascular complications or bleeding type II-IV, was assessed according to Valve Academic Research Consortium definitions. RESULTS: Patients in the USG and fluoroscopy-guided groups (median age, 81.9 [78.3-85.0] years; 47.8% female patients) showed well-balanced baseline characteristics. The overall risk profile was comparable (median EuroSCORE II: 3.2 versus 3.5; SD, 0.007 [-0.086 to 0.099]). The composite primary end point occurred less frequently in the USG group (11.7% versus 16.0%; odds ratio, 0.7; P=0.01), driven by lower rates of procedural bleeding (5.4% versus 9.2%; odds ratio, 0.56; P=0.002) and with lower rates of endovascular treatment (0.7% versus 2.5%; P=0.005). CONCLUSIONS: In patients with transfemoral TAVI, USG access demonstrated lower rates of access-related vascular complications and type II-IV bleeding compared with fluoroscopy-guided access. Implementing USG puncture as the standard of care may improve access-related outcomes after TAVI. FAU - Grundmann, David AU - Grundmann D AUID- ORCID: 0000-0001-8100-7594 AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. FAU - Rudolph, Tanja AU - Rudolph T AUID- ORCID: 0000-0001-8839-7476 AD - Department of General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University and University of Bielefeld, Germany (T.R., S. Bleiziffer, R.B.-L., M.P.). FAU - Adam, Matti AU - Adam M AUID- ORCID: 0000-0002-6990-8135 AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und internistische Intensivmedizin, Koln, Germany (M.A., M.M., H.W.). FAU - Kellner, Caroline AU - Kellner C AUID- ORCID: 0009-0000-9693-4622 AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - Center for Population Health Innovation (POINT) (C.K., A.G., S. Blankenberg), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AUID- ORCID: 0000-0001-9669-7372 AD - Department of General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University and University of Bielefeld, Germany (T.R., S. Bleiziffer, R.B.-L., M.P.). FAU - Braun, Daniel AU - Braun D AUID- ORCID: 0000-0002-6355-3222 AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Germany (D.B., J.G.). FAU - Tamm, Alexander R AU - Tamm AR AUID- ORCID: 0000-0003-2017-094X AD - Zentrum fur Kardiologie-Kardiologie I, Universitatsmedizin Mainz, Germany (A.R.T., M.G.). FAU - Meertens, Max AU - Meertens M AUID- ORCID: 0000-0002-7746-8723 AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und internistische Intensivmedizin, Koln, Germany (M.A., M.M., H.W.). FAU - Renker, Matthias AU - Renker M AUID- ORCID: 0000-0002-4756-5397 AD - Department of Cardiology/Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany (M.R., C.W.H.). FAU - Gmeiner, Jonas AU - Gmeiner J AUID- ORCID: 0000-0003-1507-6449 AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Germany (D.B., J.G.). FAU - Sedaghat, Alexander AU - Sedaghat A AUID- ORCID: 0000-0001-7015-1056 AD - Department of Cardiovascular Surgery (H.R., A.S.), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - Med. Klinik II-Kardiologie, Universitatsklinikum Bonn, Germany (A.S., M. Sudo). FAU - Leistner, David AU - Leistner D AUID- ORCID: 0000-0002-4351-420X AD - Charite-Universitatsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik fur Kardiologie, Germany (D.L., B.J.). AD - Med. Klinik III-Kardiologie, Angiologie, Universitares Herzzentrum, Universitatsmedizin Frankfurt/Main, Germany (D.L.). AD - German Centre for Cardiovascular Research (DZHK), Partner Site Rhein-Main (D.L.). FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology/Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany (M.R., C.W.H.). FAU - Wienemann, Hendrik AU - Wienemann H AUID- ORCID: 0000-0001-5810-2868 AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und internistische Intensivmedizin, Koln, Germany (M.A., M.M., H.W.). FAU - Zapustas, Norvydas AU - Zapustas N AUID- ORCID: 0000-0002-1552-809X AD - Helios Universitatsklinikum Wuppertal-Herzzentrum Universitat Witten/Herdecke, Germany (N.Z.). FAU - Juri, Benjamin AU - Juri B AD - Charite-Universitatsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik fur Kardiologie, Germany (D.L., B.J.). AD - Department of Cardiology, University Hospital Zurich, Switzerland (B.J.). FAU - Salem, Mostafa AU - Salem M AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Germany (M. Salem, J.P., D.F.). FAU - Benetti-Lehmann, Roman AU - Benetti-Lehmann R AUID- ORCID: 0009-0007-9057-9798 AD - Department of General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University and University of Bielefeld, Germany (T.R., S. Bleiziffer, R.B.-L., M.P.). FAU - Dreger, Henryk AU - Dreger H AUID- ORCID: 0000-0003-1909-4329 AD - Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum (H.D.), Deutsches Herzzentrum der Charite, Berlin, Germany. AD - Structural Heart Interventions Program (H.D.), Deutsches Herzzentrum der Charite, Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Germany (H.D.). AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin (H.D.). FAU - Gossling, Alina AU - Gossling A AUID- ORCID: 0000-0002-5211-5593 AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - Center for Population Health Innovation (POINT) (C.K., A.G., S. Blankenberg), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. FAU - Nahif, Awesta AU - Nahif A AUID- ORCID: 0009-0004-6850-6929 AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AUID- ORCID: 0000-0001-6488-2362 AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - Center for Population Health Innovation (POINT) (C.K., A.G., S. Blankenberg), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel (S. Blankenberg, H.R., D.F., M. Seiffert). FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery (H.R., A.S.), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel (S. Blankenberg, H.R., D.F., M. Seiffert). FAU - Schofer, Niklas AU - Schofer N AUID- ORCID: 0000-0001-5190-813X AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery (H.R., A.S.), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - Med. Klinik II-Kardiologie, Universitatsklinikum Bonn, Germany (A.S., M. Sudo). FAU - Popara, Jasmin AU - Popara J AUID- ORCID: 0009-0006-3703-9306 AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Germany (M. Salem, J.P., D.F.). FAU - Sudo, Misumasa AU - Sudo M AUID- ORCID: 0000-0001-5660-7264 AD - Med. Klinik II-Kardiologie, Universitatsklinikum Bonn, Germany (A.S., M. Sudo). FAU - Geyer, Martin AU - Geyer M AUID- ORCID: 0000-0002-9935-8293 AD - Zentrum fur Kardiologie-Kardiologie I, Universitatsmedizin Mainz, Germany (A.R.T., M.G.). FAU - Vorpahl, Marc AU - Vorpahl M AD - Helios Klinikum Siegburg, University of Witten/Herdecke, Germany (M.V.). FAU - Frank, Derk AU - Frank D AUID- ORCID: 0000-0001-7561-075X AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Germany (M. Salem, J.P., D.F.). AD - German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel (S. Blankenberg, H.R., D.F., M. Seiffert). FAU - Potratz, Max AU - Potratz M AD - Department of General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University and University of Bielefeld, Germany (T.R., S. Bleiziffer, R.B.-L., M.P.). FAU - Kim, Won AU - Kim W AUID- ORCID: 0000-0002-0799-7478 AD - Med. Clinic I, Cardiology and Angiology, University of Giessen und Marburg GmbH, Germany (W.K.). FAU - Seiffert, Moritz AU - Seiffert M AUID- ORCID: 0000-0002-3940-9079 AD - Department of Cardiology (D.G., C.K., A.G., A.N., S. Blankenberg, N.S., M. Seiffert), University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel (S. Blankenberg, H.R., D.F., M. Seiffert). AD - BG University Hospital Bergmannsheil, Ruhr University Bochum, Germany (M. Seiffert). LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20250529 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Female MH - Male MH - Registries MH - Aged MH - Retrospective Studies MH - Aged, 80 and over MH - *Ultrasonography, Interventional/adverse effects MH - Treatment Outcome MH - Punctures MH - Risk Factors MH - Hemorrhage/prevention & control/etiology MH - Germany MH - *Catheterization, Peripheral/adverse effects/mortality MH - Risk Assessment MH - *Femoral Artery/diagnostic imaging MH - Propensity Score MH - Time Factors MH - Fluoroscopy MH - *Hemostatic Techniques/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/physiopathology/mortality OTO - NOTNLM OT - fluoroscopy OT - hemorrhage OT - morbidity OT - punctures OT - registries OT - retrospective studies OT - standard of care COIS- Dr Rudolph received speaker and advisory fees from Abbott, Edwards Lifesciences, JenaValve, Boston Scientific, Medtronic, and Amgen. Dr Adam received consultancy or speaker fees from Abbott, Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic and is a proctor for Abbott, JenaValve, and Medtronic. Dr Braun received speaker fees from Abbott Vascular and Edwards Lifesciences. Dr Tamm received consultancy or speaker fees from Edwards Lifesciences, JenaValve, and Medtronic and is a proctor for JenaValve. Dr Bleiziffer received speaker fees from Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Leistner received speaker and advisory fees, and proctoring and travel support from Edwards Lifesciences, Abbott, and Boston Scientific. Dr Renker received proctor fees from Boston Scientific and Medtronic. Dr Dreger received proctoring, speaker, and advisory fees from Abbott and Edwards Lifesciences and research support from Abbott. Dr Reichenspurner received consultancy or speaker fees from Edwards Lifesciences, Abiomed (speakers bureau), and Medtronic (advisory board). Dr Schaefer received speaker fees and travel support from Edwards Lifesciences, Abbott, and Boston Scientific and is a proctor for Abbott, unrelated to the submitted work. Dr Geyer received consultancy or speaker fees from Edwards Lifesciences and is a proctor for JenaValve. Dr Frank received speaker fees from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific, and consulting fees and a research grant from Edwards Lifesciences, all unrelated to the presented work. Dr Kim received personal fees from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Meril Life Sciences, and Shockwave Medical. Dr Seiffert received speaker or advisory fees from Abbott Vascular, Abiomed, Amgen, AstraZeneca, Boston Scientific, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Inari Medical, Medtronic, Pfizer, Shockwave Medical, and Siemens Healthineers and a research grant from Boston Scientific, all unrelated to the submitted work. The other authors report no conflicts. EDAT- 2025/05/29 06:26 MHDA- 2025/08/31 19:59 CRDT- 2025/05/29 05:03 PHST- 2025/08/31 19:59 [medline] PHST- 2025/05/29 06:26 [pubmed] PHST- 2025/05/29 05:03 [entrez] AID - 10.1161/CIRCINTERVENTIONS.124.014771 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2025 Aug;18(8):e014771. doi: 10.1161/CIRCINTERVENTIONS.124.014771. Epub 2025 May 29. PMID- 40433868 OWN - NLM STAT- MEDLINE DCOM- 20250811 LR - 20260908 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 106 IP - 2 DP - 2025 Aug TI - Propensity Matched Analysis of 14 French Suture- Versus Plug-Based Vascular Closure During Transfemoral Transcatheter Aortic Valve Replacement (TAVR). PG - 918-925 LID - 10.1002/ccd.31626 [doi] AB - BACKGROUND: Plug-based vascular closure devices (Pb-VCD) and suture-based vascular closure devices (Sb-VCD) are used for percutaneous vascular access site closure during transcatheter aortic valve replacement (TAVR). Until now, no clear superiority of either device was shown in studies comparing 18 F VCDs solely. However, there is no data exclusively comparing the 14 F Pb-VCDs against Sb-VCDs after novel 14 F low-profile third-generation heart valve delivery sheath use with focus on vascular complications. AIMS: This study aimed to compare the safety and efficacy of 14 F Pb-VCD to Sb-VCD following 14 F low-profile transcatheter heart valve delivery sheath use during TAVR. METHODS: We performed a retrospective, propensity score-matched comparison of patients receiving either the 14 F Pb-VCD or the Sb-VCD after 14 F low-profile third-generation heart valve delivery sheath use during TAVR. Valve academic research consortium-3 (VARC-3) criteria were used to define the primary endpoint of major and minor vascular complications at the access site. Secondary endpoints included length of hospital stay and in-hospital mortality. RESULTS: Two hundred and fifteen (Sb-VCD) and 169 (Pb-VCD) patients were included in propensity score matching and resulted in 69 matched patient pairs. The primary endpoint of major vascular complications was comparable between the groups (8.7% [Sb-VCD] vs. 5.8% [Pb-VCD], p = 0.511), whereas minor vascular complications were more frequent in the Pb-VCD group (2.9% vs. 11.6%, p = 0.049). Secondary endpoints of length of hospital stay (p = 0.270) and in-hospital mortality (p = 0.366) were balanced between the groups. CONCLUSION: 14 F Pb-VCDs are associated with significantly higher rates of VARC-3 defined minor vascular complications after 14 F delivery sheath utilization during TAVR, not leading to increased in-hospital patients' mortality. Adequate vascular closure following transfemoral TAVR remains of high clinical significance and continuous efforts are needed to optimize vascular access and closure strategies. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Lerchner, Tobias AU - Lerchner T AUID- ORCID: 0000-0003-1120-4087 AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany. FAU - Michel, Lars AU - Michel L AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany. FAU - Tiroch, Klaus AU - Tiroch K AD - Department of Cardiology, Heart Center Bodensee, Konstanz, Germany. FAU - Rassaf, Tienush AU - Rassaf T AD - Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany. FAU - Krane, Markus AU - Krane M AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Munich, Germany. AD - Department of Surgery, Division of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut, USA. AD - DZHK (German Center for Cardiovascular Research)-Partner Site Munich Heart Alliance, Munich, Germany. FAU - Vorpahl, Marc Michael AU - Vorpahl MM AD - Department of Cardiology, Rhythmology and Vascular Medicine, Helios Clinic Siegburg, Siegburg, Germany. FAU - Ruge, Hendrik AU - Ruge H AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Munich, Germany. LA - eng GR - T.R. was supported by the Deutsche Forschungsgemeinschaft (RA 969/12-1). L.M. was supported by the IFORES scholarship of the Medical Faculty, University Duisburg-Essen, Germany./ PT - Comparative Study PT - Journal Article DEP - 20250528 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation MH - Retrospective Studies MH - Treatment Outcome MH - *Femoral Artery/diagnostic imaging MH - Aged, 80 and over MH - Male MH - Female MH - *Vascular Closure Devices MH - *Catheterization, Peripheral/adverse effects/mortality/instrumentation MH - Punctures MH - Risk Factors MH - Aged MH - Propensity Score MH - Time Factors MH - Hospital Mortality MH - *Hemostatic Techniques/adverse effects/instrumentation/mortality MH - Risk Assessment MH - *Hemorrhage/prevention & control/mortality/etiology MH - Length of Stay MH - Equipment Design MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology PMC - PMC12336750 OTO - NOTNLM OT - Pb-VCD OT - Sb-VCD OT - TAVR OT - access site complications OT - low-profile sheath OT - plug-based vascular closure OT - structural heart OT - suture-based vascular closure OT - transfemoral COIS- T.R. reports personal fees and others from Edwards, Novartis, Bristol Myers Squibb, Bayer, Daiichi Sankyo und AstraZeneca, and Pfizer outside of the submitted work. T.R. is a cofounder of Bimyo, a company focusing on the development of cardioprotective peptides. L.M. reports personal fees from Bayer, Alnylam, AstraZeneca, Bristol Myers Squibb, Pfizer, IFFM e.V., and from Bund der Niedergelassenen Kardiologen (BNK) outside of the submitted work. H.R. serves as a physician proctor for Abbott and Edwards Lifescience, a consultant for Medtronic, Abbott, and Edwards Lifescience, and a member of the Abbott advisory board. M.K. is a physician proctor and a member of the medical advisory board for JOMDD, a physician proctor for Peter Duschek, is a medical consultant for EVOTEC and Moderna and has received speakers' honoraria from Medtronic and Terumo. The other authors declare no conflicts of interest. EDAT- 2025/05/28 12:28 MHDA- 2025/08/11 06:27 PMCR- 2025/08/11 CRDT- 2025/05/28 06:53 PHST- 2025/03/17 00:00 [revised] PHST- 2024/12/07 00:00 [received] PHST- 2025/05/17 00:00 [accepted] PHST- 2025/08/11 06:27 [medline] PHST- 2025/05/28 12:28 [pubmed] PHST- 2025/05/28 06:53 [entrez] PHST- 2025/08/11 00:00 [pmc-release] AID - CCD31626 [pii] AID - 10.1002/ccd.31626 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Aug;106(2):918-925. doi: 10.1002/ccd.31626. Epub 2025 May 28. PMID- 40430236 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250531 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 15 IP - 5 DP - 2025 May 19 TI - Complex Transfemoral Access During Transcatheter Aortic Valve Replacement: A Narrative Review of Management, Complexity Scores, and Alternative Access. LID - 10.3390/life15050810 [doi] LID - 810 AB - Transcatheter aortic valve replacement (TAVR) has become a well-established treatment for severe aortic stenosis across all levels of surgical risk. While transfemoral access remains the default approach, complications arising from vascular access-especially in patients with peripheral artery disease (PAD)-pose significant challenges. Hostile vascular access, characterized by narrow vessel diameters, severe calcification, and tortuosity, complicates the procedure and necessitates alternative strategies. Recent advancements, such as intravascular lithotripsy (IVL), have shown promise in managing severely calcified arteries, improving the feasibility of transfemoral TAVR in patients previously considered ineligible. IVL uses pulsatile sonic waves to fragment arterial calcifications, enhancing vessel compliance and facilitating safe device delivery. Studies have demonstrated that IVL-assisted TAVR improves procedural success and reduces complications in patients with PAD. Additionally, orbital atherectomy, an adjunctive therapy targeting both concentric and eccentric calcifications, may complement the management of complex arterial calcification. The Hostile and passage-puncture scores offer valuable risk stratification tools for predicting vascular complications, aiding in better access site selection. Post-procedural echocardiography, particularly femoral artery sonography, may also play a role in detecting vascular complications early, enabling timely intervention. Finally, alternative access sites are increasingly being explored, with emerging data helping to guide the final access site decision. As TAVR continues to expand into lower risk populations, optimizing vascular access strategies remains essential to improving procedural outcomes. This review highlights the importance of preoperative imaging, endovascular techniques, and post-procedural monitoring in overcoming vascular challenges and ensuring successful TAVR outcomes. FAU - Skalidis, Ioannis AU - Skalidis I AUID- ORCID: 0000-0002-4374-0389 AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. AD - School of Medicine, University of Crete, 71500 Heraklion, Greece. FAU - Sayah, Neila AU - Sayah N AUID- ORCID: 0009-0009-0473-9623 AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Unterseeh, Thierry AU - Unterseeh T AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Hovasse, Thomas AU - Hovasse T AUID- ORCID: 0000-0002-1359-9185 AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Sanguineti, Francesca AU - Sanguineti F AUID- ORCID: 0000-0003-2127-5778 AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Garot, Philippe AU - Garot P AUID- ORCID: 0009-0001-8960-7006 AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Lounes, Youcef AU - Lounes Y AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Neylon, Antoinette AU - Neylon A AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. FAU - Akodad, Mariama AU - Akodad M AD - Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, 91300 Massy, France. LA - eng PT - Journal Article PT - Review DEP - 20250519 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC12112901 OTO - NOTNLM OT - alternative vascular access OT - aortic stenosis OT - complex femoral access OT - peripheral artery disease OT - transcatheter aortic valve replacement COIS- Dr Skalidis is supported by grant from the Gottfried and Julia Bangerter-Rhyner Foundation and from the Professor Dr Max Cloetta Foundation. M. Akodad is a consultant to Medtronic, Edwards Lifesciences, and Abbott. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/05/28 06:29 MHDA- 2025/05/28 06:30 PMCR- 2025/05/19 CRDT- 2025/05/28 01:27 PHST- 2025/04/11 00:00 [received] PHST- 2025/05/09 00:00 [revised] PHST- 2025/05/15 00:00 [accepted] PHST- 2025/05/28 06:30 [medline] PHST- 2025/05/28 06:29 [pubmed] PHST- 2025/05/28 01:27 [entrez] PHST- 2025/05/19 00:00 [pmc-release] AID - life15050810 [pii] AID - life-15-00810 [pii] AID - 10.3390/life15050810 [doi] PST - epublish SO - Life (Basel). 2025 May 19;15(5):810. doi: 10.3390/life15050810. PMID- 40429465 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20251023 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 10 DP - 2025 May 15 TI - When Real-World Outcomes Do Not Meet the Results of Clinical Trials: Transfemoral Transcatheter vs. Surgical Aortic Valve Replacement in an Intermediate-Age Population (The Outstanding Italy Study). LID - 10.3390/jcm14103471 [doi] LID - 3471 AB - Objective: Aortic valve stenosis is the most common valvular heart disease in the elderly, and its treatment may be either surgical (SAVR) or transcatheter (TAVI). Although age is one of the main determinants of the therapeutic choice, current guidelines leave a "discrepancy area" between 65 and 75 years, with the American guidelines allowing TAVI for patients older than 65 years, while the European guidelines consider TAVI for patients older than 75 years. The present study addresses the outcomes of SAVR vs. TAVI in a real-world population aged 65 to 80 years, that is, one largely inclusive of the discrepancy area. Methods: This is a retrospective registry study based on data retrieved from administrative health databases of two large Italian regions (Lombardy and Puglia). Patients aged 65 to 80 years receiving either SAVR or a TAVI between 2018 and 2021 were selected. SAVR and TAVI outcomes (death, cardiac and non-cardiac events) were compared using a propensity-matching analysis, with a follow-up of 2 to 5 years and mortality as the primary outcome. Results: After propensity matching, two groups of 786 patients were compared in Lombardy and two groups of 321 patients were compared in Puglia. In both regions, at the end of follow-up, mortality was significantly (p < 0.001) lower in SAVR vs. TAVI (24.6% vs. 47.2% in Lombardy and 18.1% vs. 44.1% in Puglia). Conclusions: Our results are in contrast with the randomized controlled trials showing equivalence or even the superiority of TAVI vs. SAVR, but in agreement with other registry studies based on real-world data. With respect to the randomized controlled trials, the main difference is a better outcome in SAVR. Caution should be applied in addressing patients < 80 years with TAVI unless SAVR is contraindicated. FAU - Ranucci, Marco AU - Ranucci M AUID- ORCID: 0000-0002-4915-3572 AD - Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy. FAU - Staszewsky, Lidia AU - Staszewsky L AD - Laboratory Clinical Research in Brain and Cardiovascular Injury, Department of Acute Brain and Cardiovascular Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy. FAU - Cartabia, Massimo AU - Cartabia M AUID- ORCID: 0000-0002-3794-4772 AD - Laboratory of Geriatric Neuropsychiatry, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy. FAU - Tettamanti, Mauro AU - Tettamanti M AUID- ORCID: 0000-0001-7345-0887 AD - Laboratory of Geriatric Neuropsychiatry, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy. FAU - Lepore, Vito AU - Lepore V AD - Laboratory of Medical Research and Consumer Involvement, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy. FAU - Robusto, Fabio AU - Robusto F AD - Puglia Health System, Medonline-Statte, ASL-TA, 74010 Taranto, Italy. FAU - Clavenna, Antonio AU - Clavenna A AUID- ORCID: 0000-0001-5536-4192 AD - Scientific Department, Centre for Inherited Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy. FAU - D'Ettorre, Antonio AU - D'Ettorre A AUID- ORCID: 0000-0002-5880-4234 AD - Puglia Health System, Medonline-Statte, ASL-TA, 74010 Taranto, Italy. FAU - Arbustini, Eloisa AU - Arbustini E AD - Scientific Department, Centre for Inherited Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy. FAU - Baldassarre, Damiano AU - Baldassarre D AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. AD - Department of Medical Biotechnology and Translational Medicine, Universita degli Studi di Milano, 20129 Milan, Italy. FAU - La Rovere, Maria Teresa AU - La Rovere MT AUID- ORCID: 0000-0002-1884-5058 AD - Department of Cardiology, Istituti Clinici Scientifici Maugeri, Montescano Institute-IRCCS, 27040 Montescano, Italy. FAU - Montorfano, Matteo AU - Montorfano M AD - School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy. AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. FAU - Parati, Gianfranco AU - Parati G AUID- ORCID: 0000-0001-9402-7439 AD - Istituto Auxologico Italiano, S. Luca Hospital, University of Milan-Bicocca, 20126 Milan, Italy. AD - Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 20126 Milan, Italy. FAU - Pedretti, Roberto F E AU - Pedretti RFE AUID- ORCID: 0000-0003-1789-8657 AD - School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy. AD - Cardiovascular Department, IRCCS MultiMedica, 20099 Sesto San Giovanni, Italy. FAU - Raffa, Giuseppe Maria AU - Raffa GM AUID- ORCID: 0000-0001-7141-2561 AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, 90127 Palermo, Italy. AD - Cardiac Surgery Unit, Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, 90133 Palermo, Italy. FAU - Santini, Francesco AU - Santini F AD - Cardiac Surgery, Ospedale Policlinico San Martino, University of Genoa, 16126 Genoa, Italy. FAU - Stefanini, Giulio AU - Stefanini G AUID- ORCID: 0000-0002-3558-6967 AD - IRCCS Istituto Clinico Humanitas, 20089 Rozzano, Italy. FAU - Volterrani, Maurizio AU - Volterrani M AUID- ORCID: 0000-0002-2624-9213 AD - Cardiopulmonary Department, IRCCS San Raffaele Roma, 00166 Rome, Italy. AD - Exercise Medicine and Science, San Raffaele Open University, 00166 Rome, Italy. FAU - Fortino, Ida AU - Fortino I AD - Puglia Health System, Agenzia Regionale Strategica per la Salute ed il Sociale, AReSS Puglia, Area Epidemiologia e Care Intelligence, 70121 Bari, Italy. FAU - Bisceglia, Lucia AU - Bisceglia L AD - Laboratory for Pharmacoepidemiology, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy. FAU - Menicanti, Lorenzo AU - Menicanti L AD - Department of Cardiac Surgery, IRCCS Policlinico San Donato, 20097 Milan, Italy. FAU - Latini, Roberto AU - Latini R AD - Laboratory Clinical Research in Brain and Cardiovascular Injury, Department of Acute Brain and Cardiovascular Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy. LA - eng GR - N/A/Italian Ministry of Health/ PT - Journal Article DEP - 20250515 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12539603 OTO - NOTNLM OT - aortic valve stenosis OT - outcome OT - surgical aortic valve replacement OT - transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2025/05/28 06:28 MHDA- 2025/05/28 06:29 PMCR- 2025/05/15 CRDT- 2025/05/28 01:22 PHST- 2025/03/10 00:00 [received] PHST- 2025/04/18 00:00 [revised] PHST- 2025/05/08 00:00 [accepted] PHST- 2025/05/28 06:29 [medline] PHST- 2025/05/28 06:28 [pubmed] PHST- 2025/05/28 01:22 [entrez] PHST- 2025/05/15 00:00 [pmc-release] AID - jcm14103471 [pii] AID - jcm-14-03471 [pii] AID - 10.3390/jcm14103471 [doi] PST - epublish SO - J Clin Med. 2025 May 15;14(10):3471. doi: 10.3390/jcm14103471. PMID- 40418351 OWN - NLM STAT- MEDLINE DCOM- 20250526 LR - 20250630 IS - 2509-8020 (Electronic) IS - 2509-8020 (Linking) VI - 9 IP - 1 DP - 2025 May 26 TI - Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months. PG - 58 LID - 10.1186/s41687-025-00894-1 [doi] LID - 58 AB - AIM: The study aimed to determine the proportion of patients with significant improvements in Health-Related Quality of Life (HRQoL) 12 months after Transcatheter Aortic Valve Implantation (TAVI), using a threshold for physical function (PF) and physical role (RP) domains of the SF-36 questionnaire. Additionally, we explored shared baseline characteristics of patients reporting these improvements. METHODOLOGY: In this prospective observational study, 88 patients with symptomatic, severe aortic stenosis (AS) and preserved ejection fraction were enrolled between April 2017 and February 2020. Exclusion criteria were clinical instability, pacemaker, chronic AF, comorbidities with life expectancy < 1 year. HRQoL was evaluated before and 12 months after transfemoral TAVI using the Norwegian version 2.0 of SF-36, and presented as mean (95% confidence interval). Other outcome measures were 6-minute walking test and NYHA- classification. Independent samples t-test or Mann-Whitney U test was used for between-group comparisons as appropriate. Logistic regression or Chi2-test were used to explore associations between changes in PF and RP and clinical parameters. Statistical significance was set at p /= 15 points in the PF and RP categories. RESULTS: Mean age of the cohort was 80 +/- 6 years. 44 (50%) patients reported clinically significant improvement in PF, and 46 (52%) in the RP domain. Baseline scores were significantly lower in patients reporting clinical improvement after TAVI, with PF scores pre intervention 43.07 (37.37-48.78) vs. 65.34 (59.01-71.68), p < 0.001, and RP 36.01 (29.56-42.46) vs. 59.92 (50.91-68.92), p < 0.001. No significant associations were found between improvement in domain scores and parameters from the routine baseline examination, but having >/= 15-point improvement correlated to baseline PF and RP scores. CONCLUSION: Our study highlights the importance of defining a uniform threshold for clinically significant improvement in the SF-36 HRQoL questionnaire for patients undergoing TAVI. Half of the patients reported favorable long-term outcome for PF and RP aspects of SF-36. This emphasizes the importance of HRQoL assessment in the preoperative work up for patients undergoing TAVI. TRIAL REGISTRATION: https://www. CLINICALTRIALS: gov/ 05.04.2017 with ID NCT03107923. CI - (c) 2025. The Author(s). FAU - Saevik, Marte AU - Saevik M AUID- ORCID: 0000-0002-3683-5291 AD - The Intervention Centre, Rikshospitalet, Oslo University Hospital, Oslo, Norway. martesaevik@hotmail.com. AD - Faculty of Medicine, University of Oslo, Oslo, Norway. martesaevik@hotmail.com. AD - Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway. martesaevik@hotmail.com. FAU - Andersen, Marit Helen AU - Andersen MH AD - Department for Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway. FAU - Beitnes, Jan Otto AU - Beitnes JO AD - Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. FAU - Aaberge, Lars AU - Aaberge L AD - Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. FAU - Halvorsen, Per Steinar AU - Halvorsen PS AD - The Intervention Centre, Rikshospitalet, Oslo University Hospital, Oslo, Norway. AD - Faculty of Medicine, University of Oslo, Oslo, Norway. LA - eng SI - ClinicalTrials.gov/NCT03107923 PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20250526 PL - Germany TA - J Patient Rep Outcomes JT - Journal of patient-reported outcomes JID - 101722688 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve Stenosis/surgery MH - Patient Reported Outcome Measures MH - Prospective Studies MH - *Quality of Life MH - Surveys and Questionnaires MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome PMC - PMC12106267 OAB - Severe aortic stenosis is in the elderly treated with transcatheter aortic valve implantation, aiming to improve survival and relieve symptoms. Health- related quality of life is an important outcome to measure after the procedure. However, there are no defined values for what constitutes a significant improvement in this patient group when measuring quality of life using the widely used health-related quality of life questionnaire SF-36.Our study aimed to investigate how many patients had clinically important improvement in physical aspects of quality of life one year after valve implantation. Eighty-eight patients with an average age of 80 years were included. We proposed a new threshold of 15 points for improvement in the physical function and physical role domains of the questionnaire. We found that half of the patients improved in quality of life, and those who improved had lower scores before surgery.The study emphasizes the need for a clear standard for improvement in quality of life in these patients, highlighting the value of assessment of quality of life before and after TAVI. OABL- eng OTO - NOTNLM OT - Aortic stenosis (AS) OT - Health related quality of life (HRQoL) OT - Minimal clinically important difference (MCID) OT - SF-36 OT - Transcatheter aortic valve implantation (TAVI) COIS- Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Regional Ethics Committee South-Eastern Norway (2017/94/REK sor-ost). Written consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. Competing interests: The authors have no competing interests to declare that are relevant to the content of this article. EDAT- 2025/05/26 12:37 MHDA- 2025/05/26 12:38 PMCR- 2025/05/26 CRDT- 2025/05/26 11:14 PHST- 2024/08/16 00:00 [received] PHST- 2025/05/08 00:00 [accepted] PHST- 2025/05/26 12:38 [medline] PHST- 2025/05/26 12:37 [pubmed] PHST- 2025/05/26 11:14 [entrez] PHST- 2025/05/26 00:00 [pmc-release] AID - 10.1186/s41687-025-00894-1 [pii] AID - 894 [pii] AID - 10.1186/s41687-025-00894-1 [doi] PST - epublish SO - J Patient Rep Outcomes. 2025 May 26;9(1):58. doi: 10.1186/s41687-025-00894-1. PMID- 40417148 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260421 LR - 20260505 IS - 2604-7276 (Electronic) IS - 2604-7306 (Print) IS - 2604-7306 (Linking) VI - 7 IP - 1 DP - 2025 Jan-Mar TI - TAVI for aortic regurgitation using dedicated devices. A systematic review. PG - 29-43 LID - 10.24875/RECICE.M24000477 [doi] AB - INTRODUCTION AND OBJECTIVES: Transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation is challenging due to inadequate device anchoring and increased risks of device embolization and paravalvular regurgitation (PVR). This study aimed to review the safety and efficacy of TAVI for aortic regurgitation with devices specifically designed for this indication. METHODS: A comprehensive search of PubMed, Web of Science, Cochrane Library, and major conference archives up to April 2024 identified 143 unique results based on predefined criteria. RESULTS: Fifteen studies (n = 788 patients) were included, with J-Valve used in 357 patients and JenaValve in 431. Men represented 51% of the cohort, with a mean age of 74.7 +/- 8.8 years and an STS-PROM score of 5.8 +/- 4.9%. Transapical and transfemoral access routes were used in 62.7% and 37.3% of patients, respectively. Overall, procedural success was achieved in 95.9% of cases; surgical conversion was required in 1.8%, device migration/embolization occurred in 3.2%, and a second valve (in-valve) was required in 2.0% of patients. At 30 days, 95.5% of patients were alive, and device success was reported in 93.3% of cases. Mild PVR was observed in 18.0% of patients, moderate-to-severe PVR in 1.7%, and permanent pacemaker implantation (PPI) was required in 13.0%. In studies focusing on transfemoral procedures (all using JenaValve), the pooled estimates showed a procedural success rate of 97.8% (95%CI, 94.4-100), device success of 97.0% (95%CI, 94.8-99.2), 30-day mortality of 1.96% (95%CI, 0.20-3.72), moderate-to-severe PVR of 0.47% (95%CI, 0.00-1.47), and PPI requirement of 18.7% (95%CI, 13.9-23.4). CONCLUSIONS: This systematic review of relatively small observational studies demonstrates the safety and favorable early outcomes of TAVI using J-Valve and JenaValve in patients with pure aortic regurgitation, especially when the transfemoral approach is used. Nevertheless, the need for PPI remains frequent. CI - Copyright: (c) 2025 Sociedad Espanola de Cardiologia. FAU - Hassan, Ahmed AU - Hassan A AD - Department of Cardiology, Suez Medical Complex, Suez, Egipto Department of Cardiology Suez Medical Complex Suez Egipto. FAU - Abdelshafy, Mahmoud AU - Abdelshafy M AD - Cardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egipto Cardiology Department Faculty of Medicine Al-Azhar University Cairo Egipto. AD - Department of Cardiology, University of Galway, Galway, Irlanda Department of Cardiology University of Galway Galway Irlanda. FAU - Diab, Rehab Adel AU - Diab RA AD - Cardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egipto Cardiology Department Faculty of Medicine Al-Azhar University Cairo Egipto. FAU - Wienemann, Hendrik AU - Wienemann H AD - Clinic III for Internal Medicine, University Hospital Cologne, Cologne, Alemania Clinic III for Internal Medicine University Hospital Cologne Cologne Alemania. FAU - Adam, Matti AU - Adam M AD - Clinic III for Internal Medicine, University Hospital Cologne, Cologne, Alemania Clinic III for Internal Medicine University Hospital Cologne Cologne Alemania. FAU - Garcia, Santiago AU - Garcia S AD - Division of Cardiology, The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Estados Unidos Division of Cardiology The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education Cincinnati Estados Unidos. FAU - Saad, Marwan AU - Saad M AD - Interventional structural heart research, Lifespan Cardiovascular Institute and Warren Alpert Medical School, Brown University, Providence, Estados Unidos Interventional structural heart research Lifespan Cardiovascular Institute and Warren Alpert Medical School Brown University Providence Estados Unidos. FAU - Abdelghani, Mohammad AU - Abdelghani M AD - Cardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egipto Cardiology Department Faculty of Medicine Al-Azhar University Cairo Egipto. AD - Amsterdam UMC, University of Amsterdam, Amsterdam, Paises Bajos Amsterdam UMC University of Amsterdam Amsterdam Paises Bajos. AD - Cardiology Unit, Department of Internal Medicine, Sohar Hospital, Sohar, Oman Cardiology Unit Department of Internal Medicine Sohar Hospital Sohar Oman. LA - eng PT - Journal Article DEP - 20250224 PL - Spain TA - REC Interv Cardiol JT - REC, interventional cardiology JID - 9919033203206676 PMC - PMC12097355 OTO - NOTNLM OT - Aortic regurgitation OT - J-Valve OT - JenaValve OT - Outcome OT - Systematic review OT - Transcatheter aortic valve implantation COIS- CONFLICTO DE INTERESES: M. Adam declaro haber recibido honorarios personales y como conferenciante de Abbott, Boston Scientific, Edwards Lifesciences, JenaValve y Medtronic. Por su parte, S. Garcia declaro haber recibido subvenciones institucionales de J.C. Medical y JenaValve. Los demas autores no declararon ningun conflicto de intereses. EDAT- 2025/05/26 12:37 MHDA- 2025/05/26 12:38 PMCR- 2025/02/24 CRDT- 2025/05/26 06:11 PHST- 2024/05/14 00:00 [received] PHST- 2024/07/23 00:00 [accepted] PHST- 2025/05/26 12:37 [pubmed] PHST- 2025/05/26 12:38 [medline] PHST- 2025/05/26 06:11 [entrez] PHST- 2025/02/24 00:00 [pmc-release] AID - 2604-7306-recic-7-1-29 [pii] AID - 10.24875/RECICE.M24000477 [doi] PST - epublish SO - REC Interv Cardiol. 2025 Feb 24;7(1):29-43. doi: 10.24875/RECICE.M24000477. eCollection 2025 Jan-Mar. PMID- 40410432 OWN - NLM STAT- MEDLINE DCOM- 20250523 LR - 20250526 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 15 IP - 1 DP - 2025 May 23 TI - Efficacy and safety of transfemoral TAVR in pure aortic regurgitation patients: a single center study. PG - 17951 LID - 10.1038/s41598-025-03214-1 [doi] LID - 17951 AB - The objective of this study was to evaluate the efficacy of transcatheter aortic valve replacement (TAVR) via the femoral approach in patients with pure aortic regurgitation (AR), with a focus on mortality, adverse event rates, cardiac function, and clinical symptom improvement. The study utilised a single-centre experience to provide insights and offer guidance for the management of TAVR in AR patients. Patients with aortic valve pathology who underwent TAVR at the Second Affiliated Hospital of Nanchang University, from January 2018 to March 2023 were enrolled. They were classified into two groups: pure AR and aortic stenosis (AS) based on preoperative transthoracic echocardiography. We compared baseline characteristics, imaging data, surgical outcomes, and follow-up conditions between them. We focused on the safety and efficacy of TAVR in patients with AR and evaluated these results using regression analysis. The study cohort comprised 87 patients, with 21 in the AR group and 63 in the AS group. We revealed that AR patients exhibited low mortality and adverse event rates following transfemoral TAVR, with notable improvements in postoperative cardiac function and substantial symptom relief. However, the rates of paravalvular leak (PVL), permanent pacemaker (PPM) implantation, and valve-in-valve procedures were relatively elevated. While these findings suggest that TAVR may represent a viable therapeutic option for patients with AR, the elevated rates of PVL, PPM implantation, and readmission underscore the need for further investigation, with larger cohorts and extended follow-up, to more robustly evaluate the long-term safety and efficacy of this approach. CI - (c) 2025. The Author(s). FAU - Feng, Jie AU - Feng J AD - Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China. FAU - Wei, Haixia AU - Wei H AD - Department of Cardiology, Shangrao People's Hospital, Shangrao, 334000, Jiangxi Province, China. FAU - Zhang, Shiyuan AU - Zhang S AD - Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China. FAU - Li, Yao AU - Li Y AD - Department of Cardiology, The Affiliated Hospital of Jiujiang College, Jiujiang, 332000, Jiangxi Province, China. FAU - Liu, Hangyu AU - Liu H AD - Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China. FAU - Wu, Yanqing AU - Wu Y AUID- ORCID: 0000-0002-3042-271X AD - Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China. wuyanqing01@sina.com. LA - eng GR - 2024ZD007/the Jiangxi Provincial Health Commission Science and Technology Innovation Key Project/ PT - Journal Article DEP - 20250523 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Aortic Valve Insufficiency/surgery/mortality MH - Male MH - Female MH - Aged MH - Treatment Outcome MH - Aged, 80 and over MH - Aortic Valve Stenosis/surgery MH - Echocardiography MH - Aortic Valve/surgery MH - Postoperative Complications MH - Femoral Artery/surgery MH - Retrospective Studies PMC - PMC12102353 OTO - NOTNLM OT - Aortic regurgitation OT - Aortic stenosis OT - Perivalvular leakage OT - TAVR COIS- Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All participants provided informed consent, and all procedures and protocols were approved by the Clinical Research Ethics Committee of the Second Affiliated Hospital of Nanchang University (approval 2022.No.07) and implemented in accordance with the Declaration of Helsinki. EDAT- 2025/05/24 00:46 MHDA- 2025/05/24 00:47 PMCR- 2025/05/23 CRDT- 2025/05/23 23:29 PHST- 2024/11/16 00:00 [received] PHST- 2025/05/19 00:00 [accepted] PHST- 2025/05/24 00:47 [medline] PHST- 2025/05/24 00:46 [pubmed] PHST- 2025/05/23 23:29 [entrez] PHST- 2025/05/23 00:00 [pmc-release] AID - 10.1038/s41598-025-03214-1 [pii] AID - 3214 [pii] AID - 10.1038/s41598-025-03214-1 [doi] PST - epublish SO - Sci Rep. 2025 May 23;15(1):17951. doi: 10.1038/s41598-025-03214-1. PMID- 40408797 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250627 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 4 IP - 6 Pt 1 DP - 2025 Jun TI - Impact of Noncoaxial Transcatheter Aortic Valve Implantation on Clinical Outcomes. PG - 101834 LID - S2772-963X(25)00253-4 [pii] LID - 10.1016/j.jacadv.2025.101834 [doi] LID - 101834 AB - BACKGROUND: Noncoaxial placement of transcatheter heart valves (THVs) relative to the native aortic annulus is occasionally detected on fluoroscopy after transcatheter aortic valve replacement (TAVR). OBJECTIVES: This study aimed to evaluate the impact of noncoaxial TAVR deployment on clinical outcomes. METHODS: We retrospectively evaluated consecutive patients undergoing transfemoral TAVR in the Bern transcatheter aortic valve implantation registry. Coaxiality between the native annulus and the THV was measured using the 3-cusp view on fluoroscopic images and was defined as the angle between a line intersecting the lower points of native cusps and a line intersecting the lower hinge points of the prosthesis frame. Patients were categorized according to tertiles of coaxiality. RESULTS: Among 2,025 patients (mean age 81.6 +/- 6.5 years, mean Society of Thoracic Surgeons Predicted Risk of Mortality 4.2% +/- 3.3%) undergoing TAVR with contemporary devices between February 2014 and June 2023, the mean axial angulation of the device relative to the native annulus was 4.1 degrees . According to Valve Academic Research Consortium-3 criteria, patients in the highest tertile of THV axial angle (range, 4.8-21.7 degrees ) had reduced device early safety (56.2% vs 82.7%; aHR: 0.67; 95% CI: 0.59-0.76; P < 0.001) and higher rates of stage-2 bioprosthetic valve failure at 1-year follow-up (1.5% vs 0.7%; HR: 3.47; 95% CI: 1.26-9.54; P = 0.016), compared to those with coaxial valve positioning (range, 0.1-3.0). Left ventricle outflow tract calcium volume, predilatation, and valve type were independent predictors of noncoaxial valve implantation. CONCLUSIONS: Noncoaxial THV deployment is associated with impaired valve early safety and increased risk of bioprosthetic valve failure 1 year after TAVR. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Angellotti, Domenico AU - Angellotti D AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. FAU - Pfluger, Marc AU - Pfluger M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Maznyczka, Annette AU - Maznyczka A AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Nakase, Masaaki AU - Nakase M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Samim, Daryoush AU - Samim D AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Reineke, David AU - Reineke D AD - Department of Cardiovascular Surgery, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland. FAU - Praz, Fabien AU - Praz F AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. LA - eng PT - Journal Article DEP - 20250522 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC12150034 OTO - NOTNLM OT - axial angle OT - bioprosthetic valve failure OT - coaxial implantation OT - early safety OT - transcatheter aortic valve replacement COIS- Funding support and author disclosures Dr Angellotti is supported by a research grant provided by the CardioPath PhD program. Dr Maznyczka is an EAPCI (European Association of Percutaneous Coronary Intervention) international structural fellow; her fellowship is funded by Edwards Lifesciences through EAPCI and not directly from Edwards Lifesciences; and has received travel expenses from Edwards Lifesciences, Abbott, Boston Scientific, and Medtronic. Dr Stortecky has received research grants to the institution from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific; and has received personal fees from Boston Scientific, Teleflex, and BTG. Dr Lanz has received speaker fees to the institution from Edwards Lifesciences and Abbott. Dr Samim has received funding for an online course from Edwards Lifesciences. Dr Reineke has received travel expenses from Abbott, Edwards Lifesciences, and Medtronic and has proctor and consulting contracts with Abbott and Medtronic. Dr Praz has received travel expenses from Edwards Lifesciences, Abbott Vascular, Medira, Siemens Healthineers, and InQB8 Medical Technologies, as well as a research grant to the institution from Abbott Vascular. Dr Windecker has received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, BMS, Bayer, Biotronik, Boston Scientific, Cardinal Health, CardioValve, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Johnson & Johnson, Medicure, Medtronic, Novartis, Polares, OrPha Suisse, Pfizer, Regeneron, Sanofi, Sinomed, Terumo, and V-Wave; has served as an unpaid advisory board member and/or unpaid member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, BMS, Boston Scientific, Biotronik, Cardiovalve, Edwards Lifesciences, Med Alliance, Medtronic, Novartis, Polares, Sinomed, V-Wave, and Xeltis but has not received personal payments by pharmaceutical companies or device manufacturers; and has been a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Pilgrim has received research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; has received speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/05/23 18:39 MHDA- 2025/05/23 18:40 PMCR- 2025/05/22 CRDT- 2025/05/23 18:00 PHST- 2024/12/23 00:00 [received] PHST- 2025/03/20 00:00 [revised] PHST- 2025/04/20 00:00 [accepted] PHST- 2025/05/23 18:40 [medline] PHST- 2025/05/23 18:39 [pubmed] PHST- 2025/05/23 18:00 [entrez] PHST- 2025/05/22 00:00 [pmc-release] AID - S2772-963X(25)00253-4 [pii] AID - 101834 [pii] AID - 10.1016/j.jacadv.2025.101834 [doi] PST - ppublish SO - JACC Adv. 2025 Jun;4(6 Pt 1):101834. doi: 10.1016/j.jacadv.2025.101834. Epub 2025 May 22. PMID- 40393868 OWN - NLM STAT- MEDLINE DCOM- 20251003 LR - 20260520 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 79 DP - 2025 Oct TI - Anxiety during transcatheter aortic valve replacement under local anesthesia - the ART-VR trial. PG - 71-77 LID - S1553-8389(25)00243-X [pii] LID - 10.1016/j.carrev.2025.05.015 [doi] AB - BACKGROUND: The use of local anesthesia during transcatheter aortic valve replacement (TAVR) could result in patient discomfort. Application of immersive virtual reality (VR) during TAVR might distract the patient and enhance the overall experience. OBJECTIVE: To evaluate the effect of an immersive VR environment on periprocedural anxiety and patient discomfort, compared to standard of care in patients undergoing transfemoral (TF) TAVR under local anesthesia. METHODS: In this single-center, randomized controlled pilot study, patients were randomized to either VR immersion during TAVR or standard of care. The intervention was a VR headset to create 3D experiences during percutaneous transfemoral TAVR. The main outcome was patient-reported procedural anxiety assessed directly after the procedure on a visual analog scale (VAS). Secondary outcomes were procedural satisfaction, pain, and change in anxiety. Personality scores were obtained at baseline to explore associations between personality types and relevant outcomes. RESULTS: A total of 75 patients (VR = 37, control = 38) were included between September 2021 and January 2023. The median age was 79 (25th-75th: 75-84) years and 32 patients (43 %) were female. Overall procedural anxiety VAS was 1.0 (0.0-3.0) and satisfaction was 9.0 (8.0-10.0). There was no difference in procedural anxiety between VR and control (VAS: 1.0 [25th-75th: 0.0-3.0] versus 1.0 [25th-75th: 0.0-3.0], p = 0.59). Procedural satisfaction, pain perception and change in anxiety were not affected by VR use. CONCLUSION: Patients undergoing TF-TAVR under local anesthesia experienced mild procedural anxiety and high satisfaction levels. Procedural VR use did not affect procedural anxiety or pain perception. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Chatterjee, Sraman AU - Chatterjee S AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Ooms, Joris AU - Ooms J AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - de Ronde, Marjo AU - de Ronde M AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - van Gorsel, Stefan AU - van Gorsel S AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Mattace-Raso, Antonio Maarten AU - Mattace-Raso AM AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Goudzwaard, Jeannette AU - Goudzwaard J AD - Department of Internal Medicine, Section of Geriatrics, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Mattace-Raso, Francesco AU - Mattace-Raso F AD - Department of Internal Medicine, Section of Geriatrics, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Kardys, Isabella AU - Kardys I AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Nuis, Rutger-Jan AU - Nuis RJ AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Daemen, Joost AU - Daemen J AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. FAU - Van Mieghem, Nicolas AU - Van Mieghem N AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus MC University Medical Center, Rotterdam, the Netherlands. Electronic address: n.vanmieghem@erasmusmc.nl. LA - eng SI - ClinicalTrials.gov/NCT05069987 PT - Journal Article PT - Randomized Controlled Trial DEP - 20250515 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Female MH - Aged MH - *Anesthesia, Local/adverse effects MH - Male MH - *Anxiety/prevention & control/psychology/diagnosis/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects/psychology MH - Aged, 80 and over MH - Treatment Outcome MH - Pilot Projects MH - Pain Measurement MH - Patient Satisfaction MH - *Procedural Pain/prevention & control/etiology/psychology/diagnosis MH - *Aortic Valve Stenosis/surgery/diagnostic imaging OTO - NOTNLM OT - Anesthesia OT - Anxiety OT - Pain OT - TAVR OT - VR COIS- Declaration of competing interest Rutger-Jan Nuis received research grant support from Vifor Pharma and Merill, and consulting fees from Edwards Lifesciences, Abbott, Boston Scientific. Marjo de Ronde received honoraria or consultation fees by Edwards Lifesciences: Edwards Valve Nurse Leadership program, Edwards Benchmark Program. This program aims to streamline TAVI pathways through implementation of nurse-led best practices, leading to better patient outcomes and experience. Joost Daemen received institutional grant/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, PulseCath, Pie Medical, Sanofi, Siemens Health Care and Medtronic. Nicolas van Mieghem has received grant support/research contracts from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Daiichi Sankyo, Astra Zeneca and PulseCath BV and has received consulting/speaker fees from Abbot Vascular, Boston Scientific Corporation, Medtronic, Daiichi Sankyo, PulseCath BV, JenaValve, and Amgen. All other authors declare to have no conflicts of interest. EDAT- 2025/05/21 00:29 MHDA- 2025/10/04 00:30 CRDT- 2025/05/20 21:58 PHST- 2025/02/22 00:00 [received] PHST- 2025/05/08 00:00 [revised] PHST- 2025/05/12 00:00 [accepted] PHST- 2025/10/04 00:30 [medline] PHST- 2025/05/21 00:29 [pubmed] PHST- 2025/05/20 21:58 [entrez] AID - S1553-8389(25)00243-X [pii] AID - 10.1016/j.carrev.2025.05.015 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2025 Oct;79:71-77. doi: 10.1016/j.carrev.2025.05.015. Epub 2025 May 15. PMID- 40392217 OWN - NLM STAT- In-Process LR - 20260813 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 12 DP - 2025 Jun 16 TI - Next-day and 48-hour discharge following alternative access for transcatheter aortic valve implantation. PG - e704-e708 LID - EIJ-D-24-01048 [pii] LID - 10.4244/EIJ-D-24-01048 [doi] FAU - Zendo, Yohanna John AU - Zendo YJ AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Ordonez, Santiago AU - Ordonez S AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Chu, Michael W A AU - Chu MWA AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Valdis, Matthew AU - Valdis M AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Molloy, Siobhan AU - Molloy S AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Abbadi, Mosa AU - Abbadi M AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Teefy, Patrick AU - Teefy P AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Diamantouros, Pantelis AU - Diamantouros P AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. FAU - Bagur, Rodrigo AU - Bagur R AD - Heart Team, London Health Sciences Centre, Western University, London, ON, Canada. LA - eng PT - Journal Article DEP - 20250616 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM PMC - PMC12151162 COIS- M.W.A. Chu has received speaker honoraria from Medtronic, Edwards Lifesciences, Terumo Aortic, and Artivion Inc. P. Diamantouros is a consultant and proctor for Boston Scientific. R. Bagur is a consultant and proctor for Medtronic. The other authors have no conflicts of interest inherent to the content of this manuscript to declare. EDAT- 2025/05/20 17:05 MHDA- 2025/05/20 17:05 PMCR- 2026/06/16 CRDT- 2025/05/20 10:43 PHST- 2025/05/20 17:05 [pubmed] PHST- 2025/05/20 17:05 [medline] PHST- 2025/05/20 10:43 [entrez] PHST- 2026/06/16 00:00 [pmc-release] AID - EIJ-D-24-01048 [pii] AID - 10.4244/EIJ-D-24-01048 [doi] PST - epublish SO - EuroIntervention. 2025 Jun 16;21(12):e704-e708. doi: 10.4244/EIJ-D-24-01048. PMID- 40383183 OWN - NLM STAT- MEDLINE DCOM- 20251019 LR - 20251117 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 41 IP - 10 DP - 2025 Oct TI - The Safety and Feasibility of Same-Day Discharge for Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. PG - 1902-1914 LID - S0828-282X(25)00342-3 [pii] LID - 10.1016/j.cjca.2025.05.007 [doi] AB - BACKGROUND: Next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR) has been shown to be safe in appropriately selected patients and has been implemented into clinical practice. As the demand for TAVR grows, improving its accessibility is crucial. Several studies have trialled same-day discharge (SDD) after TAVR, but a review has not been performed. METHODS: Five databases were searched. Baseline demographics, study characteristics and the assessment criteria used to determine eligibility for SDD were extracted and compared. Proportional meta-analysis was used to compare post-TAVI outcomes between SDD and NDD patients. RESULTS: Six studies were included from 1734 screened articles. Of 3519 patients, 318 (9.0%) underwent SDD (mean age 78.2 +/- 8.7 years, 59.3% male). Balloon-expandable valves were used in 91.6% of cases, and self-expanding valves in the remaining 8.4%. Patients that underwent SDD experienced lower rates of mortality (OR 0.104, 95% CI 0.015-0.998), all-cause readmission (OR 0.194, 95% CI 0.052-0.717), cardiovascular readmissions (OR 0.155, 95% CI 0.026-0.971), and new pacemaker requirement (OR 0.167, 95% CI 0.028-0.995) at 30 days after TAVR compared with patients that underwent NDD. There was no difference in rates of stroke (OR 0.407, 95% CI 0.015-16.694) or major vascular complications (0.0% vs 0.0%). CONCLUSIONS: Current evidence supports the safety and feasibility of SDD after elective transfemoral TAVR in appropriately selected patients. Heterogeneity between eligibility criteria used to select patients for SDD, especially related to conduction disease, poses a barrier to implementation. Further research on self-expanding valves is needed. CI - Copyright (c) 2025 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Litkouhi, Princess Neila AU - Litkouhi PN AD - Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia; School of Medicine, University of Sydney, Camperdown, Australia. FAU - Rao, Karan AU - Rao K AD - Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia; School of Medicine, University of Sydney, Camperdown, Australia. FAU - Baer, Alexandra AU - Baer A AD - Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia. FAU - Hansen, Peter S AU - Hansen PS AD - Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia; School of Medicine, University of Sydney, Camperdown, Australia. FAU - Bhindi, Ravinay AU - Bhindi R AD - Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia; School of Medicine, University of Sydney, Camperdown, Australia. Electronic address: ravinay.bhindi@sydney.edu.au. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20250516 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery MH - Feasibility Studies MH - *Patient Discharge MH - Patient Readmission/statistics & numerical data MH - Postoperative Complications/epidemiology MH - *Transcatheter Aortic Valve Replacement/methods EDAT- 2025/05/19 00:37 MHDA- 2025/10/20 00:27 CRDT- 2025/05/18 19:33 PHST- 2024/12/15 00:00 [received] PHST- 2025/05/02 00:00 [revised] PHST- 2025/05/11 00:00 [accepted] PHST- 2025/10/20 00:27 [medline] PHST- 2025/05/19 00:37 [pubmed] PHST- 2025/05/18 19:33 [entrez] AID - S0828-282X(25)00342-3 [pii] AID - 10.1016/j.cjca.2025.05.007 [doi] PST - ppublish SO - Can J Cardiol. 2025 Oct;41(10):1902-1914. doi: 10.1016/j.cjca.2025.05.007. Epub 2025 May 16. PMID- 40372482 OWN - NLM STAT- MEDLINE DCOM- 20260612 LR - 20260813 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 115 IP - 7 DP - 2026 Jul TI - Mid- to long-term outcomes of covered balloon-expandable stent implantation for the management of vascular injuries in patients undergoing transfemoral transcatheter aortic valve implantation: the BE-SAFE Registry : for the RECOVER (REsults after percutaneous interventions with COVERed stents) Investigators. PG - 1120-1130 LID - 10.1007/s00392-025-02651-2 [doi] AB - BACKGROUND AND AIMS: Vascular complications occur in a non-negligible proportion of transfemoral transcatheter aortic valve implantation (Tf-TAVI) procedures. There is only limited evidence regarding the efficacy and safety of covered balloon-expandable (CBE) stents in the management of Tf-TAVI related vascular complications. We aimed to investigate the efficacy and safety of CBE stent implantation to treat access-related vascular complications in patients undergoing Tf-TAVI. METHODS: The present retrospective analysis included patients undergoing CBE stent implantation following Tf-TAVI from April 2012 to January 2023 at our centre. The primary endpoint was technical success defined as successful device delivery and implantation at the intended location with angiographic confirmation of vessel patency and absence of residual bleeding. Clinical outcomes and color Doppler ultrasonography findings were evaluated at discharge, 30 days and longest available follow-up. RESULTS: Among 3331 Tf-TAVI procedures, 93 patients (2.8%) required covered stent implantation for the treatment of access related vascular complications. Technical success was achieved in 92 patients (98.9%). BeGraft and Atrium Advanta V12 CBE stents were implanted in 76 (81.7%) and 17 (18.3%) patients, respectively. Median clinical follow-up was 455 [304; 798] days, with both in-hospital and 30-days mortality equaling 4.3% and 1-year mortality 15.1%. Pre-discharge Doppler ultrasonography was performed in 98.9% patients, with normal findings in 79.8% and minor findings (such as pseudoaneurysm, non-flow-limiting dissection, arterio-venous fistula) in the remaining patients. Clinical follow-up was available in 96.2% patients; no cases of new-onset claudication, need for repeat surgical or transcatheter vascular interventions were recorded. Follow-up Doppler ultrasonography (54.4% patients) showed persistent patency and no signs of stent failure in all patients. CONCLUSIONS: CBE stent implantation for the treatment of access site related vascular complications after Tf-TAVI is associated with excellent technical success rates, optimal short- to mid-term patency rates as well as satisfactory long-term clinical outcomes. CI - (c) 2025. The Author(s). FAU - Alvarez-Covarrubias, Hector A AU - Alvarez-Covarrubias HA AUID- ORCID: 0000-0003-0505-9530 AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. alvarez@dhm.mhn.de. AD - Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico. alvarez@dhm.mhn.de. FAU - Jurisic, Martin AU - Jurisic M AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Syryca, Finn AU - Syryca F AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Duesmann, Charlotte AU - Duesmann C AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Rheude, Tobias AU - Rheude T AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Mayr, N Patrick AU - Mayr NP AD - Institut fur Anasthesiologie, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Altaner, Niklas AU - Altaner N AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Kuhlein, Moritz AU - Kuhlein M AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Lenz, Tobias AU - Lenz T AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Blum, Edna AU - Blum E AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Taniguchi, Yousuke AU - Taniguchi Y AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Ndrepepa, Gjin AU - Ndrepepa G AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. FAU - Thilo, Christian AU - Thilo C AD - Department of Cardiology, RoMed Klinikum Rosenheim, Rosenheim, Germany. FAU - Schunkert, Heribert AU - Schunkert H AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kufner, Sebastian AU - Kufner S AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Cassese, Salvatore AU - Cassese S AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Joner, Michael AU - Joner M AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AD - Department of Cardiology, TUM University Hospital German Heart Center, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. LA - eng PT - Journal Article DEP - 20250515 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Female MH - Male MH - Retrospective Studies MH - Aged, 80 and over MH - *Registries MH - *Femoral Artery/injuries/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome MH - *Stents MH - *Vascular System Injuries/surgery/etiology MH - Time Factors MH - *Aortic Valve Stenosis/surgery MH - Follow-Up Studies MH - Prosthesis Design MH - Aged PMC - PMC13249666 OTO - NOTNLM OT - Covered balloon-expandable stent OT - Transcatheter aortic valve implantation OT - Transfemoral access OT - Vascular complication COIS- Declarations. Conflict of interest: Hector A. Alvarez-Covarrubias received lecture fees from SIS Medical AG, LifeTech and Edward Lifesciences, proctor fees from LifeTech and financial support for attending meetings or travel expenses from Abbott Vascular and LifeTech, not related to the current work. Salvatore Cassese reports consulting fees from SIS Medical, lecture fees from Abiomed, Astra Zeneca, SIS Medical and Teleflex, and financial support for attending meetings or travel expenses from SIS Medical, not related to the current work. Tobias Rheude received lecture fees from SIS Medical AG and AstraZeneca, not related to the current work. Sebastian Kufner reports speaker and consulting fees from AstraZeneca, Bristol Myers Squibb, and Bentley and speaker fees from Abbott, Boehringer-Ingelheim and Translumina and a research grant from Bentley, not related the current work. Heribert Schunkert reports personal fees from AMGEN, Daiichi-Sankyo, MSD Sharp&Dohme, Astra-Zeneca, Bazer Vital, Boehringer-Ingelheim, Novartis, Servier, Sanofi Aventis and Synlab not related to the current work. Michael Joner reports personal fees from Abbott, Alchimedics S.A.S., Astra Zeneca, Biotronik, Medtronic, Recor, Shockwave, TriCares, Veryan, grants and personal fees from Boston Scientific, Cardiac Dimensions, Edwards, grant from Infraredx outside the submitted work. Erion Xhepa reports consulting services for Edwards Lifesciences, lecture fees and honoraria from AstraZeneca, Boston Scientific, SIS Medical and Translumina not related to the current work; proctor fees from Abbott Vascular and financial support for attending meetings and/or travel expenses from Abbott Vascular and SIS Medical. The remaining authors have no conflicts of interest to declare. EDAT- 2025/05/15 12:36 MHDA- 2026/06/12 00:39 PMCR- 2025/05/15 CRDT- 2025/05/15 11:15 PHST- 2025/01/09 00:00 [received] PHST- 2025/04/06 00:00 [accepted] PHST- 2026/06/12 00:39 [medline] PHST- 2025/05/15 12:36 [pubmed] PHST- 2025/05/15 11:15 [entrez] PHST- 2025/05/15 00:00 [pmc-release] AID - 10.1007/s00392-025-02651-2 [pii] AID - 2651 [pii] AID - 10.1007/s00392-025-02651-2 [doi] PST - ppublish SO - Clin Res Cardiol. 2026 Jul;115(7):1120-1130. doi: 10.1007/s00392-025-02651-2. Epub 2025 May 15. PMID- 40371611 OWN - NLM STAT- MEDLINE DCOM- 20250520 LR - 20260701 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 14 IP - 10 DP - 2025 May 20 TI - Comparing Major Gastrointestinal Bleeding in Patients Receiving Edoxaban Versus Warfarin After Transcatheter Aortic Valve Replacement: Results From the Randomized ENVISAGE-TAVI AF Trial. PG - e033321 LID - 10.1161/JAHA.123.033321 [doi] LID - e033321 AB - BACKGROUND: Non-vitamin K oral anticoagulants are recommended over vitamin K antagonists in patients with nonvalvular atrial fibrillation (AF). However, the risk of gastrointestinal bleeding may be higher with non-vitamin K oral anticoagulants versus vitamin K antagonists. Patients after successful transcatheter aortic valve replacement (TAVR) who are elderly and frail have worse outcomes with major gastrointestinal bleeding (MGIB), including death. This study evaluated incidence, predictors, and impact of MGIB among patients with AF after successful TAVR. METHODS: This on-treatment analysis of ENVISAGE-TAVI AF (Edoxaban Compared to Standard Care After Heart Valve Replacement Using a Catheter in Patients With Atrial Fibrillation) included patients who received >/=1 dose of the study drug. Demographic, clinical, and procedural characteristics were compared between patients with versus without an MGIB event. Cox multivariable regression analysis identified predictors of MGIB. RESULTS: Of 1377 patients in this analysis, 83 (6.0%) experienced MGIB, with 56 (67.5%) of these patients receiving edoxaban. Patients with versus without MGIB were more likely to have undergone percutaneous coronary intervention /=40 mm. The probabilities of 3-year all-cause mortality were 11.9%, 7.4%, 12.1%, and 16.8% at the baseline AA diameters of <40, 40 to 44, 45 to 49, and >/=50 mm, respectively. No statistical significances were found between the groups. Only 1 patient with baseline AA diameter of 39 mm experienced type A aortic dissection 10 months after the procedure. No other adverse aortic events were observed. A positive correlation between baseline AA diameter and aortic expansion rate was found in patients with bicuspid aortic valve. However, the aortic expansion rates in patients with tricuspid aortic valve appeared to remain stable across the baseline AA diameters. CONCLUSIONS: The presence of AA dilation did not increase the overall mortality in a TAVR population. The incidence of adverse aortic events was low. However, the efficacy of TAVR in patients with bicuspid aortic valve and AA dilation requires further study. CI - (c) 2025 The Author(s). FAU - An, Kang AU - An K AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Zhang, Fengwen AU - Zhang F AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Ouyang, Wenbin AU - Ouyang W AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Han, Yu AU - Han Y AD - Department of Structural Heart Disease, Fuwai Central China Cardiovascular Hospital, Zhengzhou University, Zhengzhou, China. FAU - Zhu, Da AU - Zhu D AD - Department of Structural Heart Disease, Fuwai Yunnan Cardiovascular Hospital, Kunming Medical University, Kunming, China. FAU - Pan, Xiangbin AU - Pan X AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. AD - Department of Structural Heart Disease, Fuwai Yunnan Cardiovascular Hospital, Kunming Medical University, Kunming, China. LA - eng PT - Journal Article DEP - 20250514 PL - United States TA - JTCVS Struct Endovasc JT - JTCVS structural and endovascular JID - 9918991787106676 PMC - PMC13244710 OTO - NOTNLM OT - adverse aortic events OT - aortic expansion rate OT - ascending aorta OT - bicuspid aortic valve OT - transcatheter aortic valve replacement COIS- The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. EDAT- 2025/05/14 00:00 MHDA- 2025/05/14 00:01 PMCR- 2025/05/14 CRDT- 2026/06/17 05:18 PHST- 2025/02/10 00:00 [received] PHST- 2025/04/22 00:00 [revised] PHST- 2025/04/25 00:00 [accepted] PHST- 2025/05/14 00:01 [medline] PHST- 2025/05/14 00:00 [pubmed] PHST- 2026/06/17 05:18 [entrez] PHST- 2025/05/14 00:00 [pmc-release] AID - S2950-6050(25)00014-2 [pii] AID - 100055 [pii] AID - 10.1016/j.xjse.2025.100055 [doi] PST - epublish SO - JTCVS Struct Endovasc. 2025 May 14;6:100055. doi: 10.1016/j.xjse.2025.100055. eCollection 2025 Jun. PMID- 40364222 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250517 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 9 DP - 2025 May 5 TI - The Prognostic Value of Tricuspid Annular Dimensions in TAVI Patients: A CT-Based Retrospective Analysis of Risk Stratification and Long-Term Outcomes. LID - 10.3390/jcm14093191 [doi] LID - 3191 AB - Background: Transcatheter aortic valve implantation (TAVI) has transformed the treatment of severe aortic stenosis (AS), particularly in high-risk patients. However, comorbidities such as pulmonary hypertension (PH) and secondary tricuspid regurgitation (TR) contribute to adverse outcomes. Tricuspid annulus (TA) dilatation (TAD), a key marker of right ventricular dysfunction, has been associated with PH and TR progression. While echocardiographic assessment of TA has limitations, cardiac computed tomography (CT), routinely performed before TAVI, enables precise TA measurement. This study aimed to determine clinically relevant TA and TA indexed to body surface area (TA/BSA) cut-offs and assess their prognostic significance for long-term mortality. Methods: This retrospective, single-center study included 522 patients who underwent transfemoral TAVI between 2016 and 2022. Pre-procedural CT-derived TA measurements were analyzed to establish cut-off values predictive of right ventricular dysfunction in TAVI. Receiver operating characteristic (ROC) analysis was performed, and Kaplan-Meier survival curves, log-rank tests, and Cox regression were used to assess the impact of TA dimensions on long-term survival. Results: TAD correlated moderately with right ventricular dysfunction, with optimal cut-offs identified as TA >/= 44.50 mm and TA/BSA >/= 23.00 mm/m(2). However, Kaplan-Meier and Cox regression analyses demonstrated no significant association between TA or TA/BSA and long-term survival, with area under the curve (AUC) values close to 0.50, indicating poor prognostic value. Conclusions: Despite its relevance regarding right ventricular dysfunction in TAVI patients, TAD does not independently predict long-term mortality following TAVI. These findings challenge prior assumptions and suggest that TA dimensions alone should not guide risk stratification in TAVI patients. Further research is needed to refine prognostic models integrating multiple clinical and imaging parameters. FAU - Schorghofer, Nikolaos AU - Schorghofer N AUID- ORCID: 0000-0002-1842-0578 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Knapitsch, Christoph AU - Knapitsch C AUID- ORCID: 0000-0002-0656-7038 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Hecke, Gretha AU - Hecke G AUID- ORCID: 0009-0009-3263-372X AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Clodi, Nikolaus AU - Clodi N AUID- ORCID: 0009-0003-3443-9943 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Brandstetter, Lucas AU - Brandstetter L AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Hammerer, Matthias AU - Hammerer M AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Hergan, Klaus AU - Hergan K AUID- ORCID: 0009-0005-6571-8296 AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Hoppe, Uta C AU - Hoppe UC AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Boxhammer, Elke AU - Boxhammer E AUID- ORCID: 0000-0002-6589-3853 AD - Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. FAU - Scharinger, Bernhard AU - Scharinger B AD - Department of Radiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria. LA - eng PT - Journal Article DEP - 20250505 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12072421 OTO - NOTNLM OT - TAVI OT - aortic valve stenosis OT - computed tomography OT - tricuspid annular dimensions COIS- The authors declare no conflicts of interest. EDAT- 2025/05/14 11:41 MHDA- 2025/05/14 11:42 PMCR- 2025/05/05 CRDT- 2025/05/14 01:21 PHST- 2025/03/19 00:00 [received] PHST- 2025/04/19 00:00 [revised] PHST- 2025/05/01 00:00 [accepted] PHST- 2025/05/14 11:42 [medline] PHST- 2025/05/14 11:41 [pubmed] PHST- 2025/05/14 01:21 [entrez] PHST- 2025/05/05 00:00 [pmc-release] AID - jcm14093191 [pii] AID - jcm-14-03191 [pii] AID - 10.3390/jcm14093191 [doi] PST - epublish SO - J Clin Med. 2025 May 5;14(9):3191. doi: 10.3390/jcm14093191. PMID- 40357687 OWN - NLM STAT- MEDLINE DCOM- 20260403 LR - 20260403 IS - 2149-2271 (Electronic) IS - 2149-2263 (Print) IS - 2149-2263 (Linking) VI - 29 IP - 7 DP - 2025 May 13 TI - Self-Expanding Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis Undergoing Prosthetic Mitral Valve Replacement: A Single-Center Experience. PG - 362-370 LID - 10.14744/AnatolJCardiol.2025.5124 [doi] AB - BACKGROUND: Following the encouraging results of several registries and trials, transcatheter aortic valve implantation has become standard therapy for aortic stenosis patients with intermediate or high operative risk for surgical treatment. Good procedural success and good clinical outcomes have been shown, but very limited data exist on transcatheter aortic valve implantation in the setting of a preexisting mitral valve (MV) prosthesis regarding the technique, potential complications, and outcomes. Single-center experience is presented with this special patient cohort. METHODS: Here, 31 cases of transfemoral transcatheter aortic valve implantation with a self-expanding bioprosthesis (CoreValve and Evolut R; Medtronic, Minneapolis, MN, USA) in patients who had previously undergone MV surgery have been reported. Preprocedural, intraprocedural, and post-procedural outcomes and data were analyzed. RESULTS: Between February 2013 and December 2023, 31 patients with prior MV prostheses were included. The average age was 68.7 years, and 77.4% were female. Mechanical MV prostheses were present in 90.3% of patients. The mean Society of Thoracic Surgeon score was 9.03. Transcatheter aortic valve implantation was performed 14.75 years after MV replacement. Post-procedural complications included access site issues in 25.8% of patients, with 22.5% requiring pacemaker implantation. No procedural mortality occurred. Six out of 31 patients (n = 6/31 patients) died during follow-up, primarily due to respiratory complications, and the mean survival time was 74.9 +/- 8.4 months (95% CI: 58.4-91.4). CONCLUSION: The experiences showed that transfemoral implantation of a self-expanding aortic valve with MV prostheses patients, via the transfemoral route, is safe and feasible, with maintained long-term results. FAU - Kivrak, Ahmet AU - Kivrak A AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. FAU - Ates, Ahmet Hakan AU - Ates AH AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. FAU - Menemencioglu, Can AU - Menemencioglu C AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. FAU - Dogan, Mert AU - Dogan M AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. FAU - Sahiner, Mehmet Levent AU - Sahiner ML AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. FAU - Kaya, Ergun Baris AU - Kaya EB AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. FAU - Aytemir, Kudret AU - Aytemir K AD - Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkiye. LA - eng PT - Journal Article PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 SB - IM MH - Humans MH - Female MH - Male MH - *Aortic Valve Stenosis/surgery/mortality MH - Aged MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Bioprosthesis MH - Aged, 80 and over MH - Severity of Illness Index MH - *Mitral Valve/surgery MH - Postoperative Complications MH - Retrospective Studies MH - Middle Aged PMC - PMC12231391 COIS- Declaration of Interests: The authors have no conflicts of interest to declare. EDAT- 2025/05/13 13:50 MHDA- 2026/04/03 18:35 PMCR- 2025/05/12 CRDT- 2025/05/13 06:03 PHST- 2026/04/03 18:35 [medline] PHST- 2025/05/13 13:50 [pubmed] PHST- 2025/05/13 06:03 [entrez] PHST- 2025/05/12 00:00 [pmc-release] AID - ajc-29-7-362 [pii] AID - 10.14744/AnatolJCardiol.2025.5124 [doi] PST - ppublish SO - Anatol J Cardiol. 2025 May 13;29(7):362-370. doi: 10.14744/AnatolJCardiol.2025.5124. PMID- 40352131 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250513 IS - 2434-0790 (Electronic) IS - 2434-0790 (Linking) VI - 7 IP - 5 DP - 2025 May 9 TI - Early Changes in Left Ventricular Myocardial Mechanics After Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis. PG - 365-371 LID - 10.1253/circrep.CR-24-0139 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) improves left ventricular (LV) deformation by aortic stenosis (AS). However, the early effects of TAVR on LV mechanics as assessed by echocardiography have not been fully elucidated. METHODS AND RESULTS: Between 2021 and 2024, we included 81 patients who underwent transfemoral TAVR for severe AS. We used the natural logarithm of B-type natriuretic peptide (lnBNP) 1 week after TAVR as an indicator of the early effects on LV mechanics. To determine the association with echocardiographic parameters (LV ejection fraction [LVEF], global longitudinal strain [GLS], E/e', and Tei index) and postprocedural lnBNP, we used regression models while adjusting for covariates. There were no significant differences in LVEF, GLS or E/e' between before and after TAVR, but the postprocedural Tei index was significantly higher than the preprocedural Tei index (0.40 vs. 0.26, P<0.01). In a univariate linear regression, the preprocedural LVEF (beta=-0.28, P=0.01), GLS (beta=-0.24, P=0.04), E/e' (beta=0.36, P<0.01), and Tei index (beta=0.27, P=0.02) correlated with postprocedural lnBNP. Regarding the postprocedural parameters, GLS (beta=-0.27, P=0.02) and E/e' (beta=0.36, P<0.01) also correlated with postprocedural lnBNP, but the LVEF and Tei index did not. After adjustment for covariates, these correlations remained significant. CONCLUSIONS: Preprocedural echocardiographic parameters reflecting LV function correlated with BNP after TAVR, but the utility of postprocedural parameters may depend on preprocedural LV function or perioperative factors. CI - Copyright (c) 2025, THE JAPANESE CIRCULATION SOCIETY. FAU - Ikenaga, Takeru AU - Ikenaga T AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. FAU - Kato, Yuta AU - Kato Y AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. FAU - Kawahira, Yuto AU - Kawahira Y AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. FAU - Miyazaki, Midori AU - Miyazaki M AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. AD - Department of Clinical Laboratory and Transfusion, Fukuoka University Hospital Fukuoka Japan. FAU - Hirata, Tetsuo AU - Hirata T AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. FAU - Teratani, Hiromitsu AU - Teratani H AD - Department of Cardiovascular Surgery, Fukuoka University Hospital Fukuoka Japan. FAU - Kuwahara, Go AU - Kuwahara G AD - Department of Cardiovascular Surgery, Fukuoka University Hospital Fukuoka Japan. FAU - Sugihara, Makoto AU - Sugihara M AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. FAU - Wada, Hideichi AU - Wada H AD - Department of Cardiovascular Surgery, Fukuoka University Hospital Fukuoka Japan. FAU - Ogawa, Masahiro AU - Ogawa M AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. AD - Department of Clinical Laboratory and Transfusion, Fukuoka University Hospital Fukuoka Japan. FAU - Miura, Shin-Ichiro AU - Miura SI AD - Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan. LA - eng PT - Journal Article DEP - 20250327 PL - Japan TA - Circ Rep JT - Circulation reports JID - 101746642 PMC - PMC12061501 OTO - NOTNLM OT - Aortic stenosis OT - Echocardiography OT - Tei index OT - Transcatheter aortic valve replacement COIS- None of the authors have conflicts of interest to disclose. S.M. is a member of the Editorial Boards of Circulation Journal / Circulation Reports. EDAT- 2025/05/12 12:34 MHDA- 2025/05/12 12:35 PMCR- 2025/03/27 CRDT- 2025/05/12 06:03 PHST- 2024/11/04 00:00 [received] PHST- 2025/01/12 00:00 [revised] PHST- 2025/01/29 00:00 [accepted] PHST- 2025/05/12 12:35 [medline] PHST- 2025/05/12 12:34 [pubmed] PHST- 2025/05/12 06:03 [entrez] PHST- 2025/03/27 00:00 [pmc-release] AID - 10.1253/circrep.CR-24-0139 [doi] PST - epublish SO - Circ Rep. 2025 Mar 27;7(5):365-371. doi: 10.1253/circrep.CR-24-0139. eCollection 2025 May 9. PMID- 40348046 OWN - NLM STAT- MEDLINE DCOM- 20250809 LR - 20250812 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 250 DP - 2025 Sep 1 TI - Comparative Prognostic Value of Risk Factors for Predicting Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Systematic Review and Network Meta-Analysis. PG - 79-89 LID - S0002-9149(25)00296-6 [pii] LID - 10.1016/j.amjcard.2025.05.009 [doi] AB - This study compares the prognostic value of risk factors for Permanent pacemaker implantation (PPI) following transcatheter aortic valve replacement (TAVR). PubMed, Embase, Scopus, and Cochrane Library databases were searched until November 2024 for studies reporting PPI incidence within 30 days post-TAVR. A random-effect model was used to pool risk ratios (RR) and standardized mean differences (SDM) for binary and continuous risk factors. Network meta-analysis estimated pooled risk differences (DeltaRR) for binary predictors with male sex as the reference. Significant predictors were ranked based on their surface under the cumulative ranking curve (SUCRA) values. A total of 108 studies comprising 77,538 patients (14,560 requiring PPI) were included. Male sex (RR: 1.13), baseline atrial fibrillation (AF) (RR: 1.12), 2nd degree Mobitz I (RR: 5.16) and Mobitz II (RR: 2.30) atrioventricular blocks (AVB), 3rd degree AVB (RR: 13.46), left anterior (LAHB) (RR: 1.79) and posterior hemiblocks (LPHB) (RR: 2.57), bifascicular block (RR: 2.34), right bundle branch block (RBBB) (RR: 3.20) and intraprocedural AVB (RR: 4.15) were identified as predictors for PPI post-TAVR. The risk of PPI was higher with self-expandable valves (RR: 1.79), subclavian access (RR: 1.75), and 29 mm prostheses (RR: 1.33) compared to balloon-expandable valves, transfemoral access, and 23 mm prostheses. Network meta-analysis ranked 3rd degree AVB (SUCRA <0.01), Mobitz I AVB (SUCRA: 0.14), Mobitz II AVB (SUCRA: 0.33), intraprocedural AVB (SUCRA: 0.42), bifascicular block (SUCRA: 0.48), RBBB (SUCRA: 0.49) and LPHB (SUCRA: 0.54) as major predictors of PPI in descending order of significance. In conclusion, clinicians should closely monitor conduction abnormalities as key predictors of PPI following TAVR. Additionally, other risk factors such as subclavian access, self-expanding implantation, AF, large prosthesis diameter, and male sex should not be overlooked. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Hosseini Mohammadi, Negin Sadat AU - Hosseini Mohammadi NS AD - Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. FAU - Tavakoli, Kiarash AU - Tavakoli K AD - Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. FAU - Taebi, Morvarid AU - Taebi M AD - Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. FAU - Zafari, Ali AU - Zafari A AD - School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Riahi, Mobina AU - Riahi M AD - School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. FAU - Molaei, Mohammad Mahdi AU - Molaei MM AD - School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. FAU - Farooqi, Mashood Ahmad AU - Farooqi MA AD - Central Michigan University, Internal Medicine. FAU - Khanipour, Ramtin AU - Khanipour R AD - Department of Internal Medicine, HCA Florida Bayonet Point Hospital - University of South Florida. FAU - Karvane, Houshang Bavandpour AU - Karvane HB AD - Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. FAU - Shahrzad, Soraya AU - Shahrzad S AD - Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. FAU - Vaseghi, Marmar AU - Vaseghi M AD - Division of Cardiology, Department of Medicine, UCLA Cardiac Arrhythmia Center, University of California, Los Angeles, CA, USA. FAU - Lakkirrddy, Ghanunjaya R AU - Lakkirrddy GR AD - Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KA, USA. FAU - Mattumpuram, Jishanth AU - Mattumpuram J AD - Division of Cardiology, University of Louisville School of Medicine, Louisville, KY, USA. FAU - Tzeis, Stylianos AU - Tzeis S AD - Department of Cardiology, Mitera Hospital, Hygeia Group, Athens, Greece. FAU - Jenab, Yaser AU - Jenab Y AD - Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. FAU - Hosseini, Kaveh AU - Hosseini K AD - Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: kaveh_hosseini130@yahoo.com. LA - eng PT - Journal Article PT - Network Meta-Analysis PT - Systematic Review DEP - 20250531 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery MH - Atrial Fibrillation/epidemiology MH - *Cardiac Pacing, Artificial MH - *Pacemaker, Artificial MH - *Postoperative Complications/therapy/epidemiology MH - Prognosis MH - Risk Assessment MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement OTO - NOTNLM OT - artificial OT - atrioventricular block OT - cardiac conduction disorders OT - pacemaker OT - risk factors OT - transcatheter aortic valve replacement COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. EDAT- 2025/05/11 18:56 MHDA- 2025/08/10 06:16 CRDT- 2025/05/10 19:37 PHST- 2025/03/10 00:00 [received] PHST- 2025/04/29 00:00 [revised] PHST- 2025/05/03 00:00 [accepted] PHST- 2025/08/10 06:16 [medline] PHST- 2025/05/11 18:56 [pubmed] PHST- 2025/05/10 19:37 [entrez] AID - S0002-9149(25)00296-6 [pii] AID - 10.1016/j.amjcard.2025.05.009 [doi] PST - ppublish SO - Am J Cardiol. 2025 Sep 1;250:79-89. doi: 10.1016/j.amjcard.2025.05.009. Epub 2025 May 31. PMID- 40347199 OWN - NLM STAT- MEDLINE DCOM- 20250625 LR - 20260719 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 12 DP - 2025 Jun 23 TI - Transcatheter Aortic Valve Replacement With Intra-Annular Self-Expanding or Balloon-Expandable Valves: The Multicenter International NAVULTRA Registry. PG - 1557-1568 LID - S1936-8798(25)00923-9 [pii] LID - 10.1016/j.jcin.2025.03.015 [doi] AB - BACKGROUND: No comparative data exist with the self-expanding Navitor (NAV) and the balloon-expandable SAPIEN 3 Ultra (ULTRA) transcatheter heart valves (THVs). OBJECTIVES: This study sought to investigate the 1-year outcomes of transcatheter aortic valve replacement using the intra-annular NAV and the ULTRA THVs. METHODS: The NAVULTRA (Navitor and SAPIEN 3 Ultra) registry included consecutive patients who underwent transfemoral transcatheter aortic valve replacement at 16 centers with NAV or ULTRA between November 2018 and April 2024. Propensity score matching was used for adjustment. The primary outcomes of interest were all-cause death and the composite of all-cause death, disabling stroke, and hospitalization for heart failure at 1 year. RESULTS: The overall study cohort included 3,878 patients treated with NAV (n = 1,746) or ULTRA (n = 2,176). The propensity score-matched population resulted in 1,363 pairs. At 1 year, the rate of death from any cause was 9.7% with NAV and 9.9% with ULTRA (adjusted P = 0.585). Similarly, there were no significant differences in primary composite outcome (13.6% in the NAV group and 12.6% in the ULTRA group; adjusted P = 0.218). The rate of new permanent pacemaker implantation (20.6% vs 10.6%; adjusted P < 0.01) and heart failure rehospitalization (4.6% vs 2.8%; adjusted P < 0.05) was higher in NAV group. At 1 year, the use of NAV was associated with higher rates of mild paravalvular leak (OR: 1.53; 95% CI: 1.01 to 2.33; adjusted P < 0.05) but lower mean transprosthetic gradients compared with ULTRA (mean change:-3.90, 95% CI: -4.47 to -3.34; adjusted P < 0.01). CONCLUSIONS: Both intra-annular THVs were associated with similar 1-year clinical outcomes; however, differences were observed in secondary clinical endpoints and valve hemodynamic performance. CI - Copyright (c) 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Cannata, Stefano AU - Cannata S AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy; Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands. Electronic address: stefanocann@gmail.com. FAU - Sultan, Ibrahim AU - Sultan I AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. FAU - Van Mieghem, Nicolas AU - Van Mieghem N AD - Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Rotterdam, the Netherlands. FAU - Giordano, Arturo AU - Giordano A AD - Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - De Backer, Ole AU - De Backer O AD - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. FAU - Byrne, Johnathan AU - Byrne J AD - King's College Hospital NHS Foundation Trust, London, United Kingdom. FAU - Tchetche, Didier AU - Tchetche D AD - Department of Cardiology, Clinique Pasteur, Toulouse, France. FAU - Buccheri, Sergio AU - Buccheri S AD - Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden. FAU - Nombela-Franco, Luis AU - Nombela-Franco L AD - Cardiovascular Institute, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria San Carlos, Madrid, Spain. FAU - Teles, Rui Campante AU - Teles RC AD - Carnaxide and Comprehensive Health Research Center, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, NOVA Medical School, Lisbon, Portugal. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna Kore, Enna, Italy. FAU - Barbato, Emanuele AU - Barbato E AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. FAU - Amat Santos, Ignacio AU - Amat Santos I AD - Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Blackman, Daniel J AU - Blackman DJ AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. FAU - Maisano, Francesco AU - Maisano F AD - Division of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy. FAU - Lorusso, Roberto AU - Lorusso R AD - Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands; Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical, Maastricht, the Netherlands. FAU - La Spina, Ketty AU - La Spina K AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy. FAU - Millin, Antonella AU - Millin A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Kliner, Dustin E AU - Kliner DE AD - Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. FAU - van den Dorpel, Mark AU - van den Dorpel M AD - Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, Rotterdam, the Netherlands. FAU - Acerbi, Elena AU - Acerbi E AD - Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Italy. FAU - Lulic, Davorka AU - Lulic D AD - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. FAU - Divekar, Kaivalya AU - Divekar K AD - King's College Hospital NHS Foundation Trust, London, United Kingdom. FAU - Cesario, Vincenzo AU - Cesario V AD - Department of Cardiology, Clinique Pasteur, Toulouse, France. FAU - Chavez Solsol, Jorge Francisco AU - Chavez Solsol JF AD - Cardiovascular Institute, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria San Carlos, Madrid, Spain. FAU - Brito, Joao AU - Brito J AD - Carnaxide and Comprehensive Health Research Center, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, NOVA Medical School, Lisbon, Portugal. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, A.O.U. Policlinico G. Rodolico-San Marco, Catania, Italy. FAU - Casenghi, Matteo AU - Casenghi M AD - Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. FAU - Fernandez Cordon, Clara AU - Fernandez Cordon C AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Sherwen, Amanda AU - Sherwen A AD - Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. FAU - Buzzatti, Nicola AU - Buzzatti N AD - Division of Cardiac Surgery, San Raffaele Scientific Institute, Milan, Italy. FAU - Pasta, Salvatore AU - Pasta S AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy; University of Palermo, Palermo, Italy. FAU - Turrisi, Marco AU - Turrisi M AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy. FAU - Minacori, Michele AU - Minacori M AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy. FAU - Manca, Paolo AU - Manca P AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy. FAU - Nuzzi, Vincenzo AU - Nuzzi V AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, Centro Cuore Morgagni, Catania, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Italy. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20250510 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Male MH - Registries MH - Female MH - *Heart Valve Prosthesis MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Treatment Outcome MH - Aged, 80 and over MH - Aged MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - Time Factors MH - Prosthesis Design MH - *Aortic Valve Stenosis/mortality/diagnostic imaging/physiopathology/surgery MH - Risk Factors MH - Risk Assessment MH - *Balloon Valvuloplasty/mortality/adverse effects/instrumentation MH - Recovery of Function MH - Retrospective Studies MH - Hemodynamics MH - Heart Failure/therapy/etiology/mortality OTO - NOTNLM OT - Navitor OT - SAPIEN 3 Ultra OT - TAVR OT - intra-annular COIS- Funding Support and Author Disclosures Dr Van Mieghem has received research grants from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, Meril, Pie Medical, PulseCath BV, and Teleflex; and served as a consultant for Abbott, Abiomed, Alleviant Medical Inc., AncorValve, Anteris, Approxima Srl, Bolt Medical, Boston Scientific, Daiichi-Sankyo, LUMA Vision, Materialise, Medtronic, Pie Medical, Polares, PulseCath BV, and Siemens. Dr De Backer has received institutional research grants and consulting fees from Abbott, Boston Scientific, and Medtronic. Dr Byrne has served on the advisory board or as a physician proctor for Abbott and Edwards Lifesciences; and received educational grants from Edwards Lifesciences. Dr Barbanti has served as a consultant for Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Nombela-Franco has served as a proctor for Abbott Vascular and Edwards Lifesciences. Dr Maisano has received grant and/or research institutional support from Abbott, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific, NVT, Terumo, and Venus; has received consulting fees and honoraria (personal and institutional) from Abbott, Boston Scientific, Medtronic, Edwards Lifesciences, Xeltis, CardioValve, Occlufit, Simulands, Mtex, Venus, Squadra, Valgen, and CroiValve; has also royalty income from and IP rights with Edwards Lifesciences; and is a shareholder (including share options) of Magenta, Transseptalsolutions, and 4Tech. Dr Lorusso has received research grant support from Medtronic and LivaNova; received speaker fees from Abiomed; served on the medical advisory board of Xenios and Eurosets; and served as a consultant for Medtronic and LivaNova. Dr Tamburino has served as a consultant for Medtronic. Dr Gandolfo has served as a proctor for Edwards Lifesciences. Dr Latib has served on the advisory board or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, Abbott, Philips, Tresquare, and Anteris. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/05/11 00:46 MHDA- 2025/06/26 00:27 CRDT- 2025/05/10 10:30 PHST- 2024/10/26 00:00 [received] PHST- 2025/03/03 00:00 [revised] PHST- 2025/03/07 00:00 [accepted] PHST- 2025/06/26 00:27 [medline] PHST- 2025/05/11 00:46 [pubmed] PHST- 2025/05/10 10:30 [entrez] AID - S1936-8798(25)00923-9 [pii] AID - 10.1016/j.jcin.2025.03.015 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Jun 23;18(12):1557-1568. doi: 10.1016/j.jcin.2025.03.015. Epub 2025 May 10. PMID- 40343429 OWN - NLM STAT- MEDLINE DCOM- 20250704 LR - 20260918 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 1 DP - 2025 Jul TI - The Frontier V Study: Evaluating the Safety and Clinical Performance of a Large-Bore Vascular Closure Device After Femoral Arterial Access. PG - 521-526 LID - 10.1002/ccd.31574 [doi] AB - BACKGROUND: Vascular complications following large-bore procedures may have a significant impact on patient morbidity and mortality, highlighting the critical need for an effective, safe, and reproducible closure device. We present our prospective multi-center experience with a novel patch-based closure device. AIM: To evaluate the safety and clinical performance of the PerQseal+ closure system in achieving hemostasis after femoral arterial large-bore access with 14-22 F sheaths. METHODS: The Frontier V study (NCT04799769) is a multicenter study that included patients undergoing an endovascular procedure requiring femoral access created by 14-22 F sheaths. The primary safety outcome was major access site complications related to the PerQseal+. The primary efficacy outcome was the technical success rate of device deployment. Secondary outcomes included minor access site complications related to the device, time to hemostasia, time to deployment, and time to total closure. RESULTS: A total of 88 subjects were included at seven investigational centers in Europe. One device-related major access site complication (i.e., retroperitoneal hematoma) occurred (1.1%). The acute success rate of device deployment was 95%. There were five minor vascular access site complications directly related to the device (5.7%). The median time of device deployment was 5 min, the median time to achieve hemostasia was 1 min, and the median total closure time was 6 min. CONCLUSION: The PerQseal+ closure device was safe and effective for large-bore arterial femoral closure. These results highlight its potential as a reliable alternative for large-bore closure in endovascular procedures. CI - (c) 2025 Wiley Periodicals LLC. FAU - Frerker, Christian AU - Frerker C AUID- ORCID: 0000-0003-0226-0888 AD - Department of Cardiology, University Hospital of Schleswig-Holstein, Lubeck, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Schwindt, Arne AU - Schwindt A AD - Department of Vascular Surgery, St. Franziskus Hospital Munster, Munster, Germany. FAU - Schmidt, Andrej AU - Schmidt A AD - Clinic and Polyclinic for Angiology, Medical Faculty of the University Leipzig, Leipzig, Germany. FAU - Schmidt, Tobias AU - Schmidt T AD - Department of Cardiology, University Hospital of Schleswig-Holstein, Lubeck, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. AD - Department of Cardiology, Asklepios Westklinikum, Hamburg, Germany. FAU - Bonnet, Guillaume AU - Bonnet G AD - RHU Envisage, ANR-23-RHUS-0007, Munster, France. FAU - Branzan, Daniela AU - Branzan D AD - Clinic and Polyclinic for Vascular and Endovascular Surgery, TUM University Hospital, Clinic Rechts Der Isar, Technical University of Munich, Munich, Germany. FAU - Leroux, Lionel AU - Leroux L AD - RHU Envisage, ANR-23-RHUS-0007, Munster, France. AD - Medico-Surgical Department, Haut-Leveque Cardiological Hospital, Bordeaux University Hospital, Pessac, France. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AUID- ORCID: 0000-0002-2732-1205 AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus Medical Center, Rotterdam, The Netherlands. FAU - Panoulas, Vasileios AU - Panoulas V AD - Department of Cardiology, Royal Brompton & Harefield Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Martin, Christopher AU - Martin C AD - Vivasure Medical Ltd., Galway, Ireland. FAU - Gatto, Fernando AU - Gatto F AD - Department of Cardiology, Saarland-Heilstatten GmbH, SHG-Kliniken Volklingen, Volklingen, Germany. CN - Frontier V Investigators LA - eng GR - This study was supported by Vivasure Medical Ltd./ PT - Clinical Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20250507 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Catheterization, Peripheral/adverse effects MH - *Endovascular Procedures/adverse effects MH - Equipment Design MH - Europe MH - *Femoral Artery/diagnostic imaging MH - *Hemorrhage/prevention & control/etiology MH - *Hemostatic Techniques/instrumentation/adverse effects MH - Prospective Studies MH - Punctures MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - *Vascular Closure Devices OTO - NOTNLM OT - EVAR OT - TAVR OT - femoral arterial access OT - large bore arterial access OT - vascular closure device OT - vascular complications EDAT- 2025/05/09 18:33 MHDA- 2025/07/04 12:41 CRDT- 2025/05/09 12:50 PHST- 2025/01/14 00:00 [received] PHST- 2025/04/27 00:00 [accepted] PHST- 2025/07/04 12:41 [medline] PHST- 2025/05/09 18:33 [pubmed] PHST- 2025/05/09 12:50 [entrez] AID - 10.1002/ccd.31574 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Jul;106(1):521-526. doi: 10.1002/ccd.31574. Epub 2025 May 7. PMID- 40340124 OWN - NLM STAT- MEDLINE DCOM- 20251003 LR - 20260520 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 79 DP - 2025 Oct TI - Predictors of permanent pacemaker implantation after TAVI with Navitor transcatheter heart valve. PG - 45-51 LID - S1553-8389(25)00219-2 [pii] LID - 10.1016/j.carrev.2025.04.039 [doi] AB - AIMS: This study aimed to identify predictors of permanent pacemaker implantation (PPI) within 30 days after transcatheter aortic valve implantation (TAVI) using the Navitor (Abbott Chicago, IL, USA) transcatheter heart valve (THV). METHODS AND RESULTS: This retrospective two-center study included 173 patients with severe aortic stenosis undergoing transfemoral TAVI with Navitor THV. Patients with prior pacemaker implantation and valve-in-valve procedures were excluded. Mean age was 81.5 +/- 5.0 years, and 54 patients (31 %) required PPI; they were more often male (57 % vs. 37 %, p = 0.01), had higher left ventricular ejection fraction (55.3 +/- 9.0 vs. 52.4 +/- 9.2, p = 0.049), and higher rates of COPD (30 % vs. 16 %, p = 0.017) and pre-existing right bundle branch block (RBBB; 17 % vs. 0.8 %, p < 0.001). Procedural factors associated with PPI included greater annulus-to-THV oversizing (13.6 % +/- 3.4 vs. 12.5 % +/- 3.1, p = 0.041), implantation depth > 4 mm (75.9 % vs. 52.1 %, p = 0.002), and 29 mm valve size use (46.3 % vs. 26.9 %, p = 0.010). At multivariable analysis, COPD (OR 2.4, p = 0.049), pre-existing RBBB (OR 34.4, p = 0.001), annulus-to-THV oversizing (OR 1.2, p = 0.002), and implantation depth > 4 mm (OR 3.2, p = 0.007) were independent predictors of PPI. ROC analysis (AUC 0.58) identified an optimal cut-off of 15 % annulus-to-THV oversizing for predicting PPI. CONCLUSIONS: Annulus-to-THV oversizing emerges as a novel independent predictor for PPI after TAVI with Navitor THV. CI - Copyright (c) 2025. Published by Elsevier Inc. FAU - Casenghi, Matteo AU - Casenghi M AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. Electronic address: mcasenghi@ospedalesantandrea.it. FAU - Corradetti, Sara AU - Corradetti S AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy; Cardiovascular Center Aalst, AZORG Hospital, Aalst, Belgium. FAU - Rigattieri, Stefano AU - Rigattieri S AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Giovannelli, Francesca AU - Giovannelli F AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Belmonte, Marta AU - Belmonte M AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Redivo, Marco AU - Redivo M AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Terrone, Carlo AU - Terrone C AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Barzetti, Daniele AU - Barzetti D AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Tommasino, Antonella AU - Tommasino A AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Wyffels, Eric AU - Wyffels E AD - Cardiovascular Center Aalst, AZORG Hospital, Aalst, Belgium. FAU - Gallinoro, Emanuele AU - Gallinoro E AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Mistrulli, Raffaella AU - Mistrulli R AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy; Cardiovascular Center Aalst, AZORG Hospital, Aalst, Belgium. FAU - Paolisso, Pasquale AU - Paolisso P AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy. FAU - Berni, Andrea AU - Berni A AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. FAU - Vanderheyden, Marc AU - Vanderheyden M AD - Cardiovascular Center Aalst, AZORG Hospital, Aalst, Belgium. FAU - Barbato, Emanuele AU - Barbato E AD - Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250502 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Aged, 80 and over MH - *Pacemaker, Artificial MH - Treatment Outcome MH - Risk Factors MH - *Heart Valve Prosthesis MH - Aged MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - Time Factors MH - *Cardiac Pacing, Artificial/adverse effects MH - Severity of Illness Index MH - Prosthesis Design MH - Risk Assessment MH - *Arrhythmias, Cardiac/therapy/physiopathology/diagnosis/etiology MH - Bundle-Branch Block/therapy OTO - NOTNLM OT - Implantation depth OT - Navitor OT - Oversizing OT - Pacemaker implantation OT - TAVI OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest SC and RM are supported by a research grant from the DigiCardioPaTh PhD Program, Sapienza University, Rome, Italy. EDAT- 2025/05/09 11:51 MHDA- 2025/10/04 00:30 CRDT- 2025/05/08 22:07 PHST- 2025/03/23 00:00 [received] PHST- 2025/04/10 00:00 [revised] PHST- 2025/04/28 00:00 [accepted] PHST- 2025/10/04 00:30 [medline] PHST- 2025/05/09 11:51 [pubmed] PHST- 2025/05/08 22:07 [entrez] AID - S1553-8389(25)00219-2 [pii] AID - 10.1016/j.carrev.2025.04.039 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2025 Oct;79:45-51. doi: 10.1016/j.carrev.2025.04.039. Epub 2025 May 2. PMID- 40337394 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260809 IS - 2049-0801 (Print) IS - 2049-0801 (Electronic) IS - 2049-0801 (Linking) VI - 87 IP - 5 DP - 2025 May TI - Transcaval access for transcatheter aortic valve replacement: a systematic review and meta-analysis. PG - 2914-2927 LID - 10.1097/MS9.0000000000003193 [doi] AB - BACKGROUND: Transfemoral access is considered the standard route for transcatheter aortic valve replacement (TAVR). However, in some cases, this access route is contraindicated. Alternative access routes, such as transaxillary, are emerging as first-line approaches to address these limitations, while the transcaval approach remains uncertain. Our Meta-analysis aims to evaluate the safety of the transcaval approach compared to other access routes for TAVR. METHODS: We searched five databases, PubMed, SCOPUS, Web of Science, Cochrane Library, and Embase, from inception until April 2024 for any study that reports transcaval access alone or compares it to any alternative access in TAVR patients. We used Risk ratio (RR) for dichotomous outcomes and Mean Difference (MD) for continuous outcomes with a 95% confidence interval. RESULTS: Eleven studies with 1003 patients were included, transcaval showed non-statistically significant difference over alternatives in terms of intra-hospital, 30 days, and long-term all-cause mortality with a RR of 0.08 (95% CI -0.83 to 0.99, P = 0.86), 0.11 (95% CI -0.48 to 0.7, P = 0.71), and 1.08 (95% CI -0.50 to 2.66, P = 0.18), respectively. Furthermore, in our single-arm analysis, transcaval access has a low pooled 30-day all-cause mortality rate of 7% (95% CI 5-10) and long-term mortality of 21% (95% CI 2-77). The mean difference in length of stay in the hospital after the operation was 4.88 (95% CI 4.45-5.31), and the major bleeding rate was 14% (95% CI 8-23). CONCLUSION: Transcaval access for TAVR is a safe and feasible method that can be considered a new alternative when trans-femoral access is contraindicated. CI - Copyright (c) 2025 The Author(s). Published by Wolters Kluwer Health, Inc. FAU - Otmani, Zina AU - Otmani Z AD - Faculty of Medicine, Mouloud Mammeri University, Tizi Ouzou, Algeria. FAU - Alzawahreh, Ahmad AU - Alzawahreh A AD - Faculty of Medicine, The Hashemite University, Zarqa, Jordan. FAU - Awad, Abdelaziz A AU - Awad AA AD - Faculty of Medicine, Azhar university, Cairo, Egypt. FAU - Khalefa, Basma Badrawy AU - Khalefa BB AD - Faculty of Medicine, Ain-Shams University, Cairo, Egypt. FAU - Elsayed, Hazem Ayman AU - Elsayed HA AD - Faculty of Medicine, Zagazig university, Egypt. FAU - Amin, Omar Hany Mohamed AU - Amin OHM AD - Faculty of Medicine, Zagazig university, Egypt. FAU - Abouzid, Mohamed AU - Abouzid M AD - Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Poznan, Poland. FAU - Almansi, Amjad AU - Almansi A AD - Department of Internal Medicine, Prince Hamza Hospital, Amman, Jordan. FAU - Awad, Ayman K AU - Awad AK AD - Faculty of Medicine, Ain-Shams University, Cairo, Egypt. LA - eng PT - Journal Article DEP - 20250328 PL - England TA - Ann Med Surg (Lond) JT - Annals of medicine and surgery (2012) JID - 101616869 PMC - PMC12055168 OTO - NOTNLM OT - meta-analysis OT - transcatheter aortic valve replacement OT - transcaval COIS- Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. None. EDAT- 2025/05/08 11:14 MHDA- 2025/05/08 11:15 PMCR- 2025/03/28 CRDT- 2025/05/08 05:16 PHST- 2024/11/18 00:00 [received] PHST- 2025/03/09 00:00 [accepted] PHST- 2025/05/08 11:15 [medline] PHST- 2025/05/08 11:14 [pubmed] PHST- 2025/05/08 05:16 [entrez] PHST- 2025/03/28 00:00 [pmc-release] AID - AMSU-D-24-02431 [pii] AID - 10.1097/MS9.0000000000003193 [doi] PST - epublish SO - Ann Med Surg (Lond). 2025 Mar 28;87(5):2914-2927. doi: 10.1097/MS9.0000000000003193. eCollection 2025 May. PMID- 40301224 OWN - NLM STAT- MEDLINE DCOM- 20260612 LR - 20261010 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 115 IP - 7 DP - 2026 Jul TI - A minimalistic approach for transfemoral transcatheter aortic valve implantation therapy: a prospective "real-world" study. PG - 1131-1141 LID - 10.1007/s00392-025-02654-z [doi] AB - BACKGROUND: Optimized pathways for transcatheter aortic valve implantation (TAVI) have been reported over the past decade, but they considered specific devices and selected populations. OBJECTIVES: The aim of this study was to assess the safety and efficacy of a comprehensive, minimalistic approach to TAVI utilizing all available devices in all-comers, real-world population. METHODS: This is a prospective, single-center, single-arm clinical study. The primary endpoint of the study was a composite of 30-day all-cause mortality, disabling stroke, major bleedings, major vascular complications, stage 3 acute kidney injury (AKI), and permanent pacemaker implantation (PPI). Outcomes were compared to those of an historical cohort of patients undergoing TAVI following a standard approach, by selecting pairs of patients selected through a 1:1 propensity score matching (PSM). A cost analysis of TAVI hospitalization was performed considering costs related to procedural complications and post-procedural length of stay (LoS). RESULTS: Between January 2020 and December 2023, a total of 997 patients underwent TAVI following an optimized, minimalistic pathway. Device success was reported in 88.2% patients, with low procedural complications. The primary endpoint occurred in 21.1% of patients. After PSM, TAVI patients following the minimalistic pathway had higher device success (91.4% vs 84.2%, p = 0.004), and lower major vascular complications (4.5% vs. 10.3%, p = 0.004) compared to those following the standard approach. Median LoS was shorter (1.0 day vs. 2.0 days, p < 0.001) and the rate of next-day discharge was higher (46.7% vs. 19.0%, p < 0.001) in patients following the minimalistic pathway, with lower hospitalization costs (median euro 2200 vs. 3150; p < 0.001). At 30-day, the primary endpoint was significantly lower in patients following the minimalistic pathway (17.2% vs 23.9%, p = 0.034). CONCLUSIONS: The minimalistic TAVI care pathway was associated with favorable outcomes in an unselected, real-world population. The shorter post-procedural LoS of the minimalistic approach led to a significant cost-saving. CI - (c) 2025. Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Barbanti, Marco AU - Barbanti M AUID- ORCID: 0000-0002-4903-5437 AD - Universita degli Studi di Enna "Kore", Piazza dell'Universita, 94100, Enna, Italy. mbarbanti83@gmail.com. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Cali, Mariachiara AU - Cali M AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Sammartino, Sofia AU - Sammartino S AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Deste, Wanda AU - Deste W AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - La Rosa, Luigi AU - La Rosa L AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Garretto, Valeria AU - Garretto V AD - Division of Radiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Inserra, Cristina AU - Inserra C AD - Division of Radiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Cannizzaro, Maria Teresa AU - Cannizzaro MT AD - Division of Radiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Sgroi, Carmelo AU - Sgroi C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Veroux, Pierfrancesco AU - Veroux P AD - Division of Vascular Surgery, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Capodanno, Davide AU - Capodanno D AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. LA - eng PT - Journal Article DEP - 20250429 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/economics MH - Prospective Studies MH - *Aortic Valve Stenosis/surgery MH - Aged, 80 and over MH - Male MH - Female MH - Treatment Outcome MH - Femoral Artery MH - *Postoperative Complications/epidemiology MH - Length of Stay MH - Aged OTO - NOTNLM OT - Early discharge OT - Minimalistic approach OT - Procedural pathway OT - TAVI COIS- Declarations. Conflict of interest: Dr Barbanti is a consultant for Boston Scientifics, Edwards Lifesciences, and Medtronic. Dr Tamburino is consultant for Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/04/30 00:30 MHDA- 2026/06/12 18:42 CRDT- 2025/04/29 23:15 PHST- 2024/06/04 00:00 [received] PHST- 2025/04/15 00:00 [accepted] PHST- 2026/06/12 18:42 [medline] PHST- 2025/04/30 00:30 [pubmed] PHST- 2025/04/29 23:15 [entrez] AID - 10.1007/s00392-025-02654-z [pii] AID - 10.1007/s00392-025-02654-z [doi] PST - ppublish SO - Clin Res Cardiol. 2026 Jul;115(7):1131-1141. doi: 10.1007/s00392-025-02654-z. Epub 2025 Apr 29. PMID- 40295400 OWN - NLM STAT- MEDLINE DCOM- 20250616 LR - 20250618 IS - 1432-086X (Electronic) IS - 0174-1551 (Linking) VI - 48 IP - 6 DP - 2025 Jun TI - Experience with a Large-Bore Vascular Closure Device in Patients Undergoing a Percutaneous Endovascular Aneurysm Repair (EVAR): A Multicentre Study. PG - 751-759 LID - 10.1007/s00270-025-04040-8 [doi] AB - PURPOSE: Endovascular aneurysm repair (EVAR) is the preferred treatment for infrarenal aortic aneurysms, offering lower perioperative morbidity and mortality compared to open surgery. Common femoral artery (CFA) access can be achieved percutaneously or through surgical cutdown, with a percutaneous approach gaining more and more popularity. The MANTA vascular closure device (VCD), a collagen plug-based device, has shown promising results in transcatheter aortic valve replacement, but data on its use in percutaneous EVAR (pEVAR), particularly in obese patients, remain limited. MATERIAL AND METHODS: This retrospective study included all patients who underwent pEVAR from October 2018 to December 2022 across three Dutch hospitals and in whom the MANTA VCD has been applied. Patient demographics, perioperative characteristics, and clinical outcomes were recorded. Subgroup analysis was performed based on body mass index (BMI), comparing outcomes in obese (BMI >/= 30) and non-obese (BMI < 30) patients. Technical success and access site complications were primary and secondary outcomes, respectively. RESULTS: A total of 549 patients (mean age 75.16 +/- 7.09 years, 88.9% male) were included, with 140 classified as obese. The MANTA VCD was used in 1024 CFAs. Overall technical success, defined as vascular closure with patent CFA, without requiring immediate surgery, was 98%, with a 3.1% complication rate, primarily due to closure failure. In obese patients, technical success was 98.9%, with a 1.5% complication rate, showing comparable outcomes to non-obese patients. CONCLUSION: The MANTA VCD is effective and safe for CFA closure in pEVAR, including in obese patients. Given rising obesity rates, the favorable outcomes in this population are encouraging and suggesting a broader applicability in large-bore percutaneous procedures. CI - (c) 2025. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). FAU - Michiels, Jacob AU - Michiels J AD - Division of Vascular Surgery, Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands. FAU - Peeters, Maxim AU - Peeters M AD - Division of Vascular Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. FAU - Uittenbogaart, Martine AU - Uittenbogaart M AD - Division of Vascular Surgery, Department of Surgery, Maxima Medical Centre, Veldhoven, The Netherlands. FAU - Oosterveld, Rens AU - Oosterveld R AD - Division of Vascular Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. FAU - Bloo, Lucas AU - Bloo L AD - Faculty of Medicine, Radboud University, Nijmegen, The Netherlands. FAU - Loos, Maarten AU - Loos M AD - Division of Vascular Surgery, Department of Surgery, Maxima Medical Centre, Veldhoven, The Netherlands. FAU - Bouwman, Lee AU - Bouwman L AD - Division of Vascular Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. AD - Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands. FAU - Janssen, Roel AU - Janssen R AD - Division of Vascular Surgery, Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands. FAU - Elshof, Jan-Willem AU - Elshof JW AD - Division of Vascular Surgery, Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands. FAU - Yazar, Ozan AU - Yazar O AUID- ORCID: 0000-0002-8438-1183 AD - Division of Vascular Surgery, Department of Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. o.yazar@zuyderland.nl. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250428 PL - United States TA - Cardiovasc Intervent Radiol JT - Cardiovascular and interventional radiology JID - 8003538 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - Retrospective Studies MH - *Endovascular Procedures/methods/instrumentation MH - *Vascular Closure Devices MH - *Aortic Aneurysm, Abdominal/surgery/diagnostic imaging MH - Femoral Artery/surgery MH - Aged, 80 and over MH - Obesity/complications MH - Netherlands MH - Treatment Outcome MH - Endovascular Aneurysm Repair OTO - NOTNLM OT - EVAR OT - Endovascular aneurysm repair OT - MANTA vascular closure device OT - Obesity OT - Percutaneous closure OT - Vascular surgery COIS- Declarations. Conflict of interest: OY is consultant for Teleflex and the MANTA VCD. The other authors declare that they have no conflict of interest. Ethical Approval: For this type of study formal consent is not required. Informed Consent: For this type of study informed consent is not required. Consent for Publication: For this type of study consent for publication is not required. EDAT- 2025/04/29 00:28 MHDA- 2025/06/16 18:26 CRDT- 2025/04/28 23:15 PHST- 2024/12/03 00:00 [received] PHST- 2025/03/30 00:00 [accepted] PHST- 2025/06/16 18:26 [medline] PHST- 2025/04/29 00:28 [pubmed] PHST- 2025/04/28 23:15 [entrez] AID - 10.1007/s00270-025-04040-8 [pii] AID - 10.1007/s00270-025-04040-8 [doi] PST - ppublish SO - Cardiovasc Intervent Radiol. 2025 Jun;48(6):751-759. doi: 10.1007/s00270-025-04040-8. Epub 2025 Apr 28. PMID- 40293726 OWN - NLM STAT- MEDLINE DCOM- 20250517 LR - 20250527 IS - 2753-670X (Electronic) IS - 2753-670X (Linking) VI - 40 IP - 5 DP - 2025 May 6 TI - Transcatheter aortic valve implantation versus surgery in low-risk patients: in-hospital and mid-term outcomes. LID - 10.1093/icvts/ivaf103 [doi] LID - ivaf103 AB - OBJECTIVES: The aim of our study is to compare post-procedural outcomes and mid-term mortality of low-risk patients treated by transfemoral TAVI or surgical aortic valve replacement (AVR) for severe aortic stenosis. METHODS: Data of consecutive patients undergoing AVR or TAVI from September 2017 to December 2021 were prospectively collected and retrospectively reviewed. Eligible patients were aged between 75 and 85 years with low-surgical risk and isolated severe aortic stenosis. Exclusion criteria were prior heart surgery, valve-in-valve procedure and the need for concomitant procedures. The primary end-point was mid-term all-cause mortality. RESULTS: Three hundred fifty-one patients were enrolled. Of these, 243 underwent TAVI and 108 underwent AVR. Compared to AVR, TAVI patients were older (82 [78-83 ] vs 78 [77-80], P < 0.001), with higher incidence of advanced chronic kidney disease (33.3% vs 15.7%, P < 0.001) and poor mobility (15.6% vs 5.6%, P = 0.008) and a higher Euroscore II (2.2 [1.72-2.98] vs 1.9 [1.31-2.46 ], P = 0.002). AVR patients had a higher incidence of post-procedural AKI (29.6% vs 4.5%, P < 0.001), while TAVI patients had a higher incidence of LBBB (23.9% vs 1.8%, P < 0.001) and at least mild to moderate PVL (4.5% vs 0%, P = 0.021). Mid-term mortality was higher among TAVI patients (HR 0.38 [95% CI 0.23-0.88], P = 0.020). In the matched cohort, TAVI had a higher incidence of LBBB (11.5% vs 1.3%, P = 0.018) and permanent PM implantation (12.8% vs 5.1%, P = 0.041), while AVR patients had a higher incidence of post-procedural AKI (33.3% vs 5.1%, P < 0.001). Mid-term mortality was higher in TAVI patients (HR 0.36 [95% CI 0.21-0.87], P = 0.019). CONCLUSIONS: TAVI patients demonstrated a higher mid-term mortality and a higher incidence of post-procedural conduction abnormalities and PVL which remain a concern in low-risk patients. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Lodo, Vittoria AU - Lodo V AUID- ORCID: 0000-0002-9188-2656 AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy. FAU - Italiano, Enrico Giuseppe AU - Italiano EG AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy. FAU - Weltert, Luca AU - Weltert L AD - Department of Cardiovascular Sciences, European Hospital, Rome, Italy. FAU - Zingarelli, Edoardo AU - Zingarelli E AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy. FAU - Pietropaolo, Claudio AU - Pietropaolo C AD - Department of Cardiovascular Anesthesia and Intensive Care, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy. FAU - Buono, Gabriella AU - Buono G AD - Department of Cardiovascular Anesthesia and Intensive Care, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy. FAU - Centofanti, Paolo AU - Centofanti P AD - Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy. LA - eng PT - Comparative Study PT - Journal Article PL - England TA - Interdiscip Cardiovasc Thorac Surg JT - Interdisciplinary cardiovascular and thoracic surgery JID - 9918540787006676 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Male MH - Female MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology MH - Aged MH - Retrospective Studies MH - Risk Factors MH - *Heart Valve Prosthesis Implantation/adverse effects/mortality MH - Treatment Outcome MH - Risk Assessment MH - Time Factors MH - Postoperative Complications/mortality MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Severity of Illness Index MH - Hospital Mortality PMC - PMC12085224 OTO - NOTNLM OT - aortic valve replacement OT - low-risk patients OT - transcatheter aortic valve implantation COIS- None declared. EDAT- 2025/04/28 12:29 MHDA- 2025/05/18 18:23 PMCR- 2025/04/28 CRDT- 2025/04/28 11:32 PHST- 2024/10/16 00:00 [received] PHST- 2025/01/28 00:00 [revised] PHST- 2025/04/25 00:00 [accepted] PHST- 2025/05/18 18:23 [medline] PHST- 2025/04/28 12:29 [pubmed] PHST- 2025/04/28 11:32 [entrez] PHST- 2025/04/28 00:00 [pmc-release] AID - 8121157 [pii] AID - ivaf103 [pii] AID - 10.1093/icvts/ivaf103 [doi] PST - ppublish SO - Interdiscip Cardiovasc Thorac Surg. 2025 May 6;40(5):ivaf103. doi: 10.1093/icvts/ivaf103. PMID- 40289515 OWN - NLM STAT- MEDLINE DCOM- 20250704 LR - 20260826 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 1 DP - 2025 Jul TI - Vascular Closure Devices for Large Bore Femoral Access After Transfemoral Transcatheter Aortic Valve Replacement: A Network Meta-Analysis. PG - 423-432 LID - 10.1002/ccd.31565 [doi] AB - BACKGROUND AND AIMS: Large-bore femoral access is commonly required in transfemoral transcatheter aortic valve replacement (TF-TAVR), but vascular access complications remain prevalent, impacting patient outcomes. Various vascular closure devices (VCDs) are used for hemostasis, including the suture-based Prostar XL, Perclose ProGlide, and ProStyle, and the plug-based MANTA device. However, comprehensive comparative evidence on these VCDs, particularly single Perclose strategies, is lacking. METHODS: A systematic review and network meta-analysis were conducted according to PRISMA guidelines. We included randomized and observational studies comparing the safety and efficacy of VCDs for large-bore femoral access closure in TF-TAVR patients. Primary outcomes included major vascular complications; secondary outcomes included major and minor bleeding, minor vascular complications, VCD failure, and all-cause mortality. Frequentist and Bayesian analyses were performed using a random-effects model, with additional subgroup analyses of single Perclose strategies. RESULTS: Thirty-five studies comprising 16,503 patients met inclusion criteria. The single Perclose strategy, with or without adjunct Angio-Seal or FemoSeal, significantly reduced major vascular complications compared to dual Perclose (RR: 1.9, 95% CI [1.2-3.01]), MANTA (RR: 1.89, 95% CI [1.03-3.48]), and Prostar XL (RR: 3.46, 95% CI [1.94-6.18]). Among secondary outcomes, single Perclose also ranked highest in reducing minor complications and bleeding. CONCLUSION: Single Perclose strategies, especially when combined with Angio-Seal, demonstrated superior safety and efficacy for large-bore femoral access closure following TF-TAVR. These findings support the need for further randomized trials to validate single Perclose as a primary approach in TF-TAVR vascular closure. CI - (c) 2025 Wiley Periodicals LLC. FAU - Upadhaya, Sunil AU - Upadhaya S AD - Department of Internal Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. FAU - Upreti, Alina AU - Upreti A AD - Department of Biomedical Sciences, Tulane University School of Medicine, New Orleans, Louisiana, USA. FAU - Gupta, Kunal AU - Gupta K AD - Department of Internal Medicine, Case Western Reserve University, Cleveland, Ohio, USA. FAU - Gonzalez-Perez, Bella AU - Gonzalez-Perez B AD - Department of Internal Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. FAU - Ksayer, Radia AU - Ksayer R AD - Department of Internal Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. FAU - Cox-Alomar, Pedro AU - Cox-Alomar P AD - Department of Medicine, Section of Cardiology, University of Miami, Miami, Florida, USA. FAU - Sanina, Cristina AU - Sanina C AD - Department of Internal Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. FAU - Irimpen, Anand AU - Irimpen A AD - Department of Internal Medicine, Case Western Reserve University, Cleveland, Ohio, USA. FAU - Farhan, Serdar AU - Farhan S AD - Department of Medicine, Division of Cardiology, Lenox Hill Hospital, Northwell Health, New York, New York, USA. FAU - Wiley, Jose AU - Wiley J AD - Department of Internal Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. LA - eng GR - The authors received no specific funding for this work./ PT - Journal Article PT - Network Meta-Analysis PT - Systematic Review DEP - 20250427 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Catheterization, Peripheral/adverse effects/mortality MH - Equipment Design MH - *Femoral Artery/diagnostic imaging MH - *Hemorrhage/prevention & control/etiology/mortality MH - *Hemostatic Techniques/instrumentation/adverse effects/mortality MH - Observational Studies as Topic MH - Punctures MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Treatment Outcome MH - *Vascular Closure Devices EDAT- 2025/04/28 06:27 MHDA- 2025/07/04 12:44 CRDT- 2025/04/28 02:33 PHST- 2025/01/07 00:00 [received] PHST- 2025/04/18 00:00 [accepted] PHST- 2025/07/04 12:44 [medline] PHST- 2025/04/28 06:27 [pubmed] PHST- 2025/04/28 02:33 [entrez] AID - 10.1002/ccd.31565 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Jul;106(1):423-432. doi: 10.1002/ccd.31565. Epub 2025 Apr 27. PMID- 40289335 OWN - NLM STAT- MEDLINE DCOM- 20250428 LR - 20260508 IS - 1477-111X (Electronic) IS - 0267-6591 (Linking) VI - 40 IP - 4 DP - 2025 May TI - Feasibility of standby ECMO with preset femoral vascular sheaths for high-risk transcatheter aortic valve replacement. PG - 893-897 LID - 10.1177/02676591241263285 [doi] AB - ObjectiveVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide temporary circulatory and respiratory support allowing hemodynamic stabilization during high-risk transcatheter aortic valve replacement (TAVR). However, the optimal timing of VA-ECMO use in high-risk TAVR remains controversial. We aimed to report our experience using a novel standby ECMO strategy during high-risk TAVR.MethodsWe retrospectively evaluated consecutive patients who received high-risk TAVR with standby ECMO between March 1,2023 and March 1,2024 at the Beijing Anzhen Hospital. Small, 5F or 6F sheaths were placed in ipsilateral femoral vein and artery before TAVR procedures. The primary outcome of this study was survival to hospital discharge with good neurological recovery defined as cerebral performance category (CPC) 1-2.ResultsA total of 24 patients undergoing high-risk TAVR with standby ECMO were included. Six (25.0%) of the 24 patients with standby ECMO suffered from cardiogenic shock or cardiac arrest and required emergency VA-ECMO institution. The median (IQR) cannulation time was 8 (6-11) minutes, and the median (IQR) ECMO duration was 35 (24-48) hours. All of the 24 patients underwent successful TAVR procedures and survival to hospital discharge with CPC1-2.ConclusionsStandby ECMO with preset femoral vascular sheaths was feasible and effective for refractory cardiogenic shock and cardiac arrest during high-risk TAVR. FAU - Wang, Liangshan AU - Wang L AUID- ORCID: 0000-0002-0787-649X AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Wang, Yan AU - Wang Y AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Fu, Hongfu AU - Fu H AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Meng, Xin AU - Meng X AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Li, Chenglong AU - Li C AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Jiang, Chunjing AU - Jiang C AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Guo, Dong AU - Guo D AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Xu, Bo AU - Xu B AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Wang, Pengcheng AU - Wang P AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Li, Yu AU - Li Y AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Jia, Ming AU - Jia M AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Wang, Hong AU - Wang H AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Du, Zhongtao AU - Du Z AUID- ORCID: 0009-0003-9101-5346 AD - Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240618 PL - England TA - Perfusion JT - Perfusion JID - 8700166 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Extracorporeal Membrane Oxygenation/methods MH - Male MH - Female MH - Retrospective Studies MH - Aged MH - Aged, 80 and over MH - Feasibility Studies MH - Femoral Artery OTO - NOTNLM OT - femoral vascular sheath OT - high-risk OT - standby extracorporeal membrane oxygenation OT - transcatheter aortic valve OT - veno-arterial extracorporeal membrane oxygenation COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2025/04/28 06:26 MHDA- 2025/04/28 06:27 CRDT- 2025/04/28 00:53 PHST- 2025/04/28 06:27 [medline] PHST- 2025/04/28 06:26 [pubmed] PHST- 2025/04/28 00:53 [entrez] AID - 10.1177/02676591241263285 [doi] PST - ppublish SO - Perfusion. 2025 May;40(4):893-897. doi: 10.1177/02676591241263285. Epub 2024 Jun 18. PMID- 40262657 OWN - NLM STAT- MEDLINE DCOM- 20250713 LR - 20250716 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 118 DP - 2025 Sep TI - Single Perclose Plus Plug Based Device versus Double Perclose for Percutaneous Large Bore Arterial Access: An Systematic Review and Meta-analysis. PG - 56-67 LID - S0890-5096(25)00290-0 [pii] LID - 10.1016/j.avsg.2025.04.107 [doi] AB - BACKGROUND: Vascular Closure primarily utilizing suture-based devices (SBDs) are frequently used for large bore percutaneous arterial access in patients undergoing Transcatheter Aortic Valve Implantation and Endovascular Aneurysm Repair. Little is known about the intentional combination of SBD with plug-based device (PBD). Main objective was to determine the efficacy of adopting a combined SBD and PBD strategy compared to double SBD for large bore arterial access. METHODS: We searched randomized and observational studies comparing both strategies and that reported the outcomes of major vascular and vascular complications, major bleeding, all bleeding events, need for surgical or endovascular interventions, device failure, additional device, and pseudoaneurysm. A meta-analysis was conducted, with heterogeneity assessed using the I(2) statistic and a random-effects model applied to all outcomes. In addition, trial sequential analysis was performed. RESULTS: We included 3 randomized trials and 4 observational studies with 2,064 access. Sheath size ranged from 13Fr to 24 Fr. Vascular complications (relative risk [RR] 0.54; P < 0.01), major vascular complications (RR 0.55; P = 0.04), major bleeding (RR 0.49; P = 0.02), need for surgical intervention (RR 0.25; P = 0.01), and additional device (RR 0.12; P < 0.01) were significantly less common in patients treated with the SBD and PBD technique. Pseudoaneurysm (RR 1.13; P = 0.71), all bleeding events (RR 0.59; P = 0.1), and endovascular intervention (RR 0.65; P = 0.26) were not significantly different between groups. CONCLUSION: These findings suggest that 1 SBD, combined with PBD, was associated with less femoral access complications when compared to the exclusive double SBD as a vascular closure strategy in patients with large bore arterial access. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Bertolino, Enrico Prajiante AU - Bertolino EP AD - Departamento de Medicina da Universidade Estadual de Maringa, Maringa, Parana, Brazil. Electronic address: enricopbertolino@gmail.com. FAU - Mastra Fontoura, Milena Monteiro AU - Mastra Fontoura MM AD - Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Florencio de Mesquita, Cynthia AU - Florencio de Mesquita C AD - Faculdade de Medicina da Universidade Federal de Pernambuco, Recife, Brazil. FAU - da Silva Pimentel, Dilson Jr, AU - da Silva Pimentel D Jr, AD - Faculdade de Medicina da Universidade Federal Fluminense, Niteroi, Brazil. FAU - Fernandez, Miguel Godeiro AU - Fernandez MG AD - Escola Bahiana de Medicina e Saude Publica, Bahia, Brazil. FAU - Queiroz, Ivo AU - Queiroz I AD - Universidade Catolica de Pernambuco, Recife, Brazil. FAU - Diaz Herrera, Braiana Angeles AU - Diaz Herrera BA AD - Universidad Autonoma del Estado de Hidalgo and Instituto Nacional de Cardiologia "Ignacio Chavez", Mexico City, Mexico. FAU - Moraes, Altino Ono AU - Moraes AO AD - IMV, Instituto de Molestias Vasculares, Maringa, Brazil. FAU - Millner, Ross AU - Millner R AD - Section of Vascular Surgery and Endovascular Therapy of the University of Chicago, Chicago, IL. FAU - Mulatti, Grace Carvajal AU - Mulatti GC AD - Departamento de Cirurgia Vascular e Endovascular do Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20250420 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 SB - IM MH - Humans MH - *Catheterization, Peripheral/adverse effects/instrumentation MH - Punctures MH - Treatment Outcome MH - *Hemorrhage/prevention & control/etiology MH - *Vascular Closure Devices MH - *Hemostatic Techniques/instrumentation/adverse effects MH - Risk Factors MH - Equipment Design MH - Randomized Controlled Trials as Topic MH - Observational Studies as Topic EDAT- 2025/04/23 00:31 MHDA- 2025/07/14 00:28 CRDT- 2025/04/22 19:25 PHST- 2025/02/02 00:00 [received] PHST- 2025/04/03 00:00 [revised] PHST- 2025/04/04 00:00 [accepted] PHST- 2025/07/14 00:28 [medline] PHST- 2025/04/23 00:31 [pubmed] PHST- 2025/04/22 19:25 [entrez] AID - S0890-5096(25)00290-0 [pii] AID - 10.1016/j.avsg.2025.04.107 [doi] PST - ppublish SO - Ann Vasc Surg. 2025 Sep;118:56-67. doi: 10.1016/j.avsg.2025.04.107. Epub 2025 Apr 20. PMID- 40240155 OWN - NLM STAT- MEDLINE DCOM- 20250824 LR - 20260524 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 89 IP - 9 DP - 2025 Aug 25 TI - Factors Contributing to Hospital-Associated Disability in Elderly Patients After Transcatheter Aortic Valve Implantation. PG - 1453-1461 LID - 10.1253/circj.CJ-24-0710 [doi] AB - BACKGROUND: Hospital-associated disability (HAD), characterized by a worsening of activities of daily living and physical function following hospitalization, is a common complication in older adults during the course of acute care hospitalization. HAD is a significant concern affecting older adults undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: This retrospective study investigated 243 consecutive patients who underwent elective transfemoral TAVI between January 2016 and April 2022. HAD was defined as a decrease of at least 1 point in the Short Physical Performance Battery (SPPB) assessed before discharge compared with before TAVI. Logistic regression identified the first ambulation day after TAVI as an independent predictor of HAD incidence (odds ratio 1.500; 95% confidence interval [CI] 1.115-2.008; P=0.007). Patients with HAD had significantly lower body mass index, hemoglobin, and albumin, and higher serum creatinine. All-cause mortality was significantly higher in patients with than without HAD (log-rank P<0.001). Kaplan-Meier analysis confirmed poorer survival in patients with HAD, regardless of the degree of decline in SPPB. Multivariate Cox analysis regression identified HAD as a predictor of all-cause death (hazard ratio 4.249; 95% CI 1.798-10.04; P<0.001). CONCLUSIONS: The timing of the first ambulation was associated with the incidence of HAD. Promoting early mobilization may reduce the risk of HAD after TAVI. FAU - Shimizu, Masashi AU - Shimizu M AD - Department of Rehabilitation, Osaka Metropolitan University Hospital. FAU - Shibata, Atsushi AU - Shibata A AD - Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine. FAU - Taniguchi, Kodai AU - Taniguchi K AD - Department of Rehabilitation, Osaka Metropolitan University Hospital. FAU - Yamaguchi, Tomohiro AU - Yamaguchi T AD - Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine. FAU - Ikebuchi, Mitsuhiko AU - Ikebuchi M AD - Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine. FAU - Yamazaki, Takanori AU - Yamazaki T AD - Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine. FAU - Takahashi, Yosuke AU - Takahashi Y AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine. FAU - Hidetomi, Terai AU - Hidetomi T AD - Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine. FAU - Shibata, Toshihiko AU - Shibata T AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine. FAU - Fukuda, Daiju AU - Fukuda D AD - Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine. LA - eng PT - Journal Article DEP - 20250417 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Aged, 80 and over MH - Retrospective Studies MH - Aged MH - Risk Factors MH - *Aortic Valve Stenosis/surgery/mortality/physiopathology MH - Activities of Daily Living MH - *Hospitalization OTO - NOTNLM OT - Early mobilization OT - Hospital-associated disability OT - Transcatheter aortic valve implantation EDAT- 2025/04/17 00:24 MHDA- 2025/08/31 19:55 CRDT- 2025/04/16 21:53 PHST- 2025/08/31 19:55 [medline] PHST- 2025/04/17 00:24 [pubmed] PHST- 2025/04/16 21:53 [entrez] AID - 10.1253/circj.CJ-24-0710 [doi] PST - ppublish SO - Circ J. 2025 Aug 25;89(9):1453-1461. doi: 10.1253/circj.CJ-24-0710. Epub 2025 Apr 17. PMID- 40231056 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250902 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 4 IP - 3Part A DP - 2025 Mar TI - SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement. PG - 102514 LID - 10.1016/j.jscai.2024.102514 [doi] LID - 102514 AB - Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options. This expert consensus statement aims to provide a comprehensive review of case selection, technical considerations, and outcomes associated with these alternative access routes in TAVR. Additionally, this document highlights the advancements in device technology and imaging guidance that have contributed to improving the safety and efficacy of alternative access TAVR. This consensus statement serves as a practical guide on best practices for interventional cardiologists, cardiothoracic surgeons, and heart teams in selecting patients and performing alternative access TAVR. CI - (c) 2025 The Author(s). FAU - Sherwood, Matthew AU - Sherwood M AD - Inova Heart and Vascular Institute, Fairfax, Virginia. FAU - Allen, Keith B AU - Allen KB AD - Saint Luke's Mid America Heart Institute, Kansas City, Missouri. FAU - Dahle, Thom G AU - Dahle TG AD - CentraCare Heart and Vascular Center, St. Cloud, Minnesota. FAU - Devireddy, Chandan M AU - Devireddy CM AD - Emory University School of Medicine, Atlanta, Georgia. FAU - Gaca, Jeffrey AU - Gaca J AD - Duke University Hospital, Durham, North Carolina. FAU - Garcia, Santiago AU - Garcia S AD - The Christ Hospital Health Network, Cincinnati, Ohio. FAU - Grubb, Kendra J AU - Grubb KJ AD - Emory University School of Medicine, Atlanta, Georgia. FAU - Kaneko, Tsuyoshi AU - Kaneko T AD - Washington University in St. Louis, St. Louis, Missouri. FAU - Kliger, Chad A AU - Kliger CA AD - Northwell Health, New Hyde Park, New York. FAU - Lederman, Robert J AU - Lederman RJ AD - Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. FAU - Messenger, John C AU - Messenger JC AD - University of Colorado Medicine, Aurora, Colorado. FAU - Parikh, Puja B AU - Parikh PB AD - Stony Brook University Hospital, Stony Brook, New York. FAU - Poulin, Marie-France AU - Poulin MF AD - Beth Israel Deaconess Medical Center, Boston, Massachusetts. FAU - Sanchez, Carlos AU - Sanchez C AD - Riverside Methodist Hospital, Columbus, Ohio. FAU - Ukaigwe, Anene AU - Ukaigwe A AD - Case Western Reserve University Hospital, Cleveland, Ohio. FAU - Yun, James J AU - Yun JJ AD - Cleveland Clinic, Cleveland, Ohio. FAU - Mahoney, Paul D AU - Mahoney PD AD - East Carolina University, Greenville, North Carolina. LA - eng PT - Journal Article DEP - 20250225 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 EIN - J Soc Cardiovasc Angiogr Interv. 2025 Jun 06;4(7):103798. doi: 10.1016/j.jscai.2025.103798. PMID: 40894334 PMC - PMC11993896 OTO - NOTNLM OT - alternative access OT - transcarotid OT - transcatheter aortic valve replacement OT - transcaval OT - vascular access EDAT- 2025/04/15 11:18 MHDA- 2025/04/15 11:19 PMCR- 2025/02/25 CRDT- 2025/04/15 04:43 PHST- 2024/10/07 00:00 [received] PHST- 2024/12/09 00:00 [revised] PHST- 2024/12/13 00:00 [accepted] PHST- 2025/04/15 11:19 [medline] PHST- 2025/04/15 11:18 [pubmed] PHST- 2025/04/15 04:43 [entrez] PHST- 2025/02/25 00:00 [pmc-release] AID - S2772-9303(24)02203-8 [pii] AID - 102514 [pii] AID - 10.1016/j.jscai.2024.102514 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2025 Feb 25;4(3Part A):102514. doi: 10.1016/j.jscai.2024.102514. eCollection 2025 Mar. PMID- 40231055 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250416 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 4 IP - 3Part A DP - 2025 Mar TI - Randomized Trial of Shortened Supine Bedrest Following Transfemoral Transcatheter Aortic Valve Replacement. PG - 102564 LID - 10.1016/j.jscai.2025.102564 [doi] LID - 102564 FAU - Elison, David AU - Elison D AD - Division of Cardiology, University of Washington Medical Center, Seattle, Washington. FAU - Casper, Morgan AU - Casper M AD - Department of Medicine, University of California Davis Medical Center, Sacramento, California. FAU - Condos, Gregory AU - Condos G AD - Department of Cardiology, Naval Medical Center, San Diego, California. FAU - Maitas, Oscar AU - Maitas O AD - Division of Cardiology, University of Washington Medical Center, Seattle, Washington. FAU - Chung, Christine J AU - Chung CJ AD - Division of Cardiology, University of Washington Medical Center, Seattle, Washington. FAU - Aldea, Gabriel AU - Aldea G AD - Division of Cardiac Surgery, University of Washington, Seattle, Washington. FAU - McCabe, James M AU - McCabe JM AD - Division of Cardiology, University of Washington Medical Center, Seattle, Washington. LA - eng PT - Journal Article DEP - 20250318 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC11993858 OTO - NOTNLM OT - bleeding OT - postprocedural care OT - transcatheter aortic valve replacement OT - vascular access EDAT- 2025/04/15 06:24 MHDA- 2025/04/15 06:25 PMCR- 2025/03/18 CRDT- 2025/04/15 04:43 PHST- 2024/10/15 00:00 [received] PHST- 2024/12/16 00:00 [revised] PHST- 2025/01/06 00:00 [accepted] PHST- 2025/04/15 06:25 [medline] PHST- 2025/04/15 06:24 [pubmed] PHST- 2025/04/15 04:43 [entrez] PHST- 2025/03/18 00:00 [pmc-release] AID - S2772-9303(25)00005-5 [pii] AID - 102564 [pii] AID - 10.1016/j.jscai.2025.102564 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2025 Mar 18;4(3Part A):102564. doi: 10.1016/j.jscai.2025.102564. eCollection 2025 Mar. PMID- 40217773 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250415 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 7 DP - 2025 Mar 28 TI - Single-Centre Experience with the Balloon-Expandable Myval Transcatheter Aortic Valve System with the First 200 Patients: 30-Day and 1-Year Follow-Up. LID - 10.3390/jcm14072323 [doi] LID - 2323 AB - Aims: The aim of this paper is to report 30-day and 1-year outcome data regarding the first 200 patients who underwent the TAVR procedure using the Myval THV system at our single centre. Methods: From November 2019 to October 2022, 200 consecutive patients underwent TAVR procedure. Outcomes were analysed according to the VARC-2 definitions, and device performance was assessed via transthoracic echocardiography. Data collection was approved by the local Ethical Committee. Results: The mean age of the cohort was 75.3 +/- 6.9 years, and 122 (61%) participants were male. The mean EuroSCORE II and STS was 5.4 +/- 5.4 and 5.8 +/- 3.8, respectively. The proportion of patients with a bicuspid aortic valve was 18%. The transfemoral access approach was the most common (surgical vs. percutaneous: 1% vs. 98%), and in two patients, surgical subclavian access was used. VARC-2 outcomes were as follows: 99% device success, 2% STROKE, 5% and 4.5% major and minor vascular complications, respectively, and a 29.5% rate of new permanent pacemaker implantation. At discharge, the incidence of aortic regurgitation grade II or above was 5.5% without relevant PVL (grade II or above 0.5%). In-hospital mortality was only 1%. At 1 year, the all-cause mortality rate was 8.5% (cardiac origin in three cases), and two patients had valve-related dysfunction requiring surgical aortic replacement. Conclusions: Our results showed excellent 30-day and 1-year outcomes regarding patient survival, technical success, and valve-related adverse events using the Myval transcatheter heart valve system. The limitations of our study comprise a single-centre design with retrospective data collection. FAU - Kittka, Balint AU - Kittka B AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. FAU - Magyari, Balazs AU - Magyari B AUID- ORCID: 0000-0002-8851-9637 AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. FAU - Gojak, Ilona AU - Gojak I AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. FAU - Kasza, Gabor AU - Kasza G AD - Department of Vascular Surgery, Medical School, University of Pecs, H-7624 Pecs, Hungary. FAU - Schonfeld, Kristof AU - Schonfeld K AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. FAU - Szapary, Laszlo Botond AU - Szapary LB AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. FAU - Simon, Mihaly AU - Simon M AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. FAU - Kiss, Rudolf AU - Kiss R AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. FAU - Bertalan, Andrea AU - Bertalan A AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. FAU - Varady, Edit AU - Varady E AD - Department of Medical Imaging, Medical School, University of Pecs, H-7624 Pecs, Hungary. FAU - Szokodi, Istvan AU - Szokodi I AUID- ORCID: 0000-0002-2162-6155 AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. FAU - Horvath, Ivan Gabor AU - Horvath IG AD - Heart Institute, Medical School, University of Pecs, 13. Ifjusag Str., H-7624 Pecs, Hungary. AD - Szentagothai Research Center, University of Pecs, H-7624 Pecs, Hungary. LA - eng GR - NKFIH K120536/National Research, Development, and Innovation Office of Hungary/ PT - Journal Article DEP - 20250328 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11989386 OTO - NOTNLM OT - TAVR OT - annular rupture OT - balloon-expandable transcatheter heart valve OT - bicuspid aortic valve OT - paravalvular leak OT - permanent pacemaker implantation COIS- Our conflict of interest is that Ivan Horvath, and Balazs Magyari, have a proctorship agreement with Meril Life Sciences. The other authors have no conflicts of interest to declare. Although Ivan Horvath, and Balazs Magyari have a proctorship agreement, there were no conflicts of interest associated with this publication, and there has been no financial support for this work that could have influenced its outcome. EDAT- 2025/04/12 21:53 MHDA- 2025/04/12 21:54 PMCR- 2025/03/28 CRDT- 2025/04/12 01:01 PHST- 2025/01/08 00:00 [received] PHST- 2025/03/15 00:00 [revised] PHST- 2025/03/20 00:00 [accepted] PHST- 2025/04/12 21:54 [medline] PHST- 2025/04/12 21:53 [pubmed] PHST- 2025/04/12 01:01 [entrez] PHST- 2025/03/28 00:00 [pmc-release] AID - jcm14072323 [pii] AID - jcm-14-02323 [pii] AID - 10.3390/jcm14072323 [doi] PST - epublish SO - J Clin Med. 2025 Mar 28;14(7):2323. doi: 10.3390/jcm14072323. PMID- 40217685 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250415 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 7 DP - 2025 Mar 25 TI - Transapical vs. Transaxillary Access in Transcatheter Aortic Valve Implantation: Comparative Mortality and Long-Term Outcomes Using Inverse Probability of Treatment Weighting Analysis. LID - 10.3390/jcm14072235 [doi] LID - 2235 AB - Background: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for symptomatic aortic stenosis in patients with moderate to high surgical risk. When transfemoral access is unsuitable, alternative routes such as transapical (TAP) or transaxillary (TAX) routes must be considered. This study compares the in-hospital mortality and clinical outcomes of TAP vs. TAX TAVI. Methods: We conducted a retrospective analysis of 76 patients who underwent TAP or TAX TAVI between 2018 and 2021 at our department. Inverse probability of treatment weighting (IPTW) was used to account for baseline differences. Results: Among 1901 TAVI procedures, a total of 76 was selected of which TAP was performed in 34.2% (n = 26), and TAX in 65.8% (n = 50) of cases. Self-expanding CoreValve Evolut R valve prostheses were used in 96% of TAX cases, while balloon-expandable Edwards SAPIEN 3 valve prostheses were exclusively implanted in TAP cases. After IPTW adjustment, baseline characteristics, including EuroSCORE II, LVEF, and NYHA class, were comparable. TAX was associated with a higher pacemaker implantation rate (22.6% vs. 0%; p = 0.032), while TAP had a higher incidence of late bacteremia (13.4% vs. 1.6%; p = 0.027) and longer hospitalization (19 [13, 28] vs. 10 [8, 21] days; p = 0.016). In-hospital (0% vs. 2.1%; p = 0.388), 30-day (3.4% vs. 3.5%; p = 0.957), and 3-year mortality (6.7% vs. 4.8%; p = 0.709) were similar. Device implantation success was 100% in both groups. Major bleeding and vascular complications were rare. Balloon predilatation was more frequent in TAX (57.6% vs. 13.3%; p = 0.002). Rates of mild and moderate aortic regurgitation did not differ. Conclusions: In patients unsuitable for transfemoral TAVI, TAP was associated with lower pacemaker rates but longer hospitalization and increased late bacteremia compared to TAX. Both approaches showed comparable safety and efficacy, emphasizing the need for individualized access selection. FAU - Schrader, Helene AU - Schrader H AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Wiedenhofer, Julia M AU - Wiedenhofer JM AUID- ORCID: 0009-0002-4913-2314 AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Berlinghof, Sophie AU - Berlinghof S AUID- ORCID: 0009-0002-2875-0981 AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. FAU - Ducaruge, Juliane AU - Ducaruge J AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. FAU - Brand, Anna AU - Brand A AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Charite Mitte, 13353 Berlin, Germany. FAU - Spethmann, Sebastian AU - Spethmann S AUID- ORCID: 0000-0003-0987-8007 AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Charite Mitte, 13353 Berlin, Germany. FAU - Landmesser, Ulf AU - Landmesser U AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Benjamin Franklin, 12203 Berlin, Germany. FAU - Blaschke, Florian AU - Blaschke F AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Grubitzsch, Herko AU - Grubitzsch H AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - Deutsches Herzzentrum der Charite, Department of Cardiothoracic and Vascular Surgery, 10785 Berlin, Germany. FAU - Falk, Volkmar AU - Falk V AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - Deutsches Herzzentrum der Charite, Department of Cardiothoracic and Vascular Surgery, 10785 Berlin, Germany. FAU - Klein, Christoph AU - Klein C AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. FAU - Unbehaun, Axel AU - Unbehaun A AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Sherif, Mohammad AU - Sherif M AUID- ORCID: 0000-0001-6999-5067 AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Dreger, Henryk AU - Dreger H AUID- ORCID: 0000-0003-1909-4329 AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Trippel, Tobias D AU - Trippel TD AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Primessnig, Uwe AU - Primessnig U AUID- ORCID: 0009-0007-0977-7974 AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum-Augustenburger Platz 1, 13353 Berlin, Germany. AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. FAU - Sundermann, Simon H AU - Sundermann SH AD - Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Chariteplatz 1, 10117 Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany. AD - Deutsches Herzzentrum der Charite, Department of Cardiothoracic and Vascular Surgery, 10785 Berlin, Germany. LA - eng PT - Journal Article DEP - 20250325 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11989286 OTO - NOTNLM OT - surgical aortic valve replacement (SAVR) OT - transapical (TAP) OT - transaxillary TAVI (TAX) OT - transcatheter aortic valve implantation (TAVI) OT - transfemoral access (TF) COIS- The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/04/12 21:55 MHDA- 2025/04/12 21:56 PMCR- 2025/03/25 CRDT- 2025/04/12 01:01 PHST- 2025/02/07 00:00 [received] PHST- 2025/03/08 00:00 [revised] PHST- 2025/03/19 00:00 [accepted] PHST- 2025/04/12 21:56 [medline] PHST- 2025/04/12 21:55 [pubmed] PHST- 2025/04/12 01:01 [entrez] PHST- 2025/03/25 00:00 [pmc-release] AID - jcm14072235 [pii] AID - jcm-14-02235 [pii] AID - 10.3390/jcm14072235 [doi] PST - epublish SO - J Clin Med. 2025 Mar 25;14(7):2235. doi: 10.3390/jcm14072235. PMID- 40204013 OWN - NLM STAT- MEDLINE DCOM- 20250825 LR - 20250827 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 41 IP - 8 DP - 2025 Aug TI - Vascular Complications in Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices. PG - 1490-1502 LID - S0828-282X(25)00244-2 [pii] LID - 10.1016/j.cjca.2025.03.034 [doi] AB - BACKGROUND: Vascular complications (VCs) remain a major concern after transcatheter aortic valve replacement (TAVR). However, their occurrence in patients treated with newer generation devices has been scarcely studied. Therefore, the aim of this study was to determine the incidence, management, predictors, and clinical impact of VCs in patients undergoing TAVR with contemporary devices. METHODS: Multicenter study including 8815 patients that underwent transfemoral TAVR. VCs were classified based on the Valve Academic Research Consortium-3 criteria. Baseline, procedural, and follow-up data were prospectively collected in a dedicated database. RESULTS: VCs occurred in 1464 patients (16.5%), being major and minor in 44.7% and 55.3% of cases, respectively, and most of them related to primary access (87%). Vascular injury (75.2%) and device closure failure (21.2%) were the most predominant subtypes. Major VCs were independently associated with a substantial increase in 1-year mortality (hazard ratio [HR] 2.33, 95% confidence interval [CI] 1.92-2.82, P = 0.001). However, this association was absent in minor VCs, even if an unplanned intervention occurred. Female sex, dual-antiplatelet therapy, access-related anatomic factors, and use of large plug-based vascular closure were associated with an increased risk of major VCs (P < 0.05 for all), with echocardiography-guided access and secondary radial access emerging as protective factors (P < 0.01 for all). CONCLUSIONS: VCs persist as a major issue in patients undergoing TAVR with contemporary devices, with multiple modifiable factors determining a higher risk. Major, but not minor VCs were associated with poorer short- and long-term survival. Given their negative impact on clinical outcomes, every effort should be made to minimize the occurrence of VCs after TAVR. CI - Copyright (c) 2025 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Cepas-Guillen, Pedro AU - Cepas-Guillen P AD - Cardiology Department, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Avvedimento, Marisa AU - Avvedimento M AD - Cardiology Department, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Ternacle, Julien AU - Ternacle J AD - Cardiology Department, Hopital Cardiologique Haut-Leveque, CHU de Bordeaux, Bordeaux, France. FAU - Urena, Marina AU - Urena M AD - Cardiology Department, Bichat-Claude Bernard Hospital, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Alperi, Alberto AU - Alperi A AD - Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. FAU - Cheema, Asim N AU - Cheema AN AD - Cardiology Department, Southlake Regional Health Centre Newmarket, Newmarket, Ontario, Canada. FAU - Veiga-Fernandez, Gabriela AU - Veiga-Fernandez G AD - Cardiology Department, Hospital Marques de Valdecilla, Instituto de Investigacion Valdecilla, Santander, Spain. FAU - Nombela-Franco, Luis AU - Nombela-Franco L AD - Cardiology Department, Instituto Cardiovascular, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico de San Carlos, Madrid, Spain. FAU - Vilalta, Victoria AU - Vilalta V AD - Cardiology Department, Hospital Germans Trias i Pujol, Badalona, Spain. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. FAU - Indolfi, Ciro AU - Indolfi C AD - Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy. FAU - Trigo, Maria Del AU - Trigo MD AD - Cardiology Department, Hospital Puerta de Hierro, Madrid, Spain. FAU - Munoz-Garcia, Antonio AU - Munoz-Garcia A AD - Cardiology Department, Hospital Regional Virgen de la Victoria, Malaga, Spain. FAU - Maneiro, Nicolas AU - Maneiro N AD - Cardiology Department, Hospital Doce de Octubre, Madrid, Spain. FAU - Asmarats, Lluis AU - Asmarats L AD - Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. FAU - Regueiro, Ander AU - Regueiro A AD - Cardiology Department, Institut Clinic Cardiovascular, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain. FAU - Val, David Del AU - Val DD AD - Cardiology Department, Hospital de La Princesa, Madrid, Spain. FAU - Serra, Vicenc AU - Serra V AD - Cardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain. FAU - Gonzalvez-Garcia, Ariana AU - Gonzalvez-Garcia A AD - Cardiology Department, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada; Cardiology Department, Hospital Universitario La Paz, Madrid, Spain. FAU - Bonnet, Guillaume AU - Bonnet G AD - Cardiology Department, Hopital Cardiologique Haut-Leveque, CHU de Bordeaux, Bordeaux, France. FAU - Di Renzo, Antonio AU - Di Renzo A AD - Cardiology Department, Hopital Cardiologique Haut-Leveque, CHU de Bordeaux, Bordeaux, France. FAU - Mesnier, Jules AU - Mesnier J AD - Cardiology Department, Bichat-Claude Bernard Hospital, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Suc, Gaspard AU - Suc G AD - Cardiology Department, Bichat-Claude Bernard Hospital, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Avanzas, Pablo AU - Avanzas P AD - Cardiology Department, Southlake Regional Health Centre Newmarket, Newmarket, Ontario, Canada. FAU - Rezaei, Effat AU - Rezaei E AD - Cardiology Department, Southlake Regional Health Centre Newmarket, Newmarket, Ontario, Canada. FAU - Fradejas-Sastre, Victor AU - Fradejas-Sastre V AD - Cardiology Department, Hospital Marques de Valdecilla, Instituto de Investigacion Valdecilla, Santander, Spain. FAU - Chavez Solsol, Jorge F AU - Chavez Solsol JF AD - Cardiology Department, Hospital Germans Trias i Pujol, Badalona, Spain. FAU - Fernandez-Nofrerias, Eduard AU - Fernandez-Nofrerias E AD - Cardiology Department, Hospital Germans Trias i Pujol, Badalona, Spain. FAU - Angellotti, Domenico AU - Angellotti D AD - Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. FAU - Sorrentino, Sabato AU - Sorrentino S AD - Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy. FAU - Oteo, Juan Francisco AU - Oteo JF AD - Cardiology Department, Hospital Doce de Octubre, Madrid, Spain. FAU - Diez-Delhoyo, Felipe AU - Diez-Delhoyo F AD - Cardiology Department, Hospital Doce de Octubre, Madrid, Spain. FAU - Gutierrez-Alonso, Lola AU - Gutierrez-Alonso L AD - Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. FAU - Ruberti, Andrea AU - Ruberti A AD - Cardiology Department, Institut Clinic Cardiovascular, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain. FAU - Alfonso, Fernando AU - Alfonso F AD - Cardiology Department, Hospital de La Princesa, Madrid, Spain. FAU - Monastyrski, Andrea AU - Monastyrski A AD - Cardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain. FAU - Pelletier-Beaumont, Emilie AU - Pelletier-Beaumont E AD - Cardiology Department, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Cardiology Department, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada; Department of Research and Innovation, Clinic Barcelona, Barcelona, Spain. Electronic address: Josep.Rodes@criucpq.ulaval.ca. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250409 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Female MH - Male MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery MH - Incidence MH - Aged MH - *Postoperative Complications/epidemiology MH - Risk Factors MH - Follow-Up Studies MH - *Heart Valve Prosthesis/adverse effects MH - Prospective Studies MH - *Vascular System Injuries/epidemiology/etiology EDAT- 2025/04/10 00:20 MHDA- 2025/08/31 19:54 CRDT- 2025/04/09 19:32 PHST- 2024/12/03 00:00 [received] PHST- 2025/03/24 00:00 [revised] PHST- 2025/03/29 00:00 [accepted] PHST- 2025/08/31 19:54 [medline] PHST- 2025/04/10 00:20 [pubmed] PHST- 2025/04/09 19:32 [entrez] AID - S0828-282X(25)00244-2 [pii] AID - 10.1016/j.cjca.2025.03.034 [doi] PST - ppublish SO - Can J Cardiol. 2025 Aug;41(8):1490-1502. doi: 10.1016/j.cjca.2025.03.034. Epub 2025 Apr 9. PMID- 40187628 OWN - NLM STAT- In-Process LR - 20250517 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 247 DP - 2025 Jul 15 TI - Large Bore Sheath Technology and Hemostasis Efficacy After Transfemoral Transcatheter Aortic Valve Implantation. PG - 41-43 LID - S0002-9149(25)00223-1 [pii] LID - 10.1016/j.amjcard.2025.03.045 [doi] FAU - Iacovelli, Fortunato AU - Iacovelli F AD - Division of University Cardiology, Cardiothoracic Department, Policlinico University Hospital, Bari, Italy; Division of Cardiology, "SS. Annunziata" Hospital, Taranto, Italy. Electronic address: fortunato.iacovelli@uniba.it. FAU - Cafaro, Alessandro AU - Cafaro A AD - Division of Cardiology, "V. Fazzi" Hospital, Lecce, Italy. FAU - Pignatelli, Antonio AU - Pignatelli A AD - Interventional Cardiology Service, "Anthea" Clinic, GVM Care & Research, Bari, Italy. FAU - Burattini, Osvaldo AU - Burattini O AD - Division of Cardiology, "SS. Annunziata" Hospital, Taranto, Italy. FAU - Spione, Francesco AU - Spione F AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy; Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy. FAU - Salemme, Luigi AU - Salemme L AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Cioppa, Angelo AU - Cioppa A AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Pucciarelli, Armando AU - Pucciarelli A AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Popusoi, Grigore AU - Popusoi G AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Stabile, Eugenio AU - Stabile E AD - Division of Cardiology, Department of Health Sciences, University of Basilicata, Potenza, Italy. FAU - Tesorio, Tullio AU - Tesorio T AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. LA - eng PT - Journal Article DEP - 20250403 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM OTO - NOTNLM OT - Perclose ProGlide OT - percutaneous closure device failure OT - sheath technology OT - transcatheter aortic valve implantation OT - vascular complications COIS- Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fortunato Iacovelli directly received speaker fees from General Electric Healthcare, not related to this work; Angelo Cioppa serves as transcatheter heart valve proctor for Sahajanand Medical Technologies. EDAT- 2025/04/06 04:45 MHDA- 2025/04/06 04:45 CRDT- 2025/04/05 19:35 PHST- 2025/01/23 00:00 [received] PHST- 2025/03/11 00:00 [revised] PHST- 2025/03/31 00:00 [accepted] PHST- 2025/04/06 04:45 [pubmed] PHST- 2025/04/06 04:45 [medline] PHST- 2025/04/05 19:35 [entrez] AID - S0002-9149(25)00223-1 [pii] AID - 10.1016/j.amjcard.2025.03.045 [doi] PST - ppublish SO - Am J Cardiol. 2025 Jul 15;247:41-43. doi: 10.1016/j.amjcard.2025.03.045. Epub 2025 Apr 3. PMID- 40187364 OWN - NLM STAT- MEDLINE DCOM- 20250419 LR - 20260827 IS - 1474-547X (Electronic) IS - 0140-6736 (Linking) VI - 405 IP - 10487 DP - 2025 Apr 19 TI - SAPIEN 3 versus Myval transcatheter heart valves for transcatheter aortic valve implantation (COMPARE-TAVI 1): a multicentre, randomised, non-inferiority trial. PG - 1362-1372 LID - S0140-6736(25)00106-0 [pii] LID - 10.1016/S0140-6736(25)00106-0 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a guideline-directed treatment for severe aortic stenosis and degenerated aortic bioprostheses. When new transcatheter heart valve (THV) platforms for TAVI are launched, they should be compared with best-in-practice contemporary THVs for their short-term and long-term performance. The COMPARE-TAVI 1 trial was designed to provide a head-to-head comparison of the SAPIEN 3 or SAPIEN 3 Ultra THVs and the Myval or Myval Octacor THVs. METHODS: This multicentre, all-comers, randomised, non-inferiority trial was done at three university hospitals in Denmark. Eligible patients were aged 18 years or older, scheduled for transfemoral TAVI, and eligible for treatment with SAPIEN 3 THVs or Myval THVs. Patients were randomly assigned (1:1) to treatment with SAPIEN 3 (29 mm diameter) or SAPIEN 3 Ultra (20 mm, 23 mm, or 26 mm diameter) THVs or Myval or Myval Octacor THVs (20-32 mm diameter). The TAVI procedure was performed according to local practice and under local anaesthesia unless leaflet laceration was performed. The primary endpoint was a composite of death, stroke, moderate or severe aortic regurgitation, or moderate or severe haemodynamic THV deterioration at 1 year according to Third Valve Academic Research Consortium criteria. All patients assigned to THV treatment were included in the intention-to-treat analysis, and all patients who were treated as randomly assigned were included in the per-protocol analysis. With an expected event rate of 13%, the prespecified non-inferiority margin was 5.3%. This trial is registered with ClinicalTrials.gov, NCT04443023, and is closed to accrual. FINDINGS: Between June 15, 2020, and Nov 3, 2023, 1031 patients were enrolled. Enrolment was paused twice because of patent-related legal proceedings. Of 1031 patients, 517 patients were randomly assigned to SAPIEN 3 THVs and 514 to Myval THVs. The median patient age was 81.6 years (IQR 77.6-85.0), and 415 (40%) of 1031 patients were female and 616 (60%) were male. The primary endpoint occurred in 67 (13%) of 517 patients randomly assigned to SAPIEN 3 THVs versus 71 (14%) of 514 patients randomly assigned to Myval THVs (risk difference -0.9% [one-sided upper 95% CI 4.4%]; p(non-inferiority)=0.019). INTERPRETATION: Myval THVs were non-inferior to SAPIEN 3 THVs in terms of a 1-year composite endpoint of death, stroke, moderate or severe aortic regurgitation, or moderate or severe haemodynamic THV deterioration. FUNDING: Meril Life Sciences, Vingmed Denmark, the Danish Heart Foundation, and the Central Denmark Region. CI - Copyright (c) 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies. FAU - Terkelsen, Christian Juhl AU - Terkelsen CJ AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: chriterk@rm.dk. FAU - Freeman, Philip AU - Freeman P AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Dahl, Jordi Sanchez AU - Dahl JS AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Thim, Troels AU - Thim T AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Norgaard, Bjarne Linde AU - Norgaard BL AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Mogensen, Nils Sofus Borg AU - Mogensen NSB AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Tang, Mariann AU - Tang M AD - Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark. FAU - Eftekhari, Ashkan AU - Eftekhari A AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Povlsen, Jonas Agerlund AU - Povlsen JA AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Poulsen, Steen Hvitfeldt AU - Poulsen SH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Pedersen, Lars AU - Pedersen L AD - Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark. FAU - Hjort, Jakob AU - Hjort J AD - Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. FAU - Ellert, Julia AU - Ellert J AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Christiansen, Evald Hoj AU - Christiansen EH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Sorensen, Henrik Toft AU - Sorensen HT AD - Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark. FAU - Nissen, Henrik AU - Nissen H AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. LA - eng SI - ClinicalTrials.gov/NCT04443023 PT - Comparative Study PT - Equivalence Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20250402 PL - England TA - Lancet JT - Lancet (London, England) JID - 2985213R SB - IM CIN - Lancet. 2025 Apr 19;405(10487):1316-1317. doi: 10.1016/S0140-6736(25)00259-4. PMID: 40187365 EIN - Lancet. 2025 Jun 21;405(10496):2204. doi: 10.1016/S0140-6736(25)01251-6. PMID: 40543975 EIN - Lancet. 2026 Feb 21;407(10530):762. doi: 10.1016/S0140-6736(26)00315-6. PMID: 41722966 EIN - Lancet. 2026 Aug 29;408(10557):792. doi: 10.1016/S0140-6736(26)01720-4. PMID: 42660151 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/adverse effects MH - Female MH - Male MH - *Aortic Valve Stenosis/surgery MH - Aged, 80 and over MH - *Heart Valve Prosthesis/adverse effects MH - Aged MH - Treatment Outcome MH - Prosthesis Design MH - *Bioprosthesis MH - Aortic Valve/surgery MH - Denmark MH - Postoperative Complications/epidemiology COIS- Declaration of interests CJT reports institutional research grants from Meril Life Sciences, the Danish Heart Foundation, Vingmed Denmark, and the Central Denmark Region for the conduct of the COMPARE-TAVI 1 trial; proctor fees from Meril Life Sciences; and lecture fees from Edwards Lifesciences, Meril Life Sciences, Terumo, and Medtronic. PF reports proctor fees from Meril Life Sciences; lecture fees from Edwards Lifesciences, Meril Life Sciences, and Boston Scientific; and support for meeting attendance from Edwards Lifesciences and Meril Life Sciences. JSD reports travel support for meeting attendance from Edwards Life Sciences. TT reports lecture fees from Terumo and Chiesi; and travel support for meeting attendance from Chiesi. JE reports advisory board participation for Boston Scientific. BLN reports institutional research grants from the Novo Nordisk Foundation. EHC reports institutional research grants from Abbott; proctor fees from Edwards Lifesciences, Meril Life Sciences, Boston Scientific, and Abbott; and lecture fees from Edwards Life Sciences, Meril Lifesciences, Boston Scientific, and Abbott. HN reports institutional research grants from Meril Life Sciences and Vingmed Denmark, and lecture fees from Edwards Lifesciences and Meril Life Sciences. All other authors declare no competing interests. EDAT- 2025/04/06 04:44 MHDA- 2025/04/20 00:44 CRDT- 2025/04/05 18:53 PHST- 2024/11/09 00:00 [received] PHST- 2025/01/12 00:00 [revised] PHST- 2025/01/15 00:00 [accepted] PHST- 2025/04/20 00:44 [medline] PHST- 2025/04/06 04:44 [pubmed] PHST- 2025/04/05 18:53 [entrez] AID - S0140-6736(25)00106-0 [pii] AID - 10.1016/S0140-6736(25)00106-0 [doi] PST - ppublish SO - Lancet. 2025 Apr 19;405(10487):1362-1372. doi: 10.1016/S0140-6736(25)00106-0. Epub 2025 Apr 2. PMID- 40176098 OWN - NLM STAT- MEDLINE DCOM- 20250515 LR - 20250515 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 20 IP - 1 DP - 2025 Apr 2 TI - Reducing access complications in an interdisciplinary structural heart program. PG - 177 LID - 10.1186/s13019-025-03407-9 [doi] LID - 177 AB - BACKGROUND: Vascular (VC) and cardiac structural complications (CSC) are frequent complications following transcatheter aortic valve implantation (TAVI). Aim of this single-center retrospective study was to evaluate strategies for minimizing periprocedural access complications as part of an interdisciplinary structural heart program. METHODS: Included were all patients who underwent TAVI between 09/2022 and 08/2023 at our institution. All procedures were performed by a heart team, consisting of a cardiovascular surgeon with peripheral vascular and interventional experience and an interventional cardiologist on site. Valvular type and size, access route and backup strategies were assessed by the heart team according to the preoperative CT-imaging. Baseline characteristics, periprocedural data, complications and 30-day outcomes were analyzed concerning the access route using Mann-Whitney-U-test or Fisher s exact test. RESULTS: Analyzed were 167 consecutive patients (81 (76-85) years; 53.3% male). 48 (28.7%) of these had severe peripheral artery disease. 130 (77.8%) procedures were performed via a percutaneous transfemoral approach, 13 (7.8%) via a femoral cut-down and 4 (2.4%) via a transaxillary access. For 20 procedures (11.9%) a transapical access was used. 106 patients (72%) with transvascular and all patients with transapical access received a balloon-expanding valve, whereas 41 (28%) patients with transvascular access received a self-expanding prosthesis. No coronary occlusion was seen. Annular rupture occurred in one patient (0.6%), valve displacement in two patients (1.2%). Totally 5 (3%) access femoral arteries were stented and 8 (4.8%) needed a surgical reconstruction. 30-day mortality was 2.99%. CONCLUSIONS: On site interventional and cardiovascular surgical expertise may minimize VC and CSC following TAVI. CI - (c) 2025. The Author(s). FAU - Berres, Dinah Maria AU - Berres DM AD - Department of Cardiothoracic Surgery, BG University Hospital Bergmannsheil Ruhr-University of Bochum, Burkle de la Camp-Platz 1, 44789, Bochum, Germany. dinah.berres@gmx.de. FAU - Schlomicher, Markus AU - Schlomicher M AD - Department of Cardiothoracic Surgery, BG University Hospital Bergmannsheil Ruhr-University of Bochum, Burkle de la Camp-Platz 1, 44789, Bochum, Germany. FAU - Dickmann, Boris AU - Dickmann B AD - Department of Cardiology, Marien Hospital Witten, Witten, Germany. FAU - Buck, Thomas AU - Buck T AD - Departement of Cardiology, Klinikum Westfalen Knappschaftskrankenhaus Dortmund, Dortmund, Germany. FAU - Strauch, Justus Thomas AU - Strauch JT AD - Department of Cardiothoracic Surgery, BG University Hospital Bergmannsheil Ruhr-University of Bochum, Burkle de la Camp-Platz 1, 44789, Bochum, Germany. FAU - Ahmad, Farhan AU - Ahmad F AD - Department of Cardiology, University Hospital Bergmannsheil, Bochum, Germany. FAU - Coman, Horatiu AU - Coman H AD - Department of Vascular Surgery, St. Josef-Hospital Bochum, Bochum, Germany. AD - Vascular Surgery Clinic, Cluj-Napoca County Emergency Hospital, Cluj-Napoca, Romania. FAU - Haldenwang, Peter Lukas AU - Haldenwang PL AD - Department of Cardiothoracic Surgery, BG University Hospital Bergmannsheil Ruhr-University of Bochum, Burkle de la Camp-Platz 1, 44789, Bochum, Germany. LA - eng PT - Journal Article DEP - 20250402 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Humans MH - Male MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Female MH - Aged MH - Aged, 80 and over MH - *Postoperative Complications/prevention & control/epidemiology/etiology MH - *Aortic Valve Stenosis/surgery MH - *Patient Care Team PMC - PMC11963681 OTO - NOTNLM OT - Aortic valve OT - Artery/arteries OT - CardiaC OT - Heart valve, transapical, percutaneous (TAVI) OT - Outcomes (includes mortality, morbidity) OT - Peripheral vascular disease COIS- Declarations. Ethics approval and consent to participate: The study was reviewed and approved by the Medical Faculty;s ethics committee (No.: 23-7946 Medical Faculty of the Ruhr-University, Bochum, Germany). Consent for publication: Requirement for consent was waived because the data were analyzed anonymously. Competing interests: The authors declare no competing interests. EDAT- 2025/04/03 00:25 MHDA- 2025/04/03 18:25 PMCR- 2025/04/02 CRDT- 2025/04/02 23:53 PHST- 2024/11/10 00:00 [received] PHST- 2025/03/13 00:00 [accepted] PHST- 2025/04/03 18:25 [medline] PHST- 2025/04/03 00:25 [pubmed] PHST- 2025/04/02 23:53 [entrez] PHST- 2025/04/02 00:00 [pmc-release] AID - 10.1186/s13019-025-03407-9 [pii] AID - 3407 [pii] AID - 10.1186/s13019-025-03407-9 [doi] PST - epublish SO - J Cardiothorac Surg. 2025 Apr 2;20(1):177. doi: 10.1186/s13019-025-03407-9. PMID- 40171878 OWN - NLM STAT- MEDLINE DCOM- 20250609 LR - 20250625 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 46 IP - 22 DP - 2025 Jun 9 TI - Transcatheter vs. surgical aortic valve replacement in women: the RHEIA trial. PG - 2079-2088 LID - 10.1093/eurheartj/ehaf133 [doi] AB - BACKGROUND AND AIMS: Although women with severe symptomatic aortic stenosis have more complications than men when undergoing surgical valve replacement, they are under-represented in clinical trials. The Randomized researcH in womEn all comers wIth Aortic stenosis (RHEIA) trial investigates the balance of benefits and risks of transcatheter aortic valve implantation (TAVI) vs. surgery in women. METHODS: Women were randomized 1:1 to transfemoral TAVI with a balloon-expandable valve or surgery. The primary composite endpoint was death, stroke, or (valve, procedure or heart failure related) rehospitalization at 1 year. Non-inferiority testing with a pre-specified 6% margin and superiority testing were performed in the as-treated population. RESULTS: At 48 European centres, 443 women underwent randomization, and 420 were treated as randomized. Mean age was 73 years, and the mean estimated surgical risk of death was 2.1% (Society of Thoracic Surgeons risk score). Kaplan-Meier estimates of the primary endpoint event rates at 1 year were 8.9% in the TAVI and 15.6% in the surgery group. This difference of -6.8% with an upper 95% confidence limit of -1.5% demonstrated the non-inferiority of TAVI (P < .001). The two-sided 95% confidence interval of -13.0% to -.5% further resulted in superiority (P = .034). The 1-year incidence of the primary endpoint components was: .9% with TAVI vs. 2.0% with surgery for death from any cause, 3.3% vs. 3.0% for stroke, and 5.8% vs. 11.4% for rehospitalization. CONCLUSIONS: Among women with severe aortic stenosis, the incidence of the composite of death, stroke, or rehospitalization at 1 year was lower with TAVI than with surgery. CLINICALTRIALS.GOV NUMBER: NCT04160130. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Tchetche, Didier AU - Tchetche D AUID- ORCID: 0000-0001-7243-9408 AD - Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, 45 avenue de Lombez, 31076 Toulouse Cedex 3, France. FAU - Pibarot, Philippe AU - Pibarot P AUID- ORCID: 0000-0002-3607-279X AD - Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Bax, Jeroen J AU - Bax JJ AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Bonaros, Nikolaos AU - Bonaros N AD - Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Windecker, Stephan AU - Windecker S AUID- ORCID: 0000-0003-2653-6762 AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Dumonteil, Nicolas AU - Dumonteil N AD - Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, 45 avenue de Lombez, 31076 Toulouse Cedex 3, France. FAU - Nietlispach, Fabian AU - Nietlispach F AD - HeartCenter Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland. FAU - Messika-Zeitoun, David AU - Messika-Zeitoun D AUID- ORCID: 0000-0002-6278-5670 AD - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Pocock, Stuart J AU - Pocock SJ AD - Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK. FAU - Berthoumieu, Pierre AU - Berthoumieu P AD - Department of Cardiac and Thoracic Surgery, Clinic Pasteur, Toulouse, France. FAU - Swaans, Martin J AU - Swaans MJ AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. FAU - Timmers, Leo AU - Timmers L AD - Department of Cardiology, St Antonius Ziekenhuis Nieuwegein, Nieuwegein, The Netherlands. FAU - Rudolph, Tanja Katharina AU - Rudolph TK AD - Clinic for General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AUID- ORCID: 0000-0001-9669-7372 AD - Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Leroux, Lionel AU - Leroux L AD - Department of Interventional Cardiology, Cardiology Hospital of the Haut-Leveque, University of Bordeaux, Pessac, France. FAU - Modine, Thomas AU - Modine T AUID- ORCID: 0000-0003-4169-3766 AD - Service Medico-chirurgical de cardiologie, CHU de Bordeaux, Pessac, France. FAU - van der Kley, Frank AU - van der Kley F AUID- ORCID: 0000-0003-4521-8698 AD - Hart Long Centrum, Leids Universitair Medisch Centrum, Leiden, The Netherlands. FAU - Auffret, Vincent AU - Auffret V AUID- ORCID: 0000-0002-9481-646X AD - Service de Cardiologie, CHU de Rennes, Inserm LTSI U1099, Universite de Rennes 1, 35000 Rennes, France. FAU - Tomasi, Jacques AU - Tomasi J AUID- ORCID: 0000-0002-9527-8958 AD - Chirurgie thoracique, cardiaque et vasculaire, CHU Rennes-Hopital de Pontchaillou, Rennes, France. FAU - Stastny, Lukas AU - Stastny L AD - Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Hengstenberg, Christian AU - Hengstenberg C AUID- ORCID: 0000-0002-8284-2994 AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Andreas, Martin AU - Andreas M AUID- ORCID: 0000-0003-4950-5432 AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Leclercq, Florence AU - Leclercq F AUID- ORCID: 0000-0001-5936-5184 AD - Department of Cardiology, Montpellier University Hospital, Montpellier, France. FAU - Gandet, Thomas AU - Gandet T AD - Chirugie cardiaque, CHU Montpellier-Hopital Arnaud de Villeneuve, Montpellier, France. FAU - Mascherbauer, Julia AU - Mascherbauer J AD - Department of Internal Medicine 3/Cardiology, University Hospital Sankt Polten, Karl Landsteiner University of Medical Science, Krems, Austria. FAU - Trescher, Karola AU - Trescher K AD - Department of Heart Surgery, University Hospital Sankt Polten, Karl Landsteiner University of Medical Science, Krems, Austria. FAU - Prendergast, Bernard AU - Prendergast B AUID- ORCID: 0000-0002-6031-2124 AD - St. Thomas' Hospital, London, United Kingdom. FAU - Vasa-Nicotera, Mariuca AU - Vasa-Nicotera M AD - Cardiology Department, Hospital Sindelfingen-Boblingen, Sindelfingen, Germany. FAU - Chieffo, Alaide AU - Chieffo A AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Mares, Jan AU - Mares J AD - Department of Data Science, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. FAU - Wesselink, Wilbert AU - Wesselink W AD - Medical Affairs, Edwards Lifesciences, Prague, Czech Republic. FAU - Rakova, Radka AU - Rakova R AD - Medical Affairs, Edwards Lifesciences, Prague, Czech Republic. FAU - Kurucova, Jana AU - Kurucova J AD - Medical Affairs, Edwards Lifesciences, Prague, Czech Republic. FAU - Bramlage, Peter AU - Bramlage P AUID- ORCID: 0000-0003-4970-2110 AD - Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany. FAU - Eltchaninoff, Helene AU - Eltchaninoff H AUID- ORCID: 0000-0002-2652-7973 AD - Inserm U1096, CHU Rouen, Department of Cardiology, Univ Rouen Normandie, F-76000 Rouen, France. LA - eng SI - ClinicalTrials.gov/NCT04160130 GR - Edwards Lifesciences/ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/methods/mortality/adverse effects MH - *Aortic Valve Stenosis/surgery/mortality MH - Aged MH - *Heart Valve Prosthesis Implantation/methods/mortality/adverse effects MH - Aged, 80 and over MH - Postoperative Complications/mortality/epidemiology MH - *Aortic Valve/surgery MH - Patient Readmission/statistics & numerical data MH - Treatment Outcome MH - Heart Valve Prosthesis MH - Stroke/etiology/epidemiology OTO - NOTNLM OT - Aortic stenosis OT - SAVR OT - TAVI OT - Women EDAT- 2025/04/02 12:35 MHDA- 2025/06/09 06:26 CRDT- 2025/04/02 06:33 PHST- 2024/08/02 00:00 [received] PHST- 2024/10/11 00:00 [revised] PHST- 2025/02/18 00:00 [accepted] PHST- 2025/06/09 06:26 [medline] PHST- 2025/04/02 12:35 [pubmed] PHST- 2025/04/02 06:33 [entrez] AID - 8103699 [pii] AID - 10.1093/eurheartj/ehaf133 [doi] PST - ppublish SO - Eur Heart J. 2025 Jun 9;46(22):2079-2088. doi: 10.1093/eurheartj/ehaf133. PMID- 40169813 OWN - NLM STAT- MEDLINE DCOM- 20250618 LR - 20250618 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 15 IP - 1 DP - 2025 Apr 1 TI - Long-term survival evaluation after transcatheter aortic valve implantation in patients with severe aortic valve stenosis: a retrospective cohort study. PG - 11161 LID - 10.1038/s41598-025-90102-3 [doi] LID - 11161 AB - Transcatheter aortic valve implantation (TAVI) in patients with severe aortic valve stenosis (AS) is becoming an established technique. However, data on long-term survival in Japan are limited and regional disparities remain. We aimed to evaluate long-term survival after TAVI using the Nara Kokuho Database (KDB). Patients who underwent TAVI between July 2014 and March 2023 were enrolled. The study outcomes were to evaluate survival rates after TAVI over 1-7 years and predict long-term prognostic factors using Kaplan-Meier analysis and Cox proportional hazards model. Of 446 consecutive patients, 284 were female participants (63.7%). The mean age was 84.1 +/- 4.3 years. The overall survival rates were 95.1-54.4% over 1-7 years. Cox proportional hazards model analysis revealed that younger age (< 85 years, hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20-0.69; p = 0.002) and transfemoral approach (HR, 0.37; 95% CI 0.17-0.78; p = 0.009) were predictive factors. However, renal disease (HR, 2.02; 95% CI 1.08-3.77; p = 0.03), cerebrovascular disease (HR, 2.02; 95% CI 1.13-3.63; p = 0.02), and rheumatologic disease (HR, 2.71; 95% CI 1.19-6.18; p = 0.02) were poor long-term prognostic factors. This study measured the long-term survival after TAVI using Nara KDB data, identifying factors that might serve as predictive indicators. CI - (c) 2025. The Author(s). FAU - Takemoto, Kiyoshi AU - Takemoto K AD - Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara City, Nara, Japan. AD - Department of Critical Care Medicine, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Myojin, Tomoya AU - Myojin T AD - Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara City, Nara, Japan. t-myojin@naramed-u.ac.jp. AD - Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan. t-myojin@naramed-u.ac.jp. FAU - Nishioka, Yuichi AU - Nishioka Y AD - Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara City, Nara, Japan. FAU - Soeda, Tsunenari AU - Soeda T AD - Department of Cardiovascular Medicine, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Yamanaka, Kazuo AU - Yamanaka K AD - Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Nakahira, Atsushi AU - Nakahira A AD - Department of Critical Care Medicine, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Nishina, Takeshi AU - Nishina T AD - Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Kawata, Hiroyuki AU - Kawata H AD - Department of Cardiovascular Medicine, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Atagi, Kazuaki AU - Atagi K AD - Department of Critical Care Medicine, Nara Prefecture General Medical Center, Nara City, Nara, Japan. FAU - Noda, Tatsuya AU - Noda T AD - Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara City, Nara, Japan. FAU - Imamura, Tomoaki AU - Imamura T AD - Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara City, Nara, Japan. LA - eng PT - Journal Article DEP - 20250401 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Humans MH - Retrospective Studies MH - Cohort Studies MH - *Aortic Valve Stenosis/mortality/surgery/therapy MH - *Transcatheter Aortic Valve Replacement MH - Survival Analysis MH - Male MH - Female MH - Aged MH - Aged, 80 and over PMC - PMC11962164 OTO - NOTNLM OT - Aortic valve stenosis OT - Kokuho database OT - Long-term survival OT - Nara prefecture OT - Prognostic factors OT - Transcatheter aortic valve implantation COIS- Declarations. Competing interests: The authors declare no competing interests. EDAT- 2025/04/02 00:25 MHDA- 2025/04/02 00:26 PMCR- 2025/04/01 CRDT- 2025/04/01 23:38 PHST- 2024/09/02 00:00 [received] PHST- 2025/02/10 00:00 [accepted] PHST- 2025/04/02 00:26 [medline] PHST- 2025/04/02 00:25 [pubmed] PHST- 2025/04/01 23:38 [entrez] PHST- 2025/04/01 00:00 [pmc-release] AID - 10.1038/s41598-025-90102-3 [pii] AID - 90102 [pii] AID - 10.1038/s41598-025-90102-3 [doi] PST - epublish SO - Sci Rep. 2025 Apr 1;15(1):11161. doi: 10.1038/s41598-025-90102-3. PMID- 40156693 OWN - NLM STAT- MEDLINE DCOM- 20250514 LR - 20261010 IS - 1875-8312 (Electronic) IS - 1569-5794 (Linking) VI - 41 IP - 5 DP - 2025 May TI - Aortic shape and diameter variations are predictive of short-term complications in transcatheter aortic valve replacement. PG - 955-965 LID - 10.1007/s10554-025-03381-2 [doi] AB - INTRODUCTION: Anatomic and geometric considerations are critical components for transcatheter aortic valve replacement (TAVR) procedural planning. Aortic root geometry and 3-dimensional orientation have been previously associated with short-term complications but with mixed and inconsistent results. The purpose of this study was to investigate aortic 3-dimensional anatomical shape variants identified by principal component analysis (PCA) and whether these variants are associated with short-term complications. METHODS: Pre-TAVR planning chest CT angiograms (N = 100) were analyzed to create 3-dimensional anatomic aortic models were subjected to PCA. Aortic shape variants described by principal components (PCs) and their respective scores were calculated for each patient in addition to standard planning geometric parameters. A short-term composite complication outcome within 1-month from the implantation included major and minor stroke, life-threatening and major bleeding, stage 3 acute kidney injury, new heart block and moderate plus paravalvular leak (PVL). RESULTS: A total of 25 patients (25%) experienced perioperative complications following TAVR. Shape based PCs were: PC1 - variation in aortic arch height, isthmic angle, and aortic arch angle; PC2 aortic length; PC3- aortic tilt. Diameter based PCs described: PC1- diameter size along the entire aortic length; PC2- aortic diameter tapering, PC3- ascending to arch diameter ratio. On univariable logistic regression, four variables were predictive of periprocedural complications, including the ascending aortic diameter at the level of Valsalva sinuses (OR: 0.88 (95%CI: 0.78-1.00), P = 0.044), PC1-shape scores (OR: 1.01 (95%CI: 1.00-1.02), P = 0.011), PC2-shape scores (OR: 0.98 (95%CI: 0.97-1.00), P = 0.034), and PC-1 diameter scores (OR: 0.98 (95%CI: 0.96-1.00), P = 0.023). An optimized multivariable model considering only PC1-shape and PC1-diameter revealed a C-statistic of 0.76 with a sensitivity of 92.0% and specificity of 32.0%. CONCLUSION: Aortic shape variants combining increased aortic arch height, acute isthmic angle, and mild aortic arch angle as identified by PCA were associated along with aortic size with higher rates of periprocedural complications in patients undergoing transfemoral TAVR. PCA identified shape variations outperformed standard 2-dimensional geometric measurements and could be considered as part of risk stratification prior to TAVR planning. CI - (c) 2025. The Author(s), under exclusive licence to Springer Nature B.V. FAU - Schafer, Michal AU - Schafer M AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. michal.schafer@hsc.utah.edu. FAU - Glotzbach, Jason P AU - Glotzbach JP AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. FAU - Sharma, Vikas AU - Sharma V AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. FAU - Tandar, Anwar AU - Tandar A AD - Division of Cardiology, University of Utah Health, Salt Lake City, UT, USA. FAU - Welt, Frederick G AU - Welt FG AD - Division of Cardiology, University of Utah Health, Salt Lake City, UT, USA. FAU - L Goodwin, Matthew AU - L Goodwin M AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. FAU - Smego, Douglas AU - Smego D AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. FAU - Selzman, Craig H AU - Selzman CH AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. FAU - Pereira, Sara J AU - Pereira SJ AD - Division of Cardiothoracic Surgery, University of Utah Health, 30 N Mario Capecchi Drive, Salt Lake City, UT, 84112, USA. LA - eng PT - Journal Article DEP - 20250329 PL - United States TA - Int J Cardiovasc Imaging JT - The international journal of cardiovascular imaging JID - 100969716 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Female MH - Predictive Value of Tests MH - Risk Factors MH - Aged, 80 and over MH - Time Factors MH - Treatment Outcome MH - *Aortic Valve/diagnostic imaging/surgery/physiopathology MH - *Computed Tomography Angiography MH - *Aortography/methods MH - Aged MH - *Postoperative Complications/etiology MH - Principal Component Analysis MH - Retrospective Studies MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/physiopathology MH - Risk Assessment MH - *Patient-Specific Modeling MH - *Multidetector Computed Tomography MH - Anatomic Variation MH - ROC Curve MH - Radiographic Image Interpretation, Computer-Assisted OTO - NOTNLM OT - Aortic shape OT - Periprocedural outcomes OT - TAVR COIS- Declarations. Competing interests: The authors declare no competing interests. EDAT- 2025/03/30 23:01 MHDA- 2025/05/14 11:41 CRDT- 2025/03/29 12:06 PHST- 2024/12/09 00:00 [received] PHST- 2025/03/12 00:00 [accepted] PHST- 2025/05/14 11:41 [medline] PHST- 2025/03/30 23:01 [pubmed] PHST- 2025/03/29 12:06 [entrez] AID - 10.1007/s10554-025-03381-2 [pii] AID - 10.1007/s10554-025-03381-2 [doi] PST - ppublish SO - Int J Cardiovasc Imaging. 2025 May;41(5):955-965. doi: 10.1007/s10554-025-03381-2. Epub 2025 Mar 29. PMID- 40149588 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250330 IS - 2227-9059 (Print) IS - 2227-9059 (Electronic) IS - 2227-9059 (Linking) VI - 13 IP - 3 DP - 2025 Mar 3 TI - Hemodynamic Factors Driving Peripheral Chemoreceptor Hypersensitivity: Is Severe Aortic Stenosis Treated with Transcatheter Aortic Valve Implantation a Valuable Human Model? LID - 10.3390/biomedicines13030611 [doi] LID - 611 AB - Background: A reduction in carotid artery blood flow (CABF) and ultimately in wall shear stress (WSS) is a major driver of heightened peripheral chemoreceptor (PCh) activity in animal models of heart failure. However, it is yet to be translated to humans. To provide more insight into this matter, we considered severe aortic stenosis (AS) before and after transcatheter aortic valve implantation (TAVI) as a human model of carotid and aortic body function under dramatically different hemodynamic conditions. Materials and Methods: A total of 26 severe AS patients (aged 77 +/- 6 y, body mass index: 29.1 +/- 5.1 kg/m(2), left ventricular ejection fraction (LVEF): 50 +/- 15%) were subjected to a transient hypoxia test twice: immediately before vs. 1-4 months after TAVI (median follow-up: 95 days). PCh function was analyzed in terms of ventilatory (HVR, L/min/SpO(2)%) and heart rate responses to hypoxia (HR slope, bpm/SpO(2)%). Standard ultrasound (inc. aortic valve area [AVA], mean aortic valve gradient, peak aortic jet velocity, LVEF, and CABF), respiratory, hemodynamic, and blood parameters were collected at both visits. Pre- vs. post-TAVI data regarding HVR and HR slopes were available for N = 26 and N = 10 patients, respectively. Results: HVR did not change following TAVI (pre- vs. post-TAVI: 0.42 +/- 0.29 vs. 0.39 +/- 0.33 L/min/SpO(2)%, p = 0.523). The HR slope increased after TAVI (pre- vs. post-TAVI: 0.26 +/- 0.23 vs. 0.37 +/- 0.30 bpm/SpO(2)%, p = 0.019), and the magnitude of the increase was strongly associated with an increase in AVA (Spearman's R = 0.80, p = 0.006). No other significant relations between pre- vs. post-TAVI changes in PCh activity measures vs. hemodynamic parameters were found (all p > 0.12). Conclusions: The ventilatory component of the PCh reflex (defined as HVR) in severe AS patients is not affected by TAVI, and pre-TAVI values in this group are fairly comparable to those reported previously for healthy subjects. On the contrary, HR responses to hypoxia are increased after TAVI, and pre-TAVI values appear to be lower compared to the healthy population. An extraordinarily strong correlation between post-TAVI increases in HR slope and AVA may suggest that hemodynamic repercussions of the surgery in the aortic body area (most likely reduced WSS) play a critical role in determining aortic body function with a negligible effect on the carotid bodies. However, caution is needed when interpreting the results of the HR response to hypoxia in our study due to the small sample size (N = 10). FAU - Jura, Maksym AU - Jura M AD - Department of Physiology and Pathophysiology, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland. FAU - Tubek, Stanislaw AU - Tubek S AUID- ORCID: 0000-0002-0059-5150 AD - Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland. FAU - Reczuch, Jedrzej AU - Reczuch J AD - Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland. FAU - Seredynski, Rafal AU - Seredynski R AD - Department of Physiology and Pathophysiology, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland. FAU - Niewinski, Piotr AU - Niewinski P AD - Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland. FAU - Protasiewicz, Marcin AU - Protasiewicz M AD - Institute of Heart Diseases, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland. FAU - Ponikowska, Beata AU - Ponikowska B AUID- ORCID: 0000-0002-6044-5322 AD - Department of Physiology and Pathophysiology, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland. FAU - Paleczny, Bartlomiej AU - Paleczny B AUID- ORCID: 0000-0001-9180-9259 AD - Department of Physiology and Pathophysiology, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland. LA - eng GR - Wroclaw Medical University (grant number: SUBZ.A421.22.044)/Ministry of Science and Higher Education (Poland)/ PT - Journal Article DEP - 20250303 PL - Switzerland TA - Biomedicines JT - Biomedicines JID - 101691304 PMC - PMC11940327 OTO - NOTNLM OT - aortic body OT - aortic stenosis OT - carotid body OT - peripheral chemoreceptors OT - peripheral chemoreflex OT - transcatheter aortic valve implantation COIS- The authors declare no competing interests. EDAT- 2025/03/28 06:24 MHDA- 2025/03/28 06:25 PMCR- 2025/03/03 CRDT- 2025/03/28 01:06 PHST- 2025/01/02 00:00 [received] PHST- 2025/02/17 00:00 [revised] PHST- 2025/02/22 00:00 [accepted] PHST- 2025/03/28 06:25 [medline] PHST- 2025/03/28 06:24 [pubmed] PHST- 2025/03/28 01:06 [entrez] PHST- 2025/03/03 00:00 [pmc-release] AID - biomedicines13030611 [pii] AID - biomedicines-13-00611 [pii] AID - 10.3390/biomedicines13030611 [doi] PST - epublish SO - Biomedicines. 2025 Mar 3;13(3):611. doi: 10.3390/biomedicines13030611. PMID- 40139852 OWN - NLM STAT- MEDLINE DCOM- 20250326 LR - 20260717 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 6 DP - 2025 Mar 24 TI - Early Results of Multicenter Trial of a Novel Balloon-Expandable Valve With Anchor for Aortic Regurgitation. PG - 752-764 LID - S1936-8798(24)01832-6 [pii] LID - 10.1016/j.jcin.2024.12.006 [doi] AB - BACKGROUND: The application of transfemoral transcatheter aortic valve replacement (TAVR) for patients with severe pure native aortic regurgitation (PNAR) is limited by a lack of dedicated devices. The Hanchor Valve system is the first transfemoral balloon-expandable transcatheter heart valve with an anchor element designed for PNAR. OBJECTIVES: The aims of this report are to present the 30-day follow-up results of transfemoral TAVR using the Hanchor Valve system in patients with severe PNAR and to provide insights into the technical aspects of the procedure. METHODS: The HAVE AR (Multi-Center Trial of Hanchor Valve for Treating Patients With Severe Pure Native Aortic Regurgitation) trial is an ongoing, prospective, multicenter, single-arm, objective performance criteria registration study. Transfemoral TAVR using the Hanchor Valve system for treating severe PNAR was performed in patients with intermediate and high surgical risk. Procedural results and 30-day clinical and echocardiographic outcomes were collected and analyzed. RESULTS: A total of 128 patients were enrolled at 13 centers in mainland China, with a median age of 74 years (Q1-Q3: 70-78 years) and a median Society of Thoracic Surgeons Predicted Risk of Mortality score of 4.84% (Q1-Q3: 4.21%-6.47%). Procedural success was achieved in 123 of 128 patients (96.09%), with a median oversizing ratio of 5.10% (Q1-Q3: 2.69%-6.83%) and a median implantation depth of 5 mm (Q1-Q3: 2-6 mm). Valve migration occurred in 3 of 128 cases, with 2 of 128 patients undergoing second valve implantation and 1 of 128 converting to surgery. Within the 30-day follow-up, 15 of 125 patients (12.00%) required new permanent pacemaker implantation, 1 of 128 patients (0.78%) experienced a major bleeding event, and 3 of 128 patients (2.34%) died. At 30-day follow-up, none of the patients had intravalvular aortic regurgitation or more than mild paravalvular regurgitation. The median effective orifice area was 2.50 cm(2) (Q1-Q3: 2.20-2.98 cm(2)). Significant improvements were observed in NYHA functional class (P < 0.001) and EQ-5D score (P < 0.001). Moreover, significant reductions were observed in left ventricular end-diastolic diameter (P < 0.001) and left ventricular end-systolic diameter (P < 0.001) at 30-day follow-up, while there was an increase in left ventricular ejection fraction (P = 0.007). CONCLUSIONS: The early results of the HAVE AR trial showed a low incidence of adverse safety events, especially low permanent pacemaker implantation rate, and good efficacy of the Hanchor Valve system for treating patients with severe PNAR at intermediate or high surgical risk. CI - Copyright (c) 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Pan, Wenzhi AU - Pan W AD - Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. FAU - Chen, Shasha AU - Chen S AD - Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. FAU - Li, Wei AU - Li W AD - Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China. FAU - Liu, Xianbao AU - Liu X AD - The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China. FAU - Chen, Yundai AU - Chen Y AD - The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Luo, Jianfang AU - Luo J AD - Guangdong Provincial People's Hospital, Guangzhou, China. FAU - Guo, Xiaogang AU - Guo X AD - The First Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China. FAU - Yuan, Yiqiang AU - Yuan Y AD - Henan Chest Hospital, Zhengzhou, China. FAU - Tao, Ling AU - Tao L AD - The First Affiliated Hospital of Air Force Medical University, Xian, China. FAU - Wu, Yanqing AU - Wu Y AD - The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Li, Yan AU - Li Y AD - The Second Affiliated Hospital of Air Force Medical University, Xian, China. FAU - Zhang, Zhihui AU - Zhang Z AD - The First Affiliated Hospital of Army Medical University, Chongqing, China. FAU - Zhou, Shenghua AU - Zhou S AD - The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Guo, Zhifu AU - Guo Z AD - The First Affiliated Hospital of Naval Medical University, Shanghai, China. FAU - Jiang, Xiaofei AU - Jiang X AD - Zhuhai People's Hospital, Zhuhai, China. FAU - Li, Mingfei AU - Li M AD - Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. FAU - Chen, Shengda AU - Chen S AD - Shanghai Healing Medical Devices, Shanghai, China. FAU - Wang, Jianan AU - Wang J AD - The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China. FAU - Zhou, Daxin AU - Zhou D AD - Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. Electronic address: zhou.daxin@zs-hospital.sh.cn. FAU - Ge, Junbo AU - Ge J AD - Department of Cardiology, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. Electronic address: ge.junbo2@zs-hospital.sh.cn. LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Aortic Valve Insufficiency/physiopathology/diagnostic imaging/surgery/mortality MH - Aged MH - *Heart Valve Prosthesis MH - Male MH - Female MH - Treatment Outcome MH - Prosthesis Design MH - Time Factors MH - Prospective Studies MH - *Aortic Valve/physiopathology/diagnostic imaging/surgery MH - Severity of Illness Index MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects/mortality MH - Risk Factors MH - China MH - Recovery of Function MH - Hemodynamics MH - *Balloon Valvuloplasty/adverse effects/instrumentation/mortality OTO - NOTNLM OT - paravalvular regurgitation OT - pure native aortic regurgitation OT - transcatheter heart valve OT - transfemoral transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures This study was funded by Healing Medical Devices. Dr Chen is a shareholder in Healing Medical Devices. Drs Zhou and Pan are consultants for Hanyu Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/03/27 16:08 MHDA- 2025/03/27 16:09 CRDT- 2025/03/26 21:55 PHST- 2024/06/11 00:00 [received] PHST- 2024/10/23 00:00 [revised] PHST- 2024/12/03 00:00 [accepted] PHST- 2025/03/27 16:09 [medline] PHST- 2025/03/27 16:08 [pubmed] PHST- 2025/03/26 21:55 [entrez] AID - S1936-8798(24)01832-6 [pii] AID - 10.1016/j.jcin.2024.12.006 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Mar 24;18(6):752-764. doi: 10.1016/j.jcin.2024.12.006. PMID- 40135378 OWN - NLM STAT- MEDLINE DCOM- 20250415 LR - 20250417 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 18 IP - 4 DP - 2025 Apr TI - Transcarotid Versus Surgical Aortic Valve Replacement for the Treatment of Severe Aortic Stenosis. PG - e014928 LID - 10.1161/CIRCINTERVENTIONS.124.014928 [doi] AB - BACKGROUND: Current guidelines recommend surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis and unfavorable iliofemoral access. Transcarotid transcatheter aortic valve replacement (TC-TAVR) has emerged as an alternative access in suboptimal transfemoral candidates, but no data exist comparing TC-TAVR and SAVR. The main objective of this study was to compare the clinical outcomes in a propensity-matched population of TC-TAVR and SAVR patients with severe aortic stenosis. METHODS: A total of 786 patients (SAVR, 352; TC-TAVR, 434) were included, and a total of 182 patients were propensity-matched and included in each group. The primary outcome was a composite of death from any cause, stroke/transient ischemic attack, and procedure-related or valve-related hospitalization at 30 days and at 1 year. Data were prospectively collected in dedicated databases, and clinical events were defined according to Valve Academic Research Consortium-3 criteria. RESULTS: Baseline characteristics were well balanced between the matched groups, and the mean age and Society for Thoracic Surgeons score of the study population were 75 years and 3.6%, respectively. At 30 days, the SAVR group showed a higher rate of the primary composite outcome compared with the TC-TAVR group (12.6% versus 4.3%; hazard ratio, 2.93 [95% CI, 1.45-5.94]). Acute kidney injury stages 2 to 4, bleeding events, and new-onset atrial fibrillation occurred more often in the SAVR group during the hospital period (P<0.001). In contrast, vascular complications and the need for permanent pacemaker implantation occurred more often in the TC-TAVR group (P=0.01 and P=0.001, respectively). At 1-year follow-up, there were no significant differences between groups in the primary outcome rates (SAVR, 19.7% versus TC-TAVR, 12.7%; hazard ratio, 1.63 [95% CI, 0.98-2.73]). CONCLUSIONS: TC-TAVR was associated with improved 30-day clinical outcomes compared with SAVR, with no significant differences in death, stroke, and hospitalization at 1-year follow-up. These findings suggest that TC-TAVR may be a valid alternative to SAVR in nontransfemoral-TAVR candidates. FAU - Del Portillo, Juan Hernando AU - Del Portillo JH AUID- ORCID: 0000-0002-2756-7635 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Cepas-Guillen, Pedro AU - Cepas-Guillen P AUID- ORCID: 0000-0001-8814-7039 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Kalavrouziotis, Dimitri AU - Kalavrouziotis D AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Dumont, Eric AU - Dumont E AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Porterie, Jean AU - Porterie J AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Paradis, Jean-Michel AU - Paradis JM AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Poulin, Anthony AU - Poulin A AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Beaupre, Frederic AU - Beaupre F AUID- ORCID: 0000-0003-0630-3144 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Avvedimento, Marisa AU - Avvedimento M AUID- ORCID: 0000-0002-8443-7888 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Mas-Peiro, Silvia AU - Mas-Peiro S AUID- ORCID: 0000-0002-3828-8180 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Mengi, Siddhartha AU - Mengi S AUID- ORCID: 0000-0001-6825-8794 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Mohammadi, Siamak AU - Mohammadi S AUID- ORCID: 0000-0001-7622-4172 AD - Quebec Heart and Lung Institute, Laval University, Canada. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AUID- ORCID: 0000-0001-8237-7095 AD - Quebec Heart and Lung Institute, Laval University, Canada. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20250326 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology MH - Aged MH - Male MH - Female MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Aged, 80 and over MH - Time Factors MH - Severity of Illness Index MH - Risk Factors MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - *Heart Valve Prosthesis Implantation/adverse effects/mortality/instrumentation/methods MH - Risk Assessment MH - Databases, Factual MH - *Catheterization, Peripheral/mortality/adverse effects/methods MH - Retrospective Studies MH - Stroke/etiology/mortality MH - Postoperative Complications/mortality/therapy OTO - NOTNLM OT - aortic valve stenosis OT - carotid arteries OT - heart valve prosthesis implantation OT - transcatheter aortic valve replacement COIS- Dr Rodes-Cabau received institutional research grants and consultant/speaker fees from Edwards Lifesciences and Medtronic. Dr Mohammadi received institutional grants and consultant/speaker fees from Edwards Lifesciences, Medtronic, and Abbott. The other authors report no conflicts. EDAT- 2025/03/26 13:06 MHDA- 2025/04/15 18:24 CRDT- 2025/03/26 05:12 PHST- 2025/04/15 18:24 [medline] PHST- 2025/03/26 13:06 [pubmed] PHST- 2025/03/26 05:12 [entrez] AID - 10.1161/CIRCINTERVENTIONS.124.014928 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2025 Apr;18(4):e014928. doi: 10.1161/CIRCINTERVENTIONS.124.014928. Epub 2025 Mar 26. PMID- 40129291 OWN - NLM STAT- Publisher LR - 20250325 IS - 1545-1550 (Electronic) IS - 1526-6028 (Linking) DP - 2025 Mar 24 TI - Rescue and Redeploy: Successful Valve-in-Valve Implantation After Transcatheter Aortic Valve Embolization. PG - 15266028251325656 LID - 10.1177/15266028251325656 [doi] AB - BACKGROUND: Pacing failure is a common cause of transcatheter aortic valve replacement (TAVR) malposition and embolization. Transcatheter aortic valve embolization that compromises aortic branches usually necessitates open surgery. However, a salvage technique can address this complication percutaneously. CASE SUMMARY: We report a case involving a 26 mm Edwards transcatheter valve that was cephalically embolized during rapid pacing due to ventricular tachycardia with a single capture beat. The semiinflated embolized valve was successfully pulled back to a position just distal to the left subclavian artery. Subsequently, a second 26 mm valve was implanted through the embolized valve and deployed successfully in the correct position. CONCLUSION: Carefully pulling back the embolized transcatheter aortic valve (TAV) to the area distal to the left subclavian artery is a viable salvage technique for embolized TAV. Another attempt of TAVR through the embolized valve can be safely performed, with careful monitoring of left ventricular capture during rapid pacing.Clinical ImpactQuestion: Can transcatheter aortic valve (TAV) embolization be solved percutaneously? Findings: The semi-inflated embolized valve was successfully pulled back to a position just distal to the left subclavian artery. Subsequently, a second 26 mm valve was implanted through the embolized valve and deployed successfully in the correct position. Results: Carefully pulling back an embolized TAV to the descending aorta is a viable salvage technique for managing embolized TAV. FAU - Abdelrehim, Ahmad AU - Abdelrehim A AUID- ORCID: 0000-0003-2702-3299 AD - Internal Medicine Department, Capital Health Regional Medical Center, Trenton, NJ, USA. FAU - Abdelrahman, Ameer AU - Abdelrahman A AD - Internal Medicine Department, Capital Health Regional Medical Center, Trenton, NJ, USA. FAU - Almagazzachi, Ahmad AU - Almagazzachi A AD - Internal Medicine Department, Capital Health Regional Medical Center, Trenton, NJ, USA. FAU - Desai, Harit AU - Desai H AD - Interventional Cardiology, Capital Health Regional Medical Center, Trenton, NJ, USA. FAU - Drucker, David AU - Drucker D AD - Interventional Cardiology, Capital Health Regional Medical Center, Trenton, NJ, USA. LA - eng PT - Journal Article DEP - 20250324 PL - United States TA - J Endovasc Ther JT - Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists JID - 100896915 SB - IM OTO - NOTNLM OT - angiography OT - aortic valve OT - embolized TAV salvage OT - transcatheter aortic valve OT - transcatheter aortic valve embolization EDAT- 2025/03/25 06:25 MHDA- 2025/03/25 06:25 CRDT- 2025/03/25 03:33 PHST- 2025/03/25 06:25 [medline] PHST- 2025/03/25 06:25 [pubmed] PHST- 2025/03/25 03:33 [entrez] AID - 10.1177/15266028251325656 [doi] PST - aheadofprint SO - J Endovasc Ther. 2025 Mar 24:15266028251325656. doi: 10.1177/15266028251325656. PMID- 40126434 OWN - NLM STAT- In-Process LR - 20250911 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 83 IP - 6 DP - 2025 TI - Dissection of the left common carotid artery during a TAVI procedure successfully treated by surgical intervention. PG - 757-758 LID - 10.33963/v.phj.105345 [doi] FAU - Gocol, Radoslaw AU - Gocol R AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. FAU - Wojakowski, Wojciech AU - Wojakowski W AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Parma, Radoslaw AU - Parma R AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Darocha, Tomasz AU - Darocha T AD - Department of Anesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland. FAU - Hudziak, Damian AU - Hudziak D AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. damhud@gmail.com. LA - eng PT - Journal Article DEP - 20250324 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM EDAT- 2025/03/24 12:45 MHDA- 2025/03/24 12:45 CRDT- 2025/03/24 11:13 PHST- 2025/03/13 00:00 [received] PHST- 2025/03/13 00:00 [accepted] PHST- 2025/03/24 12:45 [pubmed] PHST- 2025/03/24 12:45 [medline] PHST- 2025/03/24 11:13 [entrez] AID - VM/OJS/J/105345 [pii] AID - 10.33963/v.phj.105345 [doi] PST - ppublish SO - Kardiol Pol. 2025;83(6):757-758. doi: 10.33963/v.phj.105345. Epub 2025 Mar 24. PMID- 40124081 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250325 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 9 IP - 2 DP - 2025 Feb TI - Successful Transseptal Transcatheter Aortic Valve Replacement With Monitored Anesthesia Care and Standard Delivery System. PG - 100358 LID - 10.1016/j.shj.2024.100358 [doi] LID - 100358 AB - Transcatheter aortic valve replacement (TAVR) has emerged as a viable treatment option for patients with symptomatic aortic stenosis across all surgical risk groups. Although the need for alternative access to transfemoral access is becoming less frequent due to better device profiles, there is a continued need for such options. Common approaches used today include subclavian, carotid, caval, aortic, or apical. However, the transseptal approach has not been described with the current S3 delivery system. We present, to our knowledge, the first reported case of a transseptal TAVR using the standard delivery system and under monitored anesthesia care (MAC). This case demonstrates that advances in maneuverability and device profile make transseptal delivery of the S3 valve a safe and effective approach in some patients with no other peripheral arterial access. CI - (c) 2024 Published by Elsevier Inc. on behalf of Cardiovascular Research Foundation. FAU - Akras, Zade AU - Akras Z AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Sabbak, Nabil AU - Sabbak N AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Sheng, Calvin C AU - Sheng CC AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Yun, James AU - Yun J AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. LA - eng PT - Journal Article DEP - 20240903 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC11925030 OTO - NOTNLM OT - Intracardiac echocardiography OT - Transcatheter Aortic Valve Replacement OT - aortic stenosis OT - monitored anesthesia care OT - transseptal EDAT- 2025/03/24 06:30 MHDA- 2025/03/24 06:31 PMCR- 2024/09/03 CRDT- 2025/03/24 06:00 PHST- 2024/02/21 00:00 [received] PHST- 2024/07/03 00:00 [revised] PHST- 2024/07/18 00:00 [accepted] PHST- 2025/03/24 06:31 [medline] PHST- 2025/03/24 06:30 [pubmed] PHST- 2025/03/24 06:00 [entrez] PHST- 2024/09/03 00:00 [pmc-release] AID - S2474-8706(24)00113-1 [pii] AID - 100358 [pii] AID - 10.1016/j.shj.2024.100358 [doi] PST - epublish SO - Struct Heart. 2024 Sep 3;9(2):100358. doi: 10.1016/j.shj.2024.100358. eCollection 2025 Feb. PMID- 40124077 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250325 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 9 IP - 2 DP - 2025 Feb TI - Transcatheter Aortic Valve Replacement in Patients With Small Aortic Annulus: An Observational Study. PG - 100338 LID - 10.1016/j.shj.2024.100338 [doi] LID - 100338 AB - BACKGROUND: The Small Annuli Randomized to Evolut or SAPIEN Trial showed superior hemodynamics of self-expanding valves (SEVs) over balloon-expandable valves (BEVs) in patients with small aortic annuli (SAA). The long-term clinical implications of these hemodynamic differences are unknown. METHODS: We conducted an observational cohort study of patients with SAA, defined as an aortic valve annular area 30 kg/m(2)). The primary outcome of the study was mortality and major adverse cardiovascular events. RESULTS: A total of 258 patients were included. The majority were female (81%) with intermediate surgical risk (median STS risk score 4.23); 90 patients (35%) received a BEV (median age 80 years [73, 86]) and 168 (65%) received a SEV (81 years [75, 85], p = 0.699). Comorbidities and risk profiles were well balanced between groups. At 30 days post-transcatheter aortic valve replacement, SEV had lower aortic valve mean gradients (8 mmHg [6, 11] vs. BEV 14 mmHg [10, 18], p < 0.001), lower peak velocities (1.86 m/s [1.60, 2.34] vs. BEV 2.52 m/s [2.14, 2.90], p < 0.001), and were less likely to have PPM (SEV 18% vs. BEV 42% (p < 0.001). At 3 years, both groups had similar mortality (SEV 23% vs. BEV 22%, p = 0.875). PPM was not associated with long-term mortality. CONCLUSIONS: In patients with SAA, we observed no difference in mortality between SEV and BEV up to 3 years after the index procedure, despite early differences in valve hemodynamics. CI - (c) 2024 The Author(s). FAU - Bashir, Hanad AU - Bashir H AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Schmidt, Christian W AU - Schmidt CW AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Ansah, Kofi AU - Ansah K AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Mendez-Hirata, Gustavo AU - Mendez-Hirata G AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Answini, Geoffrey A AU - Answini GA AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Smith, J Michael AU - Smith JM AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Hasan, Saad AU - Hasan S AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Griffin, Jeffrey AU - Griffin J AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Dowling, Robert AU - Dowling R AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Kereiakes, Dean J AU - Kereiakes DJ AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Seshiah, Puvi AU - Seshiah P AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Choo, Joseph AU - Choo J AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Alirhayim, Zaid AU - Alirhayim Z AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. FAU - Garcia, Santiago AU - Garcia S AD - The Christ Hospital Heart and Vascular Institute and the Lindner Research Center, Cincinnati, Ohio. LA - eng PT - Journal Article DEP - 20240625 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC11925031 OTO - NOTNLM OT - Balloon-expandable valves OT - Patient-prosthesis mismatch OT - Self-expanding valves OT - Small aortic annuli OT - Transcatheter aortic valve replacement COIS- The authors report no conflict of interest. EDAT- 2025/03/24 06:30 MHDA- 2025/03/24 06:31 PMCR- 2024/06/25 CRDT- 2025/03/24 06:00 PHST- 2024/05/11 00:00 [received] PHST- 2024/05/28 00:00 [revised] PHST- 2024/06/02 00:00 [accepted] PHST- 2025/03/24 06:31 [medline] PHST- 2025/03/24 06:30 [pubmed] PHST- 2025/03/24 06:00 [entrez] PHST- 2024/06/25 00:00 [pmc-release] AID - S2474-8706(24)00086-1 [pii] AID - 100338 [pii] AID - 10.1016/j.shj.2024.100338 [doi] PST - epublish SO - Struct Heart. 2024 Jun 25;9(2):100338. doi: 10.1016/j.shj.2024.100338. eCollection 2025 Feb. PMID- 40119315 OWN - NLM STAT- MEDLINE DCOM- 20250514 LR - 20250514 IS - 1471-2482 (Electronic) IS - 1471-2482 (Linking) VI - 25 IP - 1 DP - 2025 Mar 21 TI - Benefits of prophylactic veno-arterial extracorporeal membrane oxygenation for high-risk cardiac interventions. PG - 107 LID - 10.1186/s12893-025-02835-7 [doi] LID - 107 AB - BACKGROUND: Complex high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve implantation (TAVI) are challenging and frequently associated with life-threatening complications. We evaluated the benefits of prophylactic extracorporeal membrane oxygenation (ECMO)-supported interventions and the risks of this approach. METHODS: From March 2020 to September 2021, 11 patients underwent TAVI, and 15 patients underwent PCI supported with prophylactic ECMO. Clinical characteristics and outcomes in terms of the requirement of ECMO were evaluated. RESULTS: Cannulation was femoro-femoral in all patients. TAVI was performed via transfemoral access. In the TAVI group, mean patient age was 72 +/- 7.84 years and 63.64% were male. During valve implantation, supportive ECMO flow was maintained at 3.24 +/- 0.19 L/min. The additional median time in the ICU was 2 (1-4) days. Patients were discharged from the hospital after 16 (15-27) days. All of them were successfully weaned off V-AECMO. Only 1 patient died of respiratory and cardiac arrest 10 days after the operation. During PCI, ECMO flow was maintained at 3.35 +/- 0.22 L/min. The average age of the patients in this group was 59 +/- 10.80 years, and the ejection fraction was 42.59 +/- 16.34%. Fourteen patients were successfully weaned off veno-arterial ECMO and survived to hospital discharge. No ECMO-related, peripheral cannulation-related or life-threatening bleeding complications were observed in the two groups. The median follow-up was 6 months, and there was 1 late death. CONCLUSION: Based on this experience, we consider ECMO support to be a viable alternative and effective approach for complex high-risk cardiac interventions. CI - (c) 2025. The Author(s). FAU - Lv, Xiao-Chai AU - Lv XC AD - Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road No. 29, Fuzhou, Fujian, 350001, PR China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, Fujian, P. R. China. AD - Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, P. R. China. FAU - Dong, Yi AU - Dong Y AD - Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road No. 29, Fuzhou, Fujian, 350001, PR China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, Fujian, P. R. China. AD - Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, P. R. China. FAU - Wang, Lei AU - Wang L AD - Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road No. 29, Fuzhou, Fujian, 350001, PR China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, Fujian, P. R. China. AD - Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, P. R. China. FAU - Hou, Yan-Ting AU - Hou YT AD - Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road No. 29, Fuzhou, Fujian, 350001, PR China. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, Fujian, P. R. China. AD - Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, P. R. China. FAU - Chen, Liang-Wan AU - Chen LW AD - Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road No. 29, Fuzhou, Fujian, 350001, PR China. chenliangwan@fjmu.edu.cn. AD - Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, Fujian, P. R. China. chenliangwan@fjmu.edu.cn. AD - Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, P. R. China. chenliangwan@fjmu.edu.cn. LA - eng GR - 2023Y9155/Joint Funds for the innovation of science and Technology, Fujian province/ GR - 2021-76/Fujian Provincial Center for Cardiovascular Medicine Construction Project/ PT - Journal Article DEP - 20250321 PL - England TA - BMC Surg JT - BMC surgery JID - 100968567 SB - IM MH - Humans MH - *Extracorporeal Membrane Oxygenation/methods MH - Male MH - Female MH - Aged MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - *Postoperative Complications/prevention & control PMC - PMC11927369 OTO - NOTNLM OT - Extracorporeal membrane oxygenation OT - High-risk OT - Percutaneous coronary intervention OT - Transcatheter aortic valve implantation COIS- Declarations. Ethical approval and consent to participate: This study complied with the requirements of the Ethics Committee of Fujian Medical University Union Hospital and adhered to the Declaration of Helsinki. The need for written informed consent was waived due to retrospective nature of the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2025/03/22 20:47 MHDA- 2025/03/22 20:48 PMCR- 2025/03/21 CRDT- 2025/03/22 00:37 PHST- 2024/12/30 00:00 [received] PHST- 2025/03/11 00:00 [accepted] PHST- 2025/03/22 20:48 [medline] PHST- 2025/03/22 20:47 [pubmed] PHST- 2025/03/22 00:37 [entrez] PHST- 2025/03/21 00:00 [pmc-release] AID - 10.1186/s12893-025-02835-7 [pii] AID - 2835 [pii] AID - 10.1186/s12893-025-02835-7 [doi] PST - epublish SO - BMC Surg. 2025 Mar 21;25(1):107. doi: 10.1186/s12893-025-02835-7. PMID- 40117414 OWN - NLM STAT- MEDLINE DCOM- 20250501 LR - 20260717 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 8 DP - 2025 Apr 28 TI - Temporal Trends in 1-Year Cause-Specific Mortality After TAVR: Insights From the STS/ACC TVT Registry. PG - 1013-1024 LID - S1936-8798(24)01950-2 [pii] LID - 10.1016/j.jcin.2024.12.016 [doi] AB - BACKGROUND: The impact of changing patient demographics and risk profiles on cause-specific mortality after transcatheter aortic valve replacement (TAVR) remains unclear. OBJECTIVES: The aim of this study was to examine causes of death (CoDs) and temporal trends and predictors of cause-specific mortality after TAVR. METHODS: Data from the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry were analyzed to identify patients who underwent isolated TAVR between January 2012 and October 2022 who had available information on 1-year CoD. The primary outcome was cause-specific (cardiac and noncardiac) mortality at 1 year. Fine and Gray subdistribution hazard models were used to account for the competing risk for cause-specific death. RESULTS: Of 36,877 patients who died within 1 year after TAVR and had available information on CoD, 11,560 (31.3%) had cardiac death and 25,317 (68.7%) had noncardiac death. There was an initial decline in the risk-adjusted hazards of 1-year cardiac and noncardiac death after TAVR from 2012 to 2017 (adjusted HR per year: 0.95 [95% CI: 0.92-0.97] and 0.92 [95% CI: 0.90-0.93], respectively), followed by an increase from 2018 to 2022 (adjusted HR per year: 1.07 [95% CI: 1.05-1.09] and 1.22 [95% CI: 1.20-1.24], respectively). Age >80 years, comorbidities, poor functional status, nonelective procedure, nonfemoral access, and in-hospital complications were identified as independent predictors of both cardiac and noncardiac death after TAVR. CONCLUSIONS: Noncardiac causes account for two-thirds of deaths within 1 year after TAVR. Further studies are needed to examine whether the COVID-19 pandemic, the rapid expansion in the number of TAVR sites, or other patient and hospital characteristics contributed to the increased risk for cardiac and noncardiac death after TAVR in recent years. CI - Copyright (c) 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Kolte, Dhaval AU - Kolte D AD - Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address: dkolte@mgh.harvard.edu. FAU - Marquis-Gravel, Guillaume AU - Marquis-Gravel G AD - Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA. FAU - Stebbins, Amanda AU - Stebbins A AD - Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA. FAU - Vekstein, Andrew M AU - Vekstein AM AD - Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA. FAU - Vemulapalli, Sreekanth AU - Vemulapalli S AD - Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA. FAU - Elmariah, Sammy AU - Elmariah S AD - Division of Cardiology, University of California-San Francisco, Medical Center, San Francisco, California, USA. LA - eng PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20250319 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/mortality/adverse effects/trends MH - Registries MH - Female MH - Male MH - Time Factors MH - Aged MH - Risk Factors MH - Aged, 80 and over MH - Risk Assessment MH - Treatment Outcome MH - Cause of Death/trends MH - United States/epidemiology MH - *Aortic Valve Stenosis/mortality/surgery/diagnostic imaging MH - Retrospective Studies OTO - NOTNLM OT - cardiac death OT - mortality OT - outcomes OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures This research was supported by the ACC Foundation's National Cardiovascular Data Registry. The analytical work for this investigator-initiated study was performed by the Duke Clinical Research Institute, with financial support from the ACC. The STS/ACC TVT Registry is an initiative of the STS and the ACC. The views expressed in this report represent those of the authors and do not necessarily represent the official views of the National Cardiovascular Data Registry or its associated professional societies, identified at https://cvquality.acc.org/NCDR-Home. The manuscript was reviewed by the National Cardiovascular Data Registry for compliance with registry description and representation, but the sponsor had no role in the design and conduct of the study, analysis and interpretation of the data, preparation of the manuscript, or decision to submit the manuscript for publication. Dr Kolte has received a research grant from the National Heart, Lung, and Blood Institute outside the submitted work. Dr Marquis-Gravel has received speaker fees and serves as an advisory board member for Novartis, HLS Therapeutics, Boston Scientific, Cardiovascular Systems, KYE Pharmaceuticals, Jamp Pharma, and Pharmascience; and has received research funding from Bayer. Dr Vemulapalli has received grants from or has contracts with the STS, the ACC, the National Institutes of Health (R01 and UG3), Cytokinetics, Abbott Vascular, and Boston Scientific; and is a consultant for Medtronic, Edwards Lifesciences, the American College of Physicians, Total CME, and Veralox Therapeutics. Dr Elmariah is a consultant for Edwards Lifesciences and Medtronic; and has received research funding from Edwards Lifesciences, Medtronic, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/03/21 19:11 MHDA- 2025/05/01 12:30 CRDT- 2025/03/21 14:22 PHST- 2024/06/04 00:00 [received] PHST- 2024/12/11 00:00 [revised] PHST- 2024/12/17 00:00 [accepted] PHST- 2025/05/01 12:30 [medline] PHST- 2025/03/21 19:11 [pubmed] PHST- 2025/03/21 14:22 [entrez] AID - S1936-8798(24)01950-2 [pii] AID - 10.1016/j.jcin.2024.12.016 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Apr 28;18(8):1013-1024. doi: 10.1016/j.jcin.2024.12.016. Epub 2025 Mar 19. PMID- 40101855 OWN - NLM STAT- MEDLINE DCOM- 20250410 LR - 20260812 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 429 DP - 2025 Jun 15 TI - The passability of delivery catheter system during self-expanding transcatheter aortic valve replacement: A CT-based prediction model. PG - 133168 LID - S0167-5273(25)00211-6 [pii] LID - 10.1016/j.ijcard.2025.133168 [doi] AB - OBJECTIVE: Aortic anatomy may pose challenges to the advancement of the delivery catheter system (DCS) and affect the outcome of self-expanding transcatheter aortic valve replacement (SE-TAVR). This study aimed to develop a preprocedural CT-based nomogram to predict the passability of DCS and clinical SE-TAVR outcomes. METHODS AND RESULTS: Data of 348 patients who underwent transfemoral SE-TAVR were retrospectively collected from May 2018 to December 2023. A number of 118 patients received snare catheter, indicating poor DCS passaibility. All patients were randomized to development (n = 244) and validation (n = 104) sets. A predictive model was constructed by logistic regression and presented as a nomogram, which indicated that larger aortic angle, severe calcification, larger ascending aorta diameter, coronary ostial height of T (~90% of individuals). Individuals with nonclassic genotype HGPS are heterozygous for another LMNA pathogenic variant in exon 11 or intron 11 that results in production of progerin (~10% of individuals). MANAGEMENT: Targeted therapy: Lonafarnib results in increase in life span presumably due to slowed cardiovascular disease progression that includes improved arterial wall stiffness and carotid-femoral pulse wave velocity. The therapy also improves low-tone hearing and may decrease headache frequency. Side effects are primarily gastrointestinal and vary in severity and duration. Supportive care: Frequent small meals to maximize caloric intake; daily multivitamin; medication dosages are based on body weight or body surface area, not age; shoe pads for foot discomfort; school adaptations for short stature. General anesthesia and intubation should be performed with extreme caution, with fiberoptic intubation if possible. Fluoride supplementation as needed; if secondary teeth erupt palatally displaced, primary tooth extractions after the secondary teeth have erupted and/or fully descended may be required to avoid dental crowding. Sunscreen on exposed areas of skin, including the head, during outdoor activities; encourage sun-protective clothing including hat. Hip dislocation is best managed with physical therapy and body bracing; reconstructive hip surgery is possible, but comorbidities of surgery in this high-risk population should be considered. Routine treatment for bone fractures; physical and occupational therapy to maintain joint mobility, active stretching and strengthening exercises, and hydrotherapy. Though menstruation is highly variable, in females with excessive pubertal vaginal bleeding, short-term low-dose oral contraceptives can be used to decrease blood loss. Healthy diet with regular physical activity as tolerated; maintain optimal hydration, especially during hot weather and airplane travel. Low-dose aspirin to prevent cardiovascular and neurovascular complications. Nitroglycerin can be beneficial for angina; anti-congestive therapy is routine for the treatment of congestive heart failure. Modified transcatheter aortic valve replacement or modified apico-aortic valve replacement are high-risk interventions to treat critical aortic stenosis. Exercise, diet modification, and statin therapy as needed for hyperlipidemia. Hearing aids can be used when clinically necessary. Exposure keratopathy can be treated with ocular lubrication. Social work and family support. Surveillance: Assess growth, caloric intake, skin manifestations, and family needs at each visit. Blood pressure, EKG, echocardiogram, and carotid scan every six to 12 months. Dental examination with radiographs, orthopedic evaluation, occupational and physical therapy assessment, lipid profile, neurologic assessment with head and neck MRI/MRA, and ophthalmology and audiology evaluation annually. Agents/circumstances to avoid: Large crowds with taller and/or larger peers because of the risk of injury; trampolines and bouncy houses due to risk of hip dislocation; dehydration, anemia, and high fever because of cardiac and stroke risks; calcium supplementation because of extraskeletal calcium deposits. GENETIC COUNSELING: HGPS is an autosomal dominant disorder. Ninety-eight percent of individuals with HGPS have the disorder as the result of a de novo LMNA pathogenic variant. Approximately 2% of individuals have the disorder as the result of a pathogenic variant inherited from an unaffected parent with gonadal mosaicism. Because HGPS is typically caused by a de novo pathogenic variant, the recurrence risk to the sibs of a proband is low but not zero because of the possibility of parental gonadal mosaicism. Once the LMNA pathogenic variant has been identified in an affected family member, prenatal and preimplantation genetic testing are possible. CI - Copyright (c) 1993-2026, University of Washington, Seattle. GeneReviews is a registered trademark of the University of Washington, Seattle. All rights reserved. FED - Adam, Margaret P ED - Adam MP FED - Bick, Sarah ED - Bick S FED - Mirzaa, Ghayda M ED - Mirzaa GM FED - Wallace, Stephanie E ED - Wallace SE FED - Amemiya, Anne ED - Amemiya A FAU - Gordon, Leslie B AU - Gordon LB AD - Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island FAU - Brown, W Ted AU - Brown WT AD - Institute for Basic Research in Developmental Disabilities, Staten Island, New York FAU - Collins, Francis S AU - Collins FS AD - Senior Investigator, National Institutes of Health, Bethesda, Maryland LA - eng PT - Review PT - Book Chapter PL - Seattle (WA) OTO - NLM OT - Hutchinson-Gilford Progeria Syndrome, Nonclassic Genotypes OT - Hutchinson-Gilford Progeria Syndrome, Classic Genotype OT - Prelamin-A/C OT - LMNA OT - Hutchinson-Gilford Progeria Syndrome EDAT- 2025/03/13 00:00 CRDT- 2025/03/13 00:00 AID - NBK1121 [bookaccession] PMID- 40071304 OWN - NLM STAT- MEDLINE DCOM- 20250507 LR - 20250629 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 105 IP - 6 DP - 2025 May TI - Cerebral Protection Devices in Case of Left Sided Intracardiac Thrombus: A Multicentre Experience From the Cath Lab and EP Lab. PG - 1516-1522 LID - 10.1002/ccd.31487 [doi] AB - BACKGROUND: Performing a left atrial appendage occlusion (LAAO) or catheter ablation with left-sided intracardiac thrombus is considered very-high risk for periinterventional stroke. Cerebral embolic protection (CEP) devices are designed to prevent cardioembolic stroke and have been widely studied in TAVR procedures. However, their role in LAAO and catheter ablation of ventricular tachycardia (VT) or in pulmonary vein isolation (PVI) with cardiac thrombus present remains unknown. PURPOSE: to study utility and safety of CEP devices during LAAO and catheter ablation in patients with left sided intracardiac thrombus in a multicenter setting. METHODS: Two different CEP devices were used according to the physician's discretion: (1) a capture device consisting of two filters for the brachiocephalic and left common carotid arteries placed from a radial artery; or (2) a deflection device covering all three supra-aortic vessels placed over a femoral artery. Periprocedural and safety data from 2019 to 2023 were retrospectively obtained from procedural reports and discharge letters for all patients with left-sided intracardiac thrombus undergoing LAAO, VT ablation, or PVI under protection with a CEP device. Long-term safety data were obtained by clinical follow-up in the respective institutions and telephone consultations. RESULTS: Sixty-five patients were enrolled in five centers in Italy. Fifty-two patients underwent LAA closure, 12 patients underwent VT ablation and one patient underwent PVI. Mean age was 73 +/- 10 years and 43 (66%) were male, mean LVEF was 46 +/- 13%. The location of the cardiac thrombus was the LAA in all 52 patients (100%) undergoing LAA closure whereas in patients undergoing VT ablation, thrombus was present in the LAA in five cases (42%), left ventricle (n = 6; 50%) and aortic arch (n = 1;8%). One patient developed left atrial thrombus during PVI. The capture device was used in 39 out of 65 (60%) and the deflection device in 26 out of 65 cases (40%). There were no periprocedural strokes or transitory ischemic attacks (TIA). CEP-related complications at the arterial access site were noted in 4 cases (6%) and were minor, not requiring surgery. Other periprocedural events were one transient ST-elevation caused by coronary spasm in a patient undergoing LAA closure, not related to the CEP device. There was one in-hospital death after VT ablation due to cardiogenic shock, not related to the CEP device. At long-term follow-up, one TIA and three non-cardiovascular deaths occurred with a mean follow-up time of 455 days. CONCLUSIONS: This is the first multicentre experience showing that LAA closure or catheter ablation with cerebral protection in patients with cardiac thrombus is feasible without thromboembolic complications. The possibility of safely performing an intervention in this high-risk setting is promising and should be tested in a prospective randomized trial. CI - (c) 2025 Wiley Periodicals LLC. FAU - Mazzone, Patrizio AU - Mazzone P AUID- ORCID: 0000-0001-5775-1874 AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. AD - Division of arrhythmology, Niguarda Hospital, Milan, Italy. FAU - Preda, Alberto AU - Preda A AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. AD - Division of arrhythmology, Niguarda Hospital, Milan, Italy. FAU - Boccuzzi, Giacomo Giovanni AU - Boccuzzi GG AD - Division of interventional cardiology, San Giovanni Bosco Hospital, Torino, Italy. FAU - Montabone, Andrea AU - Montabone A AUID- ORCID: 0000-0002-0954-8254 AD - Division of interventional cardiology, San Giovanni Bosco Hospital, Torino, Italy. FAU - Dell'Aquila, Andrea AU - Dell'Aquila A AD - Division of arrhythmology, Bolognini Hospital, Seriate, Italy. FAU - Fierro, Nicolai AU - Fierro N AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. FAU - Marzi, Alessandra AU - Marzi A AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. FAU - Radinovic, Andrea AU - Radinovic A AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. FAU - Giannitto, Arianna AU - Giannitto A AD - Division of interventional cardiology, Sant'Andrea Hospital, Vercelli, Italy. FAU - Ugo, Fabrizio AU - Ugo F AD - Division of interventional cardiology, Sant'Andrea Hospital, Vercelli, Italy. FAU - Della Bella, Paolo AU - Della Bella P AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. FAU - Berg, Jan AU - Berg J AUID- ORCID: 0000-0001-6771-4452 AD - Division of arrhythmology, San Raffaele Hospital, Milan, Italy. AD - Cardiology, Cantonal Hospital of Aarau, Aarau, Switzerland. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250312 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Embolic Protection Devices MH - Aged MH - Male MH - *Thrombosis/diagnostic imaging/complications/therapy MH - Female MH - Treatment Outcome MH - Retrospective Studies MH - Time Factors MH - *Heart Diseases/diagnostic imaging/complications/therapy/physiopathology MH - Risk Factors MH - *Catheter Ablation/adverse effects MH - *Atrial Appendage/diagnostic imaging/physiopathology/surgery MH - *Cardiac Catheterization/adverse effects/instrumentation MH - Aged, 80 and over MH - Risk Assessment MH - Middle Aged MH - Equipment Design MH - Italy OTO - NOTNLM OT - EMBP-embolic protection devices OT - LAA-closure OT - STR-stroke OT - ablation OT - catheter/cryoblation/RF EDAT- 2025/03/12 11:34 MHDA- 2025/05/07 12:31 CRDT- 2025/03/12 04:48 PHST- 2025/01/31 00:00 [revised] PHST- 2024/11/25 00:00 [received] PHST- 2025/02/27 00:00 [accepted] PHST- 2025/05/07 12:31 [medline] PHST- 2025/03/12 11:34 [pubmed] PHST- 2025/03/12 04:48 [entrez] AID - 10.1002/ccd.31487 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 May;105(6):1516-1522. doi: 10.1002/ccd.31487. Epub 2025 Mar 12. PMID- 40058643 OWN - NLM STAT- Publisher LR - 20250327 IS - 2241-5955 (Electronic) IS - 1109-9666 (Linking) DP - 2025 Mar 7 TI - Comparative analysis of percutaneous vs. surgical access in transfemoral TAVR: a propensity-matched cohort study. LID - S1109-9666(25)00053-3 [pii] LID - 10.1016/j.hjc.2025.03.003 [doi] AB - OBJECTIVE: Transcatheter aortic valve replacement (TAVR) is a proven treatment for severe aortic stenosis. Transfemoral access is the most prevalent method, achieved either surgically or percutaneously. This study compared in-hospital outcomes and length of stay between surgical cut-down and fully percutaneous approaches. METHODS: This retrospective, propensity-matched study analyzed medical records of all patients who underwent transfemoral TAVR at our center from January 2019 to December 2023. Outcomes were assessed based on Valve Academic Research Consortium-2 (VARC-2) consensus criteria. RESULTS: A total of 251 TAVR patients (77 propensity score-matched pairs) were included (55% female) with a median (IQR) age of 80 (11) years. Surgical cut-down showed fewer vascular complications, bleeding, and transfusions. No death was reported in this group. Fewer mean hospitalization days were observed in the total cohort over the years (p < 0.001). This reduction was more pronounced after 2021 when the surgical approach was adopted. Mean hospitalization days were 6.40 +/- 6.46 for percutaneous and 4.34 +/- 1.61 for surgical groups (p < 0.001). CONCLUSION: Surgical cut-down for TAVR femoral access yields superior outcomes and shorter hospital stays compared to fully percutaneous methods. CI - Copyright (c) 2025 Hellenic Society of Cardiology. Publishing services by Elsevier Inc. All rights reserved. FAU - Papadopoulos, Georgios E AU - Papadopoulos GE AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Ninios, Ilias AU - Ninios I AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Leptopoulos, Eleftherios AU - Leptopoulos E AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Papazoglou, Konstantinos AU - Papazoglou K AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Konstantinidis, Konstantinos AU - Konstantinidis K AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Evangelou, Sotirios AU - Evangelou S AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Ioannides, Andreas AU - Ioannides A AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. FAU - Ninios, Vlasis AU - Ninios V AD - 2nd Cardiology Department, Interbalkan Medical Center, Thessaloniki, Greece. Electronic address: vninios@gmail.com. LA - eng PT - Journal Article DEP - 20250307 PL - Netherlands TA - Hellenic J Cardiol JT - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese JID - 101257381 SB - IM OTO - NOTNLM OT - Femoral access OT - Hospital length of stay OT - In-hospital outcomes OT - Percutaneous OT - Surgical cut-down OT - Transcatheter aortic valve replacement EDAT- 2025/03/10 07:59 MHDA- 2025/03/10 07:59 CRDT- 2025/03/09 20:16 PHST- 2024/11/06 00:00 [received] PHST- 2025/03/03 00:00 [accepted] PHST- 2025/03/10 07:59 [pubmed] PHST- 2025/03/10 07:59 [medline] PHST- 2025/03/09 20:16 [entrez] AID - S1109-9666(25)00053-3 [pii] AID - 10.1016/j.hjc.2025.03.003 [doi] PST - aheadofprint SO - Hellenic J Cardiol. 2025 Mar 7:S1109-9666(25)00053-3. doi: 10.1016/j.hjc.2025.03.003. PMID- 40028729 OWN - NLM STAT- MEDLINE DCOM- 20250303 LR - 20260813 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 5 DP - 2025 Mar 3 TI - A propensity-matched comparison of plug- versus suture-based vascular closure after TAVI. PG - e272-e281 LID - EIJ-D-24-00120 [pii] LID - 10.4244/EIJ-D-24-00120 [doi] AB - BACKGROUND: Vascular access site complications are associated with increased morbidity and mortality after transcatheter aortic valve implantation (TAVI). Current results comparing strategies with plug- (P-VCD; MANTA) and suture-based vascular closure devices (S-VCD; Perclose ProGlide) remain inconsistent. AIMS: It was our aim to assess the incidence of access-related vascular complications after P-VCD or S-VCD strategies after transfemoral TAVI. METHODS: The Plug or sUture based vascuLar cloSurE after TAVI (PULSE) registry retrospectively evaluated 10,120 consecutive patients who had undergone transfemoral TAVI at 10 centres from 2016 to 2021. A propensity score was used to match 900 P-VCD patients with 1,800 S-VCD patients in a 1:2 fashion. The primary outcome measures were major and minor access-related vascular complications at the primary access site, adjudicated according to Valve Academic Research Consortium 3 definitions. RESULTS: The median age was 81.8 years, 46.4% of patients were female, and the median European System for Cardiac Operative Risk Evaluation II was 3.50%. In matched P-VCD and S-VCD groups, large-bore access-related complications occurred in 14.9% vs 10.3% (p<0.001; major: 3.6% vs 4.6%; p=0.218; minor: 11.3% vs 5.8%; p<0.001) of patients. Bleeding accounted for most of these complications (9.6% vs 7.2%; p=0.028) and was treated with endovascular balloon inflation (5.4% vs 2.6%; p<0.001), stent implantation (4.7% vs 0.7%; p<0.001) or surgical repair (0.7% vs 1.7%; p=0.03). CONCLUSIONS: P-VCD were associated with higher rates of primary access-related vascular complications, driven by minor complications, compared to S-VCD. Endovascular treatment was more common after P-VCD failure. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Kim, Won AU - Kim W AD - Abteilung Kardiologie/Kardiochirurgie, Kerckhoff-Klinik GmbH, Herz und Thorax Zentrum, Bad Nauheim, Germany. FAU - Kellner, Caroline AU - Kellner C AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. AD - Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Adam, Matti AU - Adam M AD - University Hospital Cologne - Heart Center, Klinik III fur Innere Medizin - Kardiologie, Pneumologie und internistische Intensivmedizin, Cologne, Germany. FAU - Braun, Daniel AU - Braun D AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany. FAU - Tamm, Alexander R AU - Tamm AR AD - Zentrum fur Kardiologie - Kardiologie I, Universitatsmedizin Mainz, Mainz, Germany. FAU - Meertens, Max AU - Meertens M AD - University Hospital Cologne - Heart Center, Klinik III fur Innere Medizin - Kardiologie, Pneumologie und internistische Intensivmedizin, Cologne, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Abteilung Kardiologie/Kardiochirurgie, Kerckhoff-Klinik GmbH, Herz und Thorax Zentrum, Bad Nauheim, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Gmeiner, Jonas AU - Gmeiner J AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany. FAU - Sedaghat, Alexander AU - Sedaghat A AD - Med. Klinik II - Kardiologie, Universitatsklinikum Bonn, Bonn, Germany. FAU - Leistner, David AU - Leistner D AD - Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin (CBF), Medizinische Klinik fur Kardiologie, Berlin, Germany. AD - Med. Klinik III - Kardiologie, Universitatsklinikum Frankfurt, Frankfurt, Germany. FAU - Renker, Matthias AU - Renker M AD - Abteilung Kardiologie/Kardiochirurgie, Kerckhoff-Klinik GmbH, Herz und Thorax Zentrum, Bad Nauheim, Germany. FAU - Wienemann, Hendrik AU - Wienemann H AD - University Hospital Cologne - Heart Center, Klinik III fur Innere Medizin - Kardiologie, Pneumologie und internistische Intensivmedizin, Cologne, Germany. FAU - Charitos, Efstratios AU - Charitos E AD - Abteilung Kardiologie/Kardiochirurgie, Kerckhoff-Klinik GmbH, Herz und Thorax Zentrum, Bad Nauheim, Germany. FAU - Linnemann, Marie AU - Linnemann M AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany. FAU - Lerchner, Tobias AU - Lerchner T AD - Helios Universitatsklinikum Wuppertal - Herzzentrum Universitat Witten/Herdecke, Wuppertal, Germany. FAU - Juri, Benjamin AU - Juri B AD - Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin (CBF), Medizinische Klinik fur Kardiologie, Berlin, Germany. AD - Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. FAU - Salem, Mostafa AU - Salem M AD - Klinik fur Innere Medizin III, Schwerpunkte Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Kiel, Germany. FAU - Benetti-Lehmann, Roman AU - Benetti-Lehmann R AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Dreger, Henryk AU - Dreger H AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow-Klinikum, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany. FAU - Gossling, Alina AU - Gossling A AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Nahif, Awesta AU - Nahif A AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Schafer, Andreas AU - Schafer A AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Popara, Jasmin AU - Popara J AD - Klinik fur Innere Medizin III, Schwerpunkte Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Kiel, Germany. FAU - Sudo, Misumasa AU - Sudo M AD - Med. Klinik II - Kardiologie, Universitatsklinikum Bonn, Bonn, Germany. FAU - Scholtz, Smita AU - Scholtz S AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - von Bardeleben, Ralph Stephan AU - von Bardeleben RS AD - Zentrum fur Kardiologie - Kardiologie I, Universitatsmedizin Mainz, Mainz, Germany. FAU - Vorpahl, Marc AU - Vorpahl M AD - Helios Universitatsklinikum Wuppertal - Herzzentrum Universitat Witten/Herdecke, Wuppertal, Germany. FAU - Frank, Derk AU - Frank D AD - Klinik fur Innere Medizin III, Schwerpunkte Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Kiel, Germany. AD - German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Lubeck/Kiel, Hamburg/Lubeck/Kiel, Germany. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. AD - Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. AD - German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Lubeck/Kiel, Hamburg/Lubeck/Kiel, Germany. AD - BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20250303 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Aged, 80 and over MH - Retrospective Studies MH - Propensity Score MH - Aged MH - *Vascular Closure Devices MH - Registries MH - Femoral Artery/surgery MH - Treatment Outcome MH - *Suture Techniques PMC - PMC11849536 COIS- W. Kim received personal fees from Abbott, Boston Scientific, Edwards Lifesciences, Meril Life Sciences, and Shockwave Medical. M. Adam received consultancy or speaker fees from Abbott, Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic; and is a proctor for Abbott, JenaValve, and Medtronic. D. Braun received speaker fees from Abbott and Edwards Lifesciences. D. Leistner received speaker and advisory fees from Abbott. H. Dreger received proctoring, speaker and advisory fees from Abbott and Edwards Lifesciences; as well as research support from Abbott. L. Conradi received advisory fees from Abbott, Medtronic, and JenaValve; as well as consulting fees from Edwards Lifesciences, Boston Scientific, MicroPort, Pi-Cardia, and MicroInterventions. A Schafer received speaker fees and/or travel support from Edwards Lifesciences, Abbott, and Boston Scientific - unrelated to the submitted work. S. Scholtz received speaker fees from Edwards Lifesciences - unrelated to the submitted work. R.S. von Bardeleben received consulting fees from Abbott. T.K. Rudolph received speaker and advisory fees from Abbott, Edwards Lifesciences, JenaValve, Boston Scientific, Medtronic, and Amgen. M. Seiffert received speaker or advisory fees from Abbott, Abiomed, Amgen, AstraZeneca, Boston Scientific, Bristol-Myers Squibb, Daichii Sankyo, Edwards Lifesciences, Inari Medical, Medtronic, Pfizer, Shockwave Medical, and Siemens Healthineers; and a research grant from Boston Scientific - all unrelated to the submitted work. The other authors have no conflicts of interest to declare. EDAT- 2025/03/03 17:13 MHDA- 2025/03/03 17:14 PMCR- 2026/03/03 CRDT- 2025/03/03 06:42 PHST- 2025/03/03 17:14 [medline] PHST- 2025/03/03 17:13 [pubmed] PHST- 2025/03/03 06:42 [entrez] PHST- 2026/03/03 00:00 [pmc-release] AID - EIJ-D-24-00120 [pii] AID - 10.4244/EIJ-D-24-00120 [doi] PST - epublish SO - EuroIntervention. 2025 Mar 3;21(5):e272-e281. doi: 10.4244/EIJ-D-24-00120. PMID- 40004577 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250228 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 4 DP - 2025 Feb 7 TI - The Impact of Aortic Arch Morphology on Periprocedural Stroke in Transcatheter Aortic Valve Replacement. LID - 10.3390/jcm14041045 [doi] LID - 1045 AB - Objectives: Stroke after transcatheter aortic valve replacement (TAVR) continues to be one of the most concerning complications. Anatomical variations of the aortic arch may increase the risk of embolic debris entering the brain during transfemoral catheter manipulation. We aimed to analyze the influence of aortic arch morphology on the occurrence of ischemic stroke during TAVR. Methods: We performed a retrospective, 1:2 propensity-matched case-control study to compare patients with and without periprocedural stroke (defined according to the Valve Academic Research Consortium III endpoints) after transfemoral TAVR between June 2007 and September 2022. Multi-slice computed tomography (MSCT) analysis of pre-TAVR aortograms was performed to investigate arch anatomy, configuration, curvature, and the take-off angles of the epi-aortic vessels. Results: A total of 2371 patients were enrolled in this study. Periprocedural ischemic stroke was observed in 67 patients. After propensity score matching, this study included 201 patients: 67 (case) vs. 134 (control). The mean age was 80.0 +/- 13.2 and 81.6 +/- 6.4 years (p = 0.5), and the mean Euroscore II was 4.1 +/- 3.6 and 4.3 +/- 41 (p = 0.7). There was no difference in arch anatomy (p = 0.2) and configuration (p = 0.8) between the groups. Arch curvature (p = 0.9) and angulation of the brachiocephalic (p = 0.3) and left common carotid artery (p = 0.058) also did not differ significantly between the case and control groups. Conclusions: MSCT analysis in this propensity score-matched study found no correlation between aortic arch geometry and TAVR-associated stroke. FAU - Voss, Stephanie AU - Voss S AUID- ORCID: 0000-0002-8685-532X AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Rusa, Katerina AU - Rusa K AUID- ORCID: 0009-0000-1596-5778 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Campanella, Caterina AU - Campanella C AUID- ORCID: 0009-0008-9923-0696 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Georgescu, Teodora AU - Georgescu T AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Vitanova, Keti AU - Vitanova K AUID- ORCID: 0000-0002-8308-7679 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Ruge, Hendrik AU - Ruge H AUID- ORCID: 0000-0001-6886-3660 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Amabile, Andrea AU - Amabile A AUID- ORCID: 0000-0003-4689-3871 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA. AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USA. FAU - Sideris, Konstantinos AU - Sideris K AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Krane, Markus AU - Krane M AUID- ORCID: 0000-0002-5466-9290 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Centre for Cardiovascular Research)-Partner Site Munich Heart Alliance, 81377 Munich, Germany. FAU - Burri, Melchior AU - Burri M AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Centre Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. LA - eng PT - Journal Article DEP - 20250207 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11856225 OTO - NOTNLM OT - TAVR OT - aortic arch OT - aortic arch morphology OT - ischemic stroke COIS- Ruge serves as a physician proctor for Abbott and Edwards Lifescience, is a consultant for Medtronic, Abbott, and Edwards Lifescience, and is a member of the Abbott advisory board. Krane is a physician proctor and a member of the medical advisory board for Sanamedi, a physician proctor for Peter Duschek, a medical consultant for EVOTEC and Moderna, and has received speakers' honoraria from EDWARDS, AtriCure, Medtronic, and Terumo. Vitanova is a consultant for Medtronic and AstraZeneca and has received speakers' honoraria from Edwards and AtruCure. Amabile is a consultant for Sanamedi, Inc. EDAT- 2025/02/26 06:28 MHDA- 2025/02/26 06:29 PMCR- 2025/02/07 CRDT- 2025/02/26 01:18 PHST- 2024/12/16 00:00 [received] PHST- 2025/01/20 00:00 [revised] PHST- 2025/02/04 00:00 [accepted] PHST- 2025/02/26 06:29 [medline] PHST- 2025/02/26 06:28 [pubmed] PHST- 2025/02/26 01:18 [entrez] PHST- 2025/02/07 00:00 [pmc-release] AID - jcm14041045 [pii] AID - jcm-14-01045 [pii] AID - 10.3390/jcm14041045 [doi] PST - epublish SO - J Clin Med. 2025 Feb 7;14(4):1045. doi: 10.3390/jcm14041045. PMID- 39997497 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250227 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 12 IP - 2 DP - 2025 Feb 10 TI - Transfemoral Transcatheter Aortic Valve Implantation at Hospitals Without On-Site Cardiac Surgery (TAVI at Home): A Multicenter Prospective Interventional Study. LID - 10.3390/jcdd12020063 [doi] LID - 63 AB - Transcatheter aortic valve implantation (TAVI) has become the standard of care for elderly patients with aortic stenosis. International guidelines recommend that TAVI should be performed only in centers with on-site cardiac surgery (CS). However, rapidly evolving TAVI technology and increasing operator expertise have significantly reduced peri-procedural complications, including those requiring rescue surgery, which occur in less than 0.5% of cases. Furthermore, only a minority of major complications are treated with CS, and the outcomes remain unfavorable. TAVI in centers without CS could represent a solution to reduce waiting times and ensure continuity of care for fragile patients. "TAVI at Home" is a single-arm prospective interventional study. According to sample size calculations based on literature data, the study aims to enroll a total of 200 patients, beginning with a run-in phase of 20 patients to establish safety. The primary endpoint is 30-day all-cause mortality. Secondary endpoints include technical success and the evaluation of single complications 30 days after the procedure. Hospitals without CS that are eligible to perform TAVI must have a high volume of coronary percutaneous interventions, operators with established TAVI experience, collaboration with vascular surgeons, and regular Heart Team meetings to ensure rigorous patient selection. FAU - Compagnone, Miriam AU - Compagnone M AUID- ORCID: 0000-0002-3458-8717 AD - Interventional and Structural Cardiology Unit Forli-Cesena, 47121 Forli, Italy. FAU - Dall'Ara, Gianni AU - Dall'Ara G AD - Interventional and Structural Cardiology Unit Forli-Cesena, 47121 Forli, Italy. AD - Department of Medical and Surgical Sciences-DIMEC-Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy. FAU - Grotti, Simone AU - Grotti S AD - Interventional and Structural Cardiology Unit Forli-Cesena, 47121 Forli, Italy. FAU - Mambelli, Greta AU - Mambelli G AUID- ORCID: 0009-0009-0359-0871 AD - IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy. FAU - Fabbri, Elisabetta AU - Fabbri E AD - U.O. Ricerca Valutativa e Policy dei Servizi Sanitari, AUSL Romagna, 48121 Ravenna, Italy. FAU - Savini, Carlo AU - Savini C AD - Department of Medical and Surgical Sciences-DIMEC-Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy. AD - GVM Care & Research Maria Cecilia Hospital, 48033 Cotignola, Italy. FAU - Balducelli, Marco AU - Balducelli M AD - Division of Cardiology, S. Maria delle Croci Hospital, Ravenna, AUSL Romagna, 48121 Ravenna, Italy. FAU - Santarelli, Andrea AU - Santarelli A AUID- ORCID: 0000-0001-7575-6118 AD - Cardiology Unit, Bufalini Hospital, 47521 Cesena, Italy. FAU - Iorio, Elia AU - Iorio E AD - UOC Cardiologia e UTIC, Ente Ecclesiastico Ospedale Generale Regionale F Miulli, Acquaviva delle Fonti, 70021 Bari, Italy. FAU - Vaquerizo, Beatriz AU - Vaquerizo B AUID- ORCID: 0000-0002-1428-3596 AD - Hospital del Mar, 08003 Barcelona, Spain. FAU - Marchese, Alfredo AU - Marchese A AD - Ospedale S. Maria GVM Care & Research, 70124 Bari, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, 35128 Padua, Italy. FAU - Saia, Francesco AU - Saia F AD - Interventional Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, 40138 Bologna, Italy. FAU - Zingaretti, Chiara AU - Zingaretti C AD - IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy. FAU - Moretti, Carolina AU - Moretti C AD - Division of Cardiology, S. Maria delle Croci Hospital, Ravenna, AUSL Romagna, 48121 Ravenna, Italy. FAU - Cavazza, Caterina AU - Cavazza C AD - Cardiovascular Department, Infermi Hospital, AUSL Romagna, 47921 Rimini, Italy. FAU - Vertogen, Bernadette AU - Vertogen B AUID- ORCID: 0000-0002-5683-6363 AD - IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy. FAU - Ottani, Filippo AU - Ottani F AD - Cardiovascular Department, Infermi Hospital, AUSL Romagna, 47921 Rimini, Italy. FAU - Rubboli, Andrea AU - Rubboli A AD - Division of Cardiology, S. Maria delle Croci Hospital, Ravenna, AUSL Romagna, 48121 Ravenna, Italy. FAU - Nanni, Oriana AU - Nanni O AD - IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy. FAU - Pizzi, Carmine AU - Pizzi C AUID- ORCID: 0000-0002-4048-675X AD - Department of Medical and Surgical Sciences-DIMEC-Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy. AD - Cardiology Division, Morgagni Pierantoni University Hospital, AUSL Romagna, 47121 Forli, Italy. FAU - Galvani, Marcello AU - Galvani M AUID- ORCID: 0000-0001-5897-667X AD - Cardiovascular Research Unit, Fondazione Cardiologica Sacco, 47100 Forli, Italy. FAU - Tarantino, Fabio Felice AU - Tarantino FF AD - Interventional and Structural Cardiology Unit Forli-Cesena, 47121 Forli, Italy. LA - eng PT - Journal Article DEP - 20250210 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC11856494 OTO - NOTNLM OT - aortic valve stenosis OT - heart team OT - transcatheter aortic valve implantation COIS- Abbott S.r.l., Eukon S.r.l., Lopez S.p.a., Medstep S.r.l., Sintec S.r.l. are study sponsors, but there aren't conflicts of interest with the authors. This is also evaluated by Etich Comitee. EDAT- 2025/02/25 12:26 MHDA- 2025/02/25 12:27 PMCR- 2025/02/10 CRDT- 2025/02/25 08:25 PHST- 2024/12/27 00:00 [received] PHST- 2025/02/06 00:00 [revised] PHST- 2025/02/07 00:00 [accepted] PHST- 2025/02/25 12:27 [medline] PHST- 2025/02/25 12:26 [pubmed] PHST- 2025/02/25 08:25 [entrez] PHST- 2025/02/10 00:00 [pmc-release] AID - jcdd12020063 [pii] AID - jcdd-12-00063 [pii] AID - 10.3390/jcdd12020063 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2025 Feb 10;12(2):63. doi: 10.3390/jcdd12020063. PMID- 39993270 OWN - NLM STAT- MEDLINE DCOM- 20250806 LR - 20250814 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 37 IP - 8 DP - 2025 Aug TI - Cerebrovascular events with self-expanding versus balloon-expandable valves in patients with or without peripheral arterial disease. LID - 10.25270/jic/25.00020 [doi] AB - OBJECTIVES: The authors compared the risk of cerebrovascular events (CVE) with self-expanding vales (SEV) vs balloon-expandable valves (BEV) in patients with or without peripheral artery disease (PAD), stratified by the access route and the complexity of PAD (Hostile score). METHODS: The PAD-related risk of CVE between SEV vs BEV was investigated using data from the HOSTILE Registry, an observational study including 1707 patients with severe PAD undergoing transcatheter aortic valve replacement (TAVR) via different access routes. The relative risk of CVE with SEV vs BEV in patients without PAD was investigated in a meta-analysis of randomized controlled transfemoral access (TFA)-TAVR trials of patients with normal femoral arteries. The primary endpoint was the risk of 30-day CVE. RESULTS: Among the 1021 patients undergoing TAVR through TFA or transaxillary access (TAxA), 674 (66.0%) received SEVs and 329 (32.2%) received BEVs. The 30-day propensity-adjusted risk of CVE was higher for SEV compared with BEV (adjusted hazard ratio [HR], 2.70; 95% CI, 1.16-6.23), with no significant interaction between the transcatheter heart valve and either the access route or the Hostile score. Similar results were apparent at 1 year (adjusted HR, 2.98; 95% CI, 1.30-6.83). In contrast, in a meta-analysis of 4 RCTs and 2131 patients with femoral arteries suitable for TAVR, there were no significant differences in the 30-day rates of CVE between SEV and BEV (odds ratio, 0.58; 95% CI, 0.24-1.40). CONCLUSIONS: Compared with BEVs, SEVs were associated with higher 30-day and 1-year rates of CVE in patients with PAD, a finding not apparent in patients with suitable femoral arteries enrolled in RCTs. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. Email: tulliopalmerini@hotmail.com. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Bruno, Antonio Giulio AU - Bruno AG AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Iadanza, Alessandro AU - Iadanza A AD - UOSA Cardiologia Interventistica Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - Ghetti, Gabriele AU - Ghetti G AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Burzotta, Francesco AU - Burzotta F AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Van Mieghem, Nicholas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Nardi, Elena AU - Nardi E AD - Research and Innovation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Orzalkiewicz, Mateusz AU - Orzalkiewicz M AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Aranzulla, Tiziana Claudia AU - Aranzulla TC AD - A.O. Mauriziano Umberto I Hospital, Turin, Italy. FAU - Meertens, Max M AU - Meertens MM AD - University Hospital Cologne - Heart Center, Klinik III fur Innere Medizin - Kardiologie, Pneumologie und internistische Intensivmedizin, Cologne, Germany. FAU - Taglieri, Nevio AU - Taglieri N AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Joner, Michael AU - Joner M AD - German Heart Centre Munich/Deutsches Herzzentrzum Munchen - Munich, Germany. FAU - Nardi, Giulia AU - Nardi G AD - University Hospital Careggi, Florence, Italy; Heart Center Lucerne, Cardiology, Luzerner, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Cardiology, Luzerner, Switzerland. FAU - Gallitto, Enrico AU - Gallitto E AD - Vascular Surgery, University of Bologna, DIMEC, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Gargiulo, Mauro AU - Gargiulo M AD - Vascular Surgery, University of Bologna, DIMEC, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Testa, Luca AU - Testa L AD - Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, San Donato Milanese, Italy. FAU - Berti, Sergio AU - Berti S AD - Unit of Diagnostic and Interventional Cardiology, C.N.R. Reg. Toscana G. Monasterio Foundation, Ospedale del Cuore, Massa, Italy. FAU - Montorfano, Matteo AU - Montorfano M AD - Interventional Cardiology Unit - IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Leone, Alessandro AU - Leone A AD - Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy. FAU - Pacini, Davide AU - Pacini D AD - Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy. FAU - Braun, Daniel AU - Braun D AD - Department of Medicine I, University Hospital Munich, Medical faculty - LMU, Munich, Germany. FAU - Castriota, Fausto AU - Castriota F AD - Interventional Cardiology Unit - GVM Care and Research Maria Cecilia Hospital - Cotignola (RA), Italy. FAU - De Carlo, Marco AU - De Carlo M AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. FAU - Leone, Pier Pasquale AU - Leone PP AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy. FAU - Nickenig, Georg AU - Nickenig G AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn - Universitatsklinikum Bonn, Bonn, Germany. FAU - Piva, Tommaso AU - Piva T AD - Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I - GM Lancisi, Torette, Ancona, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Cardiovascular Research Foundation, New York, New York. FAU - Vercellino, Matteo AU - Vercellino M AD - Cardiology Unit, Cardio-Thoraco Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genoa, Italy. FAU - Codner, Pablo AU - Codner P AD - Rabin Medical Center, Petah Tikva, Israel. FAU - Bartorelli, Antonio L AU - Bartorelli AL AD - Unita Operativa di Cardiologia Interventistica Universitaria, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano Milan, Italy. FAU - Fraccaro, Chiara AU - Fraccaro C AD - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Stone, Gregg W AU - Stone GW AD - Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve Stenosis/surgery/complications/diagnosis MH - *Cerebrovascular Disorders/etiology/epidemiology MH - *Heart Valve Prosthesis/adverse effects MH - *Peripheral Arterial Disease/complications/diagnosis MH - Prosthesis Design MH - Registries MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods/instrumentation MH - Meta-Analysis as Topic OTO - NOTNLM OT - TAVR OT - alternative access OT - femoral access OT - transcatheter aortic valve replacement EDAT- 2025/02/24 23:04 MHDA- 2025/08/06 18:29 CRDT- 2025/02/24 16:43 PHST- 2025/08/06 18:29 [medline] PHST- 2025/02/24 23:04 [pubmed] PHST- 2025/02/24 16:43 [entrez] AID - 10.25270/jic/25.00020 [doi] PST - ppublish SO - J Invasive Cardiol. 2025 Aug;37(8). doi: 10.25270/jic/25.00020. PMID- 39986959 OWN - NLM STAT- MEDLINE DCOM- 20251003 LR - 20260520 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 79 DP - 2025 Oct TI - Long-term clinical efficacy of transfemoral transcatheter aortic valve implantation with three different platforms. PG - 24-30 LID - S1553-8389(25)00027-2 [pii] LID - 10.1016/j.carrev.2025.01.014 [doi] AB - BACKGROUND: Long-term durability and outcomes of transcatheter aortic valve implantation (TAVI) have been reported only with first generation devices. OBJECTIVES: To compare clinical efficacy of TAVI with Sapien 3 (Edwards Lifesciences), Evolut R/PRO (Medtronic) or Acurate Neo (Boston Scientific) transcatheter heart valves (THVs) at long-term. METHODS: Consecutive TAVI patients treated with Sapien 3, Evolut R/PRO and Acurate Neo THVs at Policlinico G. Rodolico of Catania with at least 5 years follow-up were included in this analysis. Patients were divided into three different groups according to the TAVI device used. Outcomes were compared after inverse probability of treatment weighting adjustment. The primary endpoint was the composite of all-cause death, disabling stroke and heart failure (HF) re-hospitalization at 7 years. The co-primary endpoint was valve-related clinical efficacy according to Valve Academic Research Consortium 3 (VARC-3) definition, at 7 years. RESULTS: From September 2014 to December 2018, 383 tranfemoral TAVI patients receiving Sapien 3 (n = 131, 34.2 %), Evolut R/PRO (n = 134, 34.9 %), or Acurate Neo (n = 118, 30.8 %) devices were compared. At 7 years, the composite primary endpoint did not differ among study groups (60.2 % vs. 51.6 % vs. 62.1 % for Sapien 3, Evolut R/PRO and Acurate Neo, respectively, p(log-rank) = 0.50). The co-primary endpoint was also similar (2.2 % vs. 1.2 % vs. 4.2 %, for Sapien 3, Evolut R/PRO and Acurate Neo, respectively, p(log-rank) = 0.86). CONCLUSIONS: Clinical efficacy of TAVI with Sapien 3, Evolut R/PRO and Acurate Neo devices was sustained and comparable up to 7 years. Low and similar rates of valve degeneration were reported among the three devices. Randomized clinical trials are necessary to corroborate these findings and to assess the impact of specific hemodynamic differences among the three THV platforms in the context of long-term clinical efficacy. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Cali, Mariachiara AU - Cali M AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Strazzieri, Orazio AU - Strazzieri O AD - Cardiology Unit, Umberto I Hospital, ASP 4 di Enna, Enna, Italy. FAU - Motta, Silvia Crescenzia AU - Motta SC AD - Cardiology Unit, Umberto I Hospital, ASP 8 di Siracusa, Siracusa, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Sammartino, Sofia AU - Sammartino S AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - La Rosa, Luigi AU - La Rosa L AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Sgroi, Carmelo AU - Sgroi C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Deste, Wanda AU - Deste W AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Veroux, Pierfrancesco AU - Veroux P AD - Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy. FAU - Lentini, Salvatore AU - Lentini S AD - Division of Cardiac Surgery, G. Rodolico - San Marco Policlinic University Hospital, Catania, Italy. FAU - Inserra, Maria Cristina AU - Inserra MC AD - Division of Radiology, G. Rodolico - San Marco Policlinic University Hospital, Catania, Italy. FAU - Cannizzaro, Maria Teresa AU - Cannizzaro MT AD - Division of Radiology, G. Rodolico - San Marco Policlinic University Hospital, Catania, Italy. FAU - Garretto, Valeria AU - Garretto V AD - Division of Radiology, G. Rodolico - San Marco Policlinic University Hospital, Catania, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Cardiology Unit, Umberto I Hospital, ASP 4 di Enna, Enna, Italy; Universita degli Studi di Enna "Kore", Enna, Italy. Electronic address: mbarbanti83@gmail.com. LA - eng PT - Comparative Study PT - Journal Article DEP - 20250218 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Female MH - Male MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Time Factors MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/mortality/physiopathology MH - Aged, 80 and over MH - Prosthesis Design MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Aged MH - Risk Factors MH - *Femoral Artery MH - *Catheterization, Peripheral/adverse effects/mortality MH - Retrospective Studies MH - Risk Assessment MH - Recovery of Function MH - Patient Readmission MH - Postoperative Complications/mortality/therapy OTO - NOTNLM OT - Bioprosthetic valve failure OT - Clinical efficacy OT - TAVI OT - Valve durability COIS- Declaration of competing interest C. Tamburino has reported that he is a consultant for Medtronic. Marco Barbanti is consultant for Medtronic, Boston Scientifics and Edwards LifeSciences. All other authors have no conflicts of interest to declare. EDAT- 2025/02/23 00:42 MHDA- 2025/10/04 00:30 CRDT- 2025/02/22 21:59 PHST- 2024/07/20 00:00 [received] PHST- 2025/01/22 00:00 [revised] PHST- 2025/01/28 00:00 [accepted] PHST- 2025/10/04 00:30 [medline] PHST- 2025/02/23 00:42 [pubmed] PHST- 2025/02/22 21:59 [entrez] AID - S1553-8389(25)00027-2 [pii] AID - 10.1016/j.carrev.2025.01.014 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2025 Oct;79:24-30. doi: 10.1016/j.carrev.2025.01.014. Epub 2025 Feb 18. PMID- 39975870 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260813 IS - 0970-9134 (Print) IS - 0973-7723 (Electronic) IS - 0970-9134 (Linking) VI - 41 IP - 3 DP - 2025 Mar TI - A comparative study on iliofemoral artery calcification distribution in alternative TAVR approaches. PG - 272-280 LID - 10.1007/s12055-024-01841-3 [doi] AB - BACKGROUND: Alternative access approaches are required for transcatheter aortic valve replacement (TAVR) cases wherein the transfemoral approach is restrictive with severe calcification. We aimed to examine the safety of the external iliac artery (EIA) as an alternative access site by evaluating the calcification distributions from the common iliac artery (CIA) to the common femoral arteries (CFA). METHODS: We retrospectively enrolled 402 patients who underwent TAVR. Using computed tomography, calcification was visually assessed based on the maximal circumferential involvement, length, and morphology, and its volumes were quantitatively measured using a minimum threshold of 600 Hounsfield units in 804 arteries. RESULTS: The calcification volumes were 0.301 (interquartile range, 0.114-0.624) cc in the CIA, 0.0 (0.0-0.041) cc in the EIA, and 0.047 (0.002-0.158) cc in the CFA (p < 0.01). Maximum calcification of >50% of the arterial circumference was observed in only 7.3% of the EIA, compared to 35.2% and 10.8% of the CIA and CFA, respectively. Almost 55% of the EIA had no calcification, compared with only <5% and 22.7% of the CIA and CFA, respectively. In a subgroup analysis of patients on dialysis, the calcification volume was smallest in the EIA at 0.011 (0.0-0.127) cc (p < 0.01). In all, 33.3% of EIAs had no calcification, while 2.0% of CIAs and 19.6% of CFAs were calcification-free. CONCLUSIONS: Calcification rarely presents qualitatively and quantitatively in the EIA, suggesting that it could be an option for TAVR when the transfemoral access is unsuitable. GRAPHICAL ABSTRACT: We qualitatively and quantitatively evaluated the distribution of calcification in the iliofemoral arteries of patients who underwent TAVR. The calcification was more rarely present in the EIA than in the CIA or CFA. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-024-01841-3. CI - (c) Indian Association of Cardiovascular-Thoracic Surgeons 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. FAU - Hohri, Yu AU - Hohri Y AUID- ORCID: 0000-0003-0112-4278 AD - Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 AD - Division of Cardiothoracic and Vascular Surgery, New York Presbyterian Hospital, Columbia University Irving Medical Center, 707 Fort Washington Avenue, New York, NY 10032 USA. ROR: https://ror.org/01esghr10. GRID: grid.239585.0. ISNI: 0000 0001 2285 2675 FAU - Zen, Kan AU - Zen K AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 FAU - Kawajiri, Hidetake AU - Kawajiri H AD - Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 FAU - Yashige, Masaki AU - Yashige M AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 FAU - Fujimoto, Tomotaka AU - Fujimoto T AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 FAU - Nakamura, Shunsuke AU - Nakamura S AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 FAU - Tani, Ryotaro AU - Tani R AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 FAU - Matoba, Satoaki AU - Matoba S AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ROR: https://ror.org/028vxwa22. GRID: grid.272458.e. ISNI: 0000 0001 0667 4960 LA - eng PT - Journal Article DEP - 20241113 PL - India TA - Indian J Thorac Cardiovasc Surg JT - Indian journal of thoracic and cardiovascular surgery JID - 8700105 PMC - PMC11832847 OTO - NOTNLM OT - Alternative approach OT - Aortic stenosis OT - Calcification OT - End-stage kidney disease OT - External iliac artery OT - Transcatheter aortic valve replacement COIS- Conflict of interestThe authors declare no competing interests. EDAT- 2025/02/20 06:22 MHDA- 2025/02/20 06:23 PMCR- 2026/03/01 CRDT- 2025/02/20 05:44 PHST- 2024/06/13 00:00 [received] PHST- 2024/09/09 00:00 [revised] PHST- 2024/09/10 00:00 [accepted] PHST- 2025/02/20 06:23 [medline] PHST- 2025/02/20 06:22 [pubmed] PHST- 2025/02/20 05:44 [entrez] PHST- 2026/03/01 00:00 [pmc-release] AID - 1841 [pii] AID - 10.1007/s12055-024-01841-3 [doi] PST - ppublish SO - Indian J Thorac Cardiovasc Surg. 2025 Mar;41(3):272-280. doi: 10.1007/s12055-024-01841-3. Epub 2024 Nov 13. PMID- 39967216 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250223 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 5 IP - 2 DP - 2025 Feb TI - Protruding and Ulcerated Aortic Atheromas as Predictors of Periprocedural Ischemic Stroke Post-Transcatheter Aortic Valve Replacement. PG - 258-269 LID - S2772-3747(24)00455-1 [pii] LID - 10.1016/j.jacasi.2024.10.020 [doi] AB - BACKGROUND: Aortic atherosclerosis can affect the strategy and outcomes of transcatheter aortic valve replacement (TAVR). Limited investigation exists into how aortic atheroma morphology influences outcomes post-TAVR. OBJECTIVES: This study aimed to assess the influence of protruding and ulcerated aortic atheromas on periprocedural ischemic stroke post-TAVR. METHODS: This analysis included 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data. Protruding aortic atheroma was defined as atheroma of >/=3 mm thickness with protruding components. Ulcerated aortic atheroma was defined as atheroma with ulcer-like intimal disruption. The primary endpoint was periprocedural ischemic stroke within 30 days post-TAVR. RESULTS: In total, 43 (4.4%) experienced periprocedural ischemic stroke. Patients with protruding or ulcerated aortic atheroma had a significantly higher incidence of periprocedural stroke compared with those without (8.0% [95% CI: 4.9%-12.2%] vs 3.2% [95% CI: 2.1%-4.8%]; P = 0.003). Protruding or ulcerated atheroma (adjusted OR [aOR]: 2.55 [95% CI: 1.37-4.74]), particularly in the aortic arch (aOR: 3.86 [95% CI: 1.69-8.83]), independently increased periprocedural stroke risk. Among patients undergoing transfemoral TAVR with self-expandable valves (n = 315, 32%), protruding or ulcerated atheroma in the aortic arch was independently associated with periprocedural stroke (aOR: 9.04 [95% CI: 1.59-51.4]), whereas it was not among those with balloon-expandable valves (n = 580, 59%) (aOR: 2.85 [95% CI: 0.92-8.84]). CONCLUSIONS: Protruding and ulcerated aortic atheromas are associated with a higher risk of periprocedural ischemic stroke post-TAVR. Careful selection of TAVR strategy, including valve type and procedural approach, is essential for patients with such aortic lesions. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kikuchi, Shinnosuke AU - Kikuchi S AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, Strasbourg, France. FAU - Trimaille, Antonin AU - Trimaille A AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, Strasbourg, France. FAU - Carmona, Adrien AU - Carmona A AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Truong, Dinh Phi AU - Truong DP AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; Vietnam National cardiovascular institute, Hanoi, Vietnam; Hanoi Medical University, Hanoi, Vietnam. FAU - Matsushita, Kensuke AU - Matsushita K AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, Strasbourg, France; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. FAU - Marchandot, Benjamin AU - Marchandot B AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, Strasbourg, France. FAU - Granier, Amandine AU - Granier A AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Reydel, Antje AU - Reydel A AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Vu, Manh Cuong AU - Vu MC AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; Vietnam National cardiovascular institute, Hanoi, Vietnam; Hanoi Medical University, Hanoi, Vietnam. FAU - Zheng, Franck AU - Zheng F AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Heyberger, Zoe AU - Heyberger Z AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Tse Sik Sun, Julien AU - Tse Sik Sun J AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Loizon, Florian AU - Loizon F AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Knellwolf, Paul AU - Knellwolf P AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Recht, Dorian AU - Recht D AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Koenig, Baudouin AU - Koenig B AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Ohana, Mickael AU - Ohana M AD - Department of Radiology, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Hibi, Kiyoshi AU - Hibi K AD - Hanoi Medical University, Hanoi, Vietnam; Department of Cardiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. FAU - Ohlmann, Patrick AU - Ohlmann P AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France. FAU - Morel, Olivier AU - Morel O AD - Department of Cardiovascular Medicine, Nouvel Hopital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, Strasbourg, France; Hanoi Medical University, Hanoi, Vietnam. Electronic address: olivier.morel@chru-strasbourg.fr. LA - eng PT - Journal Article DEP - 20241231 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC11840235 OTO - NOTNLM OT - aortic atheroma OT - periprocedural ischemic stroke OT - protruding atheroma OT - transcatheter aortic valve replacement OT - ulcerated atheroma COIS- Funding Support and Author Disclosures This work is supported by GERCA (Groupe pour l'Enseignement, la prevention et la Recherche Cardiologique en Alsace). Dr Kikuchi has received a grant from the Japan Heart Foundation/Bayer Yakuhin Research Grant Abroad. Dr Morel has received grants from AstraZeneca, Medtronic, and Boehringer Ingelheim; and his institution has been awarded grants by "Fondation Coeur et Recherche" and "Endofrance," 2 reputable charities in France committed to advancing research initiatives. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/02/19 06:22 MHDA- 2025/02/19 06:23 PMCR- 2024/12/31 CRDT- 2025/02/19 01:04 PHST- 2024/07/03 00:00 [received] PHST- 2024/10/08 00:00 [revised] PHST- 2024/10/18 00:00 [accepted] PHST- 2025/02/19 06:23 [medline] PHST- 2025/02/19 06:22 [pubmed] PHST- 2025/02/19 01:04 [entrez] PHST- 2024/12/31 00:00 [pmc-release] AID - S2772-3747(24)00455-1 [pii] AID - 10.1016/j.jacasi.2024.10.020 [doi] PST - ppublish SO - JACC Asia. 2025 Feb;5(2):258-269. doi: 10.1016/j.jacasi.2024.10.020. Epub 2024 Dec 31. PMID- 39967214 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250223 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 5 IP - 2 DP - 2025 Feb TI - Extremely Small 20-mm Versus Standard-Size Balloon-Expandable Transcatheter Heart Valves: Propensity-Matched Analysis From the OCEAN-TAVI Registry. PG - 245-254 LID - S2772-3747(24)00351-X [pii] LID - 10.1016/j.jacasi.2024.09.005 [doi] AB - BACKGROUND: The 20-mm balloon-expandable transcatheter heart valve (THV) represents the smallest available option for transcatheter aortic valve replacement (TAVR). Its current underutilization stems from concerns regarding prosthesis-patient mismatch, durability, and potential adverse outcomes. OBJECTIVES: The purpose of this study was to compare the long-term outcomes between the 20-mm balloon-expandable THVs and standard-size balloon-expandable THVs. METHODS: Patients who underwent transfemoral TAVR with SAPIEN THVs were sourced from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention) registry, an ongoing, multicenter cohort study that has enrolled over 7,000 TAVR patients in Japan. A 1:3 propensity-matched analysis, based on 24 baseline clinical and echocardiographic variables, was used to contrast the 20-mm with >20-mm balloon-expandable THVs. RESULTS: Of 5,086 eligible patients, 284 (5.6%) received the 20-mm balloon-expandable THV. After propensity-matching, the 20-mm THV group (n = 276) and the >20-mm THV group (n = 828) demonstrated balanced baseline characteristics, with an absolute standardized difference <0.10. The average follow-up duration for patients who were alive was 955 +/- 512 days, and the average time to death was 584 +/- 543 days. The 20-mm group showed a higher frequency of prosthesis-patient mismatch (PPM) (moderate PPM: 29.2% vs 10.8%; severe PPM: 4.9% vs 1.5%; P < 0.001). Over a 5-year period, all-cause mortality and heart failure rehospitalization rates were comparable between the 2 groups (all-cause mortality: 34.2% vs 38.0%; HR: 1.01; 95% CI: 0.74-1.37; P = 0.970; heart failure rehospitalization: 15.2% vs 16.3%; HR: 0.81; 95% CI: 0.50-1.29; P = 0.371). CONCLUSIONS: This registry-based study suggests that the initially observed inferior forward hemodynamics associated with the 20-mm THV do not translate into heightened long-term mortality or heart failure rehospitalization risks. (The OCEAN-TAVI registry [Optimized Transcatheter Valvular Intervention-Transcatheter Aortic Valve Implantation]; UMINID:000020423). CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Okuno, Taishi AU - Okuno T AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Izumo, Masaki AU - Izumo M AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. Electronic address: m2izumo@marianna-u.ac.jp. FAU - Takahiko, Kai AU - Takahiko K AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Kuwata, Shingo AU - Kuwata S AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Koga, Masashi AU - Koga M AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Akashi, Yoshihiro J AU - Akashi YJ AD - Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan. FAU - Shirai, Shinichi AU - Shirai S AD - Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan. FAU - Watanabe, Yusuke AU - Watanabe Y AD - Department of Cardiology, Teikyo University, Tokyo, Japan. FAU - Naganuma, Toru AU - Naganuma T AD - Department of Cardiology, New Tokyo Hospital, Chiba, Japan. FAU - Tada, Norio AU - Tada N AD - Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan. FAU - Yamanaka, Futoshi AU - Yamanaka F AD - Department of Cardiology, Shonan Kamakura General Hospital. FAU - Noguchi, Masahiko AU - Noguchi M AD - Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan. FAU - Ueno, Hiroshi AU - Ueno H AD - Department of Cardiology, Toyama University, Toyama, Japan. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University. FAU - Nishina, Hidetaka AU - Nishina H AD - Department of Cardiology, Tsukuba Medical Center Hospital, Isehara, Japan. FAU - Takagi, Kensuke AU - Takagi K AD - Department of Cardiology, National Cerebral and Cardiovascular Center, Tsukuba, Japan. FAU - Asami, Masahiko AU - Asami M AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Mizutani, Kazuki AU - Mizutani K AD - Department of Cardiology, Kinki University, Osaka, Japan. FAU - Yashima, Fumiaki AU - Yashima F AD - Department of Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan. FAU - Otsuka, Toshiaki AU - Otsuka T AD - Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan. FAU - Yamamoto, Masanori AU - Yamamoto M AD - Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20241112 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC11840232 OTO - NOTNLM OT - aortic valve stenosis OT - paravalvular regurgitation OT - prosthesis-patient mismatch OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures The OCEAN-TAVI registry is supported by Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Medical, and Daiichi-Sankyo. Dr Izumo is a screening proctor for Edwards Lifesciences. Drs Shirai, Watanabe, Tada, Yamamoto, and Hayashida, are clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. Drs Naganuma, Ueno, Takagi, and Mizutani are clinical proctors for Edwards Lifesciences and Medtronic. Drs Ohno, Nishina, Asami, and Yashima are clinical proctors for Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/02/19 06:22 MHDA- 2025/02/19 06:23 PMCR- 2024/11/12 CRDT- 2025/02/19 01:04 PHST- 2024/03/19 00:00 [received] PHST- 2024/07/16 00:00 [revised] PHST- 2024/09/08 00:00 [accepted] PHST- 2025/02/19 06:23 [medline] PHST- 2025/02/19 06:22 [pubmed] PHST- 2025/02/19 01:04 [entrez] PHST- 2024/11/12 00:00 [pmc-release] AID - S2772-3747(24)00351-X [pii] AID - 10.1016/j.jacasi.2024.09.005 [doi] PST - ppublish SO - JACC Asia. 2025 Feb;5(2):245-254. doi: 10.1016/j.jacasi.2024.09.005. Epub 2024 Nov 12. PMID- 39939238 OWN - NLM STAT- MEDLINE DCOM- 20250615 LR - 20260517 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 75 DP - 2025 Jun TI - Safety and efficacy of the unilateral, suture-based, dry-closure technique in percutaneous trans-axillary aortic valve implantation. PG - 46-51 LID - S1553-8389(25)00048-X [pii] LID - 10.1016/j.carrev.2025.02.006 [doi] AB - BACKGROUND: Transaxillary transcatheter aortic valve implantation (TAx-TAVI) is the most used alternative access when severe iliofemoral disease renders transfemoral access infeasible. Compared to surgical transaxillary access, a true percutaneous approach using vascular closure devices (VCD) has advantages but can be challenging. Herein, we describe the impact of the "unilateral, suture-mediated, dry-closure technique" on vascular safety and efficacy in patients undergoing true percutaneous TAx-TAVI. METHODS: A total of 77 patients undergoing percutaneous TAx-TAVI were categorized into a cohort before (C1, n = 40) and after (C2, n = 37) implementation of the suture-based dry-closure technique using an upstream occlusion balloon. In C1, arteriotomy closure mainly consisted of plug-based VCD. The primary (safety) endpoint was occurrence of major or minor access-site related vascular complications in accordance with Valve Academic Research Consortium 3 criteria. Technical success rates (at exit from procedure room) were used to assess procedural efficacy. RESULTS: The mean age of the study population was 79 +/- 7 years and 49 % were male. From C1 to C2, the Society of Thoracic Surgeons Predicted Risk of Mortality reduced numerically (from 4.1 to 3.6 %, p = 0.060). Procedures became more streamlined with use of local anesthesia in 100 % (83 % in C2) and the left axillary artery in 76 % (68 % in C2). The primary (safety) endpoint occurred in 34 % of the patients, but reduced from 45 % in C1 to 16 % in C2 (p = 0.011). Concurrently, there was a reduction in VCD failure (45 vs 14 % [incomplete arteriotomy closure in all 5 cases], p = 0.003), bleeding complications (45 vs 14 %, p = 0.003) and bailout vascular surgery/stenting (40 % vs. 16 %, p = 0.021). Technical success was 80 % in C1 and 87 % in C2 (p = 0.45) and median length of hospital stay reduced from 5 (25th-75th percentile: 2-7) to 3 days (25th-75th percentile: 2-5, p = 0.080). CONCLUSIONS: The unilateral, suture-based dry-closure technique facilitates safe and effective access management in high-risk patients selected for percutaneous TAx-TAVI procedures. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Nuis, Rutger-Jan AU - Nuis RJ AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Hokken, Thijmen W AU - Hokken TW AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - van Niekerk, Jenna AU - van Niekerk J AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - de Assis, Lucas Uchoa AU - de Assis LU AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Adrichem, Rik AU - Adrichem R AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - van den Dorpel, Mark AU - van den Dorpel M AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Ooms, Joris AU - Ooms J AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Kardys, Isabella AU - Kardys I AD - Clinical Epidemiology Unit, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Lenzen, Mattie AU - Lenzen M AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Daemen, Joost AU - Daemen J AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: n.vanmieghem@erasmusmc.nl. LA - eng PT - Journal Article DEP - 20250207 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - Treatment Outcome MH - Aged, 80 and over MH - Risk Factors MH - *Suture Techniques/adverse effects/mortality/instrumentation MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation/methods MH - Punctures MH - *Axillary Artery/diagnostic imaging MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Hemostatic Techniques/adverse effects/instrumentation/mortality MH - Time Factors MH - *Hemorrhage/prevention & control/etiology/mortality MH - Retrospective Studies MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Vascular Closure Devices OTO - NOTNLM OT - Aortic stenosis OT - Transaxillary access OT - Transcatheter aortic valve implantation OT - Vascular complications COIS- Declaration of competing interest Dr. Nuis received research grant support from Vifor Pharma, Merill and consulting fees from Edwards Lifesciences, Abbott, Boston Scientific. Dr. Daemen received institutional grant/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, PulseCath, Pie Medical, Sanofi, Siemens Health Care and Medtronic. Prof van Mieghem has received a research grant support from Boston Scientific, Edwards Lifesciences, Abbott Vascular and PulseCath B.V. which were received for activities outside the submitted work. The other authors have no conflict of interest to declare. EDAT- 2025/02/13 00:22 MHDA- 2025/06/16 00:26 CRDT- 2025/02/12 22:00 PHST- 2024/12/16 00:00 [received] PHST- 2025/02/04 00:00 [revised] PHST- 2025/02/06 00:00 [accepted] PHST- 2025/06/16 00:26 [medline] PHST- 2025/02/13 00:22 [pubmed] PHST- 2025/02/12 22:00 [entrez] AID - S1553-8389(25)00048-X [pii] AID - 10.1016/j.carrev.2025.02.006 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2025 Jun;75:46-51. doi: 10.1016/j.carrev.2025.02.006. Epub 2025 Feb 7. PMID- 39924380 OWN - NLM STAT- MEDLINE DCOM- 20250405 LR - 20250509 IS - 1875-2128 (Electronic) IS - 1875-2128 (Linking) VI - 118 IP - 4 DP - 2025 Apr TI - Early and late bleeding events according to Valve Academic Research Consortium 3 criteria following transcatheter aortic valve implantation. PG - 248-259 LID - S1875-2136(25)00045-2 [pii] LID - 10.1016/j.acvd.2024.12.009 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation may be associated with significant haemorrhagic complications. AIMS: To evaluate the timing, incidence, predictors and clinical impact of bleeding events after transcatheter aortic valve implantation, according to the updated Valve Academic Research Consortium (VARC)-3 criteria, compared with the VARC-2 criteria. METHODS: A retrospective observational study involving 487 consecutive patients who underwent transcatheter aortic valve implantation between July 2017 and May 2019 was performed. Bleeding events were classified according to the VARC-2 and VARC-3 definitions. RESULTS: Bleeding events occurred in 17.6% of patients, with early bleeding (in-hospital) in 12.5% and late bleeding (occurring after discharge) in 6.1%. The primary vascular access site was the most common source of early bleeding, whereas gastrointestinal bleeding was predominant in late events. Significant predictors of early VARC-3-defined bleeding included active cancer, previous implantable cardioverter-defibrillator, history of mitral valve surgery, a non-transfemoral approach and occurrence of an in-hospital major vascular complication or new-onset atrial fibrillation. Late bleeding was independently associated with a history of myocardial infarction and treatment with vitamin K antagonists at discharge. Early bleeding events were not associated with increased late all-cause mortality. No significant difference was observed based on the VARC-2 and VARC-3 bleeding definitions. CONCLUSIONS: Bleeding events occurred in one sixth of patients undergoing transcatheter aortic valve implantation without significant difference in their incidence between the VARC-2 and VARC-3 classifications. Early bleeding events were not associated with poorer long-term survival, regardless of the classification used. Larger studies with greater statistical power, including more contemporary patients, are needed to confirm these findings. CI - Copyright (c) 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved. FAU - Nolf, Maxime AU - Nolf M AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Boulmier, Dominique AU - Boulmier D AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Leurent, Guillaume AU - Leurent G AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Tomasi, Jacques AU - Tomasi J AD - Service de chirurgie thoracique et cardio-vasculaire, LTSI Inserm U1099, CHU de Rennes, universite de Rennes 1, 35000 Rennes, France. FAU - Le Bars, Florent AU - Le Bars F AD - Service de chirurgie thoracique et cardio-vasculaire, LTSI Inserm U1099, CHU de Rennes, universite de Rennes 1, 35000 Rennes, France. FAU - Bakhti, Abdelkader AU - Bakhti A AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Sharobeem, Sam AU - Sharobeem S AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Lemarchand, Leo AU - Lemarchand L AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Sost, Gwenaelle AU - Sost G AD - Service de geriatrie, CHU de Rennes, 35000 Rennes, France. FAU - Le Guellec, Marielle AU - Le Guellec M AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Le Breton, Herve AU - Le Breton H AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. FAU - Auffret, Vincent AU - Auffret V AD - Service de cardiologie, LTSI Inserm U1099, centre d'investigation clinique (CIC) Inserm 1414, CHU de Rennes, universite de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. Electronic address: vincent.auffret@chu-rennes.fr. LA - eng PT - Journal Article PT - Observational Study DEP - 20250130 PL - Netherlands TA - Arch Cardiovasc Dis JT - Archives of cardiovascular diseases JID - 101465655 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Retrospective Studies MH - Male MH - Female MH - Time Factors MH - Risk Factors MH - Aged, 80 and over MH - Aged MH - Treatment Outcome MH - *Postoperative Hemorrhage/mortality/epidemiology/diagnosis MH - Risk Assessment MH - Incidence MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality/physiopathology MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology OTO - NOTNLM OT - Bleeding OT - Mortality OT - Transcatheter aortic valve implantation OT - VARC-2 OT - VARC-3 EDAT- 2025/02/10 00:19 MHDA- 2025/04/06 04:44 CRDT- 2025/02/09 22:30 PHST- 2024/09/13 00:00 [received] PHST- 2024/12/15 00:00 [revised] PHST- 2024/12/24 00:00 [accepted] PHST- 2025/04/06 04:44 [medline] PHST- 2025/02/10 00:19 [pubmed] PHST- 2025/02/09 22:30 [entrez] AID - S1875-2136(25)00045-2 [pii] AID - 10.1016/j.acvd.2024.12.009 [doi] PST - ppublish SO - Arch Cardiovasc Dis. 2025 Apr;118(4):248-259. doi: 10.1016/j.acvd.2024.12.009. Epub 2025 Jan 30. PMID- 39916345 OWN - NLM STAT- MEDLINE DCOM- 20250624 LR - 20250624 IS - 1536-0237 (Electronic) IS - 0883-5993 (Linking) VI - 40 IP - 4 DP - 2025 Jul 1 TI - Accuracy of Single-dose Transcatheter Aortic Valve Replacement Planning CT Angiography for the Detection of Coronary Artery Disease. LID - e0824 [pii] LID - 10.1097/RTI.0000000000000824 [doi] AB - PURPOSE: To assess the accuracy of transaortic valve replacement (TAVR) planning CT examinations with a broad detector and a single dose of contrast media to diagnose CAD in a large patient cohort. MATERIALS AND METHODS: In this retrospective study, consecutive patients who underwent a dedicated TAVR planning CT examination with a single contrast media dose and a 320-detector row between November 2017 and March 2021 were screened for inclusion. Inclusion criteria were a complete and correctly performed CT exam as well as an invasive coronary angiography (ICA). The scan consisted of 3 series: (1) ECG-triggered calcium score series over the heart. (2) ECG triggered i.v. CM scanning over the heart covering the entire cardiac cycle (0% to 100%). (3) non-ECG triggered scanning over the thoracic-abdominal area including subclavian and femoral arteries. For 2 and 3, a single i.v. CM bolus was used (300 mg iodine per kg total body weight of iodixanol, minimum 47 mL, maximum 75 mL at 100 kVp; 90 mL at 120 kVp). CT-derived CAD was defined as either free of obstructive CAD (<50%) or showing obstructive disease (>50%), further subclassified in moderate stenosis (50%-70%), or severe stenosis (>70%) for each vessel. ICA data were used as standard of reference. RESULTS: We studied 599 patients (78.6+/-7.5 y, 358 men). In ICA, 428 of 2396 coronary vessels (17.8%) demonstrated stenosis of 50% or more. In a per-patient analysis, CTA had a sensitivity of 97.6% and specificity of 84.3% for the detection of patients with at least one vessel with stenosis of 50% or more as well as a NPV and PPV of 97.8% and 82.2%, respectively. In a per-vessel analysis, CTA had 80.8% sensitivity and 88.1% specificity for the detection of stenosis of 50% or more, as well as an NPV and PPV of 95.5% and 59.6%, respectively. CONCLUSIONS: Single-dose TAVR planning CT imaging with a wide detector has high sensitivity and NPV to exclude at least moderate CAD in TAVR candidates. CI - Copyright (c) 2025 Wolters Kluwer Health, Inc. All rights reserved. FAU - Gassert, Florian T AU - Gassert FT AUID- ORCID: 0000-0003-4126-462 AD - Department of Radiology in Huddinge, Karolinska University Hospital. AD - Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. FAU - Brismar, Torkel B AU - Brismar TB AD - Department of Radiology in Huddinge, Karolinska University Hospital. AD - Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden. FAU - Durukan, Taha AU - Durukan T AD - Department of Radiology in Huddinge, Karolinska University Hospital. AD - Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden. FAU - Themudo, Raquel AU - Themudo R AD - Department of Radiology in Huddinge, Karolinska University Hospital. FAU - Svensson-Marcial, Anders AU - Svensson-Marcial A AD - Department of Radiology in Huddinge, Karolinska University Hospital. AD - Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden. LA - eng PT - Journal Article DEP - 20250701 PL - United States TA - J Thorac Imaging JT - Journal of thoracic imaging JID - 8606160 RN - 0 (Contrast Media) SB - IM MH - Humans MH - Male MH - Female MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/methods MH - *Computed Tomography Angiography/methods MH - *Coronary Artery Disease/diagnostic imaging/complications MH - Contrast Media/administration & dosage MH - Aged, 80 and over MH - Aged MH - Sensitivity and Specificity MH - *Coronary Angiography/methods MH - Reproducibility of Results OTO - NOTNLM OT - computed tomography angiography OT - contrast media OT - coronary angiography OT - coronary artery disease OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2025/02/07 11:12 MHDA- 2025/06/24 13:15 CRDT- 2025/02/07 01:43 PHST- 2025/06/24 13:15 [medline] PHST- 2025/02/07 11:12 [pubmed] PHST- 2025/02/07 01:43 [entrez] AID - 00005382-990000000-00164 [pii] AID - 10.1097/RTI.0000000000000824 [doi] PST - epublish SO - J Thorac Imaging. 2025 Jul 1;40(4):e0824. doi: 10.1097/RTI.0000000000000824. PMID- 39884740 OWN - NLM STAT- MEDLINE DCOM- 20250504 LR - 20250525 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 12 IP - 1 DP - 2025 Jan 30 TI - Impact of porcelain aorta on outcomes in transfemoral aortic valve implantation (TAVI) with balloon-expandable valves. LID - 10.1136/openhrt-2024-003069 [doi] LID - e003069 AB - BACKGROUND: Current guidelines recommend transcatheter aortic valve implantation (TAVI) for patients with aortic stenosis and porcelain aorta (PA). Neurological outcomes of patients with PA undergoing TAVI with modern valves require clarification as most trials examined balloon-expandable valves (BEV) and self-expandable valves in intermediate or high-risk patients, but not specifically in patients with PA. Our aim was to compare outcomes, including stroke and mortality, in well-matched patients with and without PA who received BEV during transfemoral TAVI procedures. METHODS: Consecutive patients undergoing TAVI were entered into a registry. For this single-centre (Zentralklinik Bad Berka, Germany), retrospective analysis, we only selected patients who received BEV. PA diagnosis was made when non-contrast axial CT images fulfilled Valve Academic Research Consortium-2 criteria for PA. There was 2:1 nearest neighbour matching of patients without and with PA. The primary outcome measure was 30-day mortality or stroke within 72 hours. Secondary outcome measures were 30-day mortality, stroke within 72 hours, technical success and 30-day device success. RESULTS: After matching patients with (n=141) and without PA (n=282), the primary outcome of mortality at <30 days or stroke within 72 hours was higher in PA versus non-PA (7.8% vs 2.5%; OR 3.32 (95% CI 1.25 to 8.85); p=0.019). With regard to secondary outcomes, PA was not associated with mortality at 30 days (4.3% vs 2.1%; OR 2.04 (95% CI 0.65 to 6.48); p=0.23); however, stroke within 72 hours was significantly higher in PA versus non-PA (3.5% vs 0.4%; OR 10.33 (95% CI 1.17 to 91.12); p=0.017). Technical and device success were uninfluenced by PA. CONCLUSIONS: Transfemoral TAVI with BEV in patients with PA was associated with a higher risk of the primary combined endpoint of mortality at 30 days or stroke within 72 hours, which was primarily driven by stroke within 72 hours. These findings might influence cerebral embolic protection device use in patients with PA. CI - (c) Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - Lauten, Philipp AU - Lauten P AUID- ORCID: 0000-0001-9997-9201 AD - Heart Center/Structural Heart, Zentralklinik Bad Berka, Bad Berka, Germany philipp.lauten@me.com. AD - Philipps University of Marburg, Marburg, Germany. FAU - Kreutz, Julian AU - Kreutz J AD - Philipps University of Marburg, Marburg, Germany. AD - Department of Cardiology, Angiology, and Intensive Care Medicine, University Hospital of Giessen and Marburg, Marburg, Germany. FAU - Costello-Boerrigter, Lisa C AU - Costello-Boerrigter LC AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. AD - Clinical Research Rhon-Klinikum, Bad Neustadt, Germany. FAU - Schreiber, Mathias AU - Schreiber M AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. FAU - Boerrigter, Guido AU - Boerrigter G AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. FAU - Albert, Christian AU - Albert C AUID- ORCID: 0000-0002-6956-9962 AD - Department of Nephrology, Zentralklinik Bad Berka, Bad Berka, Germany. AD - Otto von Guericke University Magdeburg, Magdeburg, Germany. FAU - El Garhy, Mohammad AU - El Garhy M AUID- ORCID: 0000-0002-8578-0135 AD - Department of Cardiology, Klinikum Hersfeld-Rotenburg, Bad Hersfeld, Germany. FAU - Gobel, Bjorn AU - Gobel B AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. FAU - Schieffer, Bernhard AU - Schieffer B AD - Philipps University of Marburg, Marburg, Germany. AD - Department of Cardiology, Angiology, and Intensive Care Medicine, University Hospital of Giessen and Marburg, Marburg, Germany. FAU - Lapp, Harald AU - Lapp H AD - Philipps University of Marburg, Marburg, Germany. AD - Department of Cardiology and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany. FAU - Owais, Tamer AU - Owais T AD - Cardiac Surgery, Zentralklinik Bad Berka, Augsburg, Germany. AD - Cardiac Surgery, Cairo University, Cairo, Egypt. FAU - Kuntze, Thomas AU - Kuntze T AD - Department of Cardiac Surgery, Central Hospital Bad Berka, Bad Berka, Germany. FAU - Markus, Birgit AU - Markus B AD - Philipps University of Marburg, Marburg, Germany. AD - Department of Cardiology, Angiology, and Intensive Care Medicine, University Hospital of Giessen and Marburg, Marburg, Germany. LA - eng PT - Journal Article DEP - 20250130 PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Humans MH - Male MH - Retrospective Studies MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/complications/diagnosis MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation/methods MH - Female MH - Aged, 80 and over MH - Registries MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - *Aortic Valve/surgery/diagnostic imaging MH - Prosthesis Design MH - Risk Factors MH - Aged MH - Germany/epidemiology MH - Femoral Artery MH - Time Factors MH - *Aortic Diseases/complications/mortality/diagnostic imaging MH - Stroke/etiology MH - Risk Assessment MH - *Balloon Valvuloplasty/mortality/adverse effects MH - *Vascular Calcification/complications/mortality/diagnostic imaging PMC - PMC11784204 OTO - NOTNLM OT - Aortic Diseases OT - Computed Tomography Angiography OT - Heart Valve Prosthesis Implantation COIS- Competing interests: PL received honoraria for lectures by Edwards Lifesciences and Medtronic. EDAT- 2025/01/31 00:21 MHDA- 2025/01/31 00:22 PMCR- 2025/01/30 CRDT- 2025/01/30 21:03 PHST- 2024/11/20 00:00 [received] PHST- 2024/12/31 00:00 [accepted] PHST- 2025/01/31 00:22 [medline] PHST- 2025/01/31 00:21 [pubmed] PHST- 2025/01/30 21:03 [entrez] PHST- 2025/01/30 00:00 [pmc-release] AID - openhrt-2024-003069 [pii] AID - 10.1136/openhrt-2024-003069 [doi] PST - epublish SO - Open Heart. 2025 Jan 30;12(1):e003069. doi: 10.1136/openhrt-2024-003069. PMID- 39869394 OWN - NLM STAT- MEDLINE DCOM- 20250504 LR - 20260925 IS - 1743-9159 (Electronic) IS - 1743-9191 (Print) IS - 1743-9159 (Linking) VI - 111 IP - 3 DP - 2025 Mar 1 TI - Clinical value of aortic arch morphology in transfemoral TAVR: artificial intelligence evaluation. PG - 2338-2347 LID - 10.1097/JS9.0000000000002232 [doi] AB - BACKGROUND: The impact of aortic arch (AA) morphology on the management of the procedural details and the clinical outcomes of the transfemoral artery (TF)-transcatheter aortic valve replacement (TAVR) has not been evaluated. The goal of this study was to evaluate the AA morphology of patients who had TF-TAVR using an artificial intelligence algorithm and then to evaluate its predictive value for clinical outcomes. MATERIALS AND METHODS: A total of 1480 consecutive patients undergoing TF-TAVR using a new-generation transcatheter heart valve at 12 institutes were included in this retrospective study. The AA measurements were evaluated by deep learning, and then the approach index (I A ) was determined. The machine learning algorithm was used to construct the predictive model and was validated externally. RESULTS: The area under the curve of the I A model using random forest and logistic regression was 0.675 [95% confidence interval (CI): 0.586-0.764] and 0.757 (95% CI: 0.665-0.849), respectively. The I A model was validated externally, and consistent distinctions were obtained. After we used a generalized propensity score matching method for continuous exposure, the I A was the strongest correlation factor for major procedural events (odds ratio: 3.87; 95% CI: 2.13-7.59, P < 0.001). When leaflet morphology or transcatheter heart valve type was an interactive item with I A , neither of them was statistically significant in terms of clinical outcomes. CONCLUSION: I A may be used to identify the impact of AA morphology on procedural and clinical outcomes in patients having TF-TAVR and to help to predict the procedural complications. CI - Copyright (c) 2025 The Author(s). Published by Wolters Kluwer Health, Inc. FAU - Mao, Yu AU - Mao Y AD - Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, Shaanxi, China. FAU - Liu, Yang AU - Liu Y AD - Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, Shaanxi, China. FAU - Zhai, Mengen AU - Zhai M AD - Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, Shaanxi, China. FAU - Jin, Ping AU - Jin P AD - Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, Shaanxi, China. FAU - Chen, Fangyao AU - Chen F AD - Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. FAU - Yang, Yuhui AU - Yang Y AD - Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. FAU - Zhu, Guangyu AU - Zhu G AD - School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China. FAU - Yang, Tingting AU - Yang T AD - School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China. FAU - Zhang, Gejun AU - Zhang G AD - Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Xu, Kai AU - Xu K AD - Department of Cardiovascular Surgery, Northern Theater General Hospital, Shenyang, Liaoning, China. FAU - Shang, Xiaoke AU - Shang X AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Zhao, Yuan AU - Zhao Y AD - Department of Cardiac Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China. FAU - Ni, Buqing AU - Ni B AD - Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. FAU - Li, Hongxin AU - Li H AD - Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong, China. FAU - Tang, Min AU - Tang M AD - Department of Cardiovascular Surgery, Xinhua Hospital affiliated to Shanghai Jiaotong University, Shanghai, China. FAU - Jian, Zhao AU - Jian Z AD - Department of Cardiovascular Surgery, Xinqiao Hospital, Chongqing, China. FAU - Yang, Yining AU - Yang Y AD - Heart Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China. FAU - Zhang, Haibo AU - Zhang H AD - Department of Cardiovascular Surgery, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Wei, Lai AU - Wei L AD - Department of Cardiovascular Surgery, Shanghai Cardiovascular Institution and Zhongshan Hospital, Fudan University, Shanghai, China. FAU - Liu, Jian AU - Liu J AD - Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China. FAU - Noterdaeme, Timothee AU - Noterdaeme T AD - Department of cardiovascular surgery, German Heart Center Munich, Munich, Germany. FAU - Lange, Ruediger AU - Lange R AD - Departement of Cardiology, Boulevard Patience et Beaujonc, Liege, Belgium. FAU - Guo, Yingqiang AU - Guo Y AD - Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Pan, Xiangbin AU - Pan X AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Wu, Yongjian AU - Wu Y AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Yang, Jian AU - Yang J AD - Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, Shaanxi, China. LA - eng PT - Journal Article DEP - 20250301 PL - United States TA - Int J Surg JT - International journal of surgery (London, England) JID - 101228232 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Male MH - Female MH - Retrospective Studies MH - *Aorta, Thoracic/diagnostic imaging/anatomy & histology MH - Aged, 80 and over MH - Femoral Artery MH - Aged MH - *Artificial Intelligence MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome PMC - PMC12372727 COIS- The authors have no conflicts of interest to declare. EDAT- 2025/01/27 12:26 MHDA- 2025/03/14 18:28 PMCR- 2025/08/22 CRDT- 2025/01/27 11:53 PHST- 2024/08/22 00:00 [received] PHST- 2024/11/29 00:00 [accepted] PHST- 2025/03/14 18:28 [medline] PHST- 2025/01/27 12:26 [pubmed] PHST- 2025/01/27 11:53 [entrez] PHST- 2025/08/22 00:00 [pmc-release] AID - 01279778-990000000-02099 [pii] AID - IJS-D-24-04543 [pii] AID - 10.1097/JS9.0000000000002232 [doi] PST - epublish SO - Int J Surg. 2025 Mar 1;111(3):2338-2347. doi: 10.1097/JS9.0000000000002232. PMID- 39868608 OWN - NLM STAT- MEDLINE DCOM- 20250504 LR - 20250524 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 105 IP - 5 DP - 2025 Apr TI - Anatomical Predictors of Access-Related Vascular Complications Following Transfemoral Transcatheter Aortic Valve Replacement. PG - 1077-1085 LID - 10.1002/ccd.31422 [doi] AB - BACKGROUND: Access-related vascular complications (VCs) after percutaneous transfemoral transcatheter aortic valve replacement (TAVR) are associated with poor clinical outcomes and remain a significant challenge despite technological advances. The aim of this study was to identify anatomic predictors of access-related VCs after TAVR on preprocedural contrast-enhanced multidetector computed tomography (MDCT). AIMS: The aim of this study was to identify anatomical predictors of access-related VCs after TAVR on preprocedural contrast-enhanced MDCT. METHODS: A total of 348 consecutive patients with symptomatic severe AS who underwent transfemoral TAVR were included retrospectively. The primary endpoint of the study was the composite of minor and major access site complications as defined by the Valve Academic Research Consortium-3 (VARC-3) criteria. The study population was divided into two groups according to the VC including VC (+) and VC (-). RESULTS: A total of 101 patients (29%) developed VC (8.7% major, 20.3% minor) following TAVR. Regression analysis identified severe CFA calcification (p = 0.004), CFA depth (p < 0.001), minimum CFA diameter (p < 0.001), CFA depth-to-diameter ratio >/= 5.6 (p < 0.001), and sheath-to-femoral artery ratio (SFAR) (p < 0.001) as significant predictors of VC. ROC curves generated for the occurrence of VC, the AUC for the femoral artery depth-to-diameter ratio (0.720) was higher than the AUC for the SFAR and the depth of the femoral artery (0.636, 0.630). CONCLUSION: Complications related to vascular access sites continue to be a significant concern for patients undergoing TF-TAVR. The CFA depth-to-diameter ratio has demonstrated superior predictive performance for VC compared to SFAR as expressed in the literature. Utilizing this criterion may enhance risk stratification for VC in high-risk patients, potentially reducing associated morbidity and mortality. CI - (c) 2025 Wiley Periodicals LLC. FAU - Demirci, Gokhan AU - Demirci G AUID- ORCID: 0000-0003-2835-7530 AD - Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Aslan, Serkan AU - Aslan S AD - Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Sahin, Ahmet Anil AU - Sahin AA AUID- ORCID: 0000-0003-1956-2348 AD - Department of Cardiology, Faculty of Medicine, Istanbul Marmara University, Istanbul, Turkey. FAU - Demir, Ali R AU - Demir AR AD - Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Erata, Yunus Emre AU - Erata YE AD - Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Turkmen, Irem AU - Turkmen I AD - Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Kanyilmaz, Mehmet AU - Kanyilmaz M AD - Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Turkvatan, Aysel AU - Turkvatan A AD - Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Erturk, Mehmet AU - Erturk M AD - Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. LA - eng GR - The authors received no specific funding for this work./ PT - Journal Article DEP - 20250127 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - *Femoral Artery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Female MH - Retrospective Studies MH - Aged, 80 and over MH - *Catheterization, Peripheral/adverse effects MH - *Multidetector Computed Tomography MH - Risk Factors MH - Treatment Outcome MH - Punctures MH - Aged MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/physiopathology MH - Risk Assessment MH - Predictive Value of Tests MH - Computed Tomography Angiography MH - Severity of Illness Index MH - *Vascular System Injuries/etiology/diagnostic imaging OTO - NOTNLM OT - transcatheter aortic valve implantation OT - transfemoral approach OT - vascular complications EDAT- 2025/01/27 12:25 MHDA- 2025/04/02 06:26 CRDT- 2025/01/27 07:23 PHST- 2024/12/10 00:00 [revised] PHST- 2024/07/26 00:00 [received] PHST- 2025/01/11 00:00 [accepted] PHST- 2025/04/02 06:26 [medline] PHST- 2025/01/27 12:25 [pubmed] PHST- 2025/01/27 07:23 [entrez] AID - 10.1002/ccd.31422 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Apr;105(5):1077-1085. doi: 10.1002/ccd.31422. Epub 2025 Jan 27. PMID- 39865147 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250129 IS - 2363-9024 (Electronic) IS - 2363-9024 (Linking) VI - 11 IP - 1 DP - 2025 Jan 27 TI - Simultaneous transcatheter aortic valve implantation and femoral osteosynthesis: a case report. PG - 4 LID - 10.1186/s40981-025-00769-w [doi] LID - 4 AB - BACKGROUND: Simultaneous cardiac and non-cardiac surgeries can be beneficial for patients, but there are still few reports on this approach. CASE PRESENTATION: A 90-year-old woman was diagnosed with a femoral trochanteric fracture and severe aortic stenosis. A heart team conference decided to perform transcatheter aortic valve implantation (TAVI) and femoral osteosynthesis under general anesthesia on the same day. A preoperative simulation was conducted to review the surgical procedure and confirm the arrangement of the operating table and instruments. Preoperative management was carried out with attention to the risk of myocardial ischemia caused by bleeding or pain from the fracture. Transfemoral TAVI was completed without trouble, and after the patient was moved to the traction table, osteosynthesis was started. Back-up pacing with a temporary pacemaker was activated for atrioventricular block and bradycardia. After completing the surgery, the patient recovered from anesthesia, and extubation was performed after confirming the absence of paralysis. The patient had no noticeable postoperative complications and successfully underwent rehabilitation. CONCLUSIONS: Through meticulous preparation and perioperative management, we were able to perform TAVI and femoral osteosynthesis simultaneously, achieving a favorable outcome. CI - (c) 2025. The Author(s). FAU - Mitsuta, Yuki AU - Mitsuta Y AUID- ORCID: 0009-0000-6933-8454 AD - Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine-Minami, Higashi-Ku, Kumamoto, 861-8520, Japan. yuu0042001@yahoo.co.jp. FAU - Okamura, Yukiko AU - Okamura Y AD - Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine-Minami, Higashi-Ku, Kumamoto, 861-8520, Japan. FAU - Miyamoto, Yosuke AU - Miyamoto Y AD - Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine-Minami, Higashi-Ku, Kumamoto, 861-8520, Japan. FAU - Tanahira, Dai AU - Tanahira D AD - Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine-Minami, Higashi-Ku, Kumamoto, 861-8520, Japan. LA - eng PT - Journal Article DEP - 20250127 PL - Germany TA - JA Clin Rep JT - JA clinical reports JID - 101682121 PMC - PMC11769877 OTO - NOTNLM OT - Aortic stenosis OT - Hip fracture OT - Osteosynthesis OT - Transcatheter aortic valve implantation COIS- Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Written informed consent was obtained from the patient for publication of this case report. Competing interests: The authors declare that they have no competing interests. EDAT- 2025/01/27 00:20 MHDA- 2025/01/27 00:21 PMCR- 2025/01/27 CRDT- 2025/01/26 23:17 PHST- 2024/11/22 00:00 [received] PHST- 2025/01/18 00:00 [accepted] PHST- 2025/01/10 00:00 [revised] PHST- 2025/01/27 00:21 [medline] PHST- 2025/01/27 00:20 [pubmed] PHST- 2025/01/26 23:17 [entrez] PHST- 2025/01/27 00:00 [pmc-release] AID - 10.1186/s40981-025-00769-w [pii] AID - 769 [pii] AID - 10.1186/s40981-025-00769-w [doi] PST - epublish SO - JA Clin Rep. 2025 Jan 27;11(1):4. doi: 10.1186/s40981-025-00769-w. PMID- 39860509 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250128 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 2 DP - 2025 Jan 14 TI - Analysis of Calcium Patterns in the Thoracic Aorta and Clinical Outcomes of TAVR Patients Presenting with Porcelain Aorta. LID - 10.3390/jcm14020503 [doi] LID - 503 AB - Background/Objectives: In the presence of porcelain aorta (PA), transcatheter aortic valve replacement (TAVR) has become a class I therapeutic indication for the treatment of severe aortic valve stenosis. To date, few studies have analyzed the clinical outcomes of TAVR in PA patients. We aim to analyze the calcification patterns of the thoracic aorta in PA patients and to evaluate their clinical implications for TAVR procedures. Methods: This study included 161 patients who had PA confirmed through pre-operative CT and underwent TAVR between 11/2014 and 12/2022. The primary outcome was to perform a multi-slice CT (MSCT) analysis assessing the calcification in the proximal, middle, and distal thoracic aortic segments. Each segment was divided into quadrants for scoring calcifications on a scale from 1 (<25%) to 4 (>75%). The cohort was categorized into circular or noncircular calcification group. The secondary clinical outcomes were defined according to VARC-3 criteria. Results: The study cohort included 161 patients (median age, 77.2 years; IQR, 70.1-82.6 years). The median EuroSCORE II and STS predicted risk of mortality were 3.10% [1.80-5.58] and 2.70% [1.70-4.30], respectively. In 75% of patients (n = 121/161), TAVR was performed via transfemoral access. Circular calcifications were found in 8.1% of patients, while noncircular calcifications were present in 91.9%. Significant calcifications were primarily in the right quadrant of the proximal segment (33.54%), superior quadrant of the middle segment (39.75%), and left quadrant of the distal segment (73.29%). The 30-day mortality rate was 3.11% and periprocedural ischemic stroke rate 3.38%. Conclusions: Most TAVR patients with PA exhibited noncircular calcification. The most extensive calcifications were primarily in areas relevant to surgical manipulation. Patients with PA displayed low short-term mortality and relatively few stroke events. In view of these findings, TAVR constitutes a valid treatment option for patients with PA and aortic stenosis. FAU - Campanella, Caterina AU - Campanella C AUID- ORCID: 0009-0008-9923-0696 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Voss, Stephanie AU - Voss S AUID- ORCID: 0000-0002-8685-532X AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Schreyer, Julia AU - Schreyer J AUID- ORCID: 0000-0002-0069-911X AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Puluca, Nazan AU - Puluca N AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Amabile, Andrea AU - Amabile A AUID- ORCID: 0000-0003-4689-3871 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. AD - Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA 15260, USA. AD - UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USA. FAU - Wirth, Felix AU - Wirth F AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Krane, Markus AU - Krane M AUID- ORCID: 0000-0002-5466-9290 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, 81377 Munich, Germany. AD - Division of Cardiac Sugery, Department of Surgery, Yale School of Medicine, New Haven, CT 06510, USA. FAU - Ruge, Hendrik AU - Ruge H AUID- ORCID: 0000-0001-6886-3660 AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. LA - eng PT - Journal Article DEP - 20250114 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11766034 OTO - NOTNLM OT - TAVR OT - aortic arch OT - calcifications OT - porcelain aorta COIS- Hendrik Ruge is a physician proctor for Abbott and Edwards Lifesciences; a consultant for Medtronic, Abbott, and Edwards Lifesciences; and a member of the Abbott Advisory Board. Markus Krane is a physician proctor and a member of the medical advisory board for Sanamedi, a physician proctor for Peter Duschek, a medical consultant for EVOTEC and Moderna, and has received speakers' honoraria from EDWARDS, AtriCure, Medtronic, and Terumo. All other authors have no conflicts of interest to declare. EDAT- 2025/01/25 13:52 MHDA- 2025/01/25 13:53 PMCR- 2025/01/14 CRDT- 2025/01/25 01:22 PHST- 2024/12/11 00:00 [received] PHST- 2025/01/10 00:00 [revised] PHST- 2025/01/12 00:00 [accepted] PHST- 2025/01/25 13:53 [medline] PHST- 2025/01/25 13:52 [pubmed] PHST- 2025/01/25 01:22 [entrez] PHST- 2025/01/14 00:00 [pmc-release] AID - jcm14020503 [pii] AID - jcm-14-00503 [pii] AID - 10.3390/jcm14020503 [doi] PST - epublish SO - J Clin Med. 2025 Jan 14;14(2):503. doi: 10.3390/jcm14020503. PMID- 39853899 OWN - NLM STAT- MEDLINE DCOM- 20250503 LR - 20250523 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 105 IP - 5 DP - 2025 Apr TI - Platform Selection for Patients Undergoing Transcatheter Aortic Valve Replacement: A Practical Approach. PG - 1042-1055 LID - 10.1002/ccd.31420 [doi] AB - Transfemoral transcatheter aortic valve Replacement (TAVR) has become the standard therapy for patients with severe aortic stenosis in patients over 75 years old in Europe or 65 years old in the United States, regardless of the surgical risk. Furthermore, iterations of existing transcatheter aortic valves (TAVs), as well as devices with novel concepts, have provided substantial improvements with respect to the limitations of previous-generation devices. Hence, treatment of a broader spectrum of patients has become feasible, and a sophisticated selection of the appropriate TAV tailored to patients' anatomy and comorbidities is now possible. Anatomy, patient characteristics, and operator experience must all inform proper device selection. This review describes the features and performance of the current generation of TAVs with the aim of providing a practical approach for clinicians when selecting the appropriate TAV for a specific patient. CI - (c) 2025 Wiley Periodicals LLC. FAU - Valvo, Roberto AU - Valvo R AUID- ORCID: 0000-0002-7084-188X AD - IRCCS Pol. S. Donato, Milan, Italy. FAU - Popolo Rubbio, Antonio AU - Popolo Rubbio A AUID- ORCID: 0000-0002-2451-4626 AD - IRCCS Pol. S. Donato, Milan, Italy. FAU - Sisinni, Antonio AU - Sisinni A AD - IRCCS Pol. S. Donato, Milan, Italy. FAU - Squillace, Mattia AU - Squillace M AUID- ORCID: 0000-0002-1979-3130 AD - IRCCS Pol. S. Donato, Milan, Italy. FAU - Bedogni, Francesco AU - Bedogni F AUID- ORCID: 0000-0002-4975-6605 AD - IRCCS Pol. S. Donato, Milan, Italy. FAU - Testa, Luca AU - Testa L AUID- ORCID: 0000-0003-4687-3686 AD - IRCCS Pol. S. Donato, Milan, Italy. LA - eng PT - Journal Article PT - Review DEP - 20250124 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging MH - *Patient Selection MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - Prosthesis Design MH - Risk Factors MH - Clinical Decision-Making MH - Severity of Illness Index MH - Risk Assessment MH - Recovery of Function EDAT- 2025/01/24 17:37 MHDA- 2025/04/02 06:26 CRDT- 2025/01/24 11:41 PHST- 2024/12/19 00:00 [revised] PHST- 2024/04/14 00:00 [received] PHST- 2025/01/12 00:00 [accepted] PHST- 2025/04/02 06:26 [medline] PHST- 2025/01/24 17:37 [pubmed] PHST- 2025/01/24 11:41 [entrez] AID - 10.1002/ccd.31420 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Apr;105(5):1042-1055. doi: 10.1002/ccd.31420. Epub 2025 Jan 24. PMID- 39848491 OWN - NLM STAT- Publisher LR - 20250202 IS - 2241-5955 (Electronic) IS - 1109-9666 (Linking) DP - 2025 Jan 21 TI - Sex-specific anatomic differences in patients undergoing transcatheter aortic valve implantation: insights from the ST-TAVI registry. LID - S1109-9666(25)00002-8 [pii] LID - 10.1016/j.hjc.2025.01.002 [doi] AB - OBJECTIVE: The anatomic considerations of transcatheter aortic valve implantation (TAVI) have an important role for the procedure planning; however, sex-specific data are lacking. METHODS: All eligible cases undergoing evaluation for TAVI procedure in the period from November 2019 to July 2023 at the University Hospital of Split were included. Cardiac computed tomography was analyzed to derive the measures of left ventricular outflow tract (LVOT), aortic root, ascending aorta, and ilio-femoral arteries. A sex-based comparison was conducted using the descriptive statistics. RESULTS: There were 140 female (43.8%) and 180 male patients (56.2%). Female patients had smaller dimensions of aortic annulus (area 391.9 vs. 491.5 mm(2), p < 0.001), LVOT (area 373.3 vs. 481.8 mm(2), p < 0.001), and ascending aorta (maximal diameter 32.7 vs. 34.5 mm, p < 0.001), as well as ilio-femoral arteries bilaterally (p < 0.001). There was no significant difference in the proportion of ilio-femoral unfeasibility for transfemoral TAVI procedure, as measured by diameter of ilio-femoral arteries <5.0 mm (9.0% in males vs. 6.1% in females, p = 0.441) and <5.5 mm (24.7% in males vs. 16.7% in females, p = 0.156). Female patients were more likely to receive the smallest valve across different valve platforms (p < 0.001). There were sex-specific differences in the availability of conventional valve sizes across different platforms (p < 0.001). Female patients had significantly higher periprocedural mortality (7.9% vs. 1.7%, p = 0.030), whereas there were no differences in other clinical outcomes and no association of periprocedural mortality with anatomic measures. CONCLUSION: Female patients showed smaller absolute dimensions of LVOT, aortic root, and ilio-femoral arteries than male patients. There were no differences in the prevalence of ilio-femoral unfeasibility for the transfemoral TAVI procedure; however, there were sex-specific differences in the availability of conventional valve sizes across different platforms. Female patients exhibited a higher periprocedural mortality, with no difference in other clinical outcomes. CI - Copyright (c) 2025 Hellenic Society of Cardiology. Publishing services by Elsevier Inc. All rights reserved. FAU - Matetic, Andrija AU - Matetic A AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia; School of Medicine, University of Split, Split 21000, Croatia. FAU - Kristic, Ivica AU - Kristic I AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia. FAU - Crncevic, Nikola AU - Crncevic N AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia. FAU - Zanchi, Jaksa AU - Zanchi J AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia. FAU - Domjanovic Skopinic, Tea AU - Domjanovic Skopinic T AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia. FAU - Bakovic Kramaric, Darija AU - Bakovic Kramaric D AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia; School of Medicine, University of Split, Split 21000, Croatia. FAU - Runjic, Frane AU - Runjic F AD - Department of Cardiology, University Hospital of Split, Split 21000, Croatia. Electronic address: frane.runjic@gmail.com. LA - eng PT - Journal Article DEP - 20250121 PL - Netherlands TA - Hellenic J Cardiol JT - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese JID - 101257381 SB - IM OTO - NOTNLM OT - Anatomical characteristics OT - Multi-slice computed tomography OT - Severe aortic stenosis OT - Sex differences OT - Transcatheter aortic valve implantation COIS- Competing interests None. EDAT- 2025/01/24 00:26 MHDA- 2025/01/24 00:26 CRDT- 2025/01/23 19:16 PHST- 2024/03/29 00:00 [received] PHST- 2025/01/06 00:00 [revised] PHST- 2025/01/14 00:00 [accepted] PHST- 2025/01/24 00:26 [pubmed] PHST- 2025/01/24 00:26 [medline] PHST- 2025/01/23 19:16 [entrez] AID - S1109-9666(25)00002-8 [pii] AID - 10.1016/j.hjc.2025.01.002 [doi] PST - aheadofprint SO - Hellenic J Cardiol. 2025 Jan 21:S1109-9666(25)00002-8. doi: 10.1016/j.hjc.2025.01.002. PMID- 39824346 OWN - NLM STAT- MEDLINE DCOM- 20250910 LR - 20260325 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 170 IP - 3 DP - 2025 Sep TI - Endo-Bentall repair: Early results and feasibility of a physician-constructed Endo-Bentall device. PG - 639-649 LID - S0022-5223(25)00028-5 [pii] LID - 10.1016/j.jtcvs.2024.11.041 [doi] AB - OBJECTIVE: We present our experience with the endovascular Bentall procedure (Endo-Bentall) using a modular valve conduit in high-risk patients with aortic root pathologies. METHODS: The physician-constructed Endo-Bentall device is composed of a self-expanding transcatheter aortic valve (TAVR), thoracic endovascular aortic stent graft (TEVAR), and 2 wire-reinforced fenestrations for coronary artery stenting. The TAVR valve is sutured into an appropriately sized TEVAR graft. The coronary fenestrations are made in the TEVAR graft based on computed tomography angiography measurements. The Endo-Bentall device is then resheathed within the TEVAR delivery system, advanced via femoral access, and deployed during rapid pacing. If persistent endoleak is present after device deployment, the coronary ostia are accessed and stented. No cardiopulmonary support is required. RESULTS: Five patients with prohibitive risk (mean age, 79 years; 4 with type A dissection and 1 with an aortic root aneurysm) underwent Endo-Bentall repair between November 2022 and October 2023. Severe aortic insufficiency was present in 2 patients preoperatively. The median back table modification time was 120 minutes (range, 55-150 minutes). The Endo-Bentall device was successfully implanted in all patients (100%). Two patients required concomitant total endoarch repair. In-hospital mortality was 0%. No patient experienced postoperative stroke. Three patients needed coronary stenting, and 1 patient required permanent pacemaker insertion. On follow-up computed tomography scan (at a median of 172 days; range, 63-368 days), no patient had a type 1a endoleak. No aortic insufficiency was present on follow-up transthoracic echocardiography. CONCLUSIONS: Endo-Bentall repair using a single-stage valve-carrying conduit is feasible and effective, with encouraging early outcomes for highly selected patients with aortic root dissection or aneurysm who are considered not candidates for operation. Long-term follow-up data are needed to assess the persistence of the seal and ongoing durability of this novel technique. CI - Copyright (c) 2025 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. FAU - Ghoreishi, Mehrdad AU - Ghoreishi M AD - Division of Cardiac Surgery, Department of Surgery, Miami Heart Vascular Institution, Miami, Fla. Electronic address: Mehrdad.ghoreishi@gmail.com. FAU - Shah, Aakash AU - Shah A AD - Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md. FAU - Chahal, Diljon AU - Chahal D AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Md. FAU - Kang, Jeanwan AU - Kang J AD - Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md. FAU - Gupta, Anuj AU - Gupta A AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Md. FAU - Taylor, Bradly S AU - Taylor BS AD - Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md. FAU - Toursavadkohi, Shahab AU - Toursavadkohi S AD - Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md. Electronic address: Shahab.Toursavadkohi@som.umaryland.edu. LA - eng PT - Journal Article PT - Video-Audio Media DEP - 20250115 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM MH - Humans MH - Aged MH - Male MH - Female MH - Feasibility Studies MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Endovascular Procedures/instrumentation/adverse effects MH - Aged, 80 and over MH - Treatment Outcome MH - *Aortic Valve/surgery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - *Blood Vessel Prosthesis Implantation/instrumentation/adverse effects MH - *Aortic Dissection/surgery/diagnostic imaging MH - *Blood Vessel Prosthesis MH - Stents MH - Time Factors MH - *Heart Valve Prosthesis Implantation/instrumentation/adverse effects MH - Retrospective Studies OTO - NOTNLM OT - aneurysm OT - dissection OT - transcatheter aortic valve COIS- Conflict of Interest Statement Drs Ghoreishi, Taylor, and Toursavadkohi reported serving as consultants for WL Gore & Associates. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. EDAT- 2025/01/18 15:10 MHDA- 2025/09/11 00:28 CRDT- 2025/01/17 19:15 PHST- 2024/05/19 00:00 [received] PHST- 2024/10/07 00:00 [revised] PHST- 2024/11/05 00:00 [accepted] PHST- 2025/09/11 00:28 [medline] PHST- 2025/01/18 15:10 [pubmed] PHST- 2025/01/17 19:15 [entrez] AID - S0022-5223(25)00028-5 [pii] AID - 10.1016/j.jtcvs.2024.11.041 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2025 Sep;170(3):639-649. doi: 10.1016/j.jtcvs.2024.11.041. Epub 2025 Jan 15. PMID- 39814498 OWN - NLM STAT- MEDLINE DCOM- 20250501 LR - 20260717 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 1 DP - 2025 Jan 13 TI - Surgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Incidence, Trends, and Clinical Outcomes. PG - 89-99 LID - S1936-8798(24)01264-0 [pii] LID - 10.1016/j.jcin.2024.09.050 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) harbors the risk of periprocedural complications that require emergent cardiac surgery, or "surgical bailout." Surgical bailout intends to be lifesaving but is associated with high mortality. This has given rise to discussion on the necessity of surgical backup during TAVR. Therefore, recent studies in contemporary TAVR patients are warranted. OBJECTIVES: This study aimed to assess the incidence, trends, and clinical outcomes of surgical bailout in patients undergoing transfemoral TAVR. METHODS: The CENTER2 (Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation With Balloon-Expandable Valves Versus Self-Expandable Valves 2) study contains patient-level data from 10 clinical studies with patients undergoing TAVR between 2007 and 2022. RESULTS: A total of 24,010 patients undergoing transfemoral TAVR were included. The mean age was 81.5 +/- 6.7 years, and 56% were female. The median Society of Thoracic Surgeons Predicted Risk of Mortality declined over time (2007-2014: 7.1% [Q1-Q3: 4.3%-14.8%] vs 2015-2022: 3.9% [Q1-Q3: 2.6%-6.0%]; P < 0.001). Surgical bailout was reported in 125 (0.52%) patients, and its incidence decreased over time, from 0.84% in 2007 to 2010 to 0.25% in 2019 to 2022 (P(trend) < 0.001). Surgical bailout was more frequently observed in women compared with men (0.61% vs 0.41%; P = 0.03). Ventricular perforation was the most prevalent reason for surgical bailout (28.0%). Patients who underwent surgical bailout reported higher mortality rates during the 1-year follow-up compared with patients without surgical bailout (68.3% vs 15.3%; HR: 8.60; 95% CI: 6.74-10.97; P < 0.001). Interestingly, patients surviving the first 90 days reported a similar mortality risk (HR: 2.19; 95% CI: 0.91-5.27; P = 0.08). CONCLUSIONS: The incidence of surgical bailout is very low in the contemporary TAVR population. Mortality rates remain high among patients requiring surgical bailout during transfemoral TAVR, but this risk diminishes in patients surviving the postprocedural period. (Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation With Balloon-Expandable Valves Versus Self-Expandable Valves 2 [CENTER2]; NCT03588247). CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Aarts, Hugo M AU - Aarts HM AD - Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - van Nieuwkerk, Astrid C AU - van Nieuwkerk AC AD - Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Hemelrijk, Kimberley I AU - Hemelrijk KI AD - Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Salgado Fernandez, Jorge AU - Salgado Fernandez J AD - Complejo Hospitalario Universitario, A Coruna, Spain. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. FAU - de Brito, Fabio S Jr AU - de Brito FS Jr AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore," Enna, Italy. FAU - Kornowski, Ran AU - Kornowski R AD - Cardiology Department, Rabin Medical Center, Petah Tikva, Israel. FAU - Latib, Azeem AU - Latib A AD - Department of Cardiology, Montefiore Medical Center, New York, New York, USA; Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa. FAU - D'Onofrio, Augusto AU - D'Onofrio A AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. FAU - Ribichini, Flavio AU - Ribichini F AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Ferrer, Maria Cruz AU - Ferrer MC AD - Servicio de Cardiologia, Hospital Miguel Servet, Zaragoza, Spain. FAU - Dumonteil, Nicolas AU - Dumonteil N AD - Clinique Pasteur, Toulouse, France. FAU - Abizaid, Alexandre AU - Abizaid A AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Sartori, Samantha AU - Sartori S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - D'Errigo, Paola AU - D'Errigo P AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. FAU - Del Sole, Alberto Paolo AU - Del Sole AP AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Orvin, Katia AU - Orvin K AD - Cardiology Department, Rabin Medical Center, Petah Tikva, Israel. FAU - Pagnesi, Matteo AU - Pagnesi M AD - Institute of Cardiology, Azienda Socio Sanitaria Territoriale Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Pinar, Eduardo AU - Pinar E AD - Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain. FAU - Dangas, George AU - Dangas G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Voskuil, Michiel AU - Voskuil M AD - Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Delewi, Ronak AU - Delewi R AD - Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. Electronic address: r.delewi@amsterdamumc.nl. LA - eng SI - ClinicalTrials.gov/NCT03588247 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/trends/instrumentation MH - Male MH - Aged, 80 and over MH - Incidence MH - Treatment Outcome MH - Risk Factors MH - Aged MH - Time Factors MH - *Femoral Artery/surgery/diagnostic imaging MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality/physiopathology MH - Risk Assessment MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Heart Valve Prosthesis/trends MH - *Catheterization, Peripheral/adverse effects/mortality/trends MH - Prosthesis Design MH - Retrospective Studies OTO - NOTNLM OT - cardiac surgery OT - complications OT - mortality OT - surgical bailout OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures This research was supported by the Netherlands CardioVascular Research Initiative, the Dutch Heart Foundation (CVON 2018-28 and 2012-06 Heart Brain Connection), the Dutch Federation of University Medical Centres, the Netherlands Organisation for Health Research and Development, the Royal Netherlands Academy of Sciences, and the Netherlands Organization for Health Research and Development. Dr de Brito Jr is a proctor for Edwards Lifesciences and Medtronic. Dr Barbanti is a consultant for Edwards Lifesciences; and has received speaker honoraria from Medtronic and Biotronik. Dr Latib is a consultant for Medtronic; and has received honoraria from Abbott Vascular. Dr Pagnesi has received personal fees from Abbott Vascular. Dr Delewi has received educational grants from Boston Scientific, Edwards Lifesciences, and Abiomed. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/01/16 00:20 MHDA- 2025/01/16 00:21 CRDT- 2025/01/15 20:57 PHST- 2024/05/16 00:00 [received] PHST- 2024/09/05 00:00 [revised] PHST- 2024/09/17 00:00 [accepted] PHST- 2025/01/16 00:21 [medline] PHST- 2025/01/16 00:20 [pubmed] PHST- 2025/01/15 20:57 [entrez] AID - S1936-8798(24)01264-0 [pii] AID - 10.1016/j.jcin.2024.09.050 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Jan 13;18(1):89-99. doi: 10.1016/j.jcin.2024.09.050. PMID- 39814494 OWN - NLM STAT- MEDLINE DCOM- 20250115 LR - 20260709 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 1 DP - 2025 Jan 13 TI - Initial Multicenter Experience With a Novel Self-Expanding TAVR System in Patients With Aortic Valve Stenosis. PG - 60-68 LID - S1936-8798(24)01616-9 [pii] LID - 10.1016/j.jcin.2024.10.056 [doi] AB - BACKGROUND: As transcatheter aortic valve replacement is performed increasingly in younger, low-risk patients, the need for commissural alignment and coronary access has increased. Design elements of the JenaValve Trilogy (JVT) transcatheter heart valve (THV) ensure both. OBJECTIVES: This study sought to evaluate the outcome of patients with aortic stenosis (AS) treated with this novel transfemoral, self-expanding THV. METHODS: We included 43 consecutive patients with severe AS treated with the JVT system at 5 German sites. The primary endpoint of the study was technical success of the procedure. Procedural outcomes, hemodynamic valve performance, and clinical outcomes at 30 days were evaluated according to the Valve Academic Research Consortium-3 criteria. RESULTS: The median age was 81 years (Q1-Q3: 77.0-83.9 years) with a median Society of Thoracic Surgeons Risk Score of 3.1% (Q1-Q3: 2.1%-5.9%). Technical success was achieved in 98% (n = 42 of 43). One patient was converted to open surgery. The median aortic gradient was 5.0 mm Hg (Q1-Q3: 4.0-7.0 mm Hg), and no patient had moderate or greater paravalvular regurgitation (88% [n = 37 of 42] with none or trace paravalvular regurgitation). At 30 days, major vascular complications and stroke each occurred in 1 (2.3%) patient, 2 (4.7%) patients had died, and permanent pacemaker implantation was needed in 4.9% (n = 2 of 41). Overall, early safety at 30 days was achieved in 82% (n = 27 of 33) of patients. CONCLUSIONS: Treatment of AS patients with this novel transfemoral THV system is safe and effective. The JVT offers an excellent alternative to established transcatheter aortic valve replacement prostheses for patients with AS. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Tamm, Alexander R AU - Tamm AR AD - Heart Valve Center, Heart and Vascular Center, Universitatsmedizin Mainz, Mainz, Germany. FAU - Wienemann, Hendrik AU - Wienemann H AD - Department of Internal Medicine III - Cardiology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany. FAU - Treede, Hendrik AU - Treede H AD - Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany. FAU - Geyer, Martin AU - Geyer M AD - Heart Valve Center, Heart and Vascular Center, Universitatsmedizin Mainz, Mainz, Germany. FAU - Arnold, Martin AU - Arnold M AD - Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany. FAU - Marwan, Mohamed AU - Marwan M AD - Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany. FAU - Theiss, Hans AU - Theiss H AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Munich, Germany; German Centre for Cardiovascular Research, partner site Munich, Munich, Germany. FAU - Braun, Daniel AU - Braun D AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Munich, Germany; German Centre for Cardiovascular Research, partner site Munich, Munich, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Medizinische Fakultat OWL (Universitat Bielefeld), Bad Oeynhausen, Germany. FAU - Goncharov, Arseniy AU - Goncharov A AD - Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Kuhn, Elmar AU - Kuhn E AD - Department for Cardiothoracic Surgery, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany. FAU - von Bardeleben, Ralph Stephan AU - von Bardeleben RS AD - Heart Valve Center, Heart and Vascular Center, Universitatsmedizin Mainz, Mainz, Germany. FAU - Achenbach, Stephan AU - Achenbach S AD - Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany. FAU - Massberg, Steffen AU - Massberg S AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Munich, Germany; German Centre for Cardiovascular Research, partner site Munich, Munich, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department of Internal Medicine III - Cardiology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany. FAU - Adam, Matti AU - Adam M AD - Department of Internal Medicine III - Cardiology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. Electronic address: trudolph@hdz-nrw.de. LA - eng PT - Journal Article PT - Multicenter Study PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2025 Jan 13;18(1):69-71. doi: 10.1016/j.jcin.2024.11.001. PMID: 39814495 MH - Humans MH - *Aortic Valve Stenosis/physiopathology/surgery/mortality/diagnostic imaging MH - Aged MH - Aged, 80 and over MH - Male MH - Female MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects/mortality MH - Prosthesis Design MH - *Aortic Valve/physiopathology/diagnostic imaging/surgery MH - Time Factors MH - Germany MH - Hemodynamics MH - Risk Factors MH - Severity of Illness Index MH - Recovery of Function MH - Retrospective Studies OTO - NOTNLM OT - TAVR OT - aortic stenosis OT - commissural alignment OT - paravalvular regurgitation OT - permanent pacemaker implantation OT - trilogy COIS- Funding Support and Author Disclosures Dr Tamm has received grants and lecture fees from Edwards Lifesciences, Medtronic, and JenaValve; and proctoring fees for JenaValve. Dr Wienemann has received travel grants from JenaValve. Dr Treede has served as a proctor and advisor for JenaValve. Dr Arnold has served as a proctor for JenaValve; and consultant for Edwards Lifesciences. Dr Braun has received speaker honoraria from Abbott Vascular and Edwards Lifesciences. Dr Kuhn has served on the advisory board for Edwards Lifesciences, Medtronic, and Abbott. Dr von Bardeleben has received lecture and speaker fees from JenaValve, Abbott, Edwards Lifesciences, Medtronic, and Meril. Dr Baldus has received lecture fees from JenaValve and lecture and speaker fees from Edwards Lifesciences. Dr Adam has received lecture or proctoring fees from JenaValve, Abbott, Edwards Lifesciences, and Meril. Dr Rudolph has served as a proctor for JenaValve. All authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/01/16 00:20 MHDA- 2025/01/16 00:21 CRDT- 2025/01/15 20:57 PHST- 2024/05/15 00:00 [received] PHST- 2024/10/10 00:00 [revised] PHST- 2024/10/22 00:00 [accepted] PHST- 2025/01/16 00:21 [medline] PHST- 2025/01/16 00:20 [pubmed] PHST- 2025/01/15 20:57 [entrez] AID - S1936-8798(24)01616-9 [pii] AID - 10.1016/j.jcin.2024.10.056 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Jan 13;18(1):60-68. doi: 10.1016/j.jcin.2024.10.056. PMID- 39800433 OWN - NLM STAT- MEDLINE DCOM- 20250112 LR - 20260521 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 12 IP - 1 DP - 2025 Jan 11 TI - Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement. LID - 10.1136/openhrt-2024-003019 [doi] LID - e003019 AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic valve replacement instead of surgical aortic valve replacement (sAVR). We aimed to examine the impact of diabetes on 30-day mortality, 30-day readmission and compare outcomes between TAVR and sAVR. METHODS: Data were extracted from the Nationwide Readmissions Database from 2012 to 2017. The primary outcome was 30-day mortality, and the secondary outcome was 30-day readmission. RESULTS: The study included 110 135 patients who underwent aortic valve replacement. Of these, 59 466 (54.0%) were hospitalised for TAVR, and 50 669 (46.0%) underwent sAVR. Diabetes was present in 36.4% of TAVR patients and 29.1% of sAVR patients. In TAVR patients, the adjusted risk of 30-day readmission and mortality was similar regardless of diabetes status (aHR=0.94 (0.86-1.03); 0.97 (0.84-1.12); respectively). However, sAVR patients with diabetes had a higher adjusted risk of 30-day mortality (aHR=1.13 (1.01-1.25)) but not readmission (aHR=0.92 (0.84-1.01)). When comparing outcomes between TAVR and sAVR in patients with diabetes, TAVR patients were older and had a higher prevalence of chronic kidney disease (CKD). Nevertheless, 30-day readmission and mortality were lower in patients who underwent TAVR (aHR=0.59 (0.53-0.67), aHR=0.29 (0.25-0.34), respectively) compared with sAVR. Coronary artery disease was the most significant predictor of readmission in patients with diabetes. CKD increased the risk of mortality by almost twofold in both techniques. CONCLUSION: Diabetes increases the risk of short-term mortality in sAVR but not TAVR. Moreover, the incidence of 30-day mortality and readmission is lower in TAVR compared with TAVR among patients with diabetes. CI - (c) Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. FAU - D Souza, Ashton AU - D Souza A AD - Research Department, Weill Cornell Medicine-Qatar, Doha, Qatar. AD - Department of Medicine, Rochester General Hospital, Rochester, NY, USA. FAU - Bsheish, Khalifa AU - Bsheish K AD - Research Department, Weill Cornell Medicine-Qatar, Doha, Qatar. AD - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Dargham, Soha AU - Dargham S AD - Department of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar. AD - Biostatistics core, Weill Cornell Medicine - Qatar, Doha, Qatar. FAU - Jayyousi, Amin AU - Jayyousi A AD - Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar. FAU - Al Suwaidi, Jassim AU - Al Suwaidi J AD - Heart hospital, Hamad Medical Corporation, Doha, Qatar. FAU - Abi Khalil, Charbel AU - Abi Khalil C AUID- ORCID: 0000-0002-1428-6324 AD - Research Department, Weill Cornell Medicine-Qatar, Doha, Qatar cha2022@med.cornell.edu. AD - Heart hospital, Hamad Medical Corporation, Doha, Qatar. AD - Sanford and I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20250111 PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Humans MH - Male MH - Female MH - *Patient Readmission/trends MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Aged, 80 and over MH - Risk Factors MH - Incidence MH - *Aortic Valve Stenosis/surgery/mortality/diagnosis MH - *Diabetes Mellitus/mortality/diagnosis/epidemiology MH - Risk Assessment/methods MH - United States/epidemiology MH - Aged MH - Time Factors MH - Retrospective Studies MH - *Heart Valve Prosthesis Implantation/adverse effects/mortality MH - Treatment Outcome MH - *Postoperative Complications/mortality MH - *Aortic Valve/surgery MH - Survival Rate/trends MH - Databases, Factual MH - Follow-Up Studies PMC - PMC11751899 OTO - NOTNLM OT - Aortic Aneurysm OT - Aortic Diseases OT - Carotid Artery Diseases COIS- Competing interests: None declared. EDAT- 2025/01/13 00:20 MHDA- 2025/01/13 00:21 PMCR- 2025/01/11 CRDT- 2025/01/12 20:53 PHST- 2024/10/15 00:00 [received] PHST- 2024/12/05 00:00 [accepted] PHST- 2025/01/13 00:21 [medline] PHST- 2025/01/13 00:20 [pubmed] PHST- 2025/01/12 20:53 [entrez] PHST- 2025/01/11 00:00 [pmc-release] AID - openhrt-2024-003019 [pii] AID - 10.1136/openhrt-2024-003019 [doi] PST - epublish SO - Open Heart. 2025 Jan 11;12(1):e003019. doi: 10.1136/openhrt-2024-003019. PMID- 39797218 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250113 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 1 DP - 2024 Dec 29 TI - Transfemoral Compared to Transapical Transcatheter Aortic Valve Implantation in Chronic Dialysis-Dependent Patients. LID - 10.3390/jcm14010135 [doi] LID - 135 AB - Introduction: Patients with end-stage kidney disease (ESRD) represent a high-risk population in terms of both development of and death by cardiovascular diseases. Outcome data of ESRD patients with severe aortic valve stenosis (AS) treated by transcatheter aortic valve implantation (AVI) are scarce. We aim to compare the outcome of ESRD patients undergoing transfemoral (TF) or transapical (TA) AVI. Methods: From June 2006 to December 2019, 176 consecutive patients with ESRD receiving chronic hemodialysis underwent TF- or TA-AVI at two German heart centers. The primary outcome measure was 1-year all-cause mortality. Other outcomes included VARC-3 defined device success and early safety. Results: The cohort comprised 61 (34.7%) patients receiving TA-AVI and 115 (65.3%) patients receiving TF-AVI. Perioperative risk, assessed using the EuroScore II, was not different between groups. VARC-3 defined device success (52.5% vs. 80.0%, p < 0.001) and early safety (27.9% vs. 45.2%, p = 0.025) were lower in TA-AVI patients compared to the TF-AVI group. The 30-day mortality was 4.7-fold higher in TA- compared TF-AVI patients (24.6% vs. 5.2%, p < 0.001). The 1-year mortality was higher in TA- compared with TF-AVI patients (57.3% vs. 27.8%, p < 0.001). By applying a Cox regression analysis, it was found that TA-AVI was the only independent factor associated with 1-year all-cause mortality (HR(adj) 2.65 (95%-CI 1.63-4.30), p < 0.001). Conclusions: In ESRD patients, TA-AVI was associated with worse early outcomes and increased mortality up to 1 year compared to the TF-AVI. Transfemoral access is recommended, when feasible, in ESRD patients undergoing TAVI. FAU - Mangner, Norman AU - Mangner N AUID- ORCID: 0000-0003-0793-7923 AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Schrader, Manuela AU - Schrader M AD - Department of Internal Medicine/Cardiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Haussig, Stephan AU - Haussig S AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Kiefer, Philipp AU - Kiefer P AD - Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Leontyev, Sergey AU - Leontyev S AD - Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Kappert, Utz AU - Kappert U AD - Herzzentrum Dresden, Department of Cardiac Surgery, Technische Universitat Dresden, 01307 Dresden, Germany. FAU - Alexiou, Konstantin AU - Alexiou K AD - Herzzentrum Dresden, Department of Cardiac Surgery, Technische Universitat Dresden, 01307 Dresden, Germany. FAU - Crusius, Lisa AU - Crusius L AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Erbs, Sandra AU - Erbs S AD - Department of Internal Medicine/Cardiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Gasior, Tomasz AU - Gasior T AUID- ORCID: 0000-0001-5088-4164 AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. AD - Faculty of Medicine, WSB University, 41-300 Dabrowa Gornicza, Poland. FAU - Steul, Jean-Honore AU - Steul JH AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Goto, Keita AU - Goto K AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Trausch, Anne AU - Trausch A AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Hommel, Jennifer AU - Hommel J AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Department of Internal Medicine/Cardiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Borger, Michael A AU - Borger MA AUID- ORCID: 0000-0003-1046-1364 AD - Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Holzhey, David AU - Holzhey D AD - Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany. FAU - Linke, Axel AU - Linke A AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. FAU - Woitek, Felix J AU - Woitek FJ AD - Herzzentrum Dresden, Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Fetscherstr. 76, 01307 Dresden, Germany. LA - eng PT - Journal Article DEP - 20241229 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11721389 OTO - NOTNLM OT - TAVI OT - aortic stenosis OT - dialysis OT - end-stage renal disease OT - transapical OT - transfemoral COIS- Norman Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, Bayer, Abbott, Abiomed, B. Braun, and Boston Scientific outside the submitted work. Manuela Schrader reports no conflicts of interests. Stephan Haussig reports personal fees from Edwards Lifesciences, Boston Scientific, Cardiac Dimensions, and Bayer outside the submitted work. Philipp Kiefer reports no conflicts of interests. Sergey Leontyev reports no conflicts of interests. Utz Kappert reports no conflicts of interests. Konstantin Alexiou reports no conflicts of interests. Lisa Crusius reports no conflicts of interests. Sandra Erbs reports no conflicts of interests. Tomasz Gasior reports that he is currently an employee at Boehringer Ingelheim. Keita Goto reports no conflicts of interests. Anne Trausch reports no conflicts of interests. Jennifer Hommel reports no conflicts of interests. Mohamed Abdel-Wahab reports that his hospital has received speaker's honoraria and/or consultancy fees on his behalf from Edwards Lifesciences, Boston Scientific, and Medtronic. Michael A. Borger reports that his hospital has received speakers' honoraria and consulting fees from Edwards Lifesciences, Medtronic, and Artivion on his behalf outside the submitted work. David Holzhey reports no conflicts of interests. Axel Linke reports grant support from Edwards Lifesciences, speaker honoraria from Abbott, Abiomed, AstraZeneca, Bayer, Boston Scientific, Corvia, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Meril, Novartis, Pfizer, and MSD, and that he owns stock options from Picardia, Transverse Medical, and Filterlex outside the submitted work. Felix J. Woitek reports personal fees from Abbott, Abiomed, Boston Scientific, Neovasc, Asahi, Biotronik, and Corvia Medical outside the submitted work. EDAT- 2025/01/11 13:59 MHDA- 2025/01/11 14:00 PMCR- 2024/12/29 CRDT- 2025/01/11 01:14 PHST- 2024/11/25 00:00 [received] PHST- 2024/12/17 00:00 [revised] PHST- 2024/12/24 00:00 [accepted] PHST- 2025/01/11 14:00 [medline] PHST- 2025/01/11 13:59 [pubmed] PHST- 2025/01/11 01:14 [entrez] PHST- 2024/12/29 00:00 [pmc-release] AID - jcm14010135 [pii] AID - jcm-14-00135 [pii] AID - 10.3390/jcm14010135 [doi] PST - epublish SO - J Clin Med. 2024 Dec 29;14(1):135. doi: 10.3390/jcm14010135. PMID- 39762512 OWN - NLM STAT- MEDLINE DCOM- 20250429 LR - 20250612 IS - 1868-4297 (Electronic) IS - 1868-4300 (Print) IS - 1868-4297 (Linking) VI - 40 IP - 2 DP - 2025 Apr TI - Early clinical outcomes of transcatheter aortic valve implantation using the NAVITOR system. PG - 378-388 LID - 10.1007/s12928-024-01081-7 [doi] AB - Transcatheter aortic valve implantation (TAVI) using the NAVITOR system has been relatively underreported due to its recent introduction in Japan. This study aimed to assess the short-term outcomes of TAVI with the NAVITOR in real-world clinical practice. Patients with severe aortic stenosis who underwent TAVI using the NAVITOR system at our institution between December 2022 and December 2023 were prospectively enrolled. We evaluated the 30-day post-TAVI outcomes using the Valve Academic Research Consortium 3 (VARC-3). Among 32 consecutive patients (mean age, 84 years; 19% female), technical success was achieved in 31 (96.8%). One patient developed a subclavian artery vascular dissection, requiring balloon angioplasty during the TAVI procedure, and another received a permanent pacemaker due to persistent advanced atrioventricular block. At the 30-day follow-up, device success was achieved in 31 (96.8%) patients, with early safety observed in 27 (84.3%). One patient experienced sudden unexplained death after discharge. None of the patients experienced myocardial infarction, valve embolisation, life-threatening bleeding, or acute kidney injury within 30 days after the procedure. Echocardiographic follow-up showed a median effective orifice area index of 1.26 +/- 0.27. Contrast-enhanced computed tomography was performed in 19 patients 30 days after the procedure, revealing hypo-attenuated leaflet thickening (HALT) in 10 (52.6%). Although the 30-day outcomes of TAVI using the NAVITOR system appeared promising, a relatively high incidence of HALT was observed. CI - (c) 2024. The Author(s). FAU - Fujita, Kosuke AU - Fujita K AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Matsumura, Koichiro AU - Matsumura K AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Sugimoto, Keishiro AU - Sugimoto K AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Onishi, Kyohei AU - Onishi K AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Kakehi, Kazuyoshi AU - Kakehi K AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Yoshida, Ayano AU - Yoshida A AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Kawamura, Takayuki AU - Kawamura T AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Yasuda, Masakazu AU - Yasuda M AD - Division of Cardiology, Sakurabashi Watanabe Advanced Healthcare Hospital, Osaka, Japan. FAU - Matsuzoe, Hiroki AU - Matsuzoe H AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Mizutani, Kazuki AU - Mizutani K AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. AD - Division of Cardiology, Sapporo Cardio Vascular Clinic, Sapporo, Japan. FAU - Miyoshi, Tatsuya AU - Miyoshi T AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Ueno, Masafumi AU - Ueno M AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. FAU - Sakaguchi, Genichi AU - Sakaguchi G AD - Division of Cardiovascular Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Japan. FAU - Nakazawa, Gaku AU - Nakazawa G AUID- ORCID: 0000-0002-6721-1342 AD - Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. gnakazawa@med.kindai.ac.jp. LA - eng PT - Journal Article DEP - 20250106 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/adverse effects MH - Female MH - Male MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/diagnostic imaging MH - Treatment Outcome MH - Aged MH - *Aortic Valve/surgery/diagnostic imaging MH - Prospective Studies MH - Echocardiography MH - Follow-Up Studies PMC - PMC11910440 OTO - NOTNLM OT - Aortic stenosis OT - Hypo-attenuated leaflet thickening OT - NAVITOR system OT - Transcatheter aortic valve implantation COIS- Declarations. Consent to participate: Written informed consent was obtained from all the patients. Consent to publish: Written informed consent was obtained from all the patients. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Kindai University Hospital (R03-040). Conflict of interests: The authors declare no conflicts of interest. EDAT- 2025/01/07 00:21 MHDA- 2025/03/16 11:18 PMCR- 2025/01/06 CRDT- 2025/01/06 23:25 PHST- 2024/09/15 00:00 [received] PHST- 2024/12/23 00:00 [accepted] PHST- 2025/03/16 11:18 [medline] PHST- 2025/01/07 00:21 [pubmed] PHST- 2025/01/06 23:25 [entrez] PHST- 2025/01/06 00:00 [pmc-release] AID - 10.1007/s12928-024-01081-7 [pii] AID - 1081 [pii] AID - 10.1007/s12928-024-01081-7 [doi] PST - ppublish SO - Cardiovasc Interv Ther. 2025 Apr;40(2):378-388. doi: 10.1007/s12928-024-01081-7. Epub 2025 Jan 6. PMID- 39748665 OWN - NLM STAT- MEDLINE DCOM- 20250303 LR - 20250528 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 105 IP - 4 DP - 2025 Mar TI - Impact of Sheath Type on Vascular and Bleeding Complications After Transcatheter Aortic Valve Replacement: A Post Hoc Analysis From the MARVEL Registry Study. PG - 787-794 LID - 10.1002/ccd.31396 [doi] AB - BACKGROUND: Vascular and bleeding complications remain a concern after transfemoral transcatheter aortic valve replacement (TAVR). The impact of the sheath type on these complications remains unclear. METHODS: The prospective MARVEL registry study analyzed enrolled 500 patients undergoing large-bore transfemoral procedures and arteriotomy closure with the MANTA vascular closure device from 10 hospitals in Europe and Canada. We stratified these patients according to type of sheath used (expandable or conventional). A propensity-matched analysis was performed using VARC-2 major or minor vascular and bleeding complications as the primary endpoint. The secondary endpoint was time to hemostasis. RESULTS: We identified 196 propensity-matched pairs. Major vascular complications occurred in 3.6% in the expandable sheath group and 4.1% in the conventional sheath group (p = 1.0). Minor vascular complications occurred in 5.6% in the expandable sheath group and 4.6% in the conventional sheath group (p = 0.819). There were no significant differences in bleeding complications between groups. Time to hemostasis after MANTA closure was significantly shorter in the expandable sheath group (30 vs. 60 s, p < 0.001). CONCLUSIONS: A propensity-matched analysis demonstrated no significant differences in vascular complication rates with MANTA arteriotomy closure after removal of large bore expandable or conventional sheaths. Time to hemostasis was significantly shorter in the expandable sheath group. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Pan, Emily AU - Pan E AUID- ORCID: 0000-0001-9624-6539 AD - Department of Surgery, Central Finland Hospital Nova, Jyvaskyla, Finland. AD - Department of Cardiology, Turku University Hospital, Turku, Finland. FAU - Kroon, Herbert G AU - Kroon HG AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Tonino, Pim A L AU - Tonino PAL AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Amoroso, Giovanni AU - Amoroso G AD - Department of Cardiology, Onze Lieve Vrouwe Hospital, Amsterdam, The Netherlands. FAU - Laine, Mika AU - Laine M AD - Department of Cardiology, Helsinki University Hospital, Helsinki, Finland. FAU - Christiansen, Evald H AU - Christiansen EH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Department of Cardiology, Luzern Kantonsspital, Luzern, Switzerland. FAU - Ten Berg, Jur AU - Ten Berg J AUID- ORCID: 0000-0001-5192-886X AD - Department of Cardiology, St. Antonius Hospital, Utrecht, The Netherlands. FAU - Malmberg, Markus AU - Malmberg M AD - Department of Cardiology, Turku University Hospital, Turku, Finland. FAU - Slagboom, Ton AU - Slagboom T AD - Department of Cardiology, Onze Lieve Vrouwe Hospital, Amsterdam, The Netherlands. FAU - Moriyama, Noriaki AU - Moriyama N AUID- ORCID: 0000-0002-8570-5901 AD - Department of Cardiology, Helsinki University Hospital, Helsinki, Finland. AD - Clinical and Medical Affairs, Teleflex Inc. FAU - Terkelsen, Christian J AU - Terkelsen CJ AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Moccetti, Federico AU - Moccetti F AUID- ORCID: 0000-0002-5794-5676 AD - Department of Cardiology, Luzern Kantonsspital, Luzern, Switzerland. FAU - Gheorghe, Livia AU - Gheorghe L AD - Department of Cardiology, St. Antonius Hospital, Utrecht, The Netherlands. AD - Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Bigelow, Darra AU - Bigelow D AD - Clinical and Medical Affairs, Teleflex Inc. FAU - Webb, John AU - Webb J AD - Department of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada. FAU - Wood, David AU - Wood D AD - Department of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada. FAU - Van Mieghem, Nicholas AU - Van Mieghem N AUID- ORCID: 0000-0002-2732-1205 AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands. FAU - Savontaus, Mikko AU - Savontaus M AD - Department of Cardiology, Turku University Hospital, Turku, Finland. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20250103 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Registries MH - Male MH - Female MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Time Factors MH - Aged, 80 and over MH - Aged MH - Prospective Studies MH - Risk Factors MH - Europe MH - Punctures MH - *Femoral Artery/diagnostic imaging MH - *Vascular Closure Devices MH - *Hemostatic Techniques/instrumentation/adverse effects MH - *Hemorrhage/etiology/prevention & control MH - *Catheterization, Peripheral/adverse effects/instrumentation MH - Equipment Design MH - Canada MH - Risk Assessment MH - *Postoperative Hemorrhage/etiology/prevention & control MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology PMC - PMC11874187 OTO - NOTNLM OT - outcome OT - sheath type OT - transcatheter aortic valve replacement OT - vascular closure device OT - vascular complications COIS- Markus Malmberg has received educational grants from Medtronic, Edwards Lifesciences, and Boston Scientific. Nicolas Van Mieghem received research grant support from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Daiichi Sankyo, Astra Zeneca, Teleflex, PulseCath BV and advisory fees from Anteris, JenaValve, Siemens, Feops, Materialise, Abbott Vascular, Boston Scientific, Medtronic, Daiichi Sankyo, Amgen, Teleflex, PulseCath BV. Noriaki Moriyama has received honoraria from Edwards Lifesciences, Medtronic, Abbott, Daiichi Sankyo, and Boehringer Ingelheim. Mikko Savontaus received advisory fees from Medtronic and Boston Scientific. Stefan Toggweiler has received honoraria from Medtronic, Boston Scientific, Biosensors, Hi-D Imaging, Abbott Vascular, Medira, Shockwave, Teleflex, atHeart Medical, Cardiac Dimensions, Polares Medical, Amarin, Sanofi, AstraZeneca, ReCor Medical, Daiichi Sankyo, has received institutional research grants from Edwards Lifesciences, Abbott Vascular, Boston Scientific, Fumedica, Novartis, Boehringer Ingelheim, Polares Medical, and holds equity in Hi-D Imaging. EDAT- 2025/01/03 06:21 MHDA- 2025/03/03 17:12 PMCR- 2025/03/03 CRDT- 2025/01/03 03:13 PHST- 2024/10/21 00:00 [revised] PHST- 2024/04/13 00:00 [received] PHST- 2024/12/22 00:00 [accepted] PHST- 2025/03/03 17:12 [medline] PHST- 2025/01/03 06:21 [pubmed] PHST- 2025/01/03 03:13 [entrez] PHST- 2025/03/03 00:00 [pmc-release] AID - CCD31396 [pii] AID - 10.1002/ccd.31396 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Mar;105(4):787-794. doi: 10.1002/ccd.31396. Epub 2025 Jan 3. PMID- 39737477 OWN - NLM STAT- MEDLINE DCOM- 20250429 LR - 20250520 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 105 IP - 4 DP - 2025 Mar TI - Anatomy of Risk: Decoding the Predictors of Vascular Access Complications in Transcatheter Aortic Valve Replacement. PG - 725-734 LID - 10.1002/ccd.31397 [doi] AB - BACKGROUND: Despite advancements in valve implantation devices, vascular access complications (VAC) remain a significant cause of morbidity and mortality for those undergoing transcatheter aortic valve replacement (TAVR). We describe pre-operative imaging analysis of the aortoiliac and femoral arterial beds using the TransAtlantic intersociety consensus (TASC) score, ilio-femoral tortuosity, and procedural characteristics to identify anatomic risk factors predictive of VAC in TAVR. METHODS: Consecutive patients undergoing TAVR from 2012 to 2022 at a single North Dakota hospital were retrospectively reviewed. Pre-operative computed tomography angiography (CTA) was used for vascular analysis of the infrarenal aorta, iliac, and femoral vascular beds. Wilcoxon signed-rank test was used for non-normally distributed or t-test for normally distributed continuous variables and Chi-square or Fisher's exact tests for categorical variables were utilized to examine the association of each variable with vascular complications. RESULTS: One thousand eighty-nine patients were evaluated with 80 patients identified with VAC. Aortoiliac disease burden of the iliac arteries and posterior wall calcification of the common femoral artery (CFA) were predictive of VAC. Iliofemoral tortuosity and skin to CFA depth were not. Left sided CFA versus right CFA access was associated (p < 0.001). Pretreatment of diseased iliac vessels decreased odds of VAC (OR 0.21, 95% CI, 0.08-0.56). CONCLUSION: Our study highlights the importance of preoperative peripheral vascular assessment for TAVR. We identify aortoiliac disease burden, posterior CFA calcification, and left sided common femoral access as risk factors for VAC. A structured approach to the preoperative assessment may optimize planning and enhance outcomes in TAVR. CI - (c) 2024 Wiley Periodicals LLC. FAU - Row, Hunter T AU - Row HT AUID- ORCID: 0000-0003-0956-0218 AD - Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States. FAU - Edwards, Anyamaria AU - Edwards A AD - Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States. FAU - Beaudrie, Johnathan AU - Beaudrie J AD - Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States. FAU - Sahmoun, Abe AU - Sahmoun A AD - Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States. FAU - Reil, Todd AU - Reil T AD - Departments of Surgery and Cardiology, Sanford Health, Fargo, North Dakota, United States. FAU - Haldis, Thomas AU - Haldis T AD - Departments of Surgery and Cardiology, Sanford Health, Fargo, North Dakota, United States. FAU - Dyke, Cornelius AU - Dyke C AD - Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States. AD - Departments of Surgery and Cardiology, Sanford Health, Fargo, North Dakota, United States. LA - eng GR - Support for study obtained through the Sanford Surgical Research Fellowship from Sanford Health, and the Research Experience for Medical Students (REMS) program through the University of North Dakota School of Medicine and Health Sciences./ PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20241230 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Risk Factors MH - Retrospective Studies MH - *Femoral Artery/diagnostic imaging MH - Male MH - Female MH - *Iliac Artery/diagnostic imaging MH - Aged, 80 and over MH - Treatment Outcome MH - *Catheterization, Peripheral/adverse effects MH - Aged MH - Risk Assessment MH - *Computed Tomography Angiography MH - Predictive Value of Tests MH - Punctures MH - Aortography MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/physiopathology OTO - NOTNLM OT - structural heart disease OT - transAtlantic intersociety consensus (TASC) OT - transcatheter aortic valve replacement (TAVR) EDAT- 2024/12/31 11:04 MHDA- 2025/03/03 17:12 CRDT- 2024/12/31 04:42 PHST- 2024/10/15 00:00 [revised] PHST- 2024/05/15 00:00 [received] PHST- 2024/12/22 00:00 [accepted] PHST- 2025/03/03 17:12 [medline] PHST- 2024/12/31 11:04 [pubmed] PHST- 2024/12/31 04:42 [entrez] AID - 10.1002/ccd.31397 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Mar;105(4):725-734. doi: 10.1002/ccd.31397. Epub 2024 Dec 30. PMID- 39736642 OWN - NLM STAT- MEDLINE DCOM- 20241231 LR - 20250104 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 19 IP - 1 DP - 2024 Dec 30 TI - Potential of right ventricular function assessment with echocardiography in transcatheter aortic valve replacement. PG - 686 LID - 10.1186/s13019-024-03198-5 [doi] LID - 686 AB - BACKGROUND: Right ventricular (RV) function assessment by echocardiography can be challenging due to its complex morphology. Also, increasing use of sedation rather than general anesthesia for transfemoral approach transcatheter aortic valve replacement (TAVR) reduces the need for intraoperative transesophageal echocardiography (TEE). Recent clinical studies have demonstrated the importance of 3-dimensional (3D) echocardiography and a longitudinal strain for RV function assessment. In this study, we compared RV function echocardiographic assessment methodologies in TAVR and investigated its clinical utility. METHODS: This was a prospective, observational study of TAVR at a large academic hospital. Inclusion criteria were adult patients undergoing TAVR requiring intraoperative TEE between April 2023 and October 2023. Exclusion criteria include an absolute contraindication to TEE, a pacemaker, or suboptimal intraoperative echocardiography images. The primary goal is to assess the correlation of 3D RV ejection fraction (EF) with RV fraction area change (FAC), and tricuspid annular plane systolic excursion (TAPSE). The secondary goal is to assess the correlation of RV free wall longitudinal strain (FWLS) with any newly diagnosed postoperative ventricular arrhythmia, including complete atrioventricular block (CAVB) and left bundle branch block (LBBB). RESULTS: Among 33 patients who underwent TAVR, 4 patients were excluded due to poor image quality, and 7 patients were excluded due to existing pacemaker. Thus, data for 22 patients were analyzed in this study. There was a good correlation between 3D RVEF and RV FAC (correlation coefficient 0.789. p = 0.0000482), but poor correlation between 3D RVEF and TAPSE (correlation coefficient 0.182. p = 0.444). Eight patients developed a new left or right BBB and CAVB postoperatively, and 3 patients required permanent pacemaker. Regression analysis of pre and post valve deployment showed RV free wall RVFWLS was each correlated with postoperative new BBB or CAVB (pre valve deployment: hazard ratio 1.272, 95% CI 1.075 to 1.505, p = 0.004981; post valve deployment: hazard ratio 1.134, 95% CI 1.001 to 1.286, p = 0.04846). No mortality was reported during the follow-up period, and no significant tricuspid regurgitation (more than moderate) was reported. CONCLUSION: 3D RVEF and RV FAC showed a good correlation. Intraoperative RVFWLS has the potential to predict postoperative new occurrence of BBB or CAVB. CI - (c) 2024. The Author(s). FAU - Morita, Yoshihisa AU - Morita Y AD - Department of Anesthesiology, Thomas Jefferson University, 111 South 11th St Gibbon Building, Suite 8280, Philadelphia, PA, 19107, USA. Yoshihisa.morita@jefferson.edu. FAU - Kariya, Taro AU - Kariya T AD - Department of Anesthesiology, University of Tokyo, Tokyo, 113-8654, Japan. FAU - Dougherty, Michael AU - Dougherty M AD - Department of Anesthesiology, University of Tokyo, Tokyo, 113-8654, Japan. FAU - Peters, Andrew AU - Peters A AD - Department of Cardiology, Thomas Jefferson University, Philadelphia, PA, 19107, USA. FAU - Ruggiero, Nicholas AU - Ruggiero N AD - Department of Cardiology, Thomas Jefferson University, Philadelphia, PA, 19107, USA. LA - eng PT - Journal Article PT - Observational Study DEP - 20241230 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Prospective Studies MH - Male MH - Female MH - *Ventricular Function, Right/physiology MH - Aged MH - Aged, 80 and over MH - *Echocardiography, Three-Dimensional/methods MH - Aortic Valve Stenosis/surgery MH - Heart Ventricles/diagnostic imaging/physiopathology MH - Echocardiography, Transesophageal/methods PMC - PMC11684122 OTO - NOTNLM OT - Atrioventricular block OT - Right ventricular function OT - Speckle track echocardiography OT - Transcatheter aortic valve replacement COIS- Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board of Thomas Jeferson University (IRB # iRISID-2022-0802) and verbal consent was obtained from all the participants before enrollment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2024/12/31 00:19 MHDA- 2024/12/31 11:04 PMCR- 2024/12/30 CRDT- 2024/12/30 23:52 PHST- 2024/07/31 00:00 [received] PHST- 2024/12/19 00:00 [accepted] PHST- 2024/12/31 11:04 [medline] PHST- 2024/12/31 00:19 [pubmed] PHST- 2024/12/30 23:52 [entrez] PHST- 2024/12/30 00:00 [pmc-release] AID - 10.1186/s13019-024-03198-5 [pii] AID - 3198 [pii] AID - 10.1186/s13019-024-03198-5 [doi] PST - epublish SO - J Cardiothorac Surg. 2024 Dec 30;19(1):686. doi: 10.1186/s13019-024-03198-5. PMID- 39722273 OWN - NLM STAT- MEDLINE DCOM- 20241226 LR - 20260709 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 24 DP - 2024 Dec 23 TI - Femoral or Radial Secondary Access in TAVR: A Subanalysis From the Multicenter PULSE Registry. PG - 2923-2932 LID - S1936-8798(24)01205-6 [pii] LID - 10.1016/j.jcin.2024.09.020 [doi] AB - BACKGROUND: Transradial secondary access (TR-SA) may serve as an alternative to the traditional femoral secondary access (TF-SA) for pigtail placement in transcatheter aortic valve replacement (TAVR). OBJECTIVES: The aim of this study was to assess the incidence of secondary access-related vascular complications after TR-SA or TF-SA in TAVR. METHODS: The PULSE (Plug or sUture based vascuLar cloSurE after TAVR) registry retrospectively evaluated data of 10,120 patients who underwent transfemoral TAVR at 10 heart centers from 2016 to 2021. We compared TR-SA and TF-SA groups of 8,851 patients with available data regarding the secondary access location and validated observed data in 1:1 propensity score matching. Outcomes were evaluated according to Valve Academic Research Consortium 3 definitions. RESULTS: The median age was 82.0 +/- 6.9 years, and 49.1% (4,346/8,851) of patients were female. TR-SA was selected in 1,686 patients (19.0%) and TF-SA in 7,165 (81.0%) overall. Vascular complications at the secondary access occurred in 0.3% (5/1,686 [TR-SA]) vs 3.2% (232/7,165 [TF-SA]; P < 0.001) and were considered major in 0.2% (3/1,686 [TR-SA]) vs 1.5% (109/7,165 [TF-SA]) and minor in 0.1% (2/1,686 [TR-SA]) vs 1.7% (123/7,165 [TF-SA]; P < 0.001 for both). Surgical repair was required in 0 TR-SA patients and in 0.9% (66/7,165) of TF-SA patients. Primary access vascular complications were similar (11.6% (196/1,686 [TR-SA]) vs 11.5% (825/7,165 [TF-SA]); P = 0.93); bleeding type III/IV occurred less with TR-SA (2.5% [42/1,686] vs 4.7% [334/7,165] with TF-SA; P < 0.001). After propensity score matching, secondary access-related vascular complication rates remained lower for TR-SA (0.2% [1/512] vs 2.9% [15/512] for TF-SA; P < 0.001). CONCLUSIONS: During transfemoral TAVR, TR-SA was associated with lower rates of access site complications and severe bleeding compared to TF-SA. In fact, secondary access-related complications were 10x higher for TF-SA and frequently required invasive treatments. These findings challenge the fact that most TAVR procedures are still performed with TF-SA. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: d.grundmann@uke.de. FAU - Kim, Won AU - Kim W AD - Department of Cardiology/Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Kellner, Caroline AU - Kellner C AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Adam, Matti AU - Adam M AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und Internistische Intensivmedizin, Koln, Germany. FAU - Braun, Daniel AU - Braun D AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany. FAU - Tamm, Alexander R AU - Tamm AR AD - Zentrum fur Kardiologie, Kardiologie I, Universitatsmedizin Mainz, Mainz, Germany. FAU - Meertens, Max AU - Meertens M AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und Internistische Intensivmedizin, Koln, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology/Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Gmeiner, Jonas AU - Gmeiner J AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany. FAU - Sedaghat, Alexander AU - Sedaghat A AD - Medizinische Klinik II-Kardiologie, Universitatsklinikum Bonn, Bonn, Germany. FAU - Leistner, David AU - Leistner D AD - Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik fur Kardiologie, Berlin, Germany; Medizinische Klinik III-Kardiologie, Universitatsklinikum Frankfurt, Frankfurt, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Rhein-Main, Germany. FAU - Renker, Matthias AU - Renker M AD - Department of Cardiology/Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Wienemann, Hendrik AU - Wienemann H AD - University Hospital Cologne-Heart Center, Klinik III fur Innere Medizin-Kardiologie, Pneumologie und Internistische Intensivmedizin, Koln, Germany. FAU - Charitos, Efstratios AU - Charitos E AD - Department of Cardiology/Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Linnemann, Marie AU - Linnemann M AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany. FAU - Zapustas, Norvydas AU - Zapustas N AD - Helios Universitatsklinikum Wuppertal-Herzzentrum Universitat Witten/Herdecke, Witten, North Rhine-Westphalia, Germany. FAU - Juri, Benjamin AU - Juri B AD - Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik fur Kardiologie, Berlin, Germany; Department of Cardiology, University Hospital Zurich, Zurich, Switzerland. FAU - Salem, Mostafa AU - Salem M AD - Klinik fur Innere Medizin III, Schwerpunkte Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Kiel, Germany. FAU - Dreger, Henryk AU - Dreger H AD - Deutsches Herzzentrum der Charite, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Berlin, Germany; Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. FAU - Gossling, Alina AU - Gossling A AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Nahif, Awesta AU - Nahif A AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Cardiac Surgery, University Hospital Cologne, Koln, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Schafer, Andreas AU - Schafer A AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. FAU - Popara, Jasmin AU - Popara J AD - Klinik fur Innere Medizin III, Schwerpunkte Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Kiel, Germany. FAU - Sudo, Misumasa AU - Sudo M AD - Medizinische Klinik II-Kardiologie, Universitatsklinikum Bonn, Bonn, Germany. FAU - Potratz, Max AU - Potratz M AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Geyer, Martin AU - Geyer M AD - Zentrum fur Kardiologie, Kardiologie I, Universitatsmedizin Mainz, Mainz, Germany. FAU - Vorpahl, Marc AU - Vorpahl M AD - Helios Universitatsklinikum Wuppertal-Herzzentrum Universitat Witten/Herdecke, Witten, North Rhine-Westphalia, Germany; Helios Klinikum Siegburg, University of Witten/Herdecke, Siegburg, Germany. FAU - Frank, Derk AU - Frank D AD - Klinik fur Innere Medizin III, Schwerpunkte Kardiologie, Angiologie und Intensivmedizin, Universitatsklinikum Schleswig-Holstein, Kiel, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, Lubeck, Germany. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, Lubeck, Germany; BG University Hospital Bergmannsheil, Bochum, Germany. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Dec 23;17(24):2933-2935. doi: 10.1016/j.jcin.2024.10.050. PMID: 39722274 MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - *Catheterization, Peripheral/adverse effects MH - Europe MH - *Femoral Artery/diagnostic imaging MH - Hemostatic Techniques/adverse effects/instrumentation MH - *Punctures MH - *Radial Artery MH - *Registries MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - TAVR OT - access OT - femoral OT - radial OT - secondary COIS- Funding Support and Author Disclosures Dr Kim has received personal fees from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Meril Life Sciences, and Shockwave Med. Dr Adam has received consultancy or speaker fees from Abbott, Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic; and is a proctor for Abbott, JenaValve, and Medtronic. Dr Braun has received speaker fees from Abbott Vascular and Edwards Lifesciences. Dr Tamm has received consultancy or speaker fees from Edwards Lifesciences, JenaValve, and Medtronic; and is a proctor for JenaValve. Dr Bleiziffer has received speaker fees from Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Leistner has received speaker and advisory fees from Abbott. Dr Dreger has received proctoring, speaker, and advisory fees from Abbott and Edwards Lifesciences; and has received research support from Abbott. Dr Conradi has received advisory fees from Abbott, Medtronic, and JenaValve; and has received consulting fees from Edwards Lifesciences, Boston Scientific, MicroPort, PiCardia, MicroInterventions, VenusMedtech, and Smartcanula Sarl. Dr Schafer has received speaker fees and/or travel support from Edwards Lifesciences, Abbott, and Boston Scientific unrelated to the submitted work. Dr Geyer has received consultancy or speaker fees from Edwards Lifesciences; and is a proctor for JenaValve. Dr Rudolph has received speaker and advisory fees from Abbott, Edwards Lifesciences, JenaValve, Boston Scientific, Medtronic, and Amgen. Dr Seiffert has received speaker or advisory fees from Abbott Vascular, Abiomed, Amgen, AstraZeneca, Boston Scientific, Bristol Myers Squibb, Daichii-Sankyo, Edwards Lifesciences, Inari Medical, Medtronic, Pfizer, Shockwave Medical, and Siemens Healthineers; and has received a research grant from Boston Scientific all unrelated to the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/12/26 06:20 MHDA- 2024/12/26 06:21 CRDT- 2024/12/26 01:09 PHST- 2024/04/07 00:00 [received] PHST- 2024/09/02 00:00 [revised] PHST- 2024/09/10 00:00 [accepted] PHST- 2024/12/26 06:21 [medline] PHST- 2024/12/26 06:20 [pubmed] PHST- 2024/12/26 01:09 [entrez] AID - S1936-8798(24)01205-6 [pii] AID - 10.1016/j.jcin.2024.09.020 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Dec 23;17(24):2923-2932. doi: 10.1016/j.jcin.2024.09.020. PMID- 39718156 OWN - NLM STAT- MEDLINE DCOM- 20250217 LR - 20250519 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 105 IP - 3 DP - 2025 Feb TI - Transcatheter Aortic Valve Implantation in Small and Very Small Aortic Valve Annuli: A Propensity-Matched Analysis Between Self-Expanding Versus Balloon-Expandable Valves. PG - 624-632 LID - 10.1002/ccd.31374 [doi] AB - BACKGROUND: The management of Transcatheter Aortic Valve Implantation (TAVI) patients with a small aortic annulus (SAA) postures a substantial challenge, increasing the risk of patient- prosthesis mismatch (PPM) and overall mortality. AIMS: This study aimed to compare the hemodynamic and clinical outcomes of transcatheter balloon-expandable valve (BEV) versus transcatheter self-expandable valve (SEV) in SAA. METHODS: We conducted propensity score matching (PSM) of severe AS patients with SAA who underwent trans-femoral TAVR and enrolled to the Israeli TAVR registry between the years 2008 and 2023. SAA was defined as an aortic-valve annulus area 3 months, respectively) DAPT group. Propensity score matching was used to balance baseline characteristics. The primary endpoint was the occurrence of net adverse clinical events (NACEs), including all-cause death, myocardial infarction, stroke, any coronary and peripheral revascularization, systemic thromboembolism, and bleeding events, at 1 year. Survival analyses were conducted using Kaplan-Meier estimation and Cox proportional hazards regression. RESULTS: Patients who met the inclusion criteria (1,695) were selected. Propensity score matching yielded 1,215 pairs of patients: 416 and 799 in the short- and long-term DAPT groups, respectively. In the unmatched cohort, the mean ages were 79.8 +/- 6.1 and 79.7 +/- 5.8 years for the short- and long-term DAPT groups, respectively. In the matched cohort, the mean ages were 80.6 +/- 5.9 and 79.9 +/- 5.9 years for the short- and long-term DAPT groups, respectively. Over one year in the unmatched cohort, the NACE incidence was 11.9% and 11.5% in the short- and long-term DAPT groups, respectively (P = 0.893). The all-cause mortality rates were 7.4% and 4.7% (P = 0.042), composite ischemic event rates were 2.5% and 4.7% (P = 0.056), and bleeding event rates were 2.7% and 4.7% (P = 0.056) in the short- and long-term groups, respectively. In the matched cohort, the incidence of NACE was 9.6% in the short-term DAPT group and 11.6% in the long-term DAPT group, respectively (P = 0.329). The all-cause mortality rates were 6.5% and 4.9% (P = 0.298), composite ischemic event rates were 1.4% and 4.5% (P = 0.009), and bleeding event rates were 2.2% and 4.4% (P = 0.072) in the short- and long-term groups, respectively. CONCLUSION: In patients who successfully underwent transfemoral TAVR, the short- and long-term DAPT groups exhibited similar one-year NACE rates. However, patients in the long-term DAPT group experienced more bleeding and ischemic events. CI - (c) 2024 The Korean Academy of Medical Sciences. FAU - Oh, Jun-Hyok AU - Oh JH AUID- ORCID: 0000-0002-5775-5821 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Kim, Jinmi AU - Kim J AUID- ORCID: 0000-0002-6715-0447 AD - Department of Biostatistics, Clinical Trial Center, Biomedical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Kim, Jeong-Su AU - Kim JS AUID- ORCID: 0000-0001-6877-4289 AD - Department of Internal Medicine, Pusan National University School of Medicine, Cardiology, Cardiovascular Center and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea. j25ngsukim@gmail.com. FAU - Lee, Hye Won AU - Lee HW AUID- ORCID: 0000-0003-4372-153X AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Lee, Sun Hack AU - Lee SH AUID- ORCID: 0000-0002-6809-2664 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Choe, Jeong Cheon AU - Choe JC AUID- ORCID: 0000-0003-0980-0429 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Kim, Min Sun AU - Kim MS AUID- ORCID: 0000-0002-7693-4657 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Ahn, Jinhee AU - Ahn J AUID- ORCID: 0000-0001-6179-1254 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Choi, Jung Hyun AU - Choi JH AUID- ORCID: 0000-0001-7171-8843 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Lee, Han Cheol AU - Lee HC AUID- ORCID: 0000-0002-7236-4204 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. FAU - Cha, Kwang Soo AU - Cha KS AUID- ORCID: 0000-0001-7980-4578 AD - Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Pusan, Korea. LA - eng GR - Samjin Pharmaceutical Co./Korea PT - Comparative Study PT - Journal Article DEP - 20241209 PL - Korea (South) TA - J Korean Med Sci JT - Journal of Korean medical science JID - 8703518 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Female MH - Aged MH - *Platelet Aggregation Inhibitors/therapeutic use MH - Aged, 80 and over MH - *Propensity Score MH - *Kaplan-Meier Estimate MH - Treatment Outcome MH - Hemorrhage MH - Proportional Hazards Models MH - Dual Anti-Platelet Therapy MH - Stroke/etiology MH - Myocardial Infarction/mortality MH - Retrospective Studies MH - Thromboembolism/prevention & control/etiology PMC - PMC11628237 OTO - NOTNLM OT - Dual Anti-Platelet Therapy OT - Hemorrhage OT - Ischemia OT - Transcatheter Aortic Valve Replacement COIS- The authors have no potential conflicts of interest to disclose. EDAT- 2024/12/12 00:24 MHDA- 2024/12/12 00:25 PMCR- 2024/12/09 CRDT- 2024/12/11 19:03 PHST- 2024/04/28 00:00 [received] PHST- 2024/08/29 00:00 [accepted] PHST- 2024/12/12 00:25 [medline] PHST- 2024/12/12 00:24 [pubmed] PHST- 2024/12/11 19:03 [entrez] PHST- 2024/12/09 00:00 [pmc-release] AID - 39.e294 [pii] AID - 10.3346/jkms.2024.39.e294 [doi] PST - epublish SO - J Korean Med Sci. 2024 Dec 9;39(47):e294. doi: 10.3346/jkms.2024.39.e294. PMID- 39617051 OWN - NLM STAT- MEDLINE DCOM- 20250212 LR - 20260518 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 41 IP - 2 DP - 2025 Feb TI - Five-Year Multiple Comparison of Transcatheter Aortic Valves: Insights From the OBSERVANT II study. PG - 264-271 LID - S0828-282X(24)01229-7 [pii] LID - 10.1016/j.cjca.2024.10.026 [doi] AB - BACKGROUND: Head-to-head comparisons of second and third generations of transcatheter heart valves (THVs) are mostly limited to 2-arm studies and to mid-term follow-up. The aim of this study was to simultaneously compare clinical outcomes of transcatheter aortic valve replacement (TAVR) with 4 different THVs at 5 years. METHODS: Patients undergoing transfemoral TAVR with 4 second-generation THV platforms and enrolled in the multicentre prospective OBSERVANT II study from December 2016 to September 2018 were compared according to the THV received. Outcomes were adjudicated through a linkage with administrative databases and adjusted by means of inverse propensity of treatment weighting (IPTW) based on propensity score. The primary end points were death from any cause and major adverse cardiac and cerebrovascular events (MACCE) at 5 years. Cumulative rates were reported consecutively for Evolut R/Pro, Sapien 3, Acurate Neo, and Portico groups. RESULTS: A total of 2493 patients were considered. The median age was 83 years and median EuroSCORE 2 was 4.9%. After IPTW adjustment, the rates of all-cause death (53.6%, 46.7%, 50.5%, and 46.3%; P = 0.06) and MACCE (57.2%, 51.2%, 54.4%, and 50.6%; P = 0.08) did not differ among the groups at 5 years. The rate of rehospitalisation for heart failure (HF) (33.9%, 27.0%, 31.6%, 33.7%; P = 0.02) was significantly lower for Sapien 3 at 5 years. CONCLUSIONS: Data from real-world practice showed sustained and similar effectiveness of TAVR considering all the available THVs up to 5 years, but Sapien 3 showed a lower rate of rehospitalisation for HF. CI - Copyright (c) 2024 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, AOU Policlinico "G. Rodolico-San Marco," University of Catania, Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore," Enna, Italy; Division of Cardiology, Umberto I Hospital, ASP 4 di Enna, Enna, Italy. Electronic address: mbarbanti83@gmail.com. FAU - Rosato, Stefano AU - Rosato S AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Division of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padova, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, AOU Policlinico "G. Rodolico-San Marco," University of Catania, Catania, Italy. FAU - Biancari, Fausto AU - Biancari F AD - Department of Medicine, South Karelja Central Hospital, University of Helsinki, Lappeenranta, Finland. FAU - Badoni, Gabriella AU - Badoni G AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. FAU - Santoro, Gennaro AU - Santoro G AD - Fondazione "G. Monasterio" CNR/Regione Toscana per la Ricerca Medica e la Sanita Pubblica, Massa, Italy. FAU - Baiocchi, Massimo AU - Baiocchi M AD - Anestesia e Rianimazione Dipartimento Cardiotoracovascolare, IRCSS Policlinico S Orsola, Universita degli Studi di Bologna, Bologna, Italy. FAU - Baglio, Giovanni AU - Baglio G AD - Italian National Agency for Regional Health Care Services, Rome, Italy. FAU - D'Errigo, Paola AU - D'Errigo P AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. CN - OBSERVANT II Research Group LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20241129 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery/diagnosis MH - Aged, 80 and over MH - *Heart Valve Prosthesis MH - Prospective Studies MH - Aged MH - Prosthesis Design MH - *Postoperative Complications/epidemiology MH - Follow-Up Studies MH - Propensity Score MH - *Aortic Valve/surgery MH - Treatment Outcome MH - Time Factors FIR - Seccareccia, Fulvia IR - Seccareccia F FIR - D'Errigo, Paola IR - D'Errigo P FIR - Rosato, Stefano IR - Rosato S FIR - Badoni, Gabriella IR - Badoni G EDAT- 2024/12/02 05:30 MHDA- 2025/02/13 00:21 CRDT- 2024/12/01 19:25 PHST- 2024/04/27 00:00 [received] PHST- 2024/09/30 00:00 [revised] PHST- 2024/10/26 00:00 [accepted] PHST- 2025/02/13 00:21 [medline] PHST- 2024/12/02 05:30 [pubmed] PHST- 2024/12/01 19:25 [entrez] AID - S0828-282X(24)01229-7 [pii] AID - 10.1016/j.cjca.2024.10.026 [doi] PST - ppublish SO - Can J Cardiol. 2025 Feb;41(2):264-271. doi: 10.1016/j.cjca.2024.10.026. Epub 2024 Nov 29. PMID- 39602603 OWN - NLM STAT- MEDLINE DCOM- 20241210 LR - 20260526 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 66 IP - 6 DP - 2024 Nov 28 TI - The transaxillary concept for minimally invasive isolated aortic valve replacement: results of 1000 consecutive patients. LID - ezae427 [pii] LID - 10.1093/ejcts/ezae427 [doi] AB - OBJECTIVES: The transaxillary concept for minimally invasive cardiac surgery-aortic valve replacement is a new and versatile approach with nearly no visible scars. Due to its novelty, available data in literature are scarce. This study reports clinical outcomes of 1000 consecutive patients. METHODS: Between 2019 and 2023, 4394 patients underwent elective isolated aortic valve procedures, with 2958 (67.5%) transcatheter aortic valve implantation's and 1436 patients surgical aortic valve replacement's (32.5%). Within this period, 1st consecutive 1000 transaxillary isolated minimally invasive cardiac surgery-aortic valve replacement were enrolled. Endocarditis, redo's or combined procedures were excluded. Mean age was 67.9 +/- 8.3 years, STS-PROM 1.39 +/- 2.89% and EuroScore II 1.65 +/- 1.12%. RESULTS: Use of the transaxillary access increased from 18.7% (2019) to 97.8% (2023). Mean procedure time was 127 +/- 31 min, and average cross-clamp time was 43 +/- 14 min. Used prostheses were rapid deployment (81.1%), sutured biologic (14.5%) or sutured mechanical valves (4.1%). Conversion rate was 1.9%. No patient died intraoperatively. Thirty-day major adverse cardiac and cerebrovascular event was 1.9% including 0.9% mortality, 0.8% perioperative stroke and 0.6% myocardial infarction. Multivariate factors for major adverse cardiac and cerebrovascular event are intraoperative conversion [OR 1.08 (1.00-1.16); P = 0.04], intraoperative transfusions [OR 1.21 (1.07-1.38); P < 0.01] and respiratory failure [OR 1.39 (1.30-1.49); P < 0.01]. Corresponding factors for mortality are diabetes on insulin [OR 1.02 (1.00-1.04); P = 0.03], pure aortic regurgitation for primary indication [OR 1.03 (1.01-1.05); P < 0.01], intraoperative conversion [OR 1.11 (1.07-1.16); P < 0.01], renal failure [OR 1.08 (1.05-1.10); P < 0.01] and respiratory failure [OR 1.22 (1.17-1.26); P < 0.01]. CONCLUSIONS: Transaxillary minimally invasive cardiac surgery-aortic valve replacement is a safe, effective and cosmetically convincing method for surgical aortic valve replacement, having the potential for >95.0% minimally invasive cardiac surgery rate in selected patients. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Wilbring, Manuel AU - Wilbring M AUID- ORCID: 0000-0002-3382-1142 AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Arzt, Sebastian AU - Arzt S AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Taghizadeh-Waghefi, Ali AU - Taghizadeh-Waghefi A AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Petrov, Asen AU - Petrov A AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Di Eusanio, Marco AU - Di Eusanio M AD - Department of Cardiac Surgery, Ospedali Riuniti, Polytechnic University of Marche, Ancona, Italy. FAU - Matschke, Klaus AU - Matschke K AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Alexiou, Konstantin AU - Alexiou K AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. FAU - Kappert, Utz AU - Kappert U AUID- ORCID: 0000-0001-8202-7570 AD - Center for Minimally Invasive Cardiac Surgery, University Heart Center Dresden, Dresden, Germany. AD - Department of Cardiac Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden Heart Centre, Dresden, Germany. LA - eng PT - Journal Article PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - *Minimally Invasive Surgical Procedures/methods/adverse effects MH - *Aortic Valve/surgery MH - *Heart Valve Prosthesis Implantation/methods/adverse effects/mortality MH - Axilla MH - Middle Aged MH - Postoperative Complications/epidemiology/etiology MH - Retrospective Studies MH - Operative Time MH - Heart Valve Prosthesis MH - Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Treatment Outcome MH - Aortic Valve Stenosis/surgery OTO - NOTNLM OT - Aortic valve replacement OT - Minimally invasive OT - Transaxillary OT - minimally invasive aortic valve surgery OT - surgical aortic valve replacement EDAT- 2024/11/27 18:25 MHDA- 2024/12/11 00:23 CRDT- 2024/11/27 15:23 PHST- 2024/08/28 00:00 [received] PHST- 2024/10/25 00:00 [revised] PHST- 2024/11/25 00:00 [accepted] PHST- 2024/12/11 00:23 [medline] PHST- 2024/11/27 18:25 [pubmed] PHST- 2024/11/27 15:23 [entrez] AID - 7909804 [pii] AID - 10.1093/ejcts/ezae427 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2024 Nov 28;66(6):ezae427. doi: 10.1093/ejcts/ezae427. PMID- 39582342 OWN - NLM STAT- MEDLINE DCOM- 20250120 LR - 20260121 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 2 DP - 2025 Jan 20 TI - TAVI with the ACURATE neo2 in severe bicuspid aortic valve stenosis: the Neo2 BAV Registry. PG - e130-e139 LID - EIJ-D-24-00869 [pii] LID - 10.4244/EIJ-D-24-00869 [doi] AB - BACKGROUND: The ACURATE neo2 is a contemporary transcatheter aortic valve implantation (TAVI) system approved for the treatment of severe aortic stenosis in Europe. The ACURATE neo2 has not been evaluated in bicuspid aortic valve (BAV) stenosis. AIMS: We sought to evaluate the safety and efficacy of ACURATE neo2 in patients with BAV stenosis. METHODS: We retrospectively analysed consecutive severe BAV stenosis patients undergoing TAVI with ACURATE neo2 at 10 European centres. Imaging data from preprocedural multislice computed tomography, pre- and postprocedural echocardiography, and procedural cinefluoroscopy were evaluated by a core laboratory. Valve Academic Research Consortium 3 (VARC-3)-defined 30-day procedure safety and efficacy were the primary endpoints. Adverse events were site-reported according to VARC-3 criteria. RESULTS: Among 181 patients with BAV stenosis treated with the ACURATE neo2, the mean age was 77.5+/-7.2 years, 58.0% were female, and the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score was 2.3% (1.6-3.7%). Most procedures were transfemoral, and predilatation was performed in all cases. A second valve was required in 4 cases (2.2%). VARC-3-defined technical success was 95.6%. The primary endpoints of device success and early safety occurred in 90.6% and 82.3%, respectively. At 30 days, cardiovascular death occurred in 2.2% (N=4) and stroke in 1.6% (N=3). Core laboratory-adjudicated echocardiography reported an effective orifice area of 2.0 (1.7-2.5) cm(2) and a mean transvalvular gradient of 6.5 (4.6-9.0) mmHg. Half of all cases (51.2%) had no paravalvular leak, while moderate leak occurred in 4.3%. A new permanent pacemaker was required in 11 patients (6.5%). CONCLUSIONS: The ACURATE neo2 demonstrated favourable clinical outcomes and bioprosthetic valve performance at 30 days in selected patients with severe BAV stenosis. FAU - Ruck, Andreas AU - Ruck A AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. FAU - Del Sole, Paolo Alberto AU - Del Sole PA AD - Galway University Hospital, Galway, Ireland. FAU - Wagener, Max AU - Wagener M AD - Galway University Hospital, Galway, Ireland. AD - University Heart Center Basel, University Hospital Basel, Basel, Switzerland. FAU - McInerney, Angela AU - McInerney A AD - Galway University Hospital, Galway, Ireland. FAU - Yacoub, Magdi S AU - Yacoub MS AD - Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland. FAU - Hasabo, Elfatih A AU - Hasabo EA AD - Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland. FAU - Ayhan, Cagri AU - Ayhan C AD - Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland. FAU - Elzomor, Hesham AU - Elzomor H AD - Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland. FAU - Neiroukh, Dina AU - Neiroukh D AD - Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland. FAU - Amir, Abdul AU - Amir A AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Saleh, Nawzad AU - Saleh N AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Settergren, Magnus AU - Settergren M AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Lindler, Rickard AU - Lindler R AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Verouhis, Dinos AU - Verouhis D AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Sossalla, Samuel AU - Sossalla S AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. FAU - Renker, Matthias AU - Renker M AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany. FAU - Montorfano, Matteo AU - Montorfano M AD - School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Bellini, Barbara AU - Bellini B AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Suarez, Xavier Carrillo AU - Suarez XC AD - Department of Interventional Cardiology, Germans Trias i Pujol University Hospital, Badalona, Spain. FAU - Del Olmo, Victoria Vilalta AU - Del Olmo VV AD - Department of Interventional Cardiology, Germans Trias i Pujol University Hospital, Badalona, Spain. FAU - De Marco, Federico AU - De Marco F AD - IRCCS Centro Cardiologico Monzino, Milan, Italy. FAU - Biroli, Matteo AU - Biroli M AD - IRCCS Centro Cardiologico Monzino, Milan, Italy. FAU - Mollmann, Helge AU - Mollmann H AD - St. Johannes Hospital, Dortmund, Germany. FAU - Enno, Eckel Clemens AU - Enno EC AD - St. Johannes Hospital, Dortmund, Germany. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy. FAU - Fabris, Tommaso AU - Fabris T AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy. FAU - Costa, Giuliano AU - Costa G AD - Universita degli Studi di Enna "Kore", Umberto I Hospital, Enna, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - AOU Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy. FAU - Soliman, Osama AU - Soliman O AD - Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland. FAU - Mylotte, Darren AU - Mylotte D AD - Galway University Hospital, Galway, Ireland. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20250120 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Female MH - Male MH - Aged MH - *Aortic Valve Stenosis/surgery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/methods/instrumentation/adverse effects MH - Retrospective Studies MH - *Aortic Valve/surgery/abnormalities/diagnostic imaging MH - Aged, 80 and over MH - Treatment Outcome MH - Registries MH - Bicuspid Aortic Valve Disease MH - *Heart Valve Prosthesis MH - *Heart Valve Diseases/surgery MH - Prosthesis Design MH - Severity of Illness Index MH - Echocardiography MH - Multidetector Computed Tomography PMC - PMC11727691 COIS- A. Ruck reports grants and personal fees from Boston Scientific; and personal fees from Edwards Lifesciences, Abbott, and Anteris Technologies. W.-K. Kim reports proctor/speaker fees/advisory board participation for Abbott, Boston Scientific, Edwards Lifesciences, and Meril Life Sciences. M. Wagener received educational support from Medtronic. A. McInerney has received speaker fees from Shockwave Medical, Boston Scientific, and Novartis. M. Montorfano received consultant fees from Abbott, Boston Scientific, Kardia, and Medtronic. B. Bellini received consultant fees from Medtronic. H. Mollmann receives grants, consulting and lecture fees from Abbott, Boston Scientific, Edwards Lifesciences, Meril Life Sciences, and Medtronic; and support for attending meetings/travel from Boston Scientific, Abbott, and Edwards Lifesciences. G. Tarantini has received honoraria for lectures and consulting from Medtronic, Edwards Lifesciences, Boston Scientific, GADA group, and Abbott. M. Barbanti is a consultant for Edwards Lifesciences, Boston Scientific, and Medtronic. O. Soliman received institutional research grants, committee membership and chairmanship from Abbott, Biosensors, Boston Scientific, Cardiawave, and Meril Life Sciences. D. Mylotte reports institutional research grants from Boston Scientific and Medtronic; and is a consultant for Boston Scientific, Medtronic, and MicroPort. The other authors have no conflicts of interest to declare in relation to this manuscript. The Guest Editor reports consultancy fees from Novartis and Meril Life Sciences; speaker honoraria from Boston Scientific, Amgen, Daiichi Sankyo, and Meril Life Sciences; reports speaker honoraria paid to his institution from BMS/Pfizer, Daiichi Sankyo, Boston Scientific, Siemens, and Amgen; and research grants paid to his institution from Boston Scientific and Abbott. EDAT- 2024/11/25 11:33 MHDA- 2025/01/20 22:53 PMCR- 2026/01/20 CRDT- 2024/11/25 03:53 PHST- 2025/01/20 22:53 [medline] PHST- 2024/11/25 11:33 [pubmed] PHST- 2024/11/25 03:53 [entrez] PHST- 2026/01/20 00:00 [pmc-release] AID - EIJ-D-24-00869 [pii] AID - 10.4244/EIJ-D-24-00869 [doi] PST - epublish SO - EuroIntervention. 2025 Jan 20;21(2):e130-e139. doi: 10.4244/EIJ-D-24-00869. PMID- 39570230 OWN - NLM STAT- MEDLINE DCOM- 20250115 LR - 20260709 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 1 DP - 2025 Jan 13 TI - 1-Year Outcomes of Transcatheter Aortic Valve Replacement Using a Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve. PG - 32-40 LID - S1936-8798(24)01255-X [pii] LID - 10.1016/j.jcin.2024.09.042 [doi] AB - BACKGROUND: Mid-term comparative data for the self-expanding ACURATE neo2 transcatheter heart valve and the balloon-expandable SAPIEN 3 Ultra are lacking. OBJECTIVES: The aim of this study was to compare 1-year outcomes after transcatheter aortic valve replacement of these 2 valves. METHODS: A total of 2,106 patients from 3 centers (neo2, n = 1,166; Ultra, n = 940) undergoing transfemoral transcatheter aortic valve replacement were analyzed retrospectively. The primary endpoint was the composite of all-cause mortality, stroke, and rehospitalization at 1 year. Secondary endpoints were the individual components of the primary endpoint at 1 year. To adjust for baseline differences, nearest neighbor propensity score matching was used. RESULTS: After matching (702 pairs), baseline characteristics were similar between groups. Device success was more common in the neo2 group (87.5% vs 82.3%; P = 0.007), irrespective of matching. DP mean after the procedure was higher for Ultra (13 mm Hg [Q1-Q3: 10-15 mm Hg] vs 8 mm Hg [Q1-Q3: 6-11] mm Hg; P < 0.001). Rates of paravalvular leakage, device embolization, and multiple valve implantations were more common in the neo2 arm, whereas major cardiac structural complications and major vascular complications occurred more frequently in the Ultra group. All other in-hospital complication rates were similar between the 2 groups. At 1 year, the cumulative incidence of the primary endpoint (14.1% for neo2 vs 14.5% for Ultra; P = 0.819) was similar between the groups. Likewise, the individual components showed no difference between the groups. CONCLUSIONS: Despite differing immediate results, the outcomes at 1 year, including the composite of all-cause mortality, stroke, or hospitalization, were similar for neo2 and Ultra transcatheter heart valves. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany; Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany; Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany; German Center for Cardiovascular Research, Rhein-Main Partner Site, Bad Nauheim, Germany. Electronic address: dr.won.kim@gmail.com. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany; Deutsches Zentrum fur Herz- und Kreislauf-Forschung e.V., Partner Site Munich Heart Alliance, Munich, Germany. FAU - Eckel, Clemens AU - Eckel C AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany; Department of Internal Medicine, Carl von Ossietzky University, Oldenburg, Germany. FAU - Renker, Matthias AU - Renker M AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany; German Center for Cardiovascular Research, Rhein-Main Partner Site, Bad Nauheim, Germany. FAU - Grothusen, Christina AU - Grothusen C AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany; Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany. FAU - Choi, Yeong-Hoon AU - Choi YH AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany; German Center for Cardiovascular Research, Rhein-Main Partner Site, Bad Nauheim, Germany. FAU - Charitos, Efstratios I AU - Charitos EI AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Duesmann, Charlotte AU - Duesmann C AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany; Deutsches Zentrum fur Herz- und Kreislauf-Forschung e.V., Partner Site Munich Heart Alliance, Munich, Germany. FAU - Blumenstein, Johannes AU - Blumenstein J AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany; Department of Internal Medicine, Carl von Ossietzky University, Oldenburg, Germany. FAU - Rheude, Tobias AU - Rheude T AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany; Deutsches Zentrum fur Herz- und Kreislauf-Forschung e.V., Partner Site Munich Heart Alliance, Munich, Germany. FAU - Sossalla, Samuel AU - Sossalla S AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany; Department of Cardiology, Justus-Liebig University of Giessen, Giessen, Germany; German Center for Cardiovascular Research, Rhein-Main Partner Site, Bad Nauheim, Germany. FAU - Joner, Michael AU - Joner M AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany; Deutsches Zentrum fur Herz- und Kreislauf-Forschung e.V., Partner Site Munich Heart Alliance, Munich, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20241120 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2025 Jan 13;18(1):41-43. doi: 10.1016/j.jcin.2024.08.040. PMID: 39570232 MH - Humans MH - Treatment Outcome MH - Male MH - *Heart Valve Prosthesis MH - Female MH - Retrospective Studies MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Aged, 80 and over MH - Prosthesis Design MH - Risk Factors MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - *Aortic Valve Stenosis/mortality/physiopathology/diagnostic imaging/surgery MH - Aged MH - *Balloon Valvuloplasty/mortality/adverse effects/instrumentation MH - Patient Readmission MH - Risk Assessment MH - Recovery of Function MH - Stroke/etiology OTO - NOTNLM OT - ACURATE neo2 OT - SAPIEN 3 Ultra OT - TAVR OT - balloon-expandable OT - self-expanding COIS- Funding Support and Author Disclosures Dr Kim has received proctor and/or speaker and/or advisory honoraria from Abbott, Boston Scientific, Edwards Lifesciences, Meril Life Sciences, Shockwave, and HID Imaging. Dr Choi has received speaker and proctor fees from Edwards Lifesciences, CytoSorbents, and Getinge. Dr Charitos is a proctor for Boston Scientific. Dr Rheude has received lecture fees from Abbott, AstraZeneca, SIS Medical, and Translumina; and has received travel support from Boston Scientific and Eli Lilly (not related to the present work). Dr Joner has received lecture fees and research grants from Edwards Lifesciences and Boston Scientific; and is a consultant for Biotronik and OrbusNeich. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/11/21 12:24 MHDA- 2025/01/16 00:20 CRDT- 2024/11/21 10:34 PHST- 2024/03/06 00:00 [received] PHST- 2024/08/28 00:00 [revised] PHST- 2024/09/17 00:00 [accepted] PHST- 2025/01/16 00:20 [medline] PHST- 2024/11/21 12:24 [pubmed] PHST- 2024/11/21 10:34 [entrez] AID - S1936-8798(24)01255-X [pii] AID - 10.1016/j.jcin.2024.09.042 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Jan 13;18(1):32-40. doi: 10.1016/j.jcin.2024.09.042. Epub 2024 Nov 20. PMID- 39549774 OWN - NLM STAT- MEDLINE DCOM- 20241214 LR - 20260804 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 420 DP - 2025 Feb 1 TI - Unilateral-access vs. bilateral-access in transfemoral transcatheter aortic valve replacement: A slim fit approach. PG - 132712 LID - S0167-5273(24)01334-2 [pii] LID - 10.1016/j.ijcard.2024.132712 [doi] AB - BACKGROUND: Vascular complications remain prevalent on transfemoral transcatheter aortic valve replacement (TF-TAVR) with a significant proportion related to the secondary arterial access. We hypothesized that placing the second sheath ipsilateral and distal to the delivery sheath could reduce vascular complications with similar safety and efficacy. OBJECTIVES: Comparing vascular complications and clinical outcomes when placing the secondary arterial sheath in the ipsilateral (unilateral-access) versus in the contralateral (bilateral-access) femoral artery during TF-TAVR. METHODS: Patients who underwent TF-TAVR using unilateral-access as first-choice approach were retrospectively compared with a contemporaneous bilateral-access group. The primary endpoint was the incidence of vascular complications related to femoral access according to the VARC-3 criteria. A propensity-score analysis was performed accounting for the differences in clinical, vascular, and procedural characteristics. RESULTS: A total of 217 patients were included, of whom 150 (69.1 %) underwent TF-TAVR through bilateral- and 67 (30.9 %) through unilateral-access. Vascular complications occurred in 16.0 % of the bilateral-access group and 10.4 % of the unilateral-access group (p = 0.280). The unilateral-access group achieved high procedural success with normalization of peak aortic velocity and low rates of paravalvular leaks, valve migration and pacemaker requirement. After propensity-score matching, the overall complications rate was superior in the bilateral-access group (54.4 % vs 35.1 %, p = 0.038) due to a trend of higher vascular complications (26.3 % vs 12.3 %, p = 0.058) and a significant higher occurrence of bleeding complications (17.5 % vs 1.8 %, p = 0.008). CONCLUSIONS: Unilateral-access TF-TAVR is feasible, safe, and potentially enhances procedural efficiency and patient satisfaction while maintaining the capacity for bailout interventions in managing vascular complications. CI - Copyright (c) 2024 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Pereira, Ana Rita AU - Pereira AR AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal. FAU - Al Jaff, Ahmed A M AU - Al Jaff AAM AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. FAU - Montero-Cabezas, Jose AU - Montero-Cabezas J AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. FAU - de Weger, Arend AU - de Weger A AD - Department of Cardio-Thoracic Surgery, Leiden University Medical Center, Leiden, the Netherlands. FAU - Candura, Dario AU - Candura D AD - Department of Cardio-Thoracic Surgery, Leiden University Medical Center, Leiden, the Netherlands. FAU - Jukema, Johan Wouter AU - Jukema JW AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; The Netherlands Heart Institute, Utrecht, the Netherlands. FAU - Arslan, Fatih AU - Arslan F AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. FAU - Regeer, Madelien V AU - Regeer MV AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. FAU - Ajmone Marsan, Nina AU - Ajmone Marsan N AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. FAU - van-der-Kley, Frank AU - van-der-Kley F AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: f.van_der_kley@lumc.nl. LA - eng PT - Comparative Study PT - Journal Article DEP - 20241115 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Male MH - Female MH - *Femoral Artery MH - Retrospective Studies MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Postoperative Complications/epidemiology/prevention & control/etiology COIS- Declaration of competing interest The Department of Cardiology of Leiden University Medical Center received research grants from Abbott Vascular, Alnylam, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, Medtronic, Pie Medical, Medis, Pfizer and Novartis. AR Pereira received a research grant from Shockwave Medical and speaker fees from Daiichi-Sankyo. JM. Montero received a research grant from Shockwave Medical and speaker fees from Abiomed, Boston Scientific and Penumbra Inc. Nina Ajmone Marsan has received speaker fees from Philips Ultrasound, Abbott Vascular, Omron, and GE Healthcare. F. van der Kley received consultancy fees from Edwards Lifesciences and Abbott Vascular. EDAT- 2024/11/17 04:19 MHDA- 2024/12/15 00:41 CRDT- 2024/11/16 19:22 PHST- 2024/09/10 00:00 [received] PHST- 2024/10/25 00:00 [revised] PHST- 2024/11/04 00:00 [accepted] PHST- 2024/12/15 00:41 [medline] PHST- 2024/11/17 04:19 [pubmed] PHST- 2024/11/16 19:22 [entrez] AID - S0167-5273(24)01334-2 [pii] AID - 10.1016/j.ijcard.2024.132712 [doi] PST - ppublish SO - Int J Cardiol. 2025 Feb 1;420:132712. doi: 10.1016/j.ijcard.2024.132712. Epub 2024 Nov 15. PMID- 39549437 OWN - NLM STAT- MEDLINE DCOM- 20241214 LR - 20241214 IS - 1872-7727 (Electronic) IS - 0720-048X (Linking) VI - 182 DP - 2025 Jan TI - ECG, clinical and novel CT-imaging predictors of necessary pacemaker implantation after transfemoral aortic valve replacement. PG - 111835 LID - S0720-048X(24)00551-5 [pii] LID - 10.1016/j.ejrad.2024.111835 [doi] AB - PURPOSE: Newly onset conduction disturbances with the need for permanent pacemaker (PPM) implantation remain the most common complication of transcatheter aortic valve replacement (TAVR). The objective was to evaluate the predictive value of clinical, ECG and new pre-procedural CT-imaging parameters for the requirement of PPM-implantation after TAVR. METHODS: 2105 consecutive patients receiving TAVR using a balloon expandable prosthesis (Sapien 3, Edwards Lifesciences, Irving, CA, USA) at our institution were enrolled. Patients receiving a valve-in-valve prosthesis, TAVR after surgical repair, with missing or non-diagnostic CT-scans, with pre-implanted PPM and after TAVR in mitral position were excluded. The most suitable classification model for the given dataset was first identified through benchmark testing and later applied for prediction analysis. RESULTS: 312 eligible patients requiring PPM implantation were compared to an age- matched control group of 305 patients not requiring PPM implantation. A scaled LASSO model allowed for most accurate prediction with an AUC of 0.70. Right bundle branch block was the strongest predictor (OR 2.739), followed by atrioventricular block 1 degrees (OR 2.091), prosthesis diameter (OR 1.351), atrial fibrillation (OR 1.255), arterial hypertension (OR 1.215), coronary artery disease (1.070), the angle of ventricle axis and aortic root (OR 1.030), sinotubular junction height (OR 1.014) and the calcification of the left coronary cuspid (OR 1.007). CONCLUSIONS: ECG- and clinical outperform imaging parameters in predicting PPM-implantation following TAVR. Right bundle branch block emerged as the most significant predictor overall, while the angle of ventricle axis and aortic root as a novel imaging-based predictor. CI - Copyright (c) 2024 The Author(s). Published by Elsevier B.V. All rights reserved. FAU - Klambauer, Konstantin AU - Klambauer K AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. Electronic address: konstantin.klambauer@med.uni-muenchen.de. FAU - Puhr-Westerheide, Daniel AU - Puhr-Westerheide D AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Fabritius, Matthias P AU - Fabritius MP AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Kunz, Wolfgang G AU - Kunz WG AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Dinkel, Julien AU - Dinkel J AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Schmid-Tannwald, Christine AU - Schmid-Tannwald C AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Utz, Christina AU - Utz C AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Grathwohl, Fabian AU - Grathwohl F AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Fink, Nicola AU - Fink N AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Rizas, Konstantinos D AU - Rizas KD AD - Department of Internal Medicine I, LMU University Hospital, LMU Munich, Munich, Germany; German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Munich, Germany. FAU - Ricke, Jens AU - Ricke J AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Ingrisch, Michael AU - Ingrisch M AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. FAU - Stuber, Anna T AU - Stuber AT AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany; Chair of Statistical Learning & Data Science, Department of Statistics, LMU Munich, Munich, Germany. FAU - Curta, Adrian AU - Curta A AD - Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. LA - eng PT - Journal Article DEP - 20241113 PL - Ireland TA - Eur J Radiol JT - European journal of radiology JID - 8106411 SB - IM MH - Humans MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aged, 80 and over MH - *Electrocardiography MH - *Pacemaker, Artificial MH - *Tomography, X-Ray Computed MH - Aged MH - Postoperative Complications/diagnostic imaging MH - Predictive Value of Tests MH - Aortic Valve Stenosis/surgery/diagnostic imaging MH - Reproducibility of Results MH - Treatment Outcome MH - Femoral Artery/diagnostic imaging OTO - NOTNLM OT - CT-imaging OT - ECG OT - LASSO OT - Pacemaker OT - Prediction OT - TAVR COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/11/17 04:19 MHDA- 2024/12/15 00:41 CRDT- 2024/11/16 18:05 PHST- 2024/03/20 00:00 [received] PHST- 2024/11/05 00:00 [revised] PHST- 2024/11/11 00:00 [accepted] PHST- 2024/12/15 00:41 [medline] PHST- 2024/11/17 04:19 [pubmed] PHST- 2024/11/16 18:05 [entrez] AID - S0720-048X(24)00551-5 [pii] AID - 10.1016/j.ejrad.2024.111835 [doi] PST - ppublish SO - Eur J Radiol. 2025 Jan;182:111835. doi: 10.1016/j.ejrad.2024.111835. Epub 2024 Nov 13. PMID- 39537283 OWN - NLM STAT- MEDLINE DCOM- 20241113 LR - 20241113 IS - 2211-7466 (Electronic) IS - 2211-7458 (Linking) VI - 14 IP - 1 DP - 2025 Jan TI - Outcome Factors for Women Undergoing Transcatheter Aortic Valve Replacement. PG - 117-125 LID - S2211-7458(24)00091-9 [pii] LID - 10.1016/j.iccl.2024.08.009 [doi] AB - Women with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) have a higher burden of symptoms, are older at the time of the TAVR procedure, and have unique anatomic features that increase the periprocedural risk. However, long-term outcomes including mortality are favorable for women compared with men. Careful attention is needed in considering the vascular access route and choice of valve platform to mitigate complications. Large prospective trials dedicated to women undergoing TAVR are needed to investigate individual female-specific factors determining outcomes. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Shabbir, Muhammad Asim AU - Shabbir MA AD - University of Nebraska Medical Center, 42 and Emile, Omaha, NE, USA. Electronic address: asimshabbir202@gmail.com. FAU - Berry, Natalia AU - Berry N AD - Mid-Atlantic Permanente Medical Group, Mclean, VA, USA. FAU - Perdoncin, Emily AU - Perdoncin E AD - Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA. FAU - Velagapudi, Poonam AU - Velagapudi P AD - University of Nebraska Medical Center, 42 and Emile, Omaha, NE, USA. Electronic address: https://twitter.com/pooh_velagapudi. LA - eng PT - Journal Article PT - Review DEP - 20241003 PL - Netherlands TA - Interv Cardiol Clin JT - Interventional cardiology clinics JID - 101615153 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Female MH - Risk Factors MH - Sex Factors MH - Treatment Outcome MH - Aortic Valve/surgery MH - Postoperative Complications/prevention & control/epidemiology OTO - NOTNLM OT - Female OT - Gender differences OT - Outcomes OT - TAVR OT - Women COIS- Disclosure P. Velagapudi: Speaking fees from Medtronic, and Shockwave Medical; Advisory board for Medtronic. All other authors have nothing to disclose. EDAT- 2024/11/14 03:58 MHDA- 2024/11/14 03:59 CRDT- 2024/11/13 21:02 PHST- 2024/11/14 03:59 [medline] PHST- 2024/11/14 03:58 [pubmed] PHST- 2024/11/13 21:02 [entrez] AID - S2211-7458(24)00091-9 [pii] AID - 10.1016/j.iccl.2024.08.009 [doi] PST - ppublish SO - Interv Cardiol Clin. 2025 Jan;14(1):117-125. doi: 10.1016/j.iccl.2024.08.009. Epub 2024 Oct 3. PMID- 39537103 OWN - NLM STAT- MEDLINE DCOM- 20241205 LR - 20260804 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 419 DP - 2025 Jan 15 TI - Transcaval access for transcatheter aortic valve implantation: A meta-analysis and systematic review. PG - 132720 LID - S0167-5273(24)01342-1 [pii] LID - 10.1016/j.ijcard.2024.132720 [doi] AB - BACKGROUND: Anatomical factors may preclude transfemoral (TF) arterial access for transcatheter aortic valve implantation (TAVI). Transcaval (TCav) access has been utilized as an alternative access for these patients. We aimed to investigate the outcomes of TCav access in patients undergoing TAVI. METHODS: We performed a systematic review and meta-analysis including all published studies from 1996 to November 2023 that examined TCav access in patients undergoing TAVI. The main outcomes included all cause mortality, major vascular complications, major bleeding, stroke, and myocardial infarction (MI). Outcomes were reported at 30-day and 1-year follow-up. RESULTS: We included 8 observational studies with a total of 517 patients (mean age 78.1+/-8 years, 56.6 % women, mean STS score 7 +/- 4.5). Mean (SD) procedure time was 35 +/- 9.8 mins and mean (SD) contrast volume was 136.3 +/- 77.4 ml. Procedure success was achieved in 94.3 % of the patients. At 30-day follow-up, all-cause mortality occurred in 6.4 %, major bleeding in 12.2 %, blood transfusion in 23.3 %, retroperitoneal bleeding in 19 %, major vascular complications in 7.9 %, MI in 2.8 %, and AKI in 6.4 % of patients. At 1-year, all-cause mortality was 14.7 %. In a sub-group analysis including 3 studies comparing TCav (n = 316) to alternative accesses (including transcarotid, transaxillary, and transapical) (n = 303), there were no differences in all-cause mortality, major bleeding, major vascular complications, blood transfusion, or stroke at 30-day. CONCLUSION: Transcaval approach is feasible and non-inferior to other alternative accesses in TAVI patients with prohibitive iliofemoral anatomy. CI - Copyright (c) 2024 Elsevier B.V. All rights reserved. FAU - Abraham, Bishoy AU - Abraham B AD - Department of Cardiology, Mayo Clinic, Phoenix, AZ, United States of America. Electronic address: bisho.abraham@gmail.com. FAU - Sous, Mina AU - Sous M AD - Department of Medicine, Amita Health Saint Francis Hospital, Evanston, IL, United States of America. FAU - Kaldas, Sara AU - Kaldas S AD - Department of Cardiology, Mayo Clinic, Phoenix, AZ, United States of America. FAU - Nakhla, Michael AU - Nakhla M AD - Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, United States of America. FAU - Sweeney, John AU - Sweeney J AD - Department of Cardiology, Mayo Clinic, Phoenix, AZ, United States of America. FAU - Lee, Kwan AU - Lee K AD - Department of Cardiology, Mayo Clinic, Phoenix, AZ, United States of America. FAU - Garcia, Santiago AU - Garcia S AD - Department of Cardiovascular Disease, The Christ Hospital, Cincinnati, OH, United States of America. FAU - Saad, Marwan AU - Saad M AD - Lifespan Cardiovascular Institute and Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI, United States of America. FAU - Goel, Sachin S AU - Goel SS AD - Department of Cardiovascular Disease, Houston Methodist Hospital, Houston, TX, United States of America. FAU - Fortuin, F David AU - Fortuin FD AD - Department of Cardiology, Mayo Clinic, Phoenix, AZ, United States of America. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20241112 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Aortic Valve Stenosis/surgery/diagnostic imaging MH - Observational Studies as Topic/methods MH - Postoperative Complications/epidemiology/etiology OTO - NOTNLM OT - Aortic valve stenosis OT - TAVI OT - Transcaval access COIS- Declaration of competing interest All authors have nothing to disclose. EDAT- 2024/11/14 03:58 MHDA- 2024/12/06 05:30 CRDT- 2024/11/13 19:27 PHST- 2024/06/03 00:00 [received] PHST- 2024/11/06 00:00 [revised] PHST- 2024/11/08 00:00 [accepted] PHST- 2024/12/06 05:30 [medline] PHST- 2024/11/14 03:58 [pubmed] PHST- 2024/11/13 19:27 [entrez] AID - S0167-5273(24)01342-1 [pii] AID - 10.1016/j.ijcard.2024.132720 [doi] PST - ppublish SO - Int J Cardiol. 2025 Jan 15;419:132720. doi: 10.1016/j.ijcard.2024.132720. Epub 2024 Nov 12. PMID- 39536697 OWN - NLM STAT- MEDLINE DCOM- 20241213 LR - 20260417 IS - 1095-8673 (Electronic) IS - 0022-4804 (Linking) VI - 304 DP - 2024 Dec TI - Transfemoral Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Coexisting Mitral Valve Regurgitation. PG - 101-111 LID - S0022-4804(24)00664-4 [pii] LID - 10.1016/j.jss.2024.10.012 [doi] AB - INTRODUCTION: Severe aortic stenosis with coexisting mitral regurgitation (MR) of various severity is a common finding. The goal of our study was to evaluate the relation between transcatheter transfemoral aortic valve implantation (TAVI) on coexisting MR and compare the outcome in MR improvement and nonimprovement groups. METHODS: We retrospectively analyzed 252 patients who underwent TAVI with associated at least moderate MR between January 2018 and December 2020. Effect of changes in MR grade at discharge and 6-12 mo follow-up were compared. RESULTS: Echocardiography was performed at discharge in 245 patients and at follow-up in 154 patients. MR improvement was seen in 60.8% patients and nonimprovement in 39.2%. Overall survival was significantly higher in the MR improvement group (P = 0.020). There was a statistically significant effect on MR grade with a significant increase in the proportion of patients with mild MR at follow-up compared to discharge (58.4% versus 38.3%, P < 0.001). A similar positive effect was seen on left ventricular ejection fraction (LVEF) at follow-up compared to discharge (P < 0.001). LVEF in the MR improvement group was significantly higher at follow-up versus discharge (P < 0.001), but there was no statistically significant change in LVEF in the nonimprovement group at follow-up versus discharge (P < 0.722). CONCLUSIONS: TAVI in severe aortic stenosis with coexisting significant mitral valve regurgitation decreases MR severity in more than 60% of patients and improved LVEF as well as mortality. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Salem, Mohammed AU - Salem M AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. FAU - Stankowski, Tomasz AU - Stankowski T AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. Electronic address: tomekstankowski89@gmail.com. FAU - Aboul-Hassan, Sleiman Sebastian AU - Aboul-Hassan SS AD - Department of Cardiac Surgery, Medinet Heart Center Ltd, Nowa Sol, Poland; Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, Zielona Gora, Poland. FAU - Muehle, Anja AU - Muehle A AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. FAU - Harnath, Axel AU - Harnath A AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. FAU - Rochor, Kristin AU - Rochor K AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. FAU - Lukusa, Claude Tshibangu AU - Lukusa CT AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany; Department of Cardiology, University of Mbuji Mayi, Mbuji Mayi, Democratic Republic of the Congo. FAU - Herwig, Volker AU - Herwig V AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. FAU - Erkenov, Temirlan AU - Erkenov T AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. FAU - Perek, Barlomiej AU - Perek B AD - Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Fritzsche, Dirk AU - Fritzsche D AD - Sana Heart Center Cottbus, Department of Cardiac Surgery, Cottbus, Germany. LA - eng PT - Journal Article DEP - 20241112 PL - United States TA - J Surg Res JT - The Journal of surgical research JID - 0376340 SB - IM MH - Humans MH - Male MH - Female MH - *Mitral Valve Insufficiency/surgery/complications/etiology/mortality MH - *Transcatheter Aortic Valve Replacement/mortality/methods MH - *Aortic Valve Stenosis/surgery/complications/mortality MH - Retrospective Studies MH - Aged MH - Aged, 80 and over MH - *Severity of Illness Index MH - Treatment Outcome MH - Echocardiography MH - Femoral Artery/surgery MH - Follow-Up Studies MH - Aortic Valve/surgery/diagnostic imaging OTO - NOTNLM OT - Aortic valve OT - Echocardiography OT - Mitral regurgitation OT - Outcomes OT - TAVI EDAT- 2024/11/14 03:58 MHDA- 2024/12/14 00:24 CRDT- 2024/11/13 18:11 PHST- 2024/01/11 00:00 [received] PHST- 2024/09/20 00:00 [revised] PHST- 2024/10/13 00:00 [accepted] PHST- 2024/12/14 00:24 [medline] PHST- 2024/11/14 03:58 [pubmed] PHST- 2024/11/13 18:11 [entrez] AID - S0022-4804(24)00664-4 [pii] AID - 10.1016/j.jss.2024.10.012 [doi] PST - ppublish SO - J Surg Res. 2024 Dec;304:101-111. doi: 10.1016/j.jss.2024.10.012. Epub 2024 Nov 12. PMID- 39525335 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241114 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 6 IP - 10 DP - 2024 Oct TI - An Optimized Assessment Pathway for Remote Patients: The Vancouver Facilitated Transcatheter Aortic Valve Implantation Program. PG - 1220-1226 LID - 10.1016/j.cjco.2024.07.001 [doi] AB - BACKGROUND: Novel pathways are needed to accommodate the increasing demand for transcatheter aortic valve implantation (TAVI) and ensure equitable access. A single Vancouver Facilitated TAVI program (VFTP) based at St. Paul's and Vancouver General Hospitals was established to streamline the assessment of remote patients with severe aortic stenosis using virtual technologies. METHODS: Remote patients with severe aortic stenosis who expressed difficulties traveling to complete their pre-TAVI workup were included and received prospective follow-up. Clinical and echocardiographic parameters were reported per the Valve Academic Research Consortium 3. RESULTS: Between December 2020 and March 2023, a total of 56 remote patients were included in the VFTP. The mean patient age was 79.7 +/- 9.1 years. A total of 55 patients (98%) passed the screening for candidacy; 45 patients (80%) were found suitable for transfemoral TAVI, 5 patients (9%) were directed toward surgical aortic valve replacement; 3 (5%) underwent alternative-access TAVI; and 2 patients (4%) were assigned to a watchful waiting strategy. No inpatient mortality, stroke, or major bleeding occurred in the transfemoral TAVI group, and the median hospital stay was 1 day (interquartile range, 1-2 days; range, 1-24 days). Two patients had an access-closure failure requiring surgical intervention; 1 patient had tamponade; and 4 patients had complete heart block requiring permanent pacemaker implantation. No hospital readmission had occurred at 30 days. CONCLUSIONS: A simplified assessment pathway to assess TAVI candidacy using virtual technologies is safe and feasible. The VFTP potentially can increase access to TAVI and reduce inequity in TAVI care. CI - (c) 2024 The Authors. FAU - Husain, Ali AU - Husain A AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Jelisejevas, Julius AU - Jelisejevas J AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Chatfield, Andrew AU - Chatfield A AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Akodad, Mariama AU - Akodad M AD - Institut Cardiovasculaire Paris-Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Lauck, Sandra B AU - Lauck SB AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Achtem, Leslie AU - Achtem L AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Tang, Erin AU - Tang E AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Zaky, Fady AU - Zaky F AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Blanke, Philipp AU - Blanke P AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Leipsic, Jonathan AU - Leipsic J AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Sellers, Stephanie L AU - Sellers SL AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. AD - Cardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada. FAU - Ye, Jian AU - Ye J AD - Division of Cardiac Surgery, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Cheung, Anson AU - Cheung A AD - Division of Cardiac Surgery, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Moss, Robert AU - Moss R AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Wood, David AU - Wood D AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. AD - Institut Cardiovasculaire Paris-Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Boone, Robert AU - Boone R AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Meier, David AU - Meier D AD - Cardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada. AD - Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Sathananthan, Janarthanan AU - Sathananthan J AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. AD - Cardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada. FAU - Webb, John G AU - Webb JG AD - Centre for Cardiovascular Innovation, St Paul's Hospital and Vancouver General Hospital, Vancouver, British Columbia, Canada. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. AD - Cardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada. LA - eng PT - Journal Article DEP - 20240706 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC11544281 EDAT- 2024/11/14 03:56 MHDA- 2024/11/14 03:57 PMCR- 2024/07/06 CRDT- 2024/11/11 05:39 PHST- 2024/04/02 00:00 [received] PHST- 2024/07/01 00:00 [accepted] PHST- 2024/11/14 03:57 [medline] PHST- 2024/11/14 03:56 [pubmed] PHST- 2024/11/11 05:39 [entrez] PHST- 2024/07/06 00:00 [pmc-release] AID - S2589-790X(24)00278-6 [pii] AID - 10.1016/j.cjco.2024.07.001 [doi] PST - epublish SO - CJC Open. 2024 Jul 6;6(10):1220-1226. doi: 10.1016/j.cjco.2024.07.001. eCollection 2024 Oct. PMID- 39516918 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241116 IS - 2731-6203 (Electronic) IS - 2731-6203 (Linking) VI - 3 IP - 1 DP - 2024 Oct 28 TI - Successful surgical repair of aortic root rupture during transcatheter aortic valve implantation: a case report. PG - 47 LID - 10.1186/s44215-024-00172-4 [doi] LID - 47 AB - BACKGROUND: Aortic root rupture is a rare but potentially fatal complication of transcatheter aortic valve implantation (TAVI). Herein, we report a case of aortic root rupture during TAVI that was successfully managed with partial aortic root repair and aortic valve replacement. CASE PRESENTATION: An 83-year-old woman with severe bicuspid aortic stenosis underwent transfemoral TAVI using a 26 mm SAPIEN 3 Ultra RESILIA valve. Soon after valve implantation, transesophageal echocardiography detected pericardial effusion, which was accompanied by immediate hemodynamic instability. Subxiphoid pericardial drainage was performed, and extracorporeal membrane oxygenation was promptly initiated. Owing to the eruptive hemorrhage, we converted to open-heart surgery. Direct visualization enabled the detection of the aortic root rupture and the performance of partial aortic root repair using bovine pericardium and aortic valve replacement using a 19 mm INSPIRIS RESILIA valve. The patient was transferred to a different hospital 60 days after surgery without complications and is currently doing well as an outpatient. CONCLUSIONS: In the present case, prompt treatment decisions and smooth cooperation among the institutional heart team led to the successful repair of aortic root rupture during TAVI and good clinical outcomes. CI - (c) 2024. The Author(s). FAU - Numaguchi, Ryosuke AU - Numaguchi R AUID- ORCID: 0000-0002-1277-3831 AD - Department of Cardiovascular Surgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate City, Hokkaido, 041-8680, Japan. sapmed.numaguchi@gmail.com. FAU - Yokoyama, Noriyuki AU - Yokoyama N AD - Department of Cardiovascular Surgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate City, Hokkaido, 041-8680, Japan. FAU - Ishikawa, Kazunori AU - Ishikawa K AD - Department of Cardiovascular Surgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate City, Hokkaido, 041-8680, Japan. FAU - Koya, Atsuhiro AU - Koya A AD - Department of Cardiovascular Surgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate City, Hokkaido, 041-8680, Japan. FAU - Tokuda, Yusuke AU - Tokuda Y AD - Department of Cardiology, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate City, Hokkaido, 041-8680, Japan. FAU - Shingaki, Masami AU - Shingaki M AD - Department of Cardiovascular Surgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate City, Hokkaido, 041-8680, Japan. LA - eng PT - Journal Article DEP - 20241028 PL - England TA - Gen Thorac Cardiovasc Surg Cases JT - General thoracic and cardiovascular surgery cases JID - 9918900337406676 PMC - PMC11533707 OTO - NOTNLM OT - Aortic root repair OT - Aortic root rupture OT - Aortic valve replacement OT - Transcatheter aortic valve implantation COIS- The authors declare that they have no competing interests. EDAT- 2024/11/13 14:00 MHDA- 2024/11/13 14:01 PMCR- 2024/10/28 CRDT- 2024/11/09 00:00 PHST- 2024/08/14 00:00 [received] PHST- 2024/10/16 00:00 [accepted] PHST- 2024/11/13 14:01 [medline] PHST- 2024/11/13 14:00 [pubmed] PHST- 2024/11/09 00:00 [entrez] PHST- 2024/10/28 00:00 [pmc-release] AID - 10.1186/s44215-024-00172-4 [pii] AID - 172 [pii] AID - 10.1186/s44215-024-00172-4 [doi] PST - epublish SO - Gen Thorac Cardiovasc Surg Cases. 2024 Oct 28;3(1):47. doi: 10.1186/s44215-024-00172-4. PMID- 39515630 OWN - NLM STAT- MEDLINE DCOM- 20250109 LR - 20250109 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 236 DP - 2025 Feb 1 TI - Long-Term Mortality and Impact of Implantation-Associated Factors on the Incidence of Patient-Prosthesis Mismatch After Transcatheter Aortic Valve Implantation in Patients With Small Annuli. PG - 23-29 LID - S0002-9149(24)00773-2 [pii] LID - 10.1016/j.amjcard.2024.10.033 [doi] AB - Prosthesis-patient mismatch (PPM) is a common phenomenon after transcatheter aortic valve implantation (TAVI), especially in patients with small aortic annuli. Whether factors during implantation, such as the implantation depth, have an impact on the occurrence of PPM is currently unclear. The objectives of our study were to (1) investigate the influence of procedure planning- and implantation-related factors on the occurrence of PPM and (2) evaluate the impact of PPM on long-term mortality after TAVI. Data from 315 patients with small aortic annuli, defined as multidetector computed tomography-derived annulus area <400 mm(2), treated with transfemoral TAVI between 2014 and 2021 were retrospectively analyzed. TAVI was performed with ballon-expandable valves (BEVs) in 113 and self-expanding valves (SEVs) in 202 cases. PPM was defined according to Valve Academic Research Consortium 3 and follow-up was obtained within 5 years after TAVI. Overall, PPM occurred in 121 patients (38.4%) and was significantly more frequent in patients treated with BEVs (54.9%) than with SEVs (29.2%, p <0.001). Evaluation of planning- and implantation-related factors found that deeper implantation of BEVs significantly increased the risk of PPM (p = 0.014), whereas no association was observed in SEVs. The overall mortality rates at 3 and 5 years were 25.5% and 43.1%, respectively, without significant differences between patients with and without PPM. In conclusion, PPM occurred frequently, especially after BEV implantation. In these patients, implantation depth was identified as a predictor of PPM, whereas no association was found for SEV implantation. In addition, there was no difference in longer-term mortality between patients with and without PPM. CI - Copyright (c) 2024. Published by Elsevier Inc. FAU - Voigtlander-Buschmann, Lisa AU - Voigtlander-Buschmann L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, Germany. Electronic address: l.voigtlaender-buschmann@uke.de. FAU - von der Heide, Ina AU - von der Heide I AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Gossling, Alina AU - Gossling A AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Waldschmidt, Lara AU - Waldschmidt L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Hannen, Laura AU - Hannen L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Ludwig, Sebastian AU - Ludwig S AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Demal, Till AU - Demal T AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Germany. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany. FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Germany. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, Germany; Department of Cardiology and Angiology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Germany. LA - eng PT - Journal Article DEP - 20241107 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery/mortality MH - Retrospective Studies MH - *Heart Valve Prosthesis MH - Aged, 80 and over MH - *Prosthesis Design MH - Incidence MH - Postoperative Complications/epidemiology MH - Aged MH - Aortic Valve/surgery/diagnostic imaging MH - Risk Factors MH - Multidetector Computed Tomography/methods MH - Follow-Up Studies MH - Time Factors MH - Survival Rate/trends OTO - NOTNLM OT - aortic stenosis OT - prosthesis-patient mismatch OT - small aortic annuli OT - transcatheter aortic valve implantation COIS- Declaration of competing interest Dr. Voigtlaender-Buschmann reports a relation with German Center for Cardiovascular Research that includes funding grants. Dr. Schofer reports a relation with Edwards Lifesciences and St Jude Medical that includes travel reimbursement; and Boston Scientific that includes: speaking and lecture fees and travel reimbursement. Dr. Conradi reports a relation with Abbott, Medtronic, and JenaValve that includes board membership; Edwards Lifesciences, Boston Scientific, VenusMedtech, MicroPort, PiCardia, MicroInterventions, Neovasc, and Smartcanula Sarl that includes consulting or advisory. Dr. Seiffert reports a relation with JenaValve and Boston Scientific that includes: consulting or advisory; Edwards Lifesciences, JenaValve Technology Inc., Boston Scientific, and Biotronik that includes travel reimbursement; and Medtronic that includes speaking and lecture fees. The remaining authors have no competing interests to declare. EDAT- 2024/11/13 14:00 MHDA- 2025/01/10 00:21 CRDT- 2024/11/08 19:28 PHST- 2024/06/24 00:00 [received] PHST- 2024/10/09 00:00 [revised] PHST- 2024/10/26 00:00 [accepted] PHST- 2025/01/10 00:21 [medline] PHST- 2024/11/13 14:00 [pubmed] PHST- 2024/11/08 19:28 [entrez] AID - S0002-9149(24)00773-2 [pii] AID - 10.1016/j.amjcard.2024.10.033 [doi] PST - ppublish SO - Am J Cardiol. 2025 Feb 1;236:23-29. doi: 10.1016/j.amjcard.2024.10.033. Epub 2024 Nov 7. PMID- 39514071 OWN - NLM STAT- MEDLINE DCOM- 20250430 LR - 20260813 IS - 1937-5395 (Electronic) IS - 1937-5387 (Print) IS - 1937-5387 (Linking) VI - 18 IP - 2 DP - 2025 Apr TI - Hyperspectral Imaging for Microcirculatory Assessment of Patients undergoing Transcatheter and Surgical Aortic Valve Replacement-a Prospective Observational Pilot Study. PG - 295-304 LID - 10.1007/s12265-024-10573-z [doi] AB - This prospective, observational study evaluated Hyperspectral Imaging (HSI) to assess the effects of cardiac surgery and cardiopulmonary bypass (CPB) on microcirculation. 40 Patients with severe aortic stenosis were enrolled. 20 patients underwent transapical/transaxillary/transaortic aortic valve replacement (TAVR), 20 underwent an open surgical approach with CPB (SAVR). HSI was used to determine tissue oxygenation (StO(2) and NIR), hemoglobin (THI) and water content (TWI) at the palm before/after surgery (T1/T2), and on the third postoperative day (T3). TAVR patients showed no significant changes of microcirculatory parameters during surgery. TWI significantly increased until T3. SAVR patients showed an increase of TWI and a decrease of THI, while StO(2) and NIR remained unchanged at T2. In SAVR patients, StO(2) and NIR correlated negatively with the duration of CPB and StO(2) correlated with intraoperative urine output at T2. HSI was able to detect microcirculatory changes during cardiac surgery. CPB duration seemed to affect tissue oxygenation. Clinical trial registration: (German Clinical Trial Register): DRKS00024765. CI - (c) 2024. The Author(s). FAU - Dietrich, Maximilian AU - Dietrich M AUID- ORCID: 0000-0003-0960-038X AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. maximilian.dietrich@med.uni-heidelberg.de. FAU - Tayan, Aycan AU - Tayan A AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. FAU - Holle, Tobias AU - Holle T AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. FAU - Nusshag, Christian AU - Nusshag C AD - Department of Nephrology, Heidelberg University Hospital, Heidelberg, Germany. FAU - Kapp, Anne-Christine AU - Kapp AC AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. FAU - Mertens, Christina AU - Mertens C AD - Center for Translational Biomedical Iron Research, Department of Pediatric Oncology, Immunology, and Hematology, University of Heidelberg, INF 350, 69120, Heidelberg, Germany. FAU - Studier-Fischer, Alexander AU - Studier-Fischer A AD - Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany. FAU - Nickel, Felix AU - Nickel F AD - Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany. FAU - Leuschner, Florian AU - Leuschner F AD - Department of Internal Medicine III, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. FAU - Weigand, Markus Alexander AU - Weigand MA AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. FAU - Karck, Matthias AU - Karck M AD - Institute of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany. FAU - Lichtenstern, Christoph AU - Lichtenstern C AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. FAU - Arif, Rawa AU - Arif R AD - Institute of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany. FAU - Fischer, Dania AU - Fischer D AD - Department of Anesthesiology, Heidelberg University, Medical Faculty Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20241108 PL - United States TA - J Cardiovasc Transl Res JT - Journal of cardiovascular translational research JID - 101468585 RN - 0 (Biomarkers) RN - S88TT14065 (Oxygen) RN - 0 (Hemoglobins) SB - IM MH - Humans MH - Pilot Projects MH - *Microcirculation MH - Prospective Studies MH - Male MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging/blood MH - Female MH - Aged MH - *Heart Valve Prosthesis Implantation/adverse effects/methods MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Treatment Outcome MH - Predictive Value of Tests MH - Aged, 80 and over MH - Time Factors MH - *Hyperspectral Imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Cardiopulmonary Bypass/adverse effects MH - Severity of Illness Index MH - Spectroscopy, Near-Infrared MH - Biomarkers/blood MH - Oxygen/blood MH - Hemoglobins/metabolism PMC - PMC12043735 OTO - NOTNLM OT - Aortic valve replacement OT - Capillary leak OT - Cardiopulmonary bypass OT - Hyperspectral imaging OT - Microcirculation OT - Tissue oxygenation COIS- Declarations. Human Subjects/Informed Consent Statement: The study has been performed in conformance with the ethical standards of the Declaration of Helsinki and its later amendments. Ethical approval for this study (reference number S-128/2021) was provided by the Ethical Committee of the Medical Faculty of Heidelberg University, Alte Glockengiesserei 11/1, 69,115 Heidelberg, Germany (Chairperson Prof. Dr. med. Dr. h.c. Thomas Strowitzki) on 04 March 2021. Informed consent was obtained from all patients for being included in the study. Conflicts of Interest: The authors declare no conflict of interest. This study was supported by Diaspective Vision through the provision of the TIVITA(R) Tissue System. Diaspective Vision had no role in the design, execution, interpretation, or writing of the study. EDAT- 2024/11/13 13:47 MHDA- 2025/04/30 12:30 PMCR- 2024/11/08 CRDT- 2024/11/08 11:06 PHST- 2023/09/21 00:00 [received] PHST- 2024/10/18 00:00 [accepted] PHST- 2024/10/14 00:00 [revised] PHST- 2025/04/30 12:30 [medline] PHST- 2024/11/13 13:47 [pubmed] PHST- 2024/11/08 11:06 [entrez] PHST- 2024/11/08 00:00 [pmc-release] AID - 10.1007/s12265-024-10573-z [pii] AID - 10573 [pii] AID - 10.1007/s12265-024-10573-z [doi] PST - ppublish SO - J Cardiovasc Transl Res. 2025 Apr;18(2):295-304. doi: 10.1007/s12265-024-10573-z. Epub 2024 Nov 8. PMID- 39509083 OWN - NLM STAT- MEDLINE DCOM- 20241107 LR - 20250707 IS - 1424-3997 (Electronic) IS - 0036-7672 (Linking) VI - 154 DP - 2024 Oct 24 TI - Transcatheter aortic valve implantation with SAPIEN 3 versus surgical aortic valve replacement in patients with symptomatic severe aortic stenosis at low risk of surgical mortality: a cost-utility analysis for Switzerland. PG - 3558 LID - 10.57187/s.3558 [doi] AB - AIMS OF THE STUDY: The 2021 European Society of Cardiology Guidelines on valvular heart disease recommend transcatheter aortic valve implantation (TAVI) for patients with symptomatic severe aortic stenosis at low surgical risk and age >/=75 years who are suitable for a transfemoral approach (recommendation class IA) based on two large randomised controlled trials (PARTNER 3 and Evolut Low Risk) comparing transcatheter aortic valve implantation with surgical aortic valve replacement (SAVR). Whether such an approach is cost-effective in Switzerland remains unclear. The aim of this cost-utility analysis was to compare transcatheter aortic valve implantation with SAPIEN 3 versus surgical aortic valve replacement in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of Swiss compulsory health insurance using data from the PARTNER 3 trial (reflecting specifically the safety and efficacy of the SAPIEN 3 TAVI device). METHODS: A previously published two-stage Markov-based model that captured clinical outcomes from the PARTNER 3 trial was adapted from the perspective of the Swiss compulsory health insurance system, using local or geographically close general population mortality and utility data, unit costs and medical resource use from publicly available sources and based on expert opinion. The model had a lifetime horizon with a 3% yearly discounting factor. The cost-utility analysis estimated changes in both direct healthcare costs and health-related quality-adjusted life years for transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with symptomatic severe aortic stenosis at low risk of surgical mortality. RESULTS: Overall, transcatheter aortic valve implantation with SAPIEN 3 resulted in lifetime costs per patient of CHF 79,534 and quality-adjusted life years per patient of 9.64, compared with surgical aortic valve replacement lifetime costs and quality-adjusted life years per patient of CHF 76,891 and 8.96, respectively. Compared with surgical aortic valve replacement, transcatheter aortic valve implantation was estimated to offer an incremental improvement of +0.68 quality-adjusted life years per patient at an increased cost of +CHF 2643 per patient over a lifetime horizon. The incremental cost-effectiveness ratio was CHF 3866 per quality-adjusted life year gained and remained below CHF 50,000 per quality-adjusted life year gained across several sensitivity analyses. CONCLUSIONS: This analysis suggests that transcatheter aortic valve implantation using the SAPIEN 3 device is likely to be a highly cost-effective alternative for symptomatic severe aortic stenosis patients at a low risk of surgical mortality, treated in the contemporary Swiss setting. These findings may help to inform a holistic approach when making policy decisions for the management of this patient group. FAU - Wyss, Christophe Alain AU - Wyss CA AD - University of Zurich, HerzKlinik Hirslanden, Zurich, Switzerland. FAU - Corti, Roberto AU - Corti R AD - University of Zurich, HerzKlinik Hirslanden, Zurich, Switzerland. FAU - Nestelberger, Thomas AU - Nestelberger T AD - University of Basel, Basel, Switzerland. FAU - Candolfi, Pascal AU - Candolfi P AD - Edwards Lifesciences, Nyon, Switzerland. FAU - Delbaere, Alexis AU - Delbaere A AD - Edwards Lifesciences, Nyon, Switzerland. FAU - Fischer, Barbara AU - Fischer B AD - Polynomics AG, Olten, Switzerland. FAU - Schwenkglenks, Matthias AU - Schwenkglenks M AD - Health Economics Facility, Department of Public Health, University of Basel, Basel, Switzerland. FAU - Telser, Harry AU - Telser H AD - Polynomics AG, Olten, Switzerland. AD - Center for Health, Policy and Economics, University of Lucerne, Lucerne, Switzerland. LA - eng PT - Comparative Study PT - Journal Article DEP - 20241024 PL - Switzerland TA - Swiss Med Wkly JT - Swiss medical weekly JID - 100970884 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/economics/methods/mortality MH - *Aortic Valve Stenosis/surgery/economics/mortality MH - Switzerland MH - *Cost-Benefit Analysis MH - *Quality-Adjusted Life Years MH - Aged MH - Male MH - Female MH - Heart Valve Prosthesis Implantation/economics/methods MH - Aged, 80 and over MH - Aortic Valve/surgery MH - Heart Valve Prosthesis/economics MH - Markov Chains EDAT- 2024/11/13 13:57 MHDA- 2024/11/14 03:58 CRDT- 2024/11/07 11:23 PHST- 2024/11/14 03:58 [medline] PHST- 2024/11/13 13:57 [pubmed] PHST- 2024/11/07 11:23 [entrez] AID - 3558 [pii] AID - 10.57187/s.3558 [doi] PST - epublish SO - Swiss Med Wkly. 2024 Oct 24;154:3558. doi: 10.57187/s.3558. PMID- 39503651 OWN - NLM STAT- MEDLINE DCOM- 20250108 LR - 20260918 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 85 IP - 1 DP - 2025 Jan 7 TI - Effect of Valve Type and Anesthesia Strategy for TAVR: 5-Year Results of the SOLVE-TAVI Trial. PG - 74-82 LID - S0735-1097(24)08456-0 [pii] LID - 10.1016/j.jacc.2024.09.007 [doi] AB - BACKGROUND: In the randomized SOLVE-TAVI (compariSon of secOnd-generation seLf-expandable vs. balloon-expandable Valves and gEneral vs. local anesthesia in Transcatheter Aortic Valve Implantation) trial comparing newer-generation self-expanding valves (SEV) and balloon-expandable valves (BEV), as well as conscious sedation (CS) and general anesthesia (GA), clinical outcomes were similar both for valve and anesthesia comparison at 30 days and 1 year. Prosthesis durability may affect clinical outcomes during long-term follow-up. Moreover, the impact of the anesthesia strategy on long-term clinical outcomes is unknown so far. OBJECTIVES: The authors sought to compare clinical outcomes during 5-year follow-up in the randomized SOLVE-TAVI trial. METHODS: In the randomized, multicenter, 2 x 2 factorial, open-label SOLVE-TAVI trial, 447 intermediate- to high-risk patients with severe, symptomatic aortic stenosis were randomly assigned to transfemoral transcatheter aortic valve replacement (TAVR) using either SEV (Evolut R, Medtronic) or BEV (SAPIEN 3, Edwards Lifesciences) and also to CS vs GA. Patients were followed-up for 5 years. RESULTS: During 5 years of follow-up, the combined predefined endpoint of all-cause mortality, stroke, moderate or severe paravalvular leakage, and permanent pacemaker implantation was similar in the SEV and BEV groups (67.7% vs 63.4%; HR: 0.89; 95% CI: 0.70-1.13; P = 0.34). Stroke rates at 5 years were lower in the SEV group (2.2% vs 9.6%; HR: 4.84; 95% CI: 1.65-14.18; P = 0.002). Regarding the anesthesia comparison, the primary endpoint of all-cause mortality, stroke, myocardial infarction, and acute kidney injury occurred in 51.4% in the CS group and 61.3% in the GA group (HR: 0.80; 95% CI: 0.62-1.04; P = 0.09). All-cause mortality at 5 years was lower for CS (41.5% vs 54.3%; HR: 0.70; 95% CI: 0.53-0.94; P = 0.02). CONCLUSIONS: Transfemoral TAVR using either SEV and BEV as well as CS and GA showed similar clinical outcomes at 5 years using a combined clinical endpoint. CI - Copyright (c) 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Feistritzer, Hans-Josef AU - Feistritzer HJ AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany. Electronic address: hans-josef.feistritzer@medizin.uni-leipzig.de. FAU - Kurz, Thomas AU - Kurz T AD - University Heart Center Lubeck, Lubeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Vonthein, Reinhard AU - Vonthein R AD - Institute of Medical Biometry and Statistics, Lubeck, Germany. FAU - Schroder, Leonie AU - Schroder L AD - Institute of Medical Biometry and Statistics, Lubeck, Germany. FAU - Stachel, Georg AU - Stachel G AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany; Clinic and Policlinic for Cardiology, Leipzig University Clinic, Leipzig, Germany. FAU - Eitel, Ingo AU - Eitel I AD - University Heart Center Lubeck, Lubeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Marquetand, Christoph AU - Marquetand C AD - University Heart Center Lubeck, Lubeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Saraei, Roza AU - Saraei R AD - University Heart Center Lubeck, Lubeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Kirchhof, Eva AU - Kirchhof E AD - Helios Health Institute, Leipzig, Germany. FAU - Heringlake, Matthias AU - Heringlake M AD - University Heart Center Lubeck, Lubeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Desch, Steffen AU - Desch S AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig at University of Leipzig, Leipzig, Germany. CN - SOLVE-TAVI Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20241106 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Female MH - Male MH - Aged, 80 and over MH - *Heart Valve Prosthesis MH - Follow-Up Studies MH - Aged MH - Anesthesia, General/methods MH - Treatment Outcome MH - Prosthesis Design MH - Aortic Valve/surgery MH - Time Factors MH - Postoperative Complications/epidemiology/prevention & control OTO - NOTNLM OT - anesthesia OT - aortic stenosis OT - prognosis OT - transcatheter aortic valve implantation OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Funding was provided by the German Heart Research Foundation and the Helios Health Institute (formerly the Leipzig Heart Institute). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/11/06 16:18 MHDA- 2025/01/09 00:22 CRDT- 2024/11/06 10:33 PHST- 2024/07/24 00:00 [received] PHST- 2024/09/06 00:00 [revised] PHST- 2024/09/11 00:00 [accepted] PHST- 2025/01/09 00:22 [medline] PHST- 2024/11/06 16:18 [pubmed] PHST- 2024/11/06 10:33 [entrez] AID - S0735-1097(24)08456-0 [pii] AID - 10.1016/j.jacc.2024.09.007 [doi] PST - ppublish SO - J Am Coll Cardiol. 2025 Jan 7;85(1):74-82. doi: 10.1016/j.jacc.2024.09.007. Epub 2024 Nov 6. PMID- 39492973 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241105 IS - 1949-8462 (Print) IS - 1949-8462 (Electronic) VI - 16 IP - 10 DP - 2024 Oct 26 TI - Percutaneous decannulation of extracorporeal membrane oxygenation using MANTA device: A real-world single-center experience. PG - 574-579 LID - 10.4330/wjc.v16.i10.574 [doi] AB - BACKGROUND: The MANTA vascular closure device (VCD) represents a novel approach to achieving hemostasis after large-bore femoral access procedures. Numerous clinical studies have evaluated the efficacy of the MANTA device across a range of patient populations undergoing different procedures. However, there is still a paucity of data available concerning the use of MANTA devices in aiding the decannulation of venoarterial extracorporeal membrane oxygenation (VA-ECMO). AIM: To present our single-center experience of utilizing the MANTA VCD in patients undergoing this procedure. METHODS: This single-center study included all patients undergoing percutaneous decannulation of femoral VA-ECMO using the MANTA plug-based VCD between January 2021 and October 2023 at University Hospitals Cleveland Medical Center. Inclusion criteria were adult patients who required prolonged (> 24 hours) hemodynamic support with VA-ECMO. Outcomes included all-cause mortality, hemostasis, bleeding, limb ischemia, and site infection. RESULTS: This is a retrospective cohort study of 19 patients with a mean age of 56.8 years. Twelve of them were males with a mean body mass index of 29. The most common extracorporeal membrane oxygenation indication was acute coronary syndrome complicated by cardiogenic shock at 36.8%. The mean length of intensive care unit stay for these patients was 18.8 +/- 8.42 days. Seventeen out of 19 patients survived to discharge. The MANTA device was successfully deployed in 19 patients, with 10 procedures conducted at the bedside and 9 in an operating room setting. Complete hemostasis was achieved within 5 minutes of MANTA deployment in 17 out of 19 patients. In 2 patients manual compression after Manta deployment was required to achieve adequate hemostasis. Additionally, acute lower extremity ischemia was noted in two patients, necessitating endovascular interventions. No infections were reported at the site of MANTA deployment. CONCLUSION: Overall, based on our experience and that of other centers, the MANTA VCD has proven to be a simple, safe, and effective percutaneous technique for facilitating in the OR, but most of all it opens the opportunity for bedside VA-ECMO decannulation. Post-decannulation ischemic complications are higher in this series of sick patients when compared with elective procedures like transcatheter aortic valve replacement and endovascular aneurysm repair. Additionally, operators should be mindful of the incidence of ischemic complications. Distal Doppler pulse signals should always be checked, to indicate bailout options when this occurs. CI - (c)The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved. FAU - Milioglou, Ioannis AU - Milioglou I AD - Department of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States. ioannismilioglou@gmail.com. FAU - Qian, Alice AU - Qian A AD - Department of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States. FAU - Salerno, Pedro Rafael Vieira de Oliveira AU - Salerno PRVO AD - Department of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States. FAU - Pereira, Gabriel Tensol Rodrigues AU - Pereira GTR AD - Department of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States. FAU - Palma Dallan, Luis Augusto AU - Palma Dallan LA AD - Department of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States. FAU - Gray, Kelsey E AU - Gray KE AD - Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States. FAU - Morrison, Michael AU - Morrison M AD - Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States. FAU - Abu-Omar, Yasir AU - Abu-Omar Y AD - Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States. FAU - Eldiasty, Mohammad AU - Eldiasty M AD - Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States. FAU - Baeza, Cristian AU - Baeza C AD - Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States. LA - eng PT - Journal Article PL - United States TA - World J Cardiol JT - World journal of cardiology JID - 101537090 PMC - PMC11525797 OTO - NOTNLM OT - Decannulation OT - Extracorporeal membrane oxygenation OT - Hemostasis OT - Ischemia OT - MANTA COIS- Conflict-of-interest statement: No conflict of interest is declared by the authors of this manuscript. EDAT- 2024/11/04 06:23 MHDA- 2024/11/04 06:24 PMCR- 2024/10/26 CRDT- 2024/11/04 04:57 PHST- 2024/04/25 00:00 [received] PHST- 2024/08/12 00:00 [revised] PHST- 2024/09/11 00:00 [accepted] PHST- 2024/11/04 06:24 [medline] PHST- 2024/11/04 06:23 [pubmed] PHST- 2024/11/04 04:57 [entrez] PHST- 2024/10/26 00:00 [pmc-release] AID - 10.4330/wjc.v16.i10.574 [doi] PST - ppublish SO - World J Cardiol. 2024 Oct 26;16(10):574-579. doi: 10.4330/wjc.v16.i10.574. PMID- 39480381 OWN - NLM STAT- MEDLINE DCOM- 20250305 LR - 20250630 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 85 IP - 9 DP - 2025 Mar 11 TI - Transcatheter Aortic Valve Replacement in Patients With Systolic Heart Failure and Moderate Aortic Stenosis: TAVR UNLOAD. PG - 878-890 LID - S0735-1097(24)09960-1 [pii] LID - 10.1016/j.jacc.2024.10.070 [doi] AB - BACKGROUND: Neurohormonal modulation and afterload reduction are key for treatment of heart failure with reduced ejection fraction (HFrEF). In HFrEF patients with concomitant moderate aortic stenosis (AS), treatment with transcatheter aortic valve replacement (TAVR) may be complementary to guideline-directed medical therapy (GDMT). OBJECTIVES: This study sought to determine whether TAVR for moderate AS provides clinical benefit in patients with HFrEF on top of GDMT. METHODS: We performed an investigator-initiated, international, randomized controlled trial in patients with HFrEF on GDMT with moderate AS who were suitable for transfemoral TAVR with a balloon-expandable valve. Patients were randomized 1:1 to TAVR or clinical aortic stenosis surveillance (CASS) with aortic valve replacement upon progression to severe AS. The primary endpoint was the hierarchical occurrence of: 1) all-cause death; 2) disabling stroke; 3) disease-related hospitalizations and heart failure equivalents; and 4) change from baseline in the Kansas City Cardiomyopathy Questionnaire Overall Summary Score analyzed using the win ratio. RESULTS: From January 2017 to December 2022, 178 patients were randomized to TAVR (n = 89) or AS surveillance (n = 89). The mean age was 77 years, 20.8% were female, and 55.6% were in NYHA functional class III or IV. The median follow-up duration was 23 months (Q1-Q3: 12-33 months). A total of 38 (43%) patients in the CASS group (of whom 35 had progressed to severe AS) underwent TAVR at a median of 12 months postrandomization. TAVR was associated with wins in 47.6% of pairs, compared with 36.6% in the CASS group, resulting in a win ratio of 1.31 (95% CI: 0.91-1.88; P = 0.14). At 1 year, TAVR resulted in a greater improvement in the Kansas City Cardiomyopathy Questionnaire Overall Summary Score compared with the CASS group (12.8 +/- 21.9 points vs 3.2 +/- 22.8 points; P = 0.018). CONCLUSIONS: TAVR was not superior to AS surveillance for the primary hierarchical composite endpoint in patients with moderate AS and HFrEF on GDMT. Preemptive TAVR for moderate AS was safe and may provide clinically meaningful quality-of-life benefits. CI - Copyright (c) 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: n.vanmieghem@erasmusmc.nl. FAU - Elmariah, Sammy AU - Elmariah S AD - Division of Cardiology, University of San Francisco, San Francisco, California, USA. FAU - Spitzer, Ernest AU - Spitzer E AD - Department of Cardiology, Thoraxcenter, Cardiovascular Institute, Erasmus University Medical Center, Rotterdam, the Netherlands; Cardialysis, Rotterdam, the Netherlands. FAU - Pibarot, Philippe AU - Pibarot P AD - Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Nazif, Tamim M AU - Nazif TM AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA. FAU - Bax, Jeroen J AU - Bax JJ AD - Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. FAU - Hahn, Rebecca T AU - Hahn RT AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Popma, Alexandra AU - Popma A AD - Cardiovascular Research Foundation, New York, New York, USA. FAU - Ben-Yehuda, Ori AU - Ben-Yehuda O AD - Division of Cardiovascular Medicine, University of California San Diego, San Diego, California, USA. FAU - Kallel, Faouzi AU - Kallel F AD - Edwards Lifesciences, Irvine, California, USA. FAU - Redfors, Bjorn AU - Redfors B AD - Cardiovascular Research Foundation, New York, New York, USA; Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Wallenberg Laboratory, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. FAU - Chuang, Michael L AU - Chuang ML AD - Cardiovascular Research Foundation, New York, New York, USA. FAU - Alu, Maria C AU - Alu MC AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Lindeboom, Wietze AU - Lindeboom W AD - Cardialysis, Rotterdam, the Netherlands. FAU - Kolte, Dhaval AU - Kolte D AD - Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA. FAU - Zahr, Firas E AU - Zahr FE AD - Oregon Health and Science University, Portland, Oregon, USA. FAU - Kodali, Susheel K AU - Kodali SK AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA. FAU - Strote, Justin A AU - Strote JA AD - Medical Center of the Rockies, Loveland, Colorado, USA. FAU - Hermanides, Renicus S AU - Hermanides RS AD - Department of Cardiology, Isala Heart Center, Zwolle, the Netherlands. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York, New York, USA; St Francis Hospital, Roslyn, New York, USA. FAU - Tijssen, Jan G P AU - Tijssen JGP AD - Cardialysis, Rotterdam, the Netherlands; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. FAU - Leon, Martin B AU - Leon MB AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20241028 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery/complications MH - Male MH - Female MH - Aged MH - Aged, 80 and over MH - *Heart Failure, Systolic/complications/surgery/physiopathology MH - Stroke Volume/physiology MH - Treatment Outcome MH - Severity of Illness Index OTO - NOTNLM OT - heart failure with reduced ejection fraction OT - moderate aortic stenosis OT - randomized controlled trial OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures The TAVR UNLOAD trial was funded by an investigator-initiated grant from Edwards Lifesciences. The funder had no role in the study design, data collection or management, or the statistical analyses. The principal investigators had unrestricted access to the study data, wrote the manuscript, and vouched for the accuracy and completeness of the data and for the fidelity of the trial to the protocol. All the authors reviewed and approved the manuscript. Dr Van Mieghem has received grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Medtronic; and has received advisory fees from Abbott, Boston Scientific, Pulse Cath BV, and Medtronic. Dr Elmariah has received research grants from Edwards Lifesciences and Medtronic; and has received consulting fees from Edwards Lifesciences. Dr Spitzer has held institutional contracts/grants for which he receives no direct compensation from Abbott, Biosensors Europe SA, Boston Scientific, Edwards Lifesciences, Medtronic, Mixin Medtech (Suzhou), Shanghai Microport Medical, NVT GmbH, Philips Healthcare, Pie Medical Imaging, Shanghai Shenqi Medical Technologies, and Siemens Healthcare GmbH. Dr Pibarot has received funding from Edwards Lifesciences, Pi-Cardia, and Cardiac Success for echocardiography core laboratory analyses in the field of transcatheter valve therapies and Medtronic for in vitro analyses, with no personal compensation. Dr Nazif has received consulting fees or honoraria from Medtronic, Boston Scientific, Teleflex, Encompass Technologies, and Opsens Medical; and has received institutional research grants from Edwards Lifesciences, Boston Scientific, Medtronic, and Abbott. Dr Bax has received speaker fees from Abbott and Edwards Lifesciences. Dr Hahn has received speaker fees from Abbott Structural, Baylis Medical, Edwards Lifesciences, Medtronic, Philips Healthcare, and Siemens Healthineers; has held institutional consulting contracts for which she receives no direct compensation from Abbott Structural, Edwards Lifesciences, Medtronic, and Novartis; and is Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored tricuspid valve trials, for which she receives no direct industry compensation. Dr Popma's spouse is a Medtronic employee. Dr Ben-Yehuda has received consulting fees from Edwards Lifesciences, Medtronic, Cardiovalve, and Bioventrix. Dr Redfors has received consulting fees from Pfizer and Boehringer Ingelheim. Dr Kodali has received grant support, paid to his institution, from Medtronic, Boston Scientific, and Abbott Vascular; has received consulting fees from Abbott Vascular, Claret Medical, Admedus, and Meril Life Sciences; and holds equity options in BioTrace Medical, Dura Biotech, and Thubrikar Aortic Valve. Dr Hermanides has received lecture fees from Abbott Vascular, Amgen, and Novartis. Dr Cohen has received research grant support from Edwards Lifesciences, Abbott, Boston Scientific, Corvia Medical, Philips, Brain-Q, Saranas, Zoll Medical, CathWorks, and ANCORA; and has received consulting fees from Medtronic, Edwards Lifesciences, Abbott, Boston Scientific, Corvia Medical, Impulse Dynamics, AngioInsight, and HeartBeam. Dr Leon has received institutional clinical research grants from Abbott, Boston Scientific, Edwards, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/10/31 12:28 MHDA- 2025/03/06 05:04 CRDT- 2024/10/31 11:32 PHST- 2024/09/06 00:00 [received] PHST- 2024/10/10 00:00 [revised] PHST- 2024/10/11 00:00 [accepted] PHST- 2025/03/06 05:04 [medline] PHST- 2024/10/31 12:28 [pubmed] PHST- 2024/10/31 11:32 [entrez] AID - S0735-1097(24)09960-1 [pii] AID - 10.1016/j.jacc.2024.10.070 [doi] PST - ppublish SO - J Am Coll Cardiol. 2025 Mar 11;85(9):878-890. doi: 10.1016/j.jacc.2024.10.070. Epub 2024 Oct 28. PMID- 39477639 OWN - NLM STAT- MEDLINE DCOM- 20241030 LR - 20260708 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 20 DP - 2024 Oct 28 TI - Characteristics, Trends, and Outcomes of Intravascular Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Replacement in United States. PG - 2367-2376 LID - S1936-8798(24)01153-1 [pii] LID - 10.1016/j.jcin.2024.08.033 [doi] AB - BACKGROUND: Transfemoral (TF) access is the preferred approach for transcatheter aortic valve replacement (TAVR). Limited data exist regarding the outcomes of intravascular lithotripsy (IVL)-assisted TF TAVR in patients with peripheral artery disease. OBJECTIVES: This study sought to examine contemporary characteristics, trends, and outcomes of IVL TAVR in the United States. METHODS: The Vizient Clinical Database was queried for patients who underwent percutaneous TAVR between October 1, 2020, and November 30, 2023. Outcomes with IVL TAVR vs non-IVL TAVR were examined after propensity score matching. The primary outcome was a composite of in-hospital death, stroke, vascular complications, surgical vascular intervention, and major bleeding. RESULTS: Over the study period, 129,655 patients (mean age of 78.4 years, 42.2% women, 87.1% White) underwent percutaneous TAVR at 361 hospitals, 1,242 (0.96%) of whom underwent IVL TAVR. There was an uptrend in IVL TAVR, but the frequency remained low. IVL TAVR patients had a higher median Elixhauser comorbidity score (5 [Q1-Q3: 4-7] vs 4 [Q1-Q3: 3-6]) compared to non-IVL TAVR. TAVR was completed via the TF approach in 1,238 (99.7%) IVL TAVR patients. In a 3:1 propensity score matching analysis, IVL TAVR was associated with a higher rate of the primary composite outcome (21.9% vs 13.7%; P < 0.001) driven by higher rates of vascular complications, surgical vascular intervention, and major bleeding. In-hospital death and stroke were similar in both groups. CONCLUSIONS: In the United States, IVL is increasingly adopted to facilitate TF TAVR. IVL TAVR patients exhibited a higher burden of comorbidities and experienced more complications compared to non-IVL TAVR patients. Further studies are needed to identify appropriate anatomical and clinical use criteria for IVL TAVR and to compare its outcomes vs alternative non-TF TAVR. CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Imran, Hafiz M AU - Imran HM AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Has, Phinnara AU - Has P AD - Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Kassis, Nicholas AU - Kassis N AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Shippey, Ernie AU - Shippey E AD - Vizient Center for Advanced Analytics, Chicago, Illinois, USA. FAU - Elkaryoni, Ahmed AU - Elkaryoni A AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Gordon, Paul C AU - Gordon PC AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Sharaf, Barry L AU - Sharaf BL AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Soukas, Peter A AU - Soukas PA AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Hyder, Omar N AU - Hyder ON AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Sellke, Frank AU - Sellke F AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Division of Cardiothoracic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Ehsan, Afshin AU - Ehsan A AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Division of Cardiothoracic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Sodha, Neel AU - Sodha N AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Division of Cardiothoracic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Mentias, Amgad AU - Mentias A AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Elgendy, Islam Y AU - Elgendy IY AD - Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky, USA. FAU - Alkhouli, Mohamad AU - Alkhouli M AD - Department of Cardiology, Mayo Clinic School of Medicine, Rochester, Minnesota, USA. FAU - Abbott, J Dawn AU - Abbott JD AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. FAU - Aronow, Herbert D AU - Aronow HD AD - Henry Ford Health and Michigan State University, Detroit, Michigan, USA. FAU - Saad, Marwan AU - Saad M AD - Lifespan Cardiovascular Institute, Providence, Rhode Island, USA; Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Electronic address: marwan_saad@brown.edu. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Oct 28;17(20):2377-2378. doi: 10.1016/j.jcin.2024.09.049. PMID: 39477640 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/trends MH - Female MH - Male MH - Aged MH - Aged, 80 and over MH - Treatment Outcome MH - United States MH - *Femoral Artery MH - Risk Factors MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology MH - *Databases, Factual MH - Time Factors MH - *Hospital Mortality MH - *Catheterization, Peripheral/adverse effects/trends/mortality MH - *Lithotripsy/adverse effects/trends MH - Risk Assessment MH - Retrospective Studies MH - Punctures MH - Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Peripheral Arterial Disease/therapy/mortality MH - Postoperative Complications/epidemiology OTO - NOTNLM OT - intravascular lithotripsy OT - outcomes OT - peripheral artery disease OT - shock wave OT - transcatheter aortic valve replacement OT - transfemoral COIS- Funding Support and Author Disclosures Dr Soukas has received institutional research grants from Shockwave Medical. Dr Abbott has received personal fees for consulting from Abbott, Medtronic, and Penumbra Inc; and has received institutional research grants from Boston Scientific, Recor Medical, Med Alliance, and Shockwave Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/10/31 04:20 MHDA- 2024/10/31 04:21 CRDT- 2024/10/30 21:58 PHST- 2023/12/08 00:00 [received] PHST- 2024/08/19 00:00 [revised] PHST- 2024/08/22 00:00 [accepted] PHST- 2024/10/31 04:21 [medline] PHST- 2024/10/31 04:20 [pubmed] PHST- 2024/10/30 21:58 [entrez] AID - S1936-8798(24)01153-1 [pii] AID - 10.1016/j.jcin.2024.08.033 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Oct 28;17(20):2367-2376. doi: 10.1016/j.jcin.2024.08.033. PMID- 39475726 OWN - NLM STAT- MEDLINE DCOM- 20250303 LR - 20250516 IS - 0301-1526 (Print) IS - 0301-1526 (Linking) VI - 54 IP - 2 DP - 2025 Mar TI - Comparison of patients with occlusive or hemorrhagic access site complications requiring reintervention after percutaneous transfemoral transcatheter aortic valve implantation. PG - 133-141 LID - 10.1024/0301-1526/a001154 [doi] AB - Background: Transcatheter aortic valve implantation (TAVI) via transfemoral (TF) access is increasingly integral to aortic valve disease treatment, expanding beyond high-risk patients. Despite technical advancements, access-related vascular complications, occurring in approximately 10% of TAVI procedures, remain a substantial challenge. Objective: This study investigated the clinical and morphological characteristics of percutaneous TF-TAVI patients experiencing occlusive (OC) and hemorrhagic (HC) complications managed with surgical or endovascular reintervention. Methods: The cohort included patients from a Dutch and a German tertiary referral hospital, managed with TF-TAVI procedures between 2017 and 2021 that required reintervention for OC or HC. Demographics, comorbidities, procedural details, and preoperative imaging data were collected and compared between groups. Results: Among 109 TF-TAVI patients, 32 with OC and 77 with HC required reintervention. The OC group presented significantly smaller access arterial diameters (common femoral artery: OC 6.7 mm vs. HC 8.9 mm, p<.001; external iliac artery: OC 7.2 mm vs. HC 8.3 mm, p<.001; common iliac artery: OC 9.4 mm vs. HC 10.5 mm, p=.012) while the HC group presented higher tortuosity index (TI) (OC 1.24 vs. HC 1.30; p=.017). No differences were observed regarding baseline characteristics, vessel calcification or vascular closure device use. Conclusions: In patients requiring reintervention following TF-TAVI, smaller arterial diameters were associated with OC, while higher TI was linked to HC. These findings emphasize the importance of preoperative imaging in developing individualized prevention strategies. FAU - Wegner, Moritz AU - Wegner M AUID- ORCID: 0000-0003-0601-9223 AD - Department of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Smeets, Reinier R AU - Smeets RR AUID- ORCID: 0009-0006-6361-6912 AD - Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Department of Vascular Surgery, Slingeland Ziekenhuis, Doetinchem, The Netherlands. FAU - Veenstra, Leo F AU - Veenstra LF AD - Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Department of Cardiology, Zuyderland Medical Center, Heerlen, The Netherlands. FAU - Ahmad, Wael AU - Ahmad W AUID- ORCID: 0000-0001-5090-3468 AD - Department of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Behrens, Amelie L AU - Behrens AL AD - Department of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Kursch, Florian AU - Kursch F AD - Department of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Wienemann, Hendrik AU - Wienemann H AUID- ORCID: 0000-0001-5810-2868 AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Dorweiler, Bernhard AU - Dorweiler B AD - Department of Vascular and Endovascular Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Adam, Matti AU - Adam M AUID- ORCID: 0000-0002-6990-8135 AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Mees, Barend M E AU - Mees BME AUID- ORCID: 0000-0001-6545-5813 AD - Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. FAU - Meertens, Max M AU - Meertens MM AUID- ORCID: 0000-0002-7746-8723 AD - Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20241030 PL - Switzerland TA - Vasa JT - VASA. Zeitschrift fur Gefasskrankheiten JID - 0317051 SB - IM MH - Humans MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Female MH - *Femoral Artery/diagnostic imaging MH - Aged, 80 and over MH - Aged MH - Risk Factors MH - Treatment Outcome MH - Punctures MH - *Catheterization, Peripheral/adverse effects MH - *Hemorrhage/etiology/therapy/diagnostic imaging MH - Retrospective Studies MH - *Arterial Occlusive Diseases/etiology/diagnostic imaging/therapy MH - Netherlands MH - Germany MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Risk Assessment MH - *Postoperative Hemorrhage/etiology/therapy/diagnostic imaging OTO - NOTNLM OT - TAVI OT - Transcatheter aortic valve implantation OT - access site complication OT - vascular closure device EDAT- 2024/10/30 22:17 MHDA- 2025/03/03 06:21 CRDT- 2024/10/30 16:18 PHST- 2025/03/03 06:21 [medline] PHST- 2024/10/30 22:17 [pubmed] PHST- 2024/10/30 16:18 [entrez] AID - 10.1024/0301-1526/a001154 [doi] PST - ppublish SO - Vasa. 2025 Mar;54(2):133-141. doi: 10.1024/0301-1526/a001154. Epub 2024 Oct 30. PMID- 39475452 OWN - NLM STAT- In-Process LR - 20241110 IS - 1898-018X (Electronic) IS - 1897-5593 (Print) IS - 1898-018X (Linking) VI - 31 IP - 5 DP - 2024 TI - Severe angulation of the descending aorta with a kink: Buddy wire is key for a successful transfemoral transcatheter aortic valve replacement. PG - 778-779 LID - 10.5603/cj.100462 [doi] FAU - Mauler-Wittwer, Sarah AU - Mauler-Wittwer S AUID- ORCID: 0009-0002-3427-3931 AD - Department of Medicine, Cardiology Division, Structural Heart Unit, University Hospitals of Geneva, Switzerland. FAU - Arcens, Marc AU - Arcens M AD - Department of Medicine, Cardiology Division, Structural Heart Unit, University Hospitals of Geneva, Switzerland. FAU - Noble, Stephane AU - Noble S AUID- ORCID: 0000-0002-8018-2857 AD - Department of Medicine, Cardiology Division, Structural Heart Unit, University Hospitals of Geneva, Switzerland. stephane.noble@hug.ch. LA - eng PT - Journal Article PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 SB - IM PMC - PMC11544408 COIS- Conflict of interest: S. Noble reports to be a proctor for Medtronic. There are no conflicts of interest for the other authors. EDAT- 2024/10/30 12:24 MHDA- 2024/10/30 12:24 PMCR- 2024/10/30 CRDT- 2024/10/30 10:43 PHST- 2024/04/29 00:00 [received] PHST- 2024/09/15 00:00 [accepted] PHST- 2024/10/30 12:24 [medline] PHST- 2024/10/30 12:24 [pubmed] PHST- 2024/10/30 10:43 [entrez] PHST- 2024/10/30 00:00 [pmc-release] AID - VM/OJS/J/100462 [pii] AID - cardj-31-5-778 [pii] AID - 10.5603/cj.100462 [doi] PST - ppublish SO - Cardiol J. 2024;31(5):778-779. doi: 10.5603/cj.100462. PMID- 39474906 OWN - NLM STAT- MEDLINE DCOM- 20250213 LR - 20250523 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 46 IP - 7 DP - 2025 Feb 14 TI - Comparison of strategies for vascular ACCESS closure after Transcatheter Aortic Valve Implantation: the ACCESS-TAVI randomized trial. PG - 635-645 LID - 10.1093/eurheartj/ehae784 [doi] AB - BACKGROUND AND AIMS: Data from randomized trials investigating different access closure strategies after transfemoral transcatheter aortic valve implantation (TF-TAVI) remain scarce. In this study, two vascular closure device (VCD) strategies to achieve haemostasis after TF-TAVI were compared. METHODS: The ACCESS-TAVI (Comparison of Strategies for Vascular ACCESS Closure after Transcatheter Aortic Valve Implantation) is a prospective, multicentre trial in which patients undergoing TF-TAVI were randomly assigned to a strategy with a combined suture-/plug-based VCD strategy (suture/plug group) using one ProGlide/ProStyle (Abbott Vascular) and one Angio-Seal(R) (Terumo) vs. a suture-based VCD strategy (suture-only group) using two ProGlides/ProStyles. The primary endpoint was a composite of major or minor access site-related vascular complications during index hospitalization according to Valve Academic Research Consortium 3 criteria. Key secondary endpoints included time to haemostasis, bleeding type >/= 2, and all-cause mortality over 30 days. RESULTS: Between September 2022 and April 2024, 454 patients were randomized. The primary endpoint occurred in 27% (62/230) in the suture/plug group and 54% (121/224) in the suture-only group [relative risk .55 (95% confidence interval: .44, .68); P < .001]. Time to haemostasis was significantly shorter in the suture/plug group compared with the suture-only group (108 +/- 208 s vs. 206 +/- 171 s; P < .001). At 30 days, bleeding type >/= 2 occurred less often in the suture/plug group compared with the suture-only group [6.2% vs. 12.1%, relative risk .66 (.43, 1.02); P = .032], with no significant difference in mortality. CONCLUSIONS: With regard to the composite of major or minor access site-related vascular complications, a combined suture-/plug-based VCD strategy was superior to a suture-based VCD strategy for vascular access closure in patients undergoing TF-TAVI. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Rheude, Tobias AU - Rheude T AUID- ORCID: 0000-0002-3426-6080 AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Ruge, Hendrik AU - Ruge H AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Altaner, Niklas AU - Altaner N AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Alvarez Covarrubias, Hector AU - Alvarez Covarrubias H AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. AD - Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Ciudad de Mexico, Mexico. FAU - Mayr, Patrick AU - Mayr P AUID- ORCID: 0000-0002-3549-3007 AD - Institute of Anaesthesiology, German Heart Center Munich, Technical University Munich University Hospital, Munich, Germany. FAU - Cassese, Salvatore AU - Cassese S AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Kufner, Sebastian AU - Kufner S AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Taniguchi, Yousuke AU - Taniguchi Y AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Thilo, Christian AU - Thilo C AD - Department of Internal Medicine I, RoMed Klinikum Rosenheim, Rosenheim, Germany. FAU - Klos, Markus AU - Klos M AD - Medicum Tegernsee, Rottach-Weissach, Germany. FAU - Erlebach, Magdalena AU - Erlebach M AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Schneider, Simon AU - Schneider S AD - Department of Cardiology, Benedictus Krankenhaus Tutzing, Tutzing, Germany. FAU - Jurisic, Martin AU - Jurisic M AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. AD - Department of Internal Medicine I, Technical University Munich University Hospital, Munich, Germany. FAU - Lange, Rudiger AU - Lange R AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Schunkert, Heribert AU - Schunkert H AUID- ORCID: 0000-0001-6428-3001 AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AUID- ORCID: 0000-0003-4341-891X AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Krane, Markus AU - Krane M AD - Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AUID- ORCID: 0000-0002-0728-2819 AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. FAU - Joner, Michael AU - Joner M AUID- ORCID: 0000-0002-2971-8310 AD - Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Lazarettstrasse 36, 80636 Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. LA - eng GR - German Heart Center Munich/ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Male MH - Female MH - Aged, 80 and over MH - *Vascular Closure Devices MH - Aged MH - Prospective Studies MH - *Aortic Valve Stenosis/surgery MH - *Hemostatic Techniques/instrumentation MH - *Postoperative Hemorrhage/prevention & control MH - Femoral Artery MH - Suture Techniques OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - Vascular closure devices OT - Vascular complications EDAT- 2024/10/30 16:18 MHDA- 2025/02/14 00:24 CRDT- 2024/10/30 06:43 PHST- 2024/09/16 00:00 [received] PHST- 2024/10/10 00:00 [revised] PHST- 2024/10/28 00:00 [accepted] PHST- 2025/02/14 00:24 [medline] PHST- 2024/10/30 16:18 [pubmed] PHST- 2024/10/30 06:43 [entrez] AID - 7849787 [pii] AID - 10.1093/eurheartj/ehae784 [doi] PST - ppublish SO - Eur Heart J. 2025 Feb 14;46(7):635-645. doi: 10.1093/eurheartj/ehae784. PMID- 39471309 OWN - NLM STAT- MEDLINE DCOM- 20250108 LR - 20260910 IS - 2380-6591 (Electronic) VI - 10 IP - 1 DP - 2025 Jan 1 TI - Cerebral Embolic Protection by Geographic Region: A Post Hoc Analysis of the PROTECTED TAVR Randomized Clinical Trial. PG - 17-24 LID - 10.1001/jamacardio.2024.4278 [doi] AB - IMPORTANCE: Transcatheter aortic valve replacement (TAVR) is an established treatment option for many patients with severe symptomatic aortic stenosis; however, debris dislodged during the procedure can cause embolic stroke. The Sentinel cerebral embolic protection (CEP) device is approved for capture and removal of embolic material during TAVR but its efficacy has been debated. OBJECTIVE: To explore regional differences in the association of CEP utilization with stroke outcomes in patients undergoing TAVR. DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis of a prospective, postmarket, randomized clinical trial evaluating TAVR performed with or without the CEP took place at 51 hospitals in the US, Europe, and Australia from February 2020 to January 2022. Patients with symptomatic aortic stenosis treated with transfemoral TAVR were included. Randomization was stratified according to center, operative risk, and intended TAVR valve type. Patients were excluded if the left common carotid or brachiocephalic artery had greater than 70% stenosis or if the anatomy precluded placement of the CEP device. Data for this post hoc study were analyzed from August to October 2024. INTERVENTION: TAVR with or without CEP. MAIN OUTCOMES AND MEASURES: The primary end point was the rate of all stroke events at hospital discharge or 72 hours post-TAVR, whichever came first. Neurological examinations were performed at baseline and postprocedure to identify stroke, disabling stroke, and other neurological outcomes. RESULTS: The Stroke Protection With Sentinel During Transcatheter Aortic Valve Replacement (PROTECTED TAVR) trial enrolled and randomized 3000 patients (1803 [60.1%] male; mean [SD] age, 78.9 [7.8] years): 1833 in the US cohort (TAVR alone: 919, TAVR with CEP: 914) and 1167 patients in the outside the US (OUS) cohort (TAVR alone: 580, TAVR with CEP: 587). Patients in the US cohort were younger, more predominantly male, had a lower prevalence of atrial fibrillation, and had a higher prevalence of bicuspid aortic valve, diabetes, and peripheral vascular disease compared with the OUS cohort. In the main trial, the incidence of stroke within 72 hours after TAVR or before discharge did not differ significantly between the CEP group and the control group, and there was no interaction by geographic region. In this post hoc analysis, patients treated with CEP in the US cohort exhibited a 50% relative risk reduction for overall stroke and a 73% relative risk reduction for disabling stroke compared to TAVR alone; a treatment effect on stroke risk reduction was not observed in the OUS cohort. CONCLUSION AND RELEVANCE: The PROTECTED TAVR trial could not show that the use of CEP had a significant effect on the incidence of periprocedural stroke during TAVR. Although there was no significant interaction by geographic region, this exploratory post hoc analysis suggests a trend toward greater stroke reduction in the US cohort but not in the OUS cohort. These findings are hypothesis generating, and further research is needed to determine if regional differences in patient characteristics or procedural practices affect CEP efficacy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04149535. FAU - Makkar, Raj R AU - Makkar RR AD - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. FAU - Gupta, Aakriti AU - Gupta A AD - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. FAU - Waggoner, Thomas E AU - Waggoner TE AD - US Heart & Vascular, Tucson Medical Center Healthcare, Tucson, Arizona. FAU - Horr, Samuel AU - Horr S AD - Centennial Medical Center, Nashville, Tennessee. FAU - Karha, Juhana AU - Karha J AD - Baylor Scott & White, College Station, Texas. FAU - Satler, Lowell AU - Satler L AD - Washington Hospital Center, Washington, DC. FAU - Stoler, Robert C AU - Stoler RC AD - Baylor Heart & Vascular Hospital, Dallas, Texas. FAU - Alvarez, Jorge AU - Alvarez J AD - Methodist Healthcare System, San Antonio, Texas. FAU - Sakhuja, Rahul AU - Sakhuja R AD - Division of Cardiology, Massachusetts General Hospital, Boston. FAU - MacDonald, Lee AU - MacDonald L AD - South Denver Heart Center, Littleton, Colorado. FAU - Modolo, Rodrigo AU - Modolo R AD - Boston Scientific Corporation, Marlborough, Massachusetts. FAU - Leon, Martin B AU - Leon MB AD - Columbia University Medical Center, New York, New York. FAU - Linke, Axel AU - Linke A AD - University of Technology Dresden, Heart Center, University Hospital, Dresden, Germany. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio. LA - eng SI - ClinicalTrials.gov/NCT04149535 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery MH - *Embolic Protection Devices MH - Aged, 80 and over MH - Aged MH - Intracranial Embolism/prevention & control/epidemiology MH - Prospective Studies MH - United States/epidemiology MH - Stroke/prevention & control/epidemiology MH - Australia/epidemiology MH - Europe/epidemiology EDAT- 2024/10/29 22:27 MHDA- 2025/01/08 18:22 CRDT- 2024/10/29 15:33 PHST- 2025/01/08 18:22 [medline] PHST- 2024/10/29 22:27 [pubmed] PHST- 2024/10/29 15:33 [entrez] AID - 2825480 [pii] AID - 10.1001/jamacardio.2024.4278 [doi] PST - ppublish SO - JAMA Cardiol. 2025 Jan 1;10(1):17-24. doi: 10.1001/jamacardio.2024.4278. PMID- 39466903 OWN - NLM STAT- MEDLINE DCOM- 20250115 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 392 IP - 3 DP - 2025 Jan 16 TI - Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis. PG - 217-227 LID - 10.1056/NEJMoa2405880 [doi] AB - BACKGROUND: For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking. METHODS: At 75 centers in the United States and Canada, we randomly assigned, in a 1:1 ratio, patients with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance. The primary end point was a composite of death, stroke, or unplanned hospitalization for cardiovascular causes. Superiority testing was performed in the intention-to-treat population. RESULTS: A total of 901 patients underwent randomization; 455 patients were assigned to TAVR and 446 to clinical surveillance. The mean age of the patients was 75.8 years, the mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 1.8% (on a scale from 0 to 100%, with higher scores indicating a greater risk of death within 30 days after surgery), and 83.6% of patients were at low surgical risk. A primary end-point event occurred in 122 patients (26.8%) in the TAVR group and in 202 patients (45.3%) in the clinical surveillance group (hazard ratio, 0.50; 95% confidence interval, 0.40 to 0.63; P<0.001). Death occurred in 8.4% of the patients assigned to TAVR and in 9.2% of the patients assigned to clinical surveillance, stroke occurred in 4.2% and 6.7%, respectively, and unplanned hospitalization for cardiovascular causes occurred in 20.9% and 41.7%. During a median follow-up of 3.8 years, 87.0% of patients in the clinical surveillance group underwent aortic-valve replacement. There were no apparent differences in procedure-related adverse events between patients in the TAVR group and those in the clinical surveillance group who underwent aortic-valve replacement. CONCLUSIONS: Among patients with asymptomatic severe aortic stenosis, a strategy of early TAVR was superior to clinical surveillance in reducing the incidence of death, stroke, or unplanned hospitalization for cardiovascular causes. (Funded by Edwards Lifesciences; EARLY TAVR ClinicalTrials.gov number, NCT03042104.). CI - Copyright (c) 2024 Massachusetts Medical Society. FAU - Genereux, Philippe AU - Genereux P AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Schwartz, Allan AU - Schwartz A AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Oldemeyer, J Bradley AU - Oldemeyer JB AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Pibarot, Philippe AU - Pibarot P AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Cohen, David J AU - Cohen DJ AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Blanke, Philipp AU - Blanke P AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Lindman, Brian R AU - Lindman BR AUID- ORCID: 0000-0002-6879-5343 AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Babaliaros, Vasilis AU - Babaliaros V AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Fearon, William F AU - Fearon WF AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Daniels, David V AU - Daniels DV AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Chhatriwalla, Adnan K AU - Chhatriwalla AK AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Kavinsky, Clifford AU - Kavinsky C AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Gada, Hemal AU - Gada H AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Shah, Pinak AU - Shah P AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Szerlip, Molly AU - Szerlip M AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Dahle, Thom AU - Dahle T AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Goel, Kashish AU - Goel K AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - O'Neill, William AU - O'Neill W AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Sheth, Tej AU - Sheth T AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Davidson, Charles J AU - Davidson CJ AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Makkar, Raj R AU - Makkar RR AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Prince, Heather AU - Prince H AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Zhao, Yanglu AU - Zhao Y AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Hahn, Rebecca T AU - Hahn RT AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Leipsic, Jonathon AU - Leipsic J AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Redfors, Bjorn AU - Redfors B AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Pocock, Stuart J AU - Pocock SJ AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Mack, Michael AU - Mack M AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). FAU - Leon, Martin B AU - Leon MB AD - From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.). CN - EARLY TAVR Trial Investigators LA - eng SI - ClinicalTrials.gov/NCT03042104 PT - Equivalence Trial PT - Journal Article PT - Multicenter Study DEP - 20241028 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2025 Jun 5;392(21):2176. doi: 10.1056/NEJMc2502177. PMID: 40466074 CIN - N Engl J Med. 2025 Jun 5;392(21):2176-2177. doi: 10.1056/NEJMc2502177. PMID: 40466075 CIN - N Engl J Med. 2025 Jun 5;392(21):2177. doi: 10.1056/NEJMc2502177. PMID: 40466076 CIN - N Engl J Med. 2025 Jun 5;392(21):2177-2178. doi: 10.1056/NEJMc2502177. PMID: 40466077 CIN - N Engl J Med. 2025 Jun 5;392(21):2178. doi: 10.1056/NEJMc2502177. PMID: 40466078 CIN - N Engl J Med. 2025 Jun 5;392(21):2178-2179. doi: 10.1056/NEJMc2502177. PMID: 40466079 CIN - N Engl J Med. 2025 Jun 5;392(21):2179-2180. doi: 10.1056/NEJMc2502177. PMID: 40466080 CIN - J Thorac Dis. 2025 Jun 30;17(6):3484-3486. doi: 10.21037/jtd-2025-690. PMID: 40688320 MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery/mortality/complications MH - Asymptomatic Diseases/mortality/therapy MH - Cardiovascular Diseases/etiology/mortality/prevention & control MH - Heart Valve Prosthesis/adverse effects MH - Hospitalization/statistics & numerical data MH - Intention to Treat Analysis MH - Kaplan-Meier Estimate MH - *Postoperative Complications/epidemiology MH - Severity of Illness Index MH - *Stroke/epidemiology/etiology/prevention & control MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Watchful Waiting MH - Follow-Up Studies MH - Prospective Studies MH - Incidence MH - Treatment Outcome FIR - George, Isaac IR - George I FIR - Kodali, Susheel IR - Kodali S FIR - Nazif, Tamim IR - Nazif T FIR - Satler, Lowell IR - Satler L FIR - Corso, Paul IR - Corso P FIR - Hakemi, Emad IR - Hakemi E FIR - Cohen, Mauricio IR - Cohen M FIR - Cubeddu, Robert IR - Cubeddu R FIR - Kapadia, Samir IR - Kapadia S FIR - Bashir, Mohammad IR - Bashir M FIR - Horwitz, Phillip IR - Horwitz P FIR - Guyton, Robert IR - Guyton R FIR - Babaliaros, Vasilis IR - Babaliaros V FIR - Makkar, Raj IR - Makkar R FIR - McCabe, James IR - McCabe J FIR - Horlick, Eric IR - Horlick E FIR - Osten, Mark IR - Osten M FIR - Levisay, Justin IR - Levisay J FIR - Feldman, Ted IR - Feldman T FIR - Davidson, Charles IR - Davidson C FIR - Holmes, David IR - Holmes D FIR - Greason, Kevin IR - Greason K FIR - Alkhouli, Mohamad IR - Alkhouli M FIR - Fischbein, Michael IR - Fischbein M FIR - Fearon, William IR - Fearon W FIR - Chhatriwalla, Adnan IR - Chhatriwalla A FIR - Salemi, Arash IR - Salemi A FIR - Wong, Shing Chiu IR - Wong SC FIR - Shah, Pinak IR - Shah P FIR - Kaneko, Tsuyoshi IR - Kaneko T FIR - Ailawadi, Gorav IR - Ailawadi G FIR - Yount, Kenan IR - Yount K FIR - Tafur Soto, Jose IR - Tafur Soto J FIR - Ramee, Stephen IR - Ramee S FIR - Whisenant, Brian IR - Whisenant B FIR - Jones, Kent IR - Jones K FIR - Kereiakes, Dean IR - Kereiakes D FIR - Answini, Geoffrey IR - Answini G FIR - Kavinsky, Clifford IR - Kavinsky C FIR - Suradi, Hussam IR - Suradi H FIR - March, Robert IR - March R FIR - Sorajja, Paul IR - Sorajja P FIR - Garcia, Santiago IR - Garcia S FIR - Dhoble, Abhijeet IR - Dhoble A FIR - Balan, Prakash IR - Balan P FIR - Nguyen, Tom IR - Nguyen T FIR - Gupta, Anuj IR - Gupta A FIR - DeVries, James IR - DeVries J FIR - DeSimone, Joseph IR - DeSimone J FIR - Apostolou, Dimitrios IR - Apostolou D FIR - Paone, Gaetano IR - Paone G FIR - Brown, David IR - Brown D FIR - Holper, Elizabeth IR - Holper E FIR - Hutcheson, Kelley IR - Hutcheson K FIR - Szerlip, Molly IR - Szerlip M FIR - Christy, Jeffrey IR - Christy J FIR - Goldstein, Jeffrey IR - Goldstein J FIR - Gill, John IR - Gill J FIR - Goswami, Nilesh IR - Goswami N FIR - Schwartz, Richard IR - Schwartz R FIR - Harvey, James IR - Harvey J FIR - Burlingame, Mark IR - Burlingame M FIR - Haik, Bruce IR - Haik B FIR - Russo, Mark IR - Russo M FIR - Waxman, Sergio IR - Waxman S FIR - Wong, Garrett IR - Wong G FIR - Southard, Jeffrey IR - Southard J FIR - Boyd, Walter IR - Boyd W FIR - Kemp, Clinton IR - Kemp C FIR - Newton, Joseph IR - Newton J FIR - Mahoney, Paul IR - Mahoney P FIR - Anderson, David IR - Anderson D FIR - Beaver, Thomas IR - Beaver T FIR - Pershad, Ashish IR - Pershad A FIR - Eng, Marvin IR - Eng M FIR - Staniloae, Cezar IR - Staniloae C FIR - Williams, Mathew IR - Williams M FIR - Forrest, John IR - Forrest J FIR - Bailey, Stephen IR - Bailey S FIR - Brown, John IR - Brown J FIR - Genereux, Philippe IR - Genereux P FIR - Skipper, Eric IR - Skipper E FIR - Rinaldi, Michael IR - Rinaldi M FIR - McNulty, Edward IR - McNulty E FIR - Richter, Richard IR - Richter R FIR - Gnall, Eric IR - Gnall E FIR - Rodriguez, Roberto IR - Rodriguez R FIR - Sarin, Eric IR - Sarin E FIR - Yazdani, Shahram IR - Yazdani S FIR - Anderson, Curtis IR - Anderson C FIR - Jobe, Robert IR - Jobe R FIR - Oldemeyer, Brad IR - Oldemeyer B FIR - Guadagnoli, Mark IR - Guadagnoli M FIR - Vial, Conrad IR - Vial C FIR - Daniels, David IR - Daniels D FIR - Eslami-Farsani, Mahmoud IR - Eslami-Farsani M FIR - Ashraf, Hashmat IR - Ashraf H FIR - Iyer, Vijay IR - Iyer V FIR - Samy, Sanjay IR - Samy S FIR - Helmer, Gregory IR - Helmer G FIR - John, Ranjit IR - John R FIR - Gibson, Michael IR - Gibson M FIR - Jones, Noah IR - Jones N FIR - Chehab, Bassem IR - Chehab B FIR - Grizzell, Brett IR - Grizzell B FIR - Gada, Hemal IR - Gada H FIR - Mumtaz, Mubashir IR - Mumtaz M FIR - Natarajan, Madhu IR - Natarajan M FIR - Sheth, Tej IR - Sheth T FIR - Depta, Jeremiah IR - Depta J FIR - Butzel, David IR - Butzel D FIR - Coolong, Alanna IR - Coolong A FIR - Zelman, Richard IR - Zelman R FIR - Foerst, Jason IR - Foerst J FIR - Tannous, Henry IR - Tannous H FIR - Parikh, Puja IR - Parikh P FIR - Curtis, Brydan IR - Curtis B FIR - Ring, Michael IR - Ring M FIR - Schmoker, Joseph IR - Schmoker J FIR - Reed, Michael IR - Reed M FIR - Abicht, Travis IR - Abicht T FIR - Yakubov, Steven IR - Yakubov S FIR - Lindman, Brian IR - Lindman B FIR - Goel, Kashish IR - Goel K FIR - Yadav, Pradeep IR - Yadav P FIR - Thourani, Vinod IR - Thourani V FIR - Stegman, Brian IR - Stegman B FIR - Dahle, Thom IR - Dahle T FIR - Pop, Andrei IR - Pop A FIR - Pearson, Paul IR - Pearson P FIR - Mason, Peter IR - Mason P FIR - Park, James IR - Park J FIR - Jenson, Bart IR - Jenson B FIR - McAllister, David IR - McAllister D FIR - Badheka, Apurva IR - Badheka A FIR - Nanjundappa, Aravinda IR - Nanjundappa A FIR - Gharib, Elie IR - Gharib E FIR - Lewis, Stephen IR - Lewis S FIR - Labinaz, Marino IR - Labinaz M FIR - Al-Atassi, Talal IR - Al-Atassi T FIR - Uberoi, Abhimanyu IR - Uberoi A FIR - Durairaj, Azhil IR - Durairaj A FIR - Daga, Nikhil IR - Daga N FIR - Ho, Edwin IR - Ho E FIR - Goldberg, Ythan IR - Goldberg Y FIR - Klodell, Charles IR - Klodell C FIR - Barb, Ilie IR - Barb I EDAT- 2024/10/28 18:23 MHDA- 2025/01/15 18:20 CRDT- 2024/10/28 14:03 PHST- 2025/01/15 18:20 [medline] PHST- 2024/10/28 18:23 [pubmed] PHST- 2024/10/28 14:03 [entrez] AID - 10.1056/NEJMoa2405880 [doi] PST - ppublish SO - N Engl J Med. 2025 Jan 16;392(3):217-227. doi: 10.1056/NEJMoa2405880. Epub 2024 Oct 28. PMID- 39453458 OWN - NLM STAT- MEDLINE DCOM- 20251021 LR - 20251124 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 114 IP - 11 DP - 2025 Nov TI - Prognostic utility of mid-regional pro-adrenomedullin and growth differentiation factor 15 in patients undergoing transfemoral transcatheter aortic valve implantation. PG - 1508-1515 LID - 10.1007/s00392-024-02560-w [doi] AB - BACKGROUND: Risk prediction in patients with severe, symptomatic aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) remains an unsolved issue. In addition to classical risk scoring systems, novel circulating biomarkers like mid-regional pro-adrenomedullin (MR-proADM) and growth differentiation factor 15 (GDF-15) may be of value in assessing risk. METHODS: Consecutive patients undergoing elective transfemoral TAVI were included in this prospective observational study. Baseline information, imaging findings, blood samples, and clinical outcomes were collected. Blood levels of the classical biomarkers interleukin-6 (IL-6) and high-sensitivity C-reactive peptide (hsCRP) and of the novel biomarkers MR-proADM and GDF-15 were measured and their predictive utility for mortality assessed. RESULTS: The study cohort consisted of 92 patients undergoing TAVI. The median age was 80.7 years [IQR 77.2;83.3], and 48 (52.2%) were male. Analysis of the area under the curve (AUC) of the receiver-operating characteristics showed that the hsCRP levels discriminated poorly (AUC 0.66, 95% CI [0.52;0.8], p = 0.027), whereas all other biomarkers reached a higher level of discrimination (IL-6: AUC 0.76, 95% CI [0.66;0.86], p < 0.001; MR-proADM: AUC 0.73, 95% CI [0.61;0.85], p = 0.002; GDF-15: AUC 0.73, 95% CI [0.61;0.85], p = 0.002). Kaplan-Meier analysis in conjunction with Youden J-statistics yielded the optimal cutoff points for each biomarker to predict survival: IL-6 4.65 pg/mL, hsCRP 12.9 mg/L, MR-proADM 1.02 nmol/L, and GDF-15 2400.1 pg/mL. CONCLUSION: Novel circulating biomarkers like MR-proADM and GDF-15 may provide additional value in predicting survival after TAVI. CI - (c) 2024. The Author(s). FAU - Piayda, Kerstin AU - Piayda K AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Keranov, Stanislav AU - Keranov S AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Schulz, Luisa AU - Schulz L AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Arsalan, Mani AU - Arsalan M AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Medical Faculty, Department of Cardiothoracic Surgery, Goethe-University Frankfurt, Frankfurt, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Liebetrau, Christoph AU - Liebetrau C AD - Cardioangiologisches Centrum Bethanien (CCB), Im Prufling 23 60389, Frankfurt Am Main, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Hofmann, Felsix J AU - Hofmann FJ AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Bauer, Pascal AU - Bauer P AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Voss, Sandra AU - Voss S AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Troidl, Christian AU - Troidl C AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Sossalla, Samuel T AU - Sossalla ST AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Nef, Holger M AU - Nef HM AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Dorr, Oliver AU - Dorr O AUID- ORCID: 0000-0003-4526-6956 AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. o.doerr@ccb.de. AD - Cardioangiologisches Centrum Bethanien (CCB), Im Prufling 23 60389, Frankfurt Am Main, Germany. o.doerr@ccb.de. AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. o.doerr@ccb.de. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany. o.doerr@ccb.de. AD - Heart and Vascular Center Bad Segeberg, Cardiology and Angiology, Segeberger Kliniken GmbH, Bad Segeberg, Germany. o.doerr@ccb.de. LA - eng PT - Journal Article PT - Observational Study DEP - 20241025 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 148498-78-6 (Adrenomedullin) RN - 0 (Growth Differentiation Factor 15) RN - 0 (Biomarkers) RN - 0 (Protein Precursors) RN - 0 (mid-regional pro-adrenomedullin, human) RN - 0 (GDF15 protein, human) RN - 0 (Peptide Fragments) SB - IM MH - Humans MH - Male MH - *Adrenomedullin/blood MH - Female MH - *Growth Differentiation Factor 15/blood MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery/blood/mortality/diagnosis MH - Biomarkers/blood MH - Aged, 80 and over MH - Prospective Studies MH - *Protein Precursors/blood MH - Prognosis MH - Aged MH - *Peptide Fragments/blood MH - Risk Assessment MH - Predictive Value of Tests MH - Risk Factors MH - Severity of Illness Index MH - Femoral Artery MH - Treatment Outcome PMC - PMC12540537 OTO - NOTNLM OT - Biomarkers OT - Growth differentiation factor 15 OT - Mid-regional pro-adrenomedullin OT - Survival OT - TAVI COIS- Declarations. Conflict of interests: All authors have nothing to disclose relevant to the present work. EDAT- 2024/10/25 12:24 MHDA- 2025/10/21 12:35 PMCR- 2024/10/25 CRDT- 2024/10/25 11:13 PHST- 2024/03/03 00:00 [received] PHST- 2024/10/07 00:00 [accepted] PHST- 2025/10/21 12:35 [medline] PHST- 2024/10/25 12:24 [pubmed] PHST- 2024/10/25 11:13 [entrez] PHST- 2024/10/25 00:00 [pmc-release] AID - 10.1007/s00392-024-02560-w [pii] AID - 2560 [pii] AID - 10.1007/s00392-024-02560-w [doi] PST - ppublish SO - Clin Res Cardiol. 2025 Nov;114(11):1508-1515. doi: 10.1007/s00392-024-02560-w. Epub 2024 Oct 25. PMID- 39445119 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241025 IS - 2352-9067 (Print) IS - 2352-9067 (Electronic) IS - 2352-9067 (Linking) VI - 55 DP - 2024 Dec TI - Feasibility, safety and clinical impact of a less-invasive totally-endovascular (LITE) technique for transfemoral TAVI: A 1000 patients single-centre experience. PG - 101523 LID - 10.1016/j.ijcha.2024.101523 [doi] LID - 101523 AB - BACKGROUND: Trans-femoral (TF) represents the main access for TAVI. Although there are various technical strategies to conduct TF-TAVI (pacing modality, secondary arterial access, primary access puncture etc.), the optimal technique is not recognized. AIMS: In the present study, we assessed the impact of systematic use of LITE-TAVI in terms of feasibility, safety, and main access complication management using VARC-3 outcomes definitions. METHODS: At our institution, a less-invasive totally-endovascular (LITE) technique for TF-TAVI has been developed since 2017. Key aspects are: precise TAVI access puncture using angiographic-guidewire ultrasound guidance; radial/ulnar approach as the default "secondary access"; non-invasive pacing (by guidewire stimulation or definitive pacemaker external programmer). RESULTS: 1022 consecutive TF-TAVI patients (55 % women, mean age: 80 years, mean EuroSCORE II 6.1 %, mean STS-PROM 4.3 %, mean STS/ACC TVT TAVR mortality score 3.4 %) were approached using the LITE technique. Technical success was achieved in 993 (97.2 %) patients. Access-related major vascular complications occurred in 12 (1.2 %) and VARC-3 >/= type 2 bleedings in 12 (1.2 %) patients. At 30-day, all-cause death occurred in 17 (1.7 %) patients. This figure resulted significantly lower than expected on the bases of the mortality predicted not only by EuroSCORE II (6.1 %, p < 0.001) and STS-PROM score (4.3 %; p < 0.001), but also by STS/ACC TVT TAVR mortality score (3.4 %; p = 0.01). CONCLUSIONS: Systematic use of LITE-TAVI is feasible and is associated with an extremely low rate of access-related bleeding and vascular complications which may drive to outcome improvement. CI - (c) 2024 The Authors. Published by Elsevier B.V. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Bianchini, Francesco AU - Bianchini F AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Aurigemma, Cristina AU - Aurigemma C AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Zito, Andrea AU - Zito A AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Bianchini, Emiliano AU - Bianchini E AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Paraggio, Lazzaro AU - Paraggio L AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Ierardi, Carolina AU - Ierardi C AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Nesta, Marialisa AU - Nesta M AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Bruno, Piergiorgio AU - Bruno P AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Trani, Carlo AU - Trani C AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy. LA - eng PT - Journal Article DEP - 20241009 PL - Ireland TA - Int J Cardiol Heart Vasc JT - International journal of cardiology. Heart & vasculature JID - 101649525 PMC - PMC11497424 OTO - NOTNLM OT - Personalized medicine, endovascular interventions OT - Temporary pacemaker OT - Trans-femoral approach OT - Trans-radial approach OT - Transcatheter aortic valve implantation COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/10/24 16:50 MHDA- 2024/10/24 16:51 PMCR- 2024/10/09 CRDT- 2024/10/24 04:28 PHST- 2024/09/13 00:00 [received] PHST- 2024/10/02 00:00 [revised] PHST- 2024/10/03 00:00 [accepted] PHST- 2024/10/24 16:51 [medline] PHST- 2024/10/24 16:50 [pubmed] PHST- 2024/10/24 04:28 [entrez] PHST- 2024/10/09 00:00 [pmc-release] AID - S2352-9067(24)00189-1 [pii] AID - 101523 [pii] AID - 10.1016/j.ijcha.2024.101523 [doi] PST - epublish SO - Int J Cardiol Heart Vasc. 2024 Oct 9;55:101523. doi: 10.1016/j.ijcha.2024.101523. eCollection 2024 Dec. PMID- 39441764 OWN - NLM STAT- In-Process LR - 20250305 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 37 IP - 3 DP - 2025 Mar TI - Comparison of two vascular closure device strategies for transfemoral transcatheter aortic valve replacement using suture-based and collagen-plug-based techniques and associated vascular complications. LID - 10.25270/jic/24.00251 [doi] FAU - Yunus, Raza AU - Yunus R AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Alzahrani, Talal AU - Alzahrani T AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Taoutel, Roy AU - Taoutel R AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Reiner, Jonathan AU - Reiner J AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Mazhari, Ramesh AU - Mazhari R AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Najam, Farzad AU - Najam F AD - Department of Cardiothoracic Surgery, The George Washington University, Washington, DC. FAU - Trachiotis, Gregory AU - Trachiotis G AD - Department of Cardiothoracic Surgery, The George Washington University, Washington, DC. FAU - Krepp, Joseph AU - Krepp J AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Choi, Andrew AU - Choi A AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Sarin, Shawn AU - Sarin S AD - Department of Interventional Radiology, Medical Faculty Associates, The George Washington University, Washington, DC. FAU - Nagy, Christian AU - Nagy C AD - Division of Cardiology, Medical Faculty Associates, The George Washington University, Washington, DC. Email: cnagy@mfa.gwu.edu. LA - eng PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM OTO - NOTNLM OT - Perclose device OT - TAVR OT - severe aortic stenosis OT - transcatheter aortic valve replacement OT - transfemoral approach OT - vascular closure devices OT - vascular complications EDAT- 2024/10/23 18:21 MHDA- 2024/10/23 18:21 CRDT- 2024/10/23 13:23 PHST- 2024/10/23 18:21 [pubmed] PHST- 2024/10/23 18:21 [medline] PHST- 2024/10/23 13:23 [entrez] AID - 10.25270/jic/24.00251 [doi] PST - ppublish SO - J Invasive Cardiol. 2025 Mar;37(3). doi: 10.25270/jic/24.00251. PMID- 39435489 OWN - NLM STAT- MEDLINE DCOM- 20241126 LR - 20241126 IS - 1827-191X (Electronic) IS - 0021-9509 (Linking) VI - 65 IP - 5 DP - 2024 Oct TI - Large bore access for transcatheter aortic valve replacement, endovascular aortic repair, and thoracic endovascular aortic repair. A review of anatomic challenges and operative considerations. PG - 460-467 LID - 10.23736/S0021-9509.24.13150-3 [doi] AB - INTRODUCTION: Transcatheter aortic valve replacement (TAVR), endovascular aortic repair (EVAR), and thoracic endovascular aortic repair (TEVAR) are standard and prolific procedures in the modern cardiovascular world, and appropriate delivery of these endoprostheses requires adequate understanding of the requisite large bore access. Percutaneous large bore access is the preferred route but may be accompanied by complications like thrombosis, hemorrhage, or inability to deliver the device. Anatomic limitations such as vessel tortuosity, small size, and heavy calcification may require alternative approaches for successful large bore access. This study aimed to better define large bore access, as well as to elucidate optimal adjuncts and alternatives to enable successful delivery of large bore endoprostheses. EVIDENCE ACQUISITION: A systematic review for "large bore access" in the cardiovascular literature was conducted on PubMed and the Cochrane Library Central according to PRISMA guidelines. Identified articles were filtered and sub-selected for TAVR, EVAR, and TEVAR; studies related to other large bore interventions were excluded. EVIDENCE SYNTHESIS: A representative selection of 39 full-text studies included both cardiac and vascular studies and was critically interpreted to identify a consensus definition for large bore access, challenging anatomy, and adjuncts or alternative approaches to the standard transfemoral approach. CONCLUSIONS: Transfemoral access remains the first-line approach but in the setting of unfavorable anatomy, adjunct maneuvers (e.g. intravascular lithotripsy, endoconduits) or alternative approaches (supra-aortic, transcaval) help decrease morbidity, mortality, length of procedure, and overall health care cost in large bore access. FAU - Pozolo, Cara G AU - Pozolo CG AD - Division of Vascular Surgery, Department of Surgery, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA - cara.g.pozolo.mil@health.mil. FAU - Giese, Angela S AU - Giese AS AD - Division of Vascular and Endovascular Surgery, Department Surgery, University of California - Davis, Sacramento, CA, USA. FAU - Babrowski, Trissa A AU - Babrowski TA AD - Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA. LA - eng PT - Journal Article PT - Systematic Review DEP - 20241022 PL - Italy TA - J Cardiovasc Surg (Torino) JT - The Journal of cardiovascular surgery JID - 0066127 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Endovascular Procedures/adverse effects/instrumentation MH - Treatment Outcome MH - *Aorta, Thoracic/surgery/diagnostic imaging MH - Blood Vessel Prosthesis Implantation/adverse effects/instrumentation MH - Aortic Valve/surgery/diagnostic imaging MH - Aortic Diseases/surgery/diagnostic imaging MH - Risk Factors MH - Blood Vessel Prosthesis MH - Punctures MH - Heart Valve Prosthesis MH - Endovascular Aneurysm Repair EDAT- 2024/10/22 06:28 MHDA- 2024/11/26 12:30 CRDT- 2024/10/22 04:30 PHST- 2024/11/26 12:30 [medline] PHST- 2024/10/22 06:28 [pubmed] PHST- 2024/10/22 04:30 [entrez] AID - S0021-9509.24.13150-3 [pii] AID - 10.23736/S0021-9509.24.13150-3 [doi] PST - ppublish SO - J Cardiovasc Surg (Torino). 2024 Oct;65(5):460-467. doi: 10.23736/S0021-9509.24.13150-3. Epub 2024 Oct 22. PMID- 39434612 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241108 IS - 2765-1606 (Print) IS - 2765-1614 (Electronic) IS - 2765-1606 (Linking) VI - 57 IP - 6 DP - 2024 Nov 5 TI - Costs Associated with Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement in Korea. PG - 536-546 LID - 10.5090/jcs.24.048 [doi] AB - BACKGROUND: This study compared the costs associated with transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in Korea by utilizing the National Health Insurance Service database. METHODS: Between June 2015 and May 2019, 1,468 patients underwent primary isolated transfemoral TAVI, while 2,835 patients received primary isolated SAVR with a bioprosthesis. We assessed the costs of index hospitalization and subsequent healthcare utilization, categorizing the cohort into 6 age subgroups: <70, 70-74, 75-79, 80-84, 85-89, and >/=90 years. The median follow-up periods were 2.5 and 3.0 years in the TAVI and SAVR groups, respectively. RESULTS: The index hospitalization costs were 41.0 million Korean won (KRW) (interquartile range [IQR], 39.1-44.7) for the TAVI group and 24.6 million KRW (IQR, 21.3-30.2) for the SAVR group (p<0.001). The TAVI group exhibited relatively constant index hospitalization costs across different age subgroups. In contrast, the SAVR group showed increasing index hospitalization costs with advancing age. The healthcare utilization costs were 5.7 million KRW per year (IQR, 3.3-14.2) for the TAVI group and 4.0 million KRW per year (IQR, 2.2-9.0) for the SAVR group (p<0.001). Healthcare utilization costs were higher in the TAVI group than in the SAVR group for the age subgroups of <70, 70-74, and 75-79 years, and were comparable in the age subgroups of 80-84, 85-89, and >/=90 years. CONCLUSION: TAVI had much higher index hospitalization costs than SAVR. Additionally, the overall healthcare utilization costs post-discharge for TAVI were also marginally higher than those for SAVR in younger age subgroups. FAU - Sohn, Suk Ho AU - Sohn SH AUID- ORCID: 0000-0001-7391-3415 AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. FAU - Kim, Kyung Hwan AU - Kim KH AUID- ORCID: 0000-0002-2718-8758 AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. FAU - Kang, Yoonjin AU - Kang Y AUID- ORCID: 0000-0002-2528-173X AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. FAU - Choi, Jae Woong AU - Choi JW AUID- ORCID: 0000-0002-0921-756X AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. FAU - Lee, Seung Hyun AU - Lee SH AUID- ORCID: 0000-0002-0311-6565 AD - Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. FAU - Shinn, Sung Ho AU - Shinn SH AUID- ORCID: 0000-0001-9539-7941 AD - Shinn Sung Ho Cardiovascular Center, Guri, Korea. FAU - Yoo, Jae Suk AU - Yoo JS AUID- ORCID: 0000-0002-7008-054X AD - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Lim, Cheong AU - Lim C AUID- ORCID: 0000-0003-0913-7014 AD - Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. LA - eng PT - Journal Article DEP - 20241022 PL - Korea (South) TA - J Chest Surg JT - Journal of chest surgery JID - 101775790 PMC - PMC11538586 OTO - NOTNLM OT - Aortic valve disease OT - Cost OT - Heart valve prosthesis OT - Transcatheter aortic valve implantation COIS- Conflict of interest Jae Woong Choi serves as an Editorial Board member of the Journal of Chest Surgery but has no role in the decision to publish this article. Except for that, no potential conflict of interest relevant to this article was reported. EDAT- 2024/10/22 06:28 MHDA- 2024/10/22 06:29 PMCR- 2024/10/22 CRDT- 2024/10/22 03:23 PHST- 2024/04/26 00:00 [received] PHST- 2024/07/26 00:00 [revised] PHST- 2024/07/31 00:00 [accepted] PHST- 2024/10/22 06:29 [medline] PHST- 2024/10/22 06:28 [pubmed] PHST- 2024/10/22 03:23 [entrez] PHST- 2024/10/22 00:00 [pmc-release] AID - jcs.24.048 [pii] AID - jcs-57-6-536 [pii] AID - 10.5090/jcs.24.048 [doi] PST - ppublish SO - J Chest Surg. 2024 Nov 5;57(6):536-546. doi: 10.5090/jcs.24.048. Epub 2024 Oct 22. PMID- 39430041 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250303 IS - 2322-2379 (Electronic) IS - 2588-2767 (Print) IS - 2322-2379 (Linking) VI - 12 DP - 2023 TI - Type B Aortic Dissection Management: A Narrative Review of Guidelines and Systematic Reviews. PG - e2967 LID - 10.31661/gmj.v12i.2967 [doi] LID - e2967 AB - BACKGROUND: Surgical or medical treatment for type B or descending aortic dissections with difficult presentation or stable hemodynamics is debatable. This study aimed to review the type B aortic dissection therapy to assess safety and effectiveness. MATERIALS AND METHODS: Online databases of PubMed, Science Direct, Web of Science, Cochrane, and Scopus were searched for relevant systematic reviews, guidelines, and meta-analysis studies on the management of type B aortic dissection, up to July 2023. The conclusions were qualitatively synthesized. RESULTS: Best medical therapy (BMT], thoracic aortic endovascular repair (TEVAR), and open surgeries (OS) were management approaches. Hemodynamics classify type B aortic dissection as complex or simple. Both examples reveal decreased in-hospital all-cause mortality with TAVR than OS. Guidelines recommend TEVAR for difficult situations and OS if it fails. Complication analyses favour TEVAR, however left subclavian artery coverage without revascularization increases stroke risk. Studies show Type B aortic dissection is simpler than TEVAR and BMT. Acute or subacute presentation did not affect reintervention rates between treatments. TEVAR had a greater early stroke risk than BMT but a decreased long-term aortic-related and all-cause mortality. The best data showed no differences in in-hospital mortality or early re-intervention between regimens. BMT reduced early stroke but increased late all-cause death. CONCLUSION: In conclusion, addressing Type B aortic dissection is complicated, depending on presentation and hemodynamics. TEVAR is best for difficult patients, however BMT and OS also work. TEVAR may reduce in-hospital mortality but increase early stroke risk. CI - Copyright(c) 2023, Galen Medical Journal. FAU - Ghimire, Samir AU - Ghimire S AD - Carribean Medical University, Willemstad, Curacao. FAU - Arghami, Arman AU - Arghami A AD - Cardiovascular Surgery Department, Mayo Clinic, Rochester, Minnesota, USA. FAU - Masood Shah, Aresha AU - Masood Shah A AD - Jinnah Postgraduate Medical Centre, Karachi, Pakistan. FAU - Billoo, Marium AU - Billoo M AD - Jinnah Postgraduate Medical Centre, Karachi, Pakistan. FAU - Billoo, Rehan AU - Billoo R AD - Jinnah Postgraduate Medical Centre, Karachi, Pakistan. FAU - Zarenezhad, Mohammad AU - Zarenezhad M AD - Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. FAU - Iqbal, Asra AU - Iqbal A AD - Jinnah Postgraduate Medical Centre, Karachi, Pakistan. FAU - Ahmadnezhad, Somayeh AU - Ahmadnezhad S AD - Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran. FAU - Maleki, Fatemeh AU - Maleki F AD - Department of Emergency Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran. FAU - Rezvani Kakhki, Behrang AU - Rezvani Kakhki B AD - Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Sadrzadeh, Sayyed Majid AU - Sadrzadeh SM AD - Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Mehrpour, Somayeh AU - Mehrpour S AD - Department of Anesthesiology & Critical Care, Qom University of Medical Sciences, Iran. FAU - Farzaneh, Roohie AU - Farzaneh R AD - Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Yaqoob, Uzair AU - Yaqoob U AD - Department of Neurosurgery, Civil Hospital, SMBBIT, Karachi, Pakistan. LA - eng PT - Journal Article DEP - 20231218 PL - Iran TA - Galen Med J JT - Galen medical journal JID - 101625418 PMC - PMC11491120 OTO - NOTNLM OT - Aortic Dissection OT - Endovascular Repair OT - Meta-analysis OT - Review OT - Systematic Review COIS- None. EDAT- 2024/10/21 10:51 MHDA- 2024/10/21 10:52 PMCR- 2023/12/18 CRDT- 2024/10/21 05:35 PHST- 2023/03/05 00:00 [received] PHST- 2023/06/21 00:00 [revised] PHST- 2023/12/16 00:00 [accepted] PHST- 2024/10/21 10:52 [medline] PHST- 2024/10/21 10:51 [pubmed] PHST- 2024/10/21 05:35 [entrez] PHST- 2023/12/18 00:00 [pmc-release] AID - 10.31661/gmj.v12i.2967 [doi] PST - epublish SO - Galen Med J. 2023 Dec 18;12:e2967. doi: 10.31661/gmj.v12i.2967. eCollection 2023. PMID- 39421928 OWN - NLM STAT- MEDLINE DCOM- 20241107 LR - 20241112 IS - 1524-4571 (Electronic) IS - 0009-7330 (Print) IS - 0009-7330 (Linking) VI - 135 IP - 11 DP - 2024 Nov 8 TI - Shear-Sensing by C-Reactive Protein: Linking Aortic Stenosis and Inflammation. PG - 1033-1047 LID - 10.1161/CIRCRESAHA.124.324248 [doi] AB - BACKGROUND: CRP (C-reactive protein) is a prototypical acute phase reactant. Upon dissociation of the pentameric isoform (pCRP [pentameric CRP]) into its monomeric subunits (mCRP [monomeric CRP]), it exhibits prothrombotic and proinflammatory activity. Pathophysiological shear rates as observed in aortic valve stenosis (AS) can influence protein conformation and function as observed with vWF (von Willebrand factor). Given the proinflammatory function of dissociated CRP and the important role of inflammation in the pathogenesis of AS, we investigated whether shear stress can modify CRP conformation and induce inflammatory effects relevant to AS. METHODS: To determine the effects of pathological shear rates on the function of human CRP, pCRP was subjected to pathophysiologically relevant shear rates and analyzed using biophysical and biochemical methods. To investigate the effect of shear on CRP conformation in vivo, we used a mouse model of arterial stenosis. Levels of mCRP and pCRP were measured in patients with severe AS pre- and post-transcatheter aortic valve implantation, and the presence of CRP was investigated on excised valves from patients undergoing aortic valve replacement surgery for severe AS. Microfluidic models of AS were then used to recapitulate the shear rates of patients with AS and to investigate this shear-dependent dissociation of pCRP and its inflammatory function. RESULTS: Exposed to high shear rates, pCRP dissociates into its proinflammatory monomers (mCRP) and aggregates into large particles. Our in vitro findings were further confirmed in a mouse carotid artery stenosis model, where the administration of human pCRP led to the deposition of mCRP poststenosis. Patients undergoing transcatheter aortic valve implantation demonstrated significantly higher mCRP bound to circulating microvesicles pre-transcatheter aortic valve implantation compared with post-transcatheter aortic valve implantation. Excised human stenotic aortic valves display mCRP deposition. pCRP dissociated in a microfluidic model of AS and induces endothelial cell activation as measured by increased ICAM-1 (intercellular adhesion molecule 1) and P-selectin expression. mCRP also induces platelet activation and TGF-beta (transforming growth factor beta) expression on platelets. CONCLUSIONS: We identify a novel mechanism of shear-induced pCRP dissociation, which results in the activation of cells central to the development of AS. This novel mechanosensing mechanism of pCRP dissociation to mCRP is likely also relevant to other pathologies involving increased shear rates, such as in atherosclerotic and injured arteries. FAU - Zeller, Johannes AU - Zeller J AUID- ORCID: 0000-0002-8122-9063 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Plastic and Hand Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Breisgau, Germany (J.Z., J.T., D.B., S.U.E.). FAU - Loseff-Silver, Julia AU - Loseff-Silver J AUID- ORCID: 0000-0002-1570-556X AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Khoshmanesh, Khashayar AU - Khoshmanesh K AUID- ORCID: 0000-0001-6036-7371 AD - School of Engineering, RMIT University, Melbourne, Victoria, Australia (K.K.). FAU - Baratchi, Sara AU - Baratchi S AUID- ORCID: 0000-0003-3588-7951 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. FAU - Lai, Austin AU - Lai A AUID- ORCID: 0009-0003-6208-5660 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Nero, Tracy L AU - Nero TL AUID- ORCID: 0000-0002-3393-1843 AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. AD - Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute (T.L.N., K.S.C.T.S., C.J.M., M.W.P.), Clayton, Victoria, Australia. FAU - Roy, Abhishek AU - Roy A AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. FAU - Watson, Anna AU - Watson A AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Dayawansa, Nalin AU - Dayawansa N AUID- ORCID: 0000-0002-1863-092X AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia (N.D., N.M.H., D.S., A. Walton, K.P.). FAU - Sharma, Prerna AU - Sharma P AUID- ORCID: 0009-0007-6878-7240 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Barbaro-Wahl, Anastasia AU - Barbaro-Wahl A AUID- ORCID: 0009-0001-1058-7824 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Chen, Yung Chih AU - Chen YC AUID- ORCID: 0000-0002-5387-5818 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Moon, Mitchell AU - Moon M AUID- ORCID: 0000-0001-9345-5001 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. FAU - Vidallon, Mark Louis P AU - Vidallon MLP AUID- ORCID: 0000-0002-0026-3906 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. FAU - Huang, Angela AU - Huang A AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Thome, Julia AU - Thome J AUID- ORCID: 0000-0002-1962-9525 AD - Department of Plastic and Hand Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Breisgau, Germany (J.Z., J.T., D.B., S.U.E.). FAU - Cheung Tung Shing, Karen S AU - Cheung Tung Shing KS AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. AD - Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute (T.L.N., K.S.C.T.S., C.J.M., M.W.P.), Clayton, Victoria, Australia. FAU - Harvie, Dalton AU - Harvie D AUID- ORCID: 0000-0002-8501-1344 AD - Department of Chemical Engineering (D.H., M.N.B.), Clayton, Victoria, Australia. FAU - Bongiovanni, Marie N AU - Bongiovanni MN AD - Department of Chemical Engineering (D.H., M.N.B.), Clayton, Victoria, Australia. FAU - Braig, David AU - Braig D AUID- ORCID: 0000-0002-1267-0840 AD - Department of Plastic and Hand Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Breisgau, Germany (J.Z., J.T., D.B., S.U.E.). FAU - Morton, Craig J AU - Morton CJ AUID- ORCID: 0000-0001-5452-5193 AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. AD - Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute (T.L.N., K.S.C.T.S., C.J.M., M.W.P.), Clayton, Victoria, Australia. AD - The University of Melbourne, Parkville, Victoria, Australia; now with CSIRO Biomedical Manufacturing, Clayton, Victoria, Australia (C.J.M.). FAU - Htun, Nay M AU - Htun NM AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia (N.D., N.M.H., D.S., A. Walton, K.P.). FAU - Stub, Dion AU - Stub D AUID- ORCID: 0000-0001-8686-2709 AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia (N.D., N.M.H., D.S., A. Walton, K.P.). AD - Department of Epidemiology and Preventive Medicine (D.S.), Melbourne, Victoria, Australia. FAU - Walton, Anthony AU - Walton A AUID- ORCID: 0000-0002-9173-5904 AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia (N.D., N.M.H., D.S., A. Walton, K.P.). FAU - Horowitz, John AU - Horowitz J AUID- ORCID: 0000-0001-6883-0703 AD - Department of Cardiology, Queen Elizabeth Hospital, Adelaide, South Australia, Australia (J.H.). FAU - Wang, Xiaowei AU - Wang X AUID- ORCID: 0000-0001-8658-7399 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. FAU - Pietersz, Geoffrey AU - Pietersz G AUID- ORCID: 0000-0002-1999-6835 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). FAU - Parker, Michael W AU - Parker MW AUID- ORCID: 0000-0002-3101-1138 AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. AD - Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute (T.L.N., K.S.C.T.S., C.J.M., M.W.P.), Clayton, Victoria, Australia. AD - ACRF Rational Drug Discovery Centre, St Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia (M.W.P.). FAU - Eisenhardt, Steffen U AU - Eisenhardt SU AUID- ORCID: 0000-0003-4471-3160 AD - Department of Plastic and Hand Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Breisgau, Germany (J.Z., J.T., D.B., S.U.E.). FAU - McFadyen, James D AU - McFadyen JD AUID- ORCID: 0000-0002-9832-6871 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. AD - Department of Clinical Haematology (J.D.M), School of Translational Medicine Monash University, Melbourne, Victoria, Australia. FAU - Peter, Karlheinz AU - Peter K AUID- ORCID: 0000-0002-8040-2258 AD - Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (J.Z., J.L.-S., S.B., A.L., A.R., A. Watson, N.D., P.S., A.B.-W., Y.C.C., M.M., M.L.P.V., A.H., N.M.H., X.W., G.P., J.D.M., K.P.). AD - Department of Cardiometabolic Health (S.B., T.L.N., A.R., M.M., M.L.P.V., K.S.C.T.S., C.J.M., X.W., M.W.P., J.D.M., K.P.), Clayton, Victoria, Australia. AD - Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia (N.D., N.M.H., D.S., A. Walton, K.P.). LA - eng PT - Journal Article DEP - 20241018 PL - United States TA - Circ Res JT - Circulation research JID - 0047103 RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - 1029 CIN - 1030 MH - Humans MH - *Aortic Valve Stenosis/metabolism/pathology/etiology MH - *C-Reactive Protein/metabolism MH - Animals MH - *Inflammation/metabolism/pathology MH - Male MH - Mice MH - Mice, Inbred C57BL MH - Stress, Mechanical MH - Female MH - Transcatheter Aortic Valve Replacement MH - Aged MH - Aortic Valve/pathology/metabolism PMC - PMC11542976 OTO - NOTNLM OT - C-reactive protein OT - aortic valve stenosis OT - inflammation OT - proteolysis OT - thrombosis COIS- None. EDAT- 2024/10/18 06:23 MHDA- 2024/11/13 14:00 PMCR- 2024/11/07 CRDT- 2024/10/18 05:03 PHST- 2024/11/13 14:00 [medline] PHST- 2024/10/18 06:23 [pubmed] PHST- 2024/10/18 05:03 [entrez] PHST- 2024/11/07 00:00 [pmc-release] AID - CIRCRES2024324248 [pii] AID - 10.1161/CIRCRESAHA.124.324248 [doi] PST - ppublish SO - Circ Res. 2024 Nov 8;135(11):1033-1047. doi: 10.1161/CIRCRESAHA.124.324248. Epub 2024 Oct 18. PMID- 39417488 OWN - NLM STAT- MEDLINE DCOM- 20241017 LR - 20260505 IS - 1678-4170 (Electronic) IS - 0066-782X (Print) IS - 0066-782X (Linking) VI - 121 IP - 5 DP - 2024 Sep TI - In-Hospital Outcomes in the Brazilian Registry of Transcatheter Aortic Valve Implantation - 14-Year Analysis. PG - e20230551 LID - S0066-782X2024000500313 [pii] LID - 10.36660/abc.20230551 [doi] LID - e20230551 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has had an exponential increase of its indication, being incorporated into the Brazilian Unified Public Health System in 2022, thus requiring assessment of its use in Brazil. OBJETICVE: To assess the factors associated with in-hospital mortality and non-fatal complications in both genders in the Brazilian Registry of Transcatheter Aortic Valve Implantation and New Technologies (RIBAC-NT) population. METHOD: Analysis of the RIBAC-NT database from 2008 to 2022 was performed. Logistic models and machine learning were used for statistical assessment of the association between variables and outcomes. The software R was used and a 5% significance level, adopted. RESULTS: Analysis of 2588 patients (women, 51.2%; in-hospital death, 8.2%). Mortality was associated with procedural complications, of which major vascular complication (VC) and acute kidney injury (AKI) stood out (p<0.001). Major VC occurred in 6% of the patients, with 34% mortality; AKI occurred in 8.8%, with 13% mortality, which increased up to 8 times when AKI coexisted with other complications. Non-fatal complications occurred in 50.5% of all patients, affecting 63% of those with 1st generation (1G) bioprosthesis and 39% of those with 2nd generation (2G) bioprosthesis (p<0,001). Non-femoral access and heart rhythm influenced non-fatal complications in patients with 1G prostheses, while complications in patients with 2G prosthesis associated with the female gender (39.6% vs. 30.4%, p=0.003). CONCLUSION: In-hospital mortality in the RIBAC-NT population was directly associated with procedural complications, mainly major VC and AKI. The occurrence of non-fatal complications differed according to gender and bioprosthesis type. FAU - Ferreira, Maria Cristina Meira AU - Ferreira MCM AUID- ORCID: 0000-0001-8973-4438 AD - Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil. FAU - Lemke, Viviana de Mello Guzzo AU - Lemke VMG AUID- ORCID: 0000-0002-0732-9920 AD - Cardiocare Clinica Cardiologica, Curitiba, PR - Brasil. FAU - Paiva, Maria Sanali Moura de Oliveira AU - Paiva MSMO AUID- ORCID: 0000-0002-6457-3217 AD - Instituto Atena de Pesquisa Clinica, Natal, RN - Brasil. FAU - Nascimento, Emilia Matos do AU - Nascimento EMD AUID- ORCID: 0000-0001-8313-8766 AD - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ - Brasil. FAU - Pereira, Basilio de Braganca AU - Pereira BB AUID- ORCID: 0000-0003-3098-092X AD - Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil. FAU - Oliveira, Glaucia Maria Moraes de AU - Oliveira GMM AUID- ORCID: 0000-0002-0737-6188 AD - Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil. LA - eng LA - por PT - Journal Article TT - Desfechos Intra-Hospitalares no Registro Brasileiro de Implante de Bioprotese Aortica por Cateter - 14 Anos em Analise. PL - Brazil TA - Arq Bras Cardiol JT - Arquivos brasileiros de cardiologia JID - 0421031 SB - IM MH - Humans MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - *Hospital Mortality MH - Brazil/epidemiology MH - *Registries MH - Aged MH - Aged, 80 and over MH - Risk Factors MH - Postoperative Complications/mortality/epidemiology MH - Treatment Outcome MH - Aortic Valve Stenosis/surgery/mortality MH - Time Factors MH - Sex Factors PMC - PMC11081308 OAB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has had an exponential increase of its indication, being incorporated into the Brazilian Unified Public Health System in 2022, thus requiring assessment of its use in Brazil. OBJETICVE: To assess the factors associated with in-hospital mortality and non-fatal complications in both genders in the Brazilian Registry of Transcatheter Aortic Valve Implantation and New Technologies (RIBAC-NT) population. METHOD: Analysis of the RIBAC-NT database from 2008 to 2022 was performed. Logistic models and machine learning were used for statistical assessment of the association between variables and outcomes. The software R was used and a 5% significance level, adopted. RESULTS: Analysis of 2588 patients (women, 51.2%; in-hospital death, 8.2%). Mortality was associated with procedural complications, of which major vascular complication (VC) and acute kidney injury (AKI) stood out (p<0.001). Major VC occurred in 6% of the patients, with 34% mortality; AKI occurred in 8.8%, with 13% mortality, which increased up to 8 times when AKI coexisted with other complications. Non-fatal complications occurred in 50.5% of all patients, affecting 63% of those with 1(st)generation (1G) bioprosthesis and 39% of those with 2(nd)generation (2G) bioprosthesis (p<0,001). Non-femoral access and heart rhythm influenced non-fatal complications in patients with 1G prostheses, while complications in patients with 2G prosthesis associated with the female gender (39.6% vs. 30.4%, p=0.003). CONCLUSION: In-hospital mortality in the RIBAC-NT population was directly associated with procedural complications, mainly major VC and AKI. The occurrence of non-fatal complications differed according to gender and bioprosthesis type. OABL- eng COIS- Potencial conflito de interesse Nao ha conflito com o presente artigo EDAT- 2024/10/17 16:24 MHDA- 2024/10/17 16:25 PMCR- 2024/05/07 CRDT- 2024/10/17 07:34 PHST- 2023/08/12 00:00 [received] PHST- 2024/03/13 00:00 [accepted] PHST- 2024/10/17 16:25 [medline] PHST- 2024/10/17 16:24 [pubmed] PHST- 2024/10/17 07:34 [entrez] PHST- 2024/05/07 00:00 [pmc-release] AID - S0066-782X2024000500313 [pii] AID - 10.36660/abc.20230551 [doi] PST - ppublish SO - Arq Bras Cardiol. 2024 Sep;121(5):e20230551. doi: 10.36660/abc.20230551. PMID- 39412806 OWN - NLM STAT- MEDLINE DCOM- 20241016 LR - 20250701 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 7 IP - 10 DP - 2024 Oct 1 TI - Upper- vs Lower-Extremity Secondary Access During Transcatheter Aortic Valve Implantation: A Randomized Clinical Trial. PG - e2438578 LID - 10.1001/jamanetworkopen.2024.38578 [doi] LID - e2438578 AB - IMPORTANCE: An upper-extremity approach for secondary access during transfemoral transcatheter aortic valve implantation (TAVI) may reduce clinically relevant secondary access site-related bleeding. OBJECTIVE: To investigate the safety and efficacy of an upper-extremity approach compared with a lower-extremity approach in patients undergoing TAVI. DESIGN, SETTING, AND PARTICIPANTS: The TAVI XS trial was a randomized clinical trial performed between November 28, 2022, and November 15, 2023, with a 30-day follow-up, in 4 TAVI centers in the Netherlands. Eligibility was determined first, and only those patients with severe aortic stenosis and no contraindication for upper- or lower-extremity secondary access were informed about the study and asked to participate. INTERVENTION: Participants were randomized 1:1 between the upper-extremity approach (radial artery diagnostic access and upper-arm vein for temporary pacing lead placement) and lower-extremity approach (femoral artery diagnostic access and femoral vein for temporary pacing lead placement) for secondary access during TAVI. MAIN OUTCOMES AND MEASURES: Primary end point was clinically relevant bleeding (Bleeding Academic Research Consortium type 2, 3, or 5) of the randomized secondary access. Secondary end points included any clinically relevant bleeding, time to mobilization, duration of hospitalization, secondary access failure, and procedural time. RESULTS: Of a total of 324 eligible patients, 238 patients undergoing transfemoral TAVI (mean [SD] age, 79.4 [6.5] years; 150 male [63.0%]; median European System for Cardiac Operative Risk Evaluation II score, 2.2% [IQR, 1.5%-3.5%]) were included. The primary end point occurred in 5 of 119 patients (4.2%) in the upper-extremity group and 16 of 119 (13.4%) in the lower-extremity group (odds ratio [OR], 0.28 [95% CI, 0.10-0.80]; P = .01). Incidence of any clinically relevant bleeding was decreased in the upper-extremity group (25 of 119 [21.0%] vs 41 of 119 [34.5%] patients; OR, 0.51 [95% CI, 0.28-0.91]; P = .02). There was no difference in time to mobilization or duration of hospitalization. Secondary access failure (14 of 119 [11.8%] vs 1 of 119 [0.8%] patients; OR, 15.73 [95% CI, 2.03-121.69]; P = .001) and procedural time (60.0 [IQR, 39.0-88.0; 95% CI, 53.0-70.0] vs 48.0 [IQR, 34.0-64.0; 95% CI, 40.0-55.0] minutes; P = .002) were higher in the upper-extremity cohort. CONCLUSION AND RELEVANCE: In this randomized clinical trial of patients undergoing transfemoral TAVI, the upper-extremity approach for secondary access was associated with less clinically relevant access site-related bleeding compared with the conventional lower-extremity approach and should be considered to reduce periprocedural bleeding complications. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05672823. FAU - Versteeg, Geert A A AU - Versteeg GAA AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Rooijakkers, Maxim J P AU - Rooijakkers MJP AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Hemelrijk, Kimberley I AU - Hemelrijk KI AD - Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands. FAU - Vlaar, Pieter J AU - Vlaar PJ AD - Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands. FAU - Overduin, Daniel C AU - Overduin DC AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands. FAU - van Wely, Marleen H AU - van Wely MH AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Aarts, Hugo M AU - Aarts HM AD - Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands. FAU - van Ginkel, Dirk-Jan AU - van Ginkel DJ AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands. FAU - van Nunen, Lokien X AU - van Nunen LX AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - van Geuns, Robert Jan AU - van Geuns RJ AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - van Garsse, Leen A F M AU - van Garsse LAFM AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Geuzebroek, Guillaume S C AU - Geuzebroek GSC AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Verkroost, Michel W A AU - Verkroost MWA AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Cetinyurek-Yavuz, Aysun AU - Cetinyurek-Yavuz A AD - Department of IQ Health, Section of Biostatistics, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Heijmen, Robin H AU - Heijmen RH AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. FAU - Ten Berg, Jurrien M AU - Ten Berg JM AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands. AD - Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands. FAU - Tonino, Pim A L AU - Tonino PAL AD - Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands. FAU - Delewi, Ronak AU - Delewi R AD - Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. LA - eng SI - ClinicalTrials.gov/NCT05672823 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20241001 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM CIN - JAMA Netw Open. 2024 Oct 1;7(10):e2438529. doi: 10.1001/jamanetworkopen.2024.38529. PMID: 39412812 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Male MH - Female MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery MH - Femoral Artery/surgery MH - Lower Extremity/blood supply/surgery MH - Upper Extremity/blood supply/surgery MH - Netherlands MH - Radial Artery/surgery MH - Femoral Vein PMC - PMC11581581 COIS- Conflict of Interest Disclosures: Dr van Wely reported receiving personal fees from Abbott Vascular and Boston Scientific Corporation outside the submitted work. Prof van Geuns reported receiving consulting and speaker's fees from Abbott Vascular, AstraZeneca, Sanofi SA, Amgen Inc, and InfraRedx Inc and receiving institutional research grant funding from Amgen Inc, InfraRedx Inc, AstraZeneca, and Sanofi SA. Dr ten Berg reported receiving grant funding from ZonMw (Dutch government) and Daichi Sankyo Company Limited outside the submitted work. Dr Tonino reported receiving grant funding from Opsens and Biosensors International and personal fees from Medtronic PLC outside the submitted work. Dr Delewi reported receiving grant funding from Abiomed Inc, Boston Scientific Corporation, Edwards Lifesciences, and Novartis AG outside the submitted work. Dr van Royen reported receiving grant funding from Abbott Vascular, Koninklijke Philips NV, and Biotronik and speaker's fees from Abbott Vascular, Suzhou Rainmed Medical Technology Co Ltd, MicroPort, and Bayer AG outside the submitted work. No other disclosures were reported. EDAT- 2024/10/16 12:25 MHDA- 2024/10/16 12:26 PMCR- 2024/10/16 CRDT- 2024/10/16 11:34 PHST- 2024/10/16 12:26 [medline] PHST- 2024/10/16 12:25 [pubmed] PHST- 2024/10/16 11:34 [entrez] PHST- 2024/10/16 00:00 [pmc-release] AID - 2824915 [pii] AID - zoi241119 [pii] AID - 10.1001/jamanetworkopen.2024.38578 [doi] PST - epublish SO - JAMA Netw Open. 2024 Oct 1;7(10):e2438578. doi: 10.1001/jamanetworkopen.2024.38578. PMID- 39387789 OWN - NLM STAT- In-Process LR - 20241113 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 21 DP - 2024 Nov 11 TI - Transcaval Impella-Assisted CHIP-PCI and Transcaval TAVR With Impella Removal in Freshly Implanted TAVR. PG - 2565-2566 LID - S1936-8798(24)01101-4 [pii] LID - 10.1016/j.jcin.2024.08.014 [doi] FAU - Chiang, Michael AU - Chiang M AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. Electronic address: michaelcschiang@gmail.com. FAU - Ko, Alvin H Y AU - Ko AHY AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Ho, Cheuk Bong AU - Ho CB AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Fong, Esmond Y H AU - Fong EYH AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Wong, Ivan AU - Wong I AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Chui, Shing Fung AU - Chui SF AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Chan, Ka Chun Alan AU - Chan KCA AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Wong, Chi Yuen AU - Wong CY AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Chan, Kam Tim AU - Chan KT AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. FAU - Lee, Kang Yin Michael AU - Lee KYM AD - Cardiology Division, Internal Medical Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong. LA - eng PT - Journal Article DEP - 20241009 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM OTO - NOTNLM OT - CHIP OT - Impella OT - PCI OT - TAVR OT - transcaval COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/10/13 21:10 MHDA- 2024/10/13 21:10 CRDT- 2024/10/10 10:30 PHST- 2024/07/10 00:00 [received] PHST- 2024/07/26 00:00 [revised] PHST- 2024/08/06 00:00 [accepted] PHST- 2024/10/13 21:10 [pubmed] PHST- 2024/10/13 21:10 [medline] PHST- 2024/10/10 10:30 [entrez] AID - S1936-8798(24)01101-4 [pii] AID - 10.1016/j.jcin.2024.08.014 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Nov 11;17(21):2565-2566. doi: 10.1016/j.jcin.2024.08.014. Epub 2024 Oct 9. PMID- 39387783 OWN - NLM STAT- MEDLINE DCOM- 20241030 LR - 20260708 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 20 DP - 2024 Oct 28 TI - Impact of Severity and Extent of Iliofemoral Atherosclerosis on Clinical Outcomes in Patients Undergoing TAVR. PG - 2353-2363 LID - S1936-8798(24)00964-6 [pii] LID - 10.1016/j.jcin.2024.07.009 [doi] AB - BACKGROUND: Vascular complications remain a major concern in transfemoral transcatheter aortic valve replacement (TAVR). The Hostile score has been proposed to stratify risk in TAVR patients with peripheral artery disease. OBJECTIVES: The authors aimed to assess the validity of the Hostile score in predicting iliofemoral vascular complications after TAVR. METHODS: In a prospective TAVR registry, we validated the Hostile score for the prediction of puncture and non-puncture site vascular complications. This scoring system integrates the extent (number of lesions, lesion length, and minimum lumen diameter) and complexity (tortuosity, calcification, and the presence of obstruction) of iliofemoral atherosclerosis. RESULTS: Of 2,023 patients who underwent transfemoral TAVR with contemporary devices between March 2014 and June 2022, 106 (5.2%) patients experienced puncture site vascular complications and 28 (1.4%) patients experienced non-puncture site vascular complications. The Hostile score was higher in patients with vascular complications than those without complications (1.00 [Q1-Q3: 0-5.00] vs 1.00 [Q1-Q3: 0-4.00]; P < .001). A higher body mass index (OR: 1.23; 95% CI: 1.04-1.50) and the use of Prostar (OR: 6.03; 95% CI: 2.23-16.30) or MANTA (OR: 6.18; 95% CI: 2.67-14.27) compared with ProGlide were independent predictors of puncture site vascular complications, whereas a higher Hostile score (OR: 1.91; 95% CI: 1.55-2.35) and female sex (OR: 2.69; 95% CI: 1.12-6.42) were independent predictors of non-puncture site vascular complications. The area under the receiver-operating characteristic curves for the prediction of puncture site and non-puncture site vascular complications were 0.554 and 0.829, respectively. CONCLUSIONS: The Hostile score proved useful in predicting non-puncture site vascular complications after TAVR. (SwissTAVI Registry; NCT01368250). CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Nakase, Masaaki AU - Nakase M AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Samim, Daryoush AU - Samim D AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Grani, Christoph AU - Grani C AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Praz, Fabien AU - Praz F AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Reineke, David AU - Reineke D AD - Department of Cardiac Surgery, Inselspital, University of Bern, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. LA - eng SI - ClinicalTrials.gov/NCT01368250 PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Validation Study DEP - 20241009 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Oct 28;17(20):2364-2366. doi: 10.1016/j.jcin.2024.07.025. PMID: 39387784 CIN - JACC Cardiovasc Interv. 2025 Jan 13;18(1):134. doi: 10.1016/j.jcin.2024.10.051. PMID: 39814489 MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - *Catheterization, Peripheral/adverse effects MH - Decision Support Techniques MH - *Femoral Artery/diagnostic imaging MH - *Iliac Artery/diagnostic imaging/physiopathology/surgery MH - *Peripheral Arterial Disease/therapy/diagnostic imaging MH - *Predictive Value of Tests MH - Prospective Studies MH - *Punctures MH - *Registries MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - *Severity of Illness Index MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Treatment Outcome OTO - NOTNLM OT - Hostile score OT - aortic stenosis OT - iliofemoral vascular complication OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Samim has received funding for an online course from Edwards Lifesciences. Dr Grani has received funding from the Swiss National Science Foundation, InnoSuisse, Center for Artificial Intelligence in Medicine University Bern, GAMBIT foundation, Novartis Foundation for Medical-Biological Research, and Swiss Heart Foundation, outside of the submitted work. Dr Grani has served as Editor-in-Chief of The International Journal of Cardiovascular Imaging. Dr Stortecky has received research grants to the institution from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific; and personal fees from Boston Scientific, Teleflex, and BTG. Dr Reineke has received travel expenses from Abbott, Edwards Lifesciences, and Medtronic. Dr Windecker has received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, BMS, Bayer, Biotronik, Boston Scientific, Cardinal Health, CardioValve, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Johnson & Johnson, Medicure, Medtronic, Novartis, Polares, OrPha Suisse, Pfizer, Regeneron, Sanofi, Sinomed, Terumo, and V-Wave; and has served as unpaid advisory board member and/or unpaid member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, BMS, Boston Scientific, Biotronik, Cardiovalve, Edwards Lifesciences, Med Alliance, Medtronic, Novartis, Polares, Sinomed, V-Wave; and Xeltis but has not received personal payments by pharmaceutical companies or device manufacturers; served as a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration; served as an unpaid member of the Pfizer Research Award selection committee in Switzerland and of the Women as One Awards Committee; served as a member of the Clinical Study Group of the Deutsches Zentrum fur Herz Kreislauf-Forschung and of the Advisory Board of the Australian Victorian Heart Institute; served as the chairperson of the ESC Congress Program Committee; and served as Deputy Editor of JACC: Cardiovascular Interventions. Dr Pilgrim has received research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; and speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/10/13 21:10 MHDA- 2024/10/31 04:19 CRDT- 2024/10/10 10:30 PHST- 2024/03/02 00:00 [received] PHST- 2024/06/29 00:00 [revised] PHST- 2024/07/02 00:00 [accepted] PHST- 2024/10/31 04:19 [medline] PHST- 2024/10/13 21:10 [pubmed] PHST- 2024/10/10 10:30 [entrez] AID - S1936-8798(24)00964-6 [pii] AID - 10.1016/j.jcin.2024.07.009 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Oct 28;17(20):2353-2363. doi: 10.1016/j.jcin.2024.07.009. Epub 2024 Oct 9. PMID- 39378384 OWN - NLM STAT- MEDLINE DCOM- 20241112 LR - 20250508 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 6 DP - 2024 Nov TI - ProGlide-AngioSeal versus ProGlide-FemoSeal for vascular access hemostasis posttranscatheter aortic valve implantation. PG - 1251-1259 LID - 10.1002/ccd.31259 [doi] AB - BACKGROUND: The hybrid strategy combining plug-based and suture-based vascular closure devices (VCD) was introduced as a promising technique for vascular access hemostasis after transcatheter aortic valve implantation (TAVI) with satisfactory outcomes. However, data comparing two plug-based VCDs each in the combination with a suture-based VCD, namely ProGlide/AngioSeal (P/AS) with ProGlide/FemoSeal (P/FS) VCDs, is still lacking. AIMS: To compare the 30-day outcome of the hybrid strategy using P/AS versus P/FS for vascular access site closure after TAVI. METHODS: A retrospective single-center observational study included 608 patients recruited from a prospective TAVI registry between 2016 and 2022. The composite endpoint was defined as any VCD-related major vascular complications and/or bleeding more than type 1 according to Valve Academic Research Consortium criteria. RESULTS: The current study reported a significantly higher rate of composite endpoint in P/AS group, which was driven by a higher rate of major bleeding (5.4% vs. 1.4%, p = 0.036). We also found a higher rate of VCD-related minor bleeding in P/AS group (16.3% vs. 8.1%, p = 0.013). Successful access site hemostasis was achieved in 71.7% of P/AS group versus 83.1% in P/FS group (p = 0.006). The presence of anterior wall calcification at the access site was significantly associated with the composite endpoint (adj odds ratio 2.49; 95% confidence interval (1.08-5.75), p = 0.032). CONCLUSION: The hybrid strategy for large bore vascular access closure using P/FS showed a potentially better 30-day outcomes compared with P/AS. The presence of anterior calcification at the access site carries a significant risk of VCD-related complications. CI - (c) 2024 Wiley Periodicals LLC. FAU - Samy, Mohamed AU - Samy M AUID- ORCID: 0000-0002-5406-112X AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Zagazig University, Sharkia, Egypt. FAU - Landt, Martin AU - Landt M AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Mankerious, Nader AU - Mankerious N AUID- ORCID: 0000-0003-4809-5371 AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Zagazig University, Sharkia, Egypt. FAU - Kurniadi, Arief AU - Kurniadi A AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Alotaibi, Sultan AU - Alotaibi S AUID- ORCID: 0000-0002-9165-3036 AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Cardiac Centre, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. FAU - Toelg, Ralph AU - Toelg R AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Medical Faculty of the Christian-Albrechts-University of Kiel, Kiel, Germany. AD - Cardiology Department, Center for Cardiovascular and Diabetes Medicine, Asklepios Clinic Bad Oldesloe, Bad Oldesloe, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Cardiology Department, Heart Centre Leipzig at the University of Leipzig, Leipzig, Germany. FAU - Nef, Holger AU - Nef H AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. FAU - Allali, Abdelhakim AU - Allali A AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Medical Clinic II, University Heart Centre Lubeck, Lubeck, Germany. FAU - Richardt, Gert AU - Richardt G AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Center for Cardiovascular and Diabetes Medicine, Asklepios Clinic Bad Oldesloe, Bad Oldesloe, Germany. FAU - Elbasha, Karim AU - Elbasha K AUID- ORCID: 0000-0002-4763-4874 AD - Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany. AD - Cardiology Department, Zagazig University, Sharkia, Egypt. LA - eng SI - ClinicalTrials.gov/NCT03192774 PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20241008 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - Female MH - *Hemostatic Techniques/instrumentation/adverse effects MH - Retrospective Studies MH - *Registries MH - Treatment Outcome MH - *Vascular Closure Devices MH - Aged MH - Aged, 80 and over MH - *Punctures MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Time Factors MH - *Catheterization, Peripheral/adverse effects MH - Risk Factors MH - Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Suture Techniques/adverse effects MH - Femoral Artery/diagnostic imaging MH - Hemorrhage/etiology/prevention & control MH - Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology OTO - NOTNLM OT - TAVI OT - femoral access site OT - vascular access closure device EDAT- 2024/10/08 22:18 MHDA- 2024/11/13 13:54 CRDT- 2024/10/08 16:03 PHST- 2024/07/24 00:00 [revised] PHST- 2024/04/30 00:00 [received] PHST- 2024/09/29 00:00 [accepted] PHST- 2024/11/13 13:54 [medline] PHST- 2024/10/08 22:18 [pubmed] PHST- 2024/10/08 16:03 [entrez] AID - 10.1002/ccd.31259 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Nov;104(6):1251-1259. doi: 10.1002/ccd.31259. Epub 2024 Oct 8. PMID- 39336891 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240930 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 18 DP - 2024 Sep 12 TI - Zero-Contrast Transcatheter Aortic Valve Implantation vs. Standard Practice: Periprocedural and Long-Term Clinical Outcomes. LID - 10.3390/jcm13185405 [doi] LID - 5405 AB - Background: We aimed to compare the procedural efficacy and long-term clinical results of a totally contrast-free Transcatheter Aortic Valve Implantation (TAVI) procedure (i.e., contrast dye was not used for either the pre-procedural assessment or during the procedure) to those of standard practice in patients with severe renal dysfunction. Methods: All consecutive patients with a glomerular filtration rate (GFR) 35 kg/m(2) showed increased 2- and 3-year mortality compared with BMI 25-34.9 kg/m(2) but not compared with BMI <25 kg/m(2). Fat areas correlated positively to BMI (epicardial: R (2) = 0.05, P < 0.01; visceral: R (2) = 0.20, P < 0.001; subcutaneous: R (2) = 0.13, P < 0.001). Increased epicardial or visceral but not subcutaneous fat area resulted in higher long-term mortality. Patients with high BMI (1781.3 mm(2) +/- 75.8, P < 0.05) and lean patients (1729.4 +/- 52.8, P < 0.01) showed lower psoas muscle area compared with those with mildly elevated BMI (2055.2 +/- 91.7). Reduced psoas muscle area and increased visceral fat and epicardial fat areas were independent predictors of long-term mortality. The levels of serum GDF-15 were the highest in BMI >40 kg/m(2) (2793.5 pg/mL +/- 123.2) vs. BMI <25 kg/m(2) (2017.6 pg/mL +/-130.8), BMI 25-30 kg/m(2) (1881.8 pg/mL +/-127.4), or BMI 30-35 kg/m(2) (2054.2 pg/mL +/-124.1, all P < 0.05). Increased GDF-15 level predicted mortality (2587 pg/mL, area under the receiver operating characteristic curve 0.94). Serum leptin level increased with BMI without predictive value for long-term mortality. CONCLUSION: Morbidly visceral and epicardial fat accumulation, reduction in muscle area, and GDF-15 increase are strong predictors of adverse outcomes in very old patients post-TAVR. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Rohrbach, Susanne AU - Rohrbach S AUID- ORCID: 0000-0002-7523-5221 AD - Institute of Physiology, Justus Liebig University Giessen, Aulweg 129, 35392 Giessen, Germany. FAU - Uluocak, Oezge AU - Uluocak O AD - Department of Cardiac and Vascular Surgery, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Rudolph-Buchheim-Strasse 7, 35392 Giessen, Germany. FAU - Junge, Marieke AU - Junge M AD - Department of Cardiac and Vascular Surgery, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Rudolph-Buchheim-Strasse 7, 35392 Giessen, Germany. FAU - Knapp, Fabienne AU - Knapp F AD - Institute of Physiology, Justus Liebig University Giessen, Aulweg 129, 35392 Giessen, Germany. FAU - Schulz, Rainer AU - Schulz R AUID- ORCID: 0000-0002-4066-4624 AD - Institute of Physiology, Justus Liebig University Giessen, Aulweg 129, 35392 Giessen, Germany. FAU - Boning, Andreas AU - Boning A AUID- ORCID: 0000-0002-4404-510X AD - Department of Cardiac and Vascular Surgery, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Rudolph-Buchheim-Strasse 7, 35392 Giessen, Germany. FAU - Nef, Holger M AU - Nef HM AD - Department of Cardiology, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Klinikstrasse 33, 35392 Giessen, Germany. FAU - Krombach, Gabriele A AU - Krombach GA AD - Department of Radiology, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Klinikstrasse 33, 35392 Giessen, Germany. FAU - Niemann, Bernd AU - Niemann B AUID- ORCID: 0000-0003-4431-7002 AD - Department of Cardiac and Vascular Surgery, University Hospital Giessen and Marburg, Justus Liebig University Giessen, Rudolph-Buchheim-Strasse 7, 35392 Giessen, Germany. LA - eng PT - Journal Article DEP - 20240920 PL - England TA - Eur Heart J Open JT - European heart journal open JID - 9918282081406676 PMC - PMC11414403 OTO - NOTNLM OT - BMI OT - Epicardial fat OT - GDF-15 OT - Sarcopenic obesity OT - TAVR COIS- Conflict of interest: None declared. EDAT- 2024/09/23 17:42 MHDA- 2024/09/23 17:43 PMCR- 2024/09/20 CRDT- 2024/09/23 06:05 PHST- 2024/01/29 00:00 [received] PHST- 2024/07/15 00:00 [revised] PHST- 2024/08/06 00:00 [accepted] PHST- 2024/09/23 17:43 [medline] PHST- 2024/09/23 17:42 [pubmed] PHST- 2024/09/23 06:05 [entrez] PHST- 2024/09/20 00:00 [pmc-release] AID - oeae073 [pii] AID - 10.1093/ehjopen/oeae073 [doi] PST - epublish SO - Eur Heart J Open. 2024 Sep 20;4(5):oeae073. doi: 10.1093/ehjopen/oeae073. eCollection 2024 Sep. PMID- 39290681 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240919 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 8 IP - 5 DP - 2024 Sep TI - A Novel Risk Score Facilitates Femoral Artery Access in Transcatheter Aortic Valve Implantation: Passage-Puncture Score. PG - 100331 LID - 10.1016/j.shj.2024.100331 [doi] LID - 100331 AB - BACKGROUND: Vascular complications remain high in transfemoral transcatheter aortic valve implantation (TAVI). Careful evaluation of the femoral arteries is important to select the optimal access site. OBJECTIVES: This study sought to describe a novel risk score (the passage-puncture score) for transfemoral access using a single suture-based closure system. METHODS: The passage-puncture score consists of the evaluation of 1) passage feasibility of the ilio-femoral arteries (passage score) and 2) puncture site feasibility (puncture score) based on pre-TAVI computed tomography. All patients underwent fluoroscopy-guided arterial puncture and closure with a suture-based closure system. The primary endpoint was the rate of vascular complications in discharge, including minor and major vascular complications according to the definitions of the Third Valve Academic Research Consortium. RESULTS: From September 2020 to June 2021, transfemoral TAVI was performed in 98 of 99 patients. Passage score (right) was significantly higher in patients treated by left compared to those treated by right femoral access (3 vs. 1; p <0.001). Puncture score was significantly different between patients undergoing mid-femoral as compared to nonmid-femoral puncture (0 vs. 3, p <0.001). Minor vascular complications occurred in six (6%) patients. CONCLUSIONS: The passage-puncture score is effective in defining the optimal access site for transfemoral TAVI. The systematic evaluation has the potential to further reduce access-site complications. CI - (c) 2024 The Author(s). FAU - Chen, Mi AU - Chen M AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Michel, Jonathan AU - Michel J AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Stahli, Barbara E AU - Stahli BE AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Templin, Christian AU - Templin C AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Jakob, Philipp AU - Jakob P AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Gilhofer, Thomas S AU - Gilhofer TS AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Tanner, Felix C AU - Tanner FC AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. FAU - Kasel, Albert Markus AU - Kasel AM AD - Department of Cardiology, University Heart Center, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. LA - eng PT - Journal Article DEP - 20240625 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC11403084 OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - Transfemoral approach OT - Vascular closure device OT - Vascular complication COIS- M. Chen received grant from Boston Scientific and she is a consultant for Jenscare Scientific. J. Michel is a proctor for Boston Scientific. B. E. Stahli received grants to the institution from Edwards Lifesciences and Boston Scientific. A. M. Kasel is a consultant and proctor for Edwards Lifesciences and received grants to the institution from Edwards Lifesciences. The other authors had no conflicts to declare. EDAT- 2024/09/18 06:42 MHDA- 2024/09/18 06:43 PMCR- 2024/06/25 CRDT- 2024/09/18 04:31 PHST- 2024/02/07 00:00 [received] PHST- 2024/04/10 00:00 [revised] PHST- 2024/05/16 00:00 [accepted] PHST- 2024/09/18 06:43 [medline] PHST- 2024/09/18 06:42 [pubmed] PHST- 2024/09/18 04:31 [entrez] PHST- 2024/06/25 00:00 [pmc-release] AID - S2474-8706(24)00079-4 [pii] AID - 100331 [pii] AID - 10.1016/j.shj.2024.100331 [doi] PST - epublish SO - Struct Heart. 2024 Jun 25;8(5):100331. doi: 10.1016/j.shj.2024.100331. eCollection 2024 Sep. PMID- 39274553 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240916 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 17 DP - 2024 Sep 9 TI - Impact of Accidental High or Low Implantation Depth on Peri-Procedural Outcomes after Implantation with the Self-Expanding ACURATE neo2. LID - 10.3390/jcm13175342 [doi] LID - 5342 AB - Background: Precise implantation could play a crucial role in the technical success of transcatheter aortic valve replacement (TAVR) for some prostheses. The impact of an accidental implantation depth (ID) outside the recommended range has not been assessed for the ACURATE neo2 (NEO2). Methods: Data from 1839 patients with severe native aortic stenosis treated with the NEO2 prosthesis were evaluated. We compared the results of prostheses implanted in an ID both inside and outside the recommendations. The outcome assessment followed the Valve Academic Research Consortium-3 criteria. Results: Patients were retrospectively divided into high (<3 mm; n = 412), optimal (3-7 mm; n = 1236), and low (>7 mm; n = 169) implantations. Technical success (94.7% vs. 94.7% vs. 91.7%, p = 0.296) and device success were high (90.1% vs. 89.3% vs. 84.6%, p = 0.112) without differences between groups. Rates of relevant paravalvular regurgitation (PVL; >mild or VinV due to PVL) were comparable (1.2% vs. 1.8% vs. 1.2%, p = 0.759). Even when hemodynamics were superior in the high-implantation group, with greater iEOA (1.01 cm(2)/m(2) vs. 0.95 cm(2)/m(2) vs. 0.92 cm(2)/m(2), p < 0.001), spontaneous embolization or after post-dilatation was more common. Low implantation was associated with a higher rate of associated pacemaker implantation (PPI) (6.1% vs. 8.8% vs. 14.8%, p = 0.001). Conclusions: Implantation with the ACURATE neo2 showed excellent hemodynamic results, including low gradients and a small number of relevant PVL, in line with a high technical success rate that was irrespective of the ID. A favorable outcome can also be achieved in accidental low or high positions. Low implantation was associated with a higher rate of associated pacemaker implantation. Deliberately high implantation should be avoided due to the risk of embolization. FAU - Eckel, Clemens AU - Eckel C AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - School VI-School of Medicine and Health Sciences, Carl von Ossietzky Universitat Oldenburg, 26129 Oldenburg, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany. FAU - Schluter, Judith AU - Schluter J AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Renker, Matthias AU - Renker M AUID- ORCID: 0000-0002-4756-5397 AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Bargon, Sophie AU - Bargon S AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Grothusen, Christina AU - Grothusen C AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - Department of Cardiac Surgery, University of Kiel, 24118 Kiel, Germany. FAU - Elsasser, Albrecht AU - Elsasser A AD - School VI-School of Medicine and Health Sciences, Carl von Ossietzky Universitat Oldenburg, 26129 Oldenburg, Germany. FAU - Dohmen, Guido AU - Dohmen G AUID- ORCID: 0000-0001-6577-7898 AD - Department of Cardiac Surgery, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Choi, Yeong-Hoon AU - Choi YH AUID- ORCID: 0000-0002-5796-9926 AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Charitos, Efstratios I AU - Charitos EI AUID- ORCID: 0000-0003-0284-8200 AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany. FAU - Sossalla, Samuel AU - Sossalla S AUID- ORCID: 0000-0001-8034-2673 AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Blumenstein, Johannes AU - Blumenstein J AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - School VI-School of Medicine and Health Sciences, Carl von Ossietzky Universitat Oldenburg, 26129 Oldenburg, Germany. LA - eng PT - Journal Article DEP - 20240909 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11396697 OTO - NOTNLM OT - PPI OT - PPM OT - PVL OT - TAVR OT - THV OT - embolization OT - implantation depth OT - self-expanding OT - transfemoral COIS- W.-K.K. has received proctor fees and speaker honoraria from Boston Scientific Edwards Lifesciences, Medtronic and Abbott. H.M. has received proctor fees and speaker honoraria from Boston Scientific, Biotronik and Abbott. J.B. has received proctor fees and speaker honoraria from Boston Scientific and Abbott. C.W.H. is advisory board member of Medtronic. C.E., J.S., M.R., S.B., C.G., A.E., G.D., Y.-H.C., E.I.C. and S.S. have no conflicts of interest. EDAT- 2024/09/14 10:43 MHDA- 2024/09/14 10:44 PMCR- 2024/09/09 CRDT- 2024/09/14 01:14 PHST- 2024/07/22 00:00 [received] PHST- 2024/08/15 00:00 [revised] PHST- 2024/08/24 00:00 [accepted] PHST- 2024/09/14 10:44 [medline] PHST- 2024/09/14 10:43 [pubmed] PHST- 2024/09/14 01:14 [entrez] PHST- 2024/09/09 00:00 [pmc-release] AID - jcm13175342 [pii] AID - jcm-13-05342 [pii] AID - 10.3390/jcm13175342 [doi] PST - epublish SO - J Clin Med. 2024 Sep 9;13(17):5342. doi: 10.3390/jcm13175342. PMID- 39274239 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240916 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 17 DP - 2024 Aug 25 TI - Temporal Trends in Patient Characteristics and Clinical Outcomes of TAVR: Over a Decade of Practice. LID - 10.3390/jcm13175027 [doi] LID - 5027 AB - Background/Objective: Transcatheter aortic valve replacement (TAVR) is indicated for severe aortic stenosis patients with a prohibitive surgical risk. However, its use has been expanding in recent years to include intermediate- and low-risk patients. Thus, registry data describing changes in patient characteristics and outcomes are needed. The aim of this study was to analyse the temporal changes in patient profiles and clinical outcomes of all-comer TAVR. Methods: Baseline characteristics and VARC-3 outcomes of 1632 consecutive patients undergoing TAVR between 2008 and 2021 were analysed. Results: The annual rate of TAVR increased from 30 procedures in 2008-2009 to 398 in 2020-2021. Over the follow-up period, patient age decreased from 85 +/- 4 to 80 +/- 6.8 (p < 0.001) and the STS score decreased from 5.9% to 2.8% (p < 0.001). Procedural characteristics significantly changed, representing a shift into a minimally invasive approach: adoption of local anaesthesia (none to 48%, p < 0.001) and preference of transfemoral access (74% in 2011-2012 vs. 94.5% in 2020-2021, p < 0.001). The rates of almost all procedural complications decreased, including major vascular and bleeding complications, acute kidney injury (AKI) and in-hospital heart failure. There was a striking decline in rates of complete atrioventricular block (CAVB) and the need for a permanent pacemaker (PPM). PPM rates, however, remain high (17.8%). Thirty-day and one-year mortality significantly declined to 1.8% and 8.3%, respectively. Multivariable analysis shows that AKI, bleeding and stroke are strong predictors of one-year mortality (p < 0.001). Conclusions: The TAVR procedure has changed dramatically during the last 14 years in terms of patient characteristics, procedural aspects and device maturity. These shifts have led to improved procedural safety, contributing to improved short- and long-term patient outcomes. FAU - Karra, Nour AU - Karra N AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. FAU - Sharon, Amir AU - Sharon A AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. FAU - Massalha, Eias AU - Massalha E AUID- ORCID: 0000-0001-9659-535X AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Fefer, Paul AU - Fefer P AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Maor, Elad AU - Maor E AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Guetta, Victor AU - Guetta V AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Ben-Zekry, Sagit AU - Ben-Zekry S AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Kuperstein, Rafael AU - Kuperstein R AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Matetzky, Shlomi AU - Matetzky S AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Beigel, Roy AU - Beigel R AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Segev, Amit AU - Segev A AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. FAU - Barbash, Israel M AU - Barbash IM AD - Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. AD - The Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. LA - eng PT - Journal Article DEP - 20240825 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11396256 OTO - NOTNLM OT - TAVR OT - aortic stenosis OT - low risk OT - temporal trends COIS- The authors have no conflicts of interest to declare. EDAT- 2024/09/14 10:46 MHDA- 2024/09/14 10:47 PMCR- 2024/08/25 CRDT- 2024/09/14 01:13 PHST- 2024/07/18 00:00 [received] PHST- 2024/08/12 00:00 [revised] PHST- 2024/08/22 00:00 [accepted] PHST- 2024/09/14 10:47 [medline] PHST- 2024/09/14 10:46 [pubmed] PHST- 2024/09/14 01:13 [entrez] PHST- 2024/08/25 00:00 [pmc-release] AID - jcm13175027 [pii] AID - jcm-13-05027 [pii] AID - 10.3390/jcm13175027 [doi] PST - epublish SO - J Clin Med. 2024 Aug 25;13(17):5027. doi: 10.3390/jcm13175027. PMID- 39260959 OWN - NLM STAT- MEDLINE DCOM- 20240911 LR - 20260707 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 17 DP - 2024 Sep 9 TI - Asymmetrical Expansion of Balloon-Expandable Transcatheter Aortic Valve Prostheses: Implications for Valve Hemodynamic and Clinical Outcomes. PG - 2011-2022 LID - S1936-8798(24)00855-0 [pii] LID - 10.1016/j.jcin.2024.05.039 [doi] AB - BACKGROUND: Asymmetrical expansion of transcatheter heart valves (THVs), manifesting as stent frame deformation, is an occasional fluoroscopic finding in transcatheter aortic valve replacement (TAVR). OBJECTIVES: The aim of this study was to investigate the impact of asymmetrical expansion of balloon-expandable THVs on hemodynamic valve performance and clinical outcomes. METHODS: In a prospective registry, TAVR asymmetry index was measured using freeze-frame fluoroscopic images and was defined as the ratio of THV heights: [(longer height/shorter height) - 1] x 100. THV hemodynamic performance was measured using echocardiography before hospital discharge. Impaired hemodynamic valve performance was defined as a mean residual THV gradient >/=20 mm Hg and/or moderate or greater paravalvular regurgitation. RESULTS: Among 1,216 patients undergoing transfemoral TAVR for native severe aortic valve stenosis with contemporary balloon-expandable THVs between February 2014 and June 2022, asymmetry index was an excellent predictor of impaired hemodynamic valve performance (area under the receiver-operating characteristic curve: 0.88; 95% CI: 0.84-0.92; P < 0.001). The optimal asymmetry index threshold for predicting impaired THV performance was >5.5% (sensitivity 77%, specificity 86%) and occurred in 17% of patients. Higher asymmetry index, as a continuous variable, was associated with impaired hemodynamic valve performance independent of total aortic valve calcium, bicuspid anatomy, balloon-expandable valve prosthesis type or size, and Society of Thoracic Surgeons Predicted Risk of Mortality score (OR: 1.37; 95% CI: 1.29-1.46; P < 0.001). High TAVR asymmetry index was not associated with all-cause mortality during a median of 376 days of follow-up (HR: 1.00; 95% CI: 0.71-1.41; P = 0.989). CONCLUSIONS: Asymmetrical expansion of balloon-expandable THVs was associated with impaired hemodynamic valve performance but not with clinical outcomes. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Maznyczka, Annette AU - Maznyczka A AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/AMaznyczka. FAU - Heg, Dierik AU - Heg D AD - Department of Clinical Research, University of Bern, Bern, Switzerland. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/DaijiroTomii. FAU - Nakase, Masaaki AU - Nakase M AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/masaaki0825. FAU - Baekke, Pernille Steen AU - Baekke PS AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/pbaekke. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Reineke, David AU - Reineke D AD - Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Hemodynamics MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - *Heart Valve Prosthesis MH - Male MH - Female MH - *Prosthesis Design MH - *Aortic Valve Stenosis/physiopathology/surgery/diagnostic imaging/mortality MH - Aged, 80 and over MH - *Aortic Valve/physiopathology/diagnostic imaging/surgery MH - *Balloon Valvuloplasty MH - Treatment Outcome MH - Aged MH - *Registries MH - Risk Factors MH - Time Factors MH - Prospective Studies MH - Severity of Illness Index MH - Recovery of Function MH - Aortic Valve Insufficiency/physiopathology/diagnostic imaging/etiology OTO - NOTNLM OT - asymmetry OT - bioprosthetic valve function OT - clinical outcomes OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Heg's employer, CTU Bern, is involved in the design, conduct, or analysis of clinical studies funded by not-for-profit and for-profit organizations. In particular, pharmaceutical and medical device companies provide direct funding to some of these studies. For an up-to-date list of CTU Bern's conflicts of interest see http://www.ctu.unibe.ch/research/declaration_of_interest/index_eng.html. Dr Maznyczka is an European Association of Percutaneous Coronary Intervention international structural fellow (funded by Edwards Lifesciences through the European Association of Percutaneous Cardiovascular Interventions and not directly from Edwards Lifesciences); and has received travel grants from Edwards Lifesciences, Abbott, Boston Scientific, and Medtronic. Dr Baekke has received educational and research grants from Abbott, Boston Scientific, and Medtronic. Dr Stortecky has received research grants to the institution from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific; and has received personal fees from Boston Scientific, Teleflex, and BTG. Dr Windecker has received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, Bristol Myers Squibb, Bayer, Biotronik, Boston Scientific, Cardinal Health, CardioValve, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Guerbet, Infraredx, Johnson & Johnson, Medicure, Medtronic, Novartis, Polares, OrPha Suisse, Pfizer, Regeneron, Sanofi, Sinomed, Terumo, and V-Wave; serves as an unpaid advisory board member and/or an unpaid member of the steering or executive groups of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bristol Myers Squibb, Boston Scientific, Biotronik, Cardiovalve, Edwards Lifesciences, Med Alliance, Medtronic, Novartis, Polares, Sinomed, V-Wave, and Xeltis (but has not received personal payments from pharmaceutical companies or device manufacturers); is a member of the steering or executive committee groups of several investigator-initiated trials that receive funding from industry (without impact on his personal remuneration); is an unpaid member of the Pfizer Research Award selection committee in Switzerland and of the Women as One Awards Committee; is a member of the Clinical Study Group of Deutsches Zentrum fur Herz Kreislauf-Forschung and of the advisory board of the Australian Victorian Heart Institute; is chair of the European Society of Cardiology Congress Program Committee; and is associate editor of JACC: Cardiovascular Interventions. Dr Pilgrim has received research, travel, and educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; and has received speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr Reineke has received travel expenses from Abbott, Edwards Lifesciences, and Medtronic; and has proctor and consulting contracts with Abbott and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/09/12 00:42 MHDA- 2024/09/12 00:43 CRDT- 2024/09/11 21:05 PHST- 2024/03/12 00:00 [received] PHST- 2024/05/07 00:00 [revised] PHST- 2024/05/29 00:00 [accepted] PHST- 2024/09/12 00:43 [medline] PHST- 2024/09/12 00:42 [pubmed] PHST- 2024/09/11 21:05 [entrez] AID - S1936-8798(24)00855-0 [pii] AID - 10.1016/j.jcin.2024.05.039 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Sep 9;17(17):2011-2022. doi: 10.1016/j.jcin.2024.05.039. PMID- 39245341 OWN - NLM STAT- MEDLINE DCOM- 20250109 LR - 20260322 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 41 IP - 1 DP - 2025 Jan TI - Dual ProGlide vs ProGlide and Angio-Seal for Femoral Access Hemostasis After Transcatheter Aortic Valve Replacement: A Randomised Comparative Trial. PG - 12-20 LID - S0828-282X(24)00937-1 [pii] LID - 10.1016/j.cjca.2024.09.001 [doi] AB - BACKGROUND: Vascular complications increase morbidity and mortality after transcatheter aortic valve replacements (TAVR), often related to failures in vascular closure devices (VCDs). We intended to compare the dual Perclose ProGlide (PP) strategy and the hybrid combination of PP and Angio-Seal (AS) for femoral access hemostasis after TAVR. METHODS: A randomised controlled trial with 257 patients comparing dual PP with 1 PP and 1 AS (AS+PP) for vascular closure after transfemoral TAVR was conducted. The primary end point was the composite of TAVR access site-related vascular complications and life-threatening type 2/3 or 1 bleeding according to the Valve Academic Research Consortium 3. Secondary end points included additional VCD use and significant peripheral ischemia related to arteriotomy closure within 1 year. Modified VCD failure, defined as failure to achieve hemostasis within 5 minutes or requiring additional endovascular manoeuvres, was also recorded. RESULTS: The AS+PP combination yielded lower rates of the primary end point (18.2% vs 29.8%; P = 0.0381), vascular complication (18.2% vs 29.8%; P = 0.0381), additional VCD use (0.8% vs 19.0%; P < 0.0001), and modified VCD failure (9.9% vs 33.1%; P < 0.0001) than the dual PP. Bleeding complication rates were similar between the 2 groups. Three-month follow-up vascular duplex tests showed similar common femoral artery (CFA) diameters and peak systolic velocities (PSVs) between the 2 groups, but those with additional intervention had higher PSVs and smaller CFA diameters than those without. CONCLUSIONS: Combined PP+AS for large-bore femoral access hemostasis after TAVR promises to be more effective and safer than dual PP in terms of vascular complications. Moreover, additional intervention for vascular complications resulted in smaller CFA diameters. CLINICAL TRIAL REGISTRATION: NCT05491070. CI - Copyright (c) 2024 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Yeh, Chih-Fan AU - Yeh CF AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Kao, Hsien-Li AU - Kao HL AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Ko, Tsung-Yu AU - Ko TY AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, Medical College, National Taiwan University, Taipei, Taiwan. FAU - Chen, Chun-Kai AU - Chen CK AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, Medical College, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan. FAU - Tsai, Cheng-Hsuan AU - Tsai CH AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Huang, Ching-Chang AU - Huang CC AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chen, Ying-Hsien AU - Chen YH AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chan, Chih-Yang AU - Chan CY AD - Division of Cardiovascular Surgery, Department of Surgery and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. FAU - Lin, Mao-Shin AU - Lin MS AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Centre, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: linmaoshin@gmail.com. LA - eng SI - ClinicalTrials.gov/NCT05491070 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20240906 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM EIN - Can J Cardiol. 2026 Jun;42(6):1236. doi: 10.1016/j.cjca.2026.03.001. PMID: 41866133 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Femoral Artery MH - Male MH - Female MH - *Vascular Closure Devices MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery MH - Hemostatic Techniques MH - Aged MH - Treatment Outcome MH - Catheterization, Peripheral/methods/adverse effects MH - Follow-Up Studies MH - Postoperative Hemorrhage/epidemiology/etiology/diagnosis EDAT- 2024/09/09 00:50 MHDA- 2025/01/10 00:21 CRDT- 2024/09/08 19:27 PHST- 2024/05/22 00:00 [received] PHST- 2024/08/18 00:00 [revised] PHST- 2024/09/03 00:00 [accepted] PHST- 2025/01/10 00:21 [medline] PHST- 2024/09/09 00:50 [pubmed] PHST- 2024/09/08 19:27 [entrez] AID - S0828-282X(24)00937-1 [pii] AID - 10.1016/j.cjca.2024.09.001 [doi] PST - ppublish SO - Can J Cardiol. 2025 Jan;41(1):12-20. doi: 10.1016/j.cjca.2024.09.001. Epub 2024 Sep 6. PMID- 42305991 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260617 LR - 20260813 IS - 2950-6050 (Electronic) IS - 2950-6050 (Linking) VI - 3 DP - 2024 Nov TI - Initial experience with transcatheter aortic valve replacement before and after lung transplant. PG - 100022 LID - 10.1016/j.xjse.2024.100022 [doi] LID - 100022 AB - OBJECTIVES: Patients with end-stage lung disease and lung transplant (LTx) recipients are high-risk candidates for surgical aortic valve replacement (AVR). Transcatheter AVR (TAVR) is an established treatment for aortic stenosis. Experience with TAVR in the LTx population is limited. We sought to report our experience in patients who underwent TAVR before or after LTx. METHODS: Single-center, retrospective analysis, including all patients who underwent TAVR pre- or post-LTx from 2000 to 2020. Indications, mode of anesthesia, timing of TAVR, and procedural outcomes were reviewed. RESULTS: In total, 10 LTx patients underwent TAVR. Aortic stenosis was the indication for TAVR in all patients: 5 had TAVR pre-LTx, and 5 post-LTx. All 10 TAVRs were performed with transfemoral access, and 9 out of 10 with intravenous sedation and monitored anesthesia care; only 1 required general anesthesia. In the TAVR pre-LTx group, mean age was 62 years and 4 patients were men. Four TAVR valves were balloon-expandable and 1 self-expanding. Median time from TAVR to transplant was 7.4 months (range, 1.7-36 months), and median length of stay after TAVR 4 days (range, 2-36 days). The only TAVR-related complication was a pacemaker for heart block (1 out of 5). All 5 subsequently underwent successful double LTx (1 with concurrent liver transplant). In the TAVR post-LTx group, mean age was 66 years and 2 patients were men. Four TAVR valves were balloon-expandable and 1 was self-expanding. Median time from LTx to TAVR was 5 years (range, 2.6-7.6 years), and median length of stay post-TAVR was 2 days (range, 1-17 days). The only TAVR-related complication in this group was heart block requiring pacemaker (1 out of 5). In both groups, there were no intraprocedural mortalities or conversions to surgical AVR. No patients required post-TAVR surgical intervention during study follow-up. CONCLUSIONS: Our initial experience suggests that TAVR is safe and feasible for treatment of aortic stenosis in patients with end-stage lung disease awaiting LTx, and in patients who have undergone LTx. Overall TAVR-related complications included need for pacemaker. TAVR should be considered for treatment of aortic stenosis in patients with end-stage lung disease awaiting transplant, and for post-LTx patients as an alternative to surgical aortic valve replacement. CI - (c) 2024 The Author(s). FAU - Mubashir, Mujtaba AU - Mubashir M AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Barron, John O AU - Barron JO AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Kapadia, Samir AU - Kapadia S AD - Department of Cardiology, Cleveland Clinic, Cleveland, Ohio. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiology, Cleveland Clinic, Cleveland, Ohio. FAU - Unai, Shinya AU - Unai S AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - McCurry, Kenneth AU - McCurry K AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Budev, Marie AU - Budev M AD - Department of Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Reed, Grant AU - Reed G AD - Department of Cardiology, Cleveland Clinic, Cleveland, Ohio. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiology, Cleveland Clinic, Cleveland, Ohio. FAU - Elgharably, Haytham AU - Elgharably H AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Ahmad, Usman AU - Ahmad U AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Yun, James AU - Yun J AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. LA - eng PT - Journal Article DEP - 20240907 PL - United States TA - JTCVS Struct Endovasc JT - JTCVS structural and endovascular JID - 9918991787106676 PMC - PMC13244692 OTO - NOTNLM OT - TAVR OT - aortic valve OT - lung transplant OT - transcatheter aortic valve COIS- The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. EDAT- 2024/09/07 00:00 MHDA- 2024/09/07 00:01 PMCR- 2024/09/07 CRDT- 2026/06/17 05:17 PHST- 2024/05/12 00:00 [received] PHST- 2024/07/29 00:00 [revised] PHST- 2024/08/05 00:00 [accepted] PHST- 2024/09/07 00:01 [medline] PHST- 2024/09/07 00:00 [pubmed] PHST- 2026/06/17 05:17 [entrez] PHST- 2024/09/07 00:00 [pmc-release] AID - S2950-6050(24)00022-6 [pii] AID - 100022 [pii] AID - 10.1016/j.xjse.2024.100022 [doi] PST - epublish SO - JTCVS Struct Endovasc. 2024 Sep 7;3:100022. doi: 10.1016/j.xjse.2024.100022. eCollection 2024 Nov. PMID- 39235228 OWN - NLM STAT- Publisher LR - 20240905 IS - 1538-4683 (Electronic) IS - 1061-5377 (Linking) DP - 2024 Sep 5 TI - Transcatheter Aortic Valve Implantation (TAVI) in Bicuspid Aortic Valve Disease: A Systematic Review. LID - 10.1097/CRD.0000000000000784 [doi] AB - Transcatheter aortic valve implantation (TAVI) is effective and safe, but its outcomes for patients with bicuspid aortic valve (BAV) disease are relatively unclear. A comprehensive search of PubMed, Medline, and Google Scholar till November 2023 yielded studies evaluating TAVI in BAV patients. Inclusion criteria were applied, and data were extracted on clinical and procedural outcomes, including echocardiographic measures and complications. Statistical analyses included descriptive statistics, subgroup analysis, and sensitivity analysis. From the 29 studies covering 8045 BAV patients, the mean age was found to be 72.5 +/- 10.35 years with a male predominance of 56.4% +/- 7.9%. TAVI was significantly beneficial, decreasing the mean aortic gradient from 46.9 to 10.4 mm Hg postprocedure and increasing aortic valve area, evidencing improved hemodynamics. A high procedural success rate of 93.3% was noted, predominantly through femoral access. However, complications included pacemaker need (12.6%), minor bleeding, and acute kidney injury. All-cause mortality escalated from 3.7% perioperatively to 16.8% after 1 year. Hazard ratios and P values highlighted significant outcomes: perioperative hazard ratio for mortality at 3.7% (P < 0.05), reduction in perioperative versus postoperative gradients (P < 0.001), and increase in postoperative aortic valve area (P < 0.001). The need for postdilatation was less than predilatation (P < 0.05), and significant differences were noted in device sizes (P < 0.05). TAVI in BAV patients showed good perioperative outcomes but with moderate complication rates. Notably, there was a significant rise in 1-year mortality, underscoring the importance of careful patient selection and strict postoperative care. More studies are necessary to determine long-term results and refine procedures for this group. CI - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved. FAU - Goulden, Christopher J AU - Goulden CJ AD - From the Liverpool University Hospitals Foundation Trust, Liverpool, United Kingdom. FAU - Wright, Kelly AU - Wright K AD - Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom. FAU - Alim, Samina AU - Alim S AD - St George's University of London, London United Kingdom. FAU - Patel, Nikhil AU - Patel N AD - Kings College London, London, United Kingdom. FAU - Irfan, Mahnoor AU - Irfan M AD - St George's University of London, London United Kingdom. FAU - Onay, Dilsat AU - Onay D AD - Yeditepe University Faculty of Medicine, Istanbul, Turkey. FAU - Sabet, Cameron AU - Sabet C AD - Georgetown University Medical Center, Washington, DC. FAU - Nguyen, Dang AU - Nguyen D AD - Massachusetts General Hospital, Corrigan Minehan Heart Center, Harvard Medical School, Boston, MA. FAU - Harky, Amer AU - Harky A AD - Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom. LA - eng PT - Journal Article DEP - 20240905 PL - United States TA - Cardiol Rev JT - Cardiology in review JID - 9304686 SB - IM COIS- Disclosure: The authors declare no conflict of interest. EDAT- 2024/09/05 12:43 MHDA- 2024/09/05 12:43 CRDT- 2024/09/05 09:03 PHST- 2024/09/05 12:43 [medline] PHST- 2024/09/05 12:43 [pubmed] PHST- 2024/09/05 09:03 [entrez] AID - 00045415-990000000-00330 [pii] AID - 10.1097/CRD.0000000000000784 [doi] PST - aheadofprint SO - Cardiol Rev. 2024 Sep 5. doi: 10.1097/CRD.0000000000000784. PMID- 39235157 OWN - NLM STAT- MEDLINE DCOM- 20241005 LR - 20260918 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 45 IP - 37 DP - 2024 Oct 5 TI - Transfemoral or surgical aortic valve replacement in young low-risk patients with tricuspid and bicuspid aortic valve stenosis. PG - 3815-3817 LID - 10.1093/eurheartj/ehae537 [doi] FAU - Schofer, Niklas AU - Schofer N AUID- ORCID: 0000-0001-5190-813X AD - University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20251 Hamburg, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AUID- ORCID: 0000-0001-6488-2362 AD - University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20251 Hamburg, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany. LA - eng PT - Journal Article PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/complications MH - *Bicuspid Aortic Valve Disease/surgery/complications MH - *Heart Valve Prosthesis Implantation/methods MH - *Aortic Valve/surgery/abnormalities MH - Heart Valve Diseases/surgery/complications MH - Femoral Artery/surgery MH - Tricuspid Valve/surgery/diagnostic imaging MH - Adult MH - Transcatheter Aortic Valve Replacement/methods EDAT- 2024/09/05 12:45 MHDA- 2024/10/05 11:43 CRDT- 2024/09/05 08:33 PHST- 2024/10/05 11:43 [medline] PHST- 2024/09/05 12:45 [pubmed] PHST- 2024/09/05 08:33 [entrez] AID - 7749787 [pii] AID - 10.1093/eurheartj/ehae537 [doi] PST - ppublish SO - Eur Heart J. 2024 Oct 5;45(37):3815-3817. doi: 10.1093/eurheartj/ehae537. PMID- 39214537 OWN - NLM STAT- MEDLINE DCOM- 20240830 LR - 20260501 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 11 IP - 2 DP - 2024 Aug 30 TI - Hypercapnia during transcatheter aortic valve replacement under monitored anaesthesia care: a retrospective cohort study. LID - 10.1136/openhrt-2024-002801 [doi] LID - e002801 AB - BACKGROUND: Acute intraoperative hypercapnia and respiratory acidosis, which can occur during monitored anaesthesia care (MAC), pose significant cardiopulmonary risks for patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). The goal of the present study is to assess the incidence, risk factors and impact of intraoperative hypercapnia during MAC for patients undergoing transfemoral TAVR. METHODS: Data was collected retrospectively from the electronic medical record of 201 consecutive patients with available intraoperative arterial blood gas (ABG) data who underwent percutaneous transfemoral TAVR with MAC using propofol and dexmedetomidine. ABGs (pH, arterial partial pressure of carbon dioxide (PaCO(2)) and arterial partial pressure of oxygen) were performed at the start of each case (baseline), immediately prior to valve deployment (ValveDepl), and on arrival to the postanaesthesia care unit. Data was analysed using Fisher's exact test, unpaired Student's t-test, Wilcoxon rank sum or univariate linear regression as appropriate based on PaCO(2) and pH during ValveDepl (PaCO(2)-ValveDepl, pH-ValveDepl) and change in PaCO(2) and pH from baseline to ValveDepl (PaCO(2)-%increase, pH-%decrease) to determine their association with preoperative demographic data, intraoperative anaesthetic and vasoactive medications and postoperative outcomes. RESULTS: PaCO(2) increased by a mean of 28.4% and was higher than baseline in 91% of patients. Younger age, male sex, increased weight and increased propofol dose contributed to higher PaCO(2)-ValveDepl and greater PaCO(2)-%increase. Patients with PaCO(2)-ValveDepl>60 mm Hg, pH/=65 years, treated with elective isolated transfemoral TAVR or SAVR between 2012 and 2019. The study end point was the occurrence of a major complication (composite outcome) during index and up to 30 days after. Multivariable logistic regression was used to assess odds of complications for TAVR and SAVR, individually over time, and for TAVR versus SAVR, over time. The cohort included 211 212 patients (mean+/-SD age, 78.6+/-7.3 years; 45.0% women). Complication rates during index following elective isolated aortic valve replacement decreased from 49% in 2012 to 22% in 2019. These reductions were more pronounced for TAVR (41% to >19%, Delta=22%) than SAVR (51% to >47%, Delta=4%). After risk adjustment, the risk of any complication with TAVR was 47% (P<0.0001) lower compared with SAVR in 2012, and 78% (P<0.0001) lower in 2019. TAVR was independently associated with reduced odds of complications each year compared with 2012, with the magnitude of benefit increasing over time (2013 versus 2012: odds ratio [OR], 0.89 [95% CI, 0.81-0.97]; 2019 versus 2012: OR, 0.35 [95% CI, 0.33-0.38]). These findings are consistent for complications up to 30 days from index. CONCLUSIONS: Between 2012 and 2019, the risk of complications after aortic valve replacement among Medicare beneficiaries decreased significantly, with larger absolute and relative changes among patients treated with TAVR than SAVR. FAU - Harvey, James E 3rd AU - Harvey JE 3rd AUID- ORCID: 0000-0002-6656-375X AD - WellSpan Health System York PA USA. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Department of Cardiovascular Medicine Cleveland Clinic Cleveland OH USA. FAU - Cohen, David J AU - Cohen DJ AUID- ORCID: 0000-0001-9163-724X AD - Cardiovascular Research Foundation and St Francis Hospital Roslyn NY USA. FAU - Kalra, Ankur AU - Kalra A AUID- ORCID: 0000-0003-0080-1660 AD - Franciscan Health Lafayette IN USA. AD - Indiana University School of Medicine Lafayette IN USA. FAU - Irish, William AU - Irish W AUID- ORCID: 0000-0003-2605-5950 AD - Brody School of Medicine Greenville NC USA. FAU - Gunnarsson, Candace AU - Gunnarsson C AUID- ORCID: 0000-0003-0723-585X AD - Gunnarsson Consulting Jupiter FL USA. FAU - Ryan, Michael AU - Ryan M AUID- ORCID: 0000-0002-7207-7926 AD - MPR Consulting Cincinnati OH USA. FAU - Chikermane, Soumya G AU - Chikermane SG AUID- ORCID: 0000-0001-5335-3430 AD - Edwards Lifesciences Irvine CA USA. FAU - Thompson, Christin AU - Thompson C AUID- ORCID: 0000-0002-4713-4730 AD - Edwards Lifesciences Irvine CA USA. FAU - Puri, Rishi AU - Puri R AUID- ORCID: 0000-0001-8849-7426 AD - Department of Cardiovascular Medicine Cleveland Clinic Cleveland OH USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240827 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM CIN - J Am Heart Assoc. 2024 Sep 3;13(17):e035663. doi: 10.1161/JAHA.124.035663. PMID: 39189481 MH - Humans MH - Female MH - Male MH - Aged MH - United States/epidemiology MH - *Aortic Valve Stenosis/surgery/epidemiology MH - Retrospective Studies MH - *Postoperative Complications/epidemiology/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects/trends MH - Aged, 80 and over MH - Risk Factors MH - Medicare MH - Heart Valve Prosthesis Implantation/adverse effects/trends MH - Risk Assessment MH - Treatment Outcome MH - Aortic Valve/surgery MH - Time Factors PMC - PMC11646526 OTO - NOTNLM OT - aortic stenosis OT - complications OT - surgical aortic valve replacement OT - transcatheter aortic valve replacement OT - trends EDAT- 2024/08/27 12:45 MHDA- 2024/09/03 12:43 PMCR- 2024/09/03 CRDT- 2024/08/27 07:53 PHST- 2024/09/03 12:43 [medline] PHST- 2024/08/27 12:45 [pubmed] PHST- 2024/08/27 07:53 [entrez] PHST- 2024/09/03 00:00 [pmc-release] AID - JAH39565 [pii] AID - 10.1161/JAHA.123.031461 [doi] PST - ppublish SO - J Am Heart Assoc. 2024 Sep 3;13(17):e031461. doi: 10.1161/JAHA.123.031461. Epub 2024 Aug 27. PMID- 39189469 OWN - NLM STAT- In-Process LR - 20250102 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 82 IP - 11 DP - 2024 TI - Single-stage procedure of carotid artery stenting and transcatheter aortic valve implantation. PG - 1151-1153 LID - 10.33963/v.phj.102267 [doi] FAU - Mroz, Krystian AU - Mroz K AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. FAU - Okarski, Michal AU - Okarski M AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. FAU - Pieniazek, Piotr AU - Pieniazek P AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Vascular and Endovascular Surgery, St. John Paul II Hospital, Krakow, Poland. FAU - Paluszek, Piotr AU - Paluszek P AD - Department of Vascular and Endovascular Surgery, St. John Paul II Hospital, Krakow, Poland. FAU - Trebacz, Jaroslaw AU - Trebacz J AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. FAU - Konstanty-Kalandyk, Janusz AU - Konstanty-Kalandyk J AD - Clinical Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. AD - Jagiellonian University Medical College, Institute of Cardiology, Department of Cardiac Surgery and Transplantation, Krakow, Poland. FAU - Sobczynski, Robert AU - Sobczynski R AD - Clinical Department of Cardiac Surgery and Transplantation, St. John Paul II Hospital, Krakow, Poland. FAU - Stapor, Maciej AU - Stapor M AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. FAU - Legutko, Jacek AU - Legutko J AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Kleczynski, Pawel AU - Kleczynski P AD - Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland. kleczu@interia.pl. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. kleczu@interia.pl. LA - eng PT - Journal Article DEP - 20240827 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM EDAT- 2024/08/27 12:46 MHDA- 2024/08/27 12:46 CRDT- 2024/08/27 07:04 PHST- 2024/08/26 00:00 [received] PHST- 2024/08/26 00:00 [accepted] PHST- 2024/08/27 12:46 [pubmed] PHST- 2024/08/27 12:46 [medline] PHST- 2024/08/27 07:04 [entrez] AID - VM/OJS/J/102267 [pii] AID - 10.33963/v.phj.102267 [doi] PST - ppublish SO - Kardiol Pol. 2024;82(11):1151-1153. doi: 10.33963/v.phj.102267. Epub 2024 Aug 27. PMID- 39189047 OWN - NLM STAT- MEDLINE DCOM- 20241112 LR - 20250508 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 6 DP - 2024 Nov TI - Single-center experience with self-expanding transcatheter aortic valve system for symptomatic high-risk patients with severe aortic regurgitation: One-year outcomes. PG - 1275-1280 LID - 10.1002/ccd.31193 [doi] AB - AIMS: To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) for the treatment of aortic regurgitation (AR). METHODS: From September 2019 to February 2022, 62 patients who underwent transfemoral TAVI procedure for pure, symptomatic severe AR with the VitaFlow system were enrolled in the current study. The outcomes were assessed according to the Valve Academic Research Consortium 3 criteria. Procedural results and clinical outcomes for 1 year were analyzed. RESULTS: The mean age was 71.56 +/- 7.34 years and 58.1% were male. The mean Society of Thoracic Surgeons score was 5.44 +/- 3.22%. The device success rate was 79.0%. Only one patient was converted to open surgery. The in-hospital mortality rate was 1.6%. The 1-year all-cause mortality rate was 6.5%. The new permanent pacemaker implantation rate was 29.0% in-hospital and 30.7% at 1-year follow-up. The second valve implantation rate was 14.5%. No patient developed more than moderate paravalvular leakage during follow-up. The mean ejection fraction improved from 54.05 +/- 10.83% at baseline to 59.32 +/- 8.70% (p < 0.001 compared with baseline) at 12 months. Left ventricular end-diastolic diameter decreased from 61.62 +/- 5.58 mm at baseline to 55.20 +/- 4.51 mm (p < 0.001 compared with the baseline) at 12 months. CONCLUSIONS: Transfemoral TAVI procedure shows efficacy in treating patients with severe pure native AR. The safety is improved with the development of the VitaFlow system. CI - (c) 2024 Wiley Periodicals LLC. FAU - Kong, Xiang-Quan AU - Kong XQ AUID- ORCID: 0000-0001-5003-1831 AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Zhang, Juan AU - Zhang J AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Gao, Xiao-Fei AU - Gao XF AUID- ORCID: 0000-0001-7428-119X AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Wang, Zhi-Mei AU - Wang ZM AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Ye, Peng AU - Ye P AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Zhang, Jun-Jie AU - Zhang JJ AUID- ORCID: 0000-0003-2710-8516 AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Chen, Shao-Liang AU - Chen SL AUID- ORCID: 0000-0002-3887-952X AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. LA - eng GR - H2019077/Jiangsu Health Committee/ GR - JQX22007/Nanjing Health Committee/ GR - NSFC81970307, NSFC82100357, NSFC82270344/National Natural Science Foundation of China/ GR - 2019-WSN-156/Six Talent Peaks Project of Jiangsu Province/ GR - 2020YFC2008100/National Key R&D Program of China/ PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240827 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - *Aortic Valve Insufficiency/physiopathology/diagnostic imaging/surgery/mortality/etiology MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects/mortality MH - Female MH - Aged MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Time Factors MH - *Prosthesis Design MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Risk Factors MH - Aged, 80 and over MH - *Hospital Mortality MH - *Severity of Illness Index MH - *Recovery of Function MH - Retrospective Studies MH - Risk Assessment MH - *Ventricular Function, Left MH - Middle Aged MH - Hemodynamics MH - Cardiac Pacing, Artificial OTO - NOTNLM OT - VitaFlow system OT - aortic regurgitation OT - device success OT - transcatheter aortic valve implantation EDAT- 2024/08/27 09:50 MHDA- 2024/11/13 13:50 CRDT- 2024/08/27 04:32 PHST- 2024/05/25 00:00 [revised] PHST- 2023/12/24 00:00 [received] PHST- 2024/08/11 00:00 [accepted] PHST- 2024/11/13 13:50 [medline] PHST- 2024/08/27 09:50 [pubmed] PHST- 2024/08/27 04:32 [entrez] AID - 10.1002/ccd.31193 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Nov;104(6):1275-1280. doi: 10.1002/ccd.31193. Epub 2024 Aug 27. PMID- 39186224 OWN - NLM STAT- MEDLINE DCOM- 20241028 LR - 20261010 IS - 1937-5395 (Electronic) IS - 1937-5387 (Linking) VI - 17 IP - 5 DP - 2024 Oct TI - An Updated Comprehensive Review of Existing Transcatheter Aortic Valve Replacement Access. PG - 973-989 LID - 10.1007/s12265-024-10484-z [doi] AB - For the past 20 years, transcatheter aortic valve replacement (TAVR) has been the treatment of choice for symptomatic aortic stenosis. The transfemoral (TF) access is considered the gold standard approach for TAVR. However, TF-TAVR cannot be performed in some patients; thus, alternative accesses are required. Our review paper generalises the TAVR accesses currently available, including the transapical, transaortic, trans-subclavian/axillary, transcarotid, transcaval, and suprasternal approaches. Their advantages and disadvantages have been analysed. Since there is no standard recommendation for an alternative approach, access selection depends on the expertise of the local cardiac team, patient characteristics, and access properties. Each TAVR centre is recommended to master a minimum of one non-TF access alternative. Of note, more evidence is required to delve into the clinical outcomes of each approach, at both early and long-term (Figure 1). CI - (c) 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Sheng, Wenjing AU - Sheng W AD - Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310009. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310058. FAU - Dai, Hanyi AU - Dai H AD - Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310009. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310058. FAU - Zheng, Rongrong AU - Zheng R AD - Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310009. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310058. FAU - Aihemaiti, Ailifeire AU - Aihemaiti A AD - Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310009. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310058. FAU - Liu, Xianbao AU - Liu X AUID- ORCID: 0000-0003-1556-9198 AD - Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310009. liuxb@zju.edu.cn. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou, People's Republic of China, 310058. liuxb@zju.edu.cn. AD - Binjiang Institute of Zhejiang University, Hangzhou, 310052, Zhejiang, China. liuxb@zju.edu.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20240826 PL - United States TA - J Cardiovasc Transl Res JT - Journal of cardiovascular translational research JID - 101468585 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Treatment Outcome MH - Risk Factors MH - Catheterization, Peripheral/adverse effects MH - Heart Valve Prosthesis MH - Punctures OTO - NOTNLM OT - Alternative access OT - Aortic stenosis OT - Central access OT - Peripheral access OT - Transcatheter aortic valve replacement EDAT- 2024/08/26 13:44 MHDA- 2024/10/28 18:23 CRDT- 2024/08/26 11:07 PHST- 2023/10/06 00:00 [received] PHST- 2024/01/18 00:00 [accepted] PHST- 2024/10/28 18:23 [medline] PHST- 2024/08/26 13:44 [pubmed] PHST- 2024/08/26 11:07 [entrez] AID - 10.1007/s12265-024-10484-z [pii] AID - 10.1007/s12265-024-10484-z [doi] PST - ppublish SO - J Cardiovasc Transl Res. 2024 Oct;17(5):973-989. doi: 10.1007/s12265-024-10484-z. Epub 2024 Aug 26. PMID- 39179438 OWN - NLM STAT- MEDLINE DCOM- 20240920 LR - 20241012 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 33 IP - 10 DP - 2024 Oct TI - Percutaneous Versus Surgical Cutdown Access for Transfemoral Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis Focusing on Propensity-Score Matched Studies. PG - 1393-1403 LID - S1443-9506(24)00660-7 [pii] LID - 10.1016/j.hlc.2024.05.011 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a potential alternative for aortic valve surgery to treat aortic valve stenosis. There is limited evidence on the comparative outcomes of TAVI access approaches, specifically the percutaneous (PC) vs surgical cutdown (SC) approach. This study aimed to assess the short-term outcomes in patients undergoing PC vs SC access for transfemoral transcatheter aortic valve replacement. METHODS: PubMed, SCOPUS, and EMBASE were searched to identify relevant studies. The primary outcomes were short-term all-cause mortality, bleeding, vascular complications, and length of in-hospital stay for patients who underwent transfemoral TAVI. Both matched and unmatched observational studies were included and subgroup analyses were performed. This systematic review and meta-analysis was performed in line with the PRISMA guidelines. RESULTS: Fifteen observational studies involving 7,545 patients (3,033 underwent the PC approach and 2,466 underwent the SC approach) were included. There were no clinically significant between-group differences in short-term mortality, bleeding, length of in-hospital stay, or major vascular complications. However, minor vascular complications were significantly higher in patients who underwent PC-TAVI (p=0.007). In the matched subgroup, all outcomes were comparable between both groups, with the largest difference being observed in minor vascular complications more frequently occurring in the PC group (p=0.08). CONCLUSION: The evidence shows that outcomes were comparable between the two methods of access, rendering both the PC and SC approaches equally effective for transfemoral TAVI. However, it is worth noting that minor vascular complications were more pronounced in the PC group. CI - Copyright (c) 2024 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved. FAU - Riaz, Sania AU - Riaz S AD - Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan. FAU - Kasam Shiva, Pavan Kumara AU - Kasam Shiva PK AD - Bangalore Medical College and Research Institute, Bangalore, India. Electronic address: pks6399@gmail.com. FAU - Manimekalai Krishnamurthi, Jaya Surya AU - Manimekalai Krishnamurthi JS AD - Department of Medicine, Madras Medical College, Chennai, India. FAU - Shah, Roopshri Sunilkumar AU - Shah RS AD - Department of Medicine, G.M.E.R.S. Medical College, Gandhinagar, India. FAU - Cherukuri, Anjani Mahesh Kumar AU - Cherukuri AMK AD - Department of Medicine, Guntur Medical College, Guntur, India. FAU - Bhatia, Pranav AU - Bhatia P AD - Seth GS Medical College and KEM Hospital, Mumbai, India. FAU - Arul, Subiksha AU - Arul S AD - University of Perpetual Help System DALTA Jonelta Foundation School of Medicine, Manila, Philippines. FAU - Multani, Monika AU - Multani M AD - Adesh Institute of Medical Sciences and Research, Punjab, India. FAU - Singh, Adishwar AU - Singh A AD - Government Medical College and Hospital, Chandigarh, India. FAU - Suyambu, Jenisha AU - Suyambu J AD - University of Perpetual Help System DALTA Jonelta Foundation School of Medicine, Manila, Philippines. FAU - Asif, Kainat AU - Asif K AD - Department of Medicine, Dr. Ruth K. M. Pfau Civil Hospital Karachi, Karachi, Pakistan. FAU - Al-Tawil, Mohammed AU - Al-Tawil M AD - Faculty of Medicine, Al-Quds University Jerusalem, Palestine. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20240823 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Humans MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Femoral Artery/surgery MH - Postoperative Complications/epidemiology MH - *Propensity Score MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods OTO - NOTNLM OT - Aortic stenosis OT - Aortic valve replacement OT - Percutaneous OT - Surgical cutdown OT - Transcatheter aortic valve implantation OT - Transcatheter aortic valve replacement COIS- Conflict of Interest There is no conflict of interest to declare. EDAT- 2024/08/24 16:41 MHDA- 2024/09/21 11:44 CRDT- 2024/08/23 21:56 PHST- 2023/09/28 00:00 [received] PHST- 2024/05/03 00:00 [revised] PHST- 2024/05/28 00:00 [accepted] PHST- 2024/09/21 11:44 [medline] PHST- 2024/08/24 16:41 [pubmed] PHST- 2024/08/23 21:56 [entrez] AID - S1443-9506(24)00660-7 [pii] AID - 10.1016/j.hlc.2024.05.011 [doi] PST - ppublish SO - Heart Lung Circ. 2024 Oct;33(10):1393-1403. doi: 10.1016/j.hlc.2024.05.011. Epub 2024 Aug 23. PMID- 39175626 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240824 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - Alternative access in transcatheter aortic valve replacement-an updated focused review. PG - 1437626 LID - 10.3389/fcvm.2024.1437626 [doi] LID - 1437626 AB - Aortic Stenosis (AS) is a common condition with an estimated pooled prevalence of all AS in the elderly population at around 12.4%, with that of severe AS estimated to be around 3.4%. In the past, surgical aortic valve replacement was the primary treatment option for severe AS for decades. However, with the compelling evidence on the safety and efficacy of transcatheter aortic valve replacement (TAVR), it has become the gold standard treatment option for many patients with symptomatic severe AS. Transfemoral access has been the preferred method for transcatheter heart valve delivery. However, the prevalent use of TAVR on a diverse patient profile with different risk factors, such as peripheral artery disease, precluded the possibility of a transfemoral approach despite the improvement of valves and delivery systems technology. Therefore, alternative TAVR approaches have gained increasing utility in cases where transfemoral access is unfavorable. We review the journey, evolution, and techniques for different approaches of percutaneous TAVR, including transfemoral, transcarotid, transsubclavian/transaxillary, and transcaval approaches, in addition to the traditional "surgical" transaortic and transapical accesses. Consolidating these data highlights each approach's practicality and limitations, providing additional grounding for case-by-case utilization and future clinical research. CI - (c) 2024 Abdelnour, Patel, Patel, Kasel and Frangieh. FAU - Abdelnour, Mark W AU - Abdelnour MW AD - Division of Cardiology, Department of Medicine, University of California Irvine Medical Center, Orange, California, CA, United States. FAU - Patel, Vishal AU - Patel V AD - Division of Cardiology, Department of Medicine, University of California Irvine Medical Center, Orange, California, CA, United States. FAU - Patel, Pranav M AU - Patel PM AD - Division of Cardiology, Department of Medicine, University of California Irvine Medical Center, Orange, California, CA, United States. FAU - Kasel, A M AU - Kasel AM AD - Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland. FAU - Frangieh, Antonio H AU - Frangieh AH AD - Division of Cardiology, Department of Medicine, University of California Irvine Medical Center, Orange, California, CA, United States. LA - eng PT - Journal Article PT - Review DEP - 20240808 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC11338806 OTO - NOTNLM OT - TAVI OT - TAVR OT - TAVR - current and future OT - TAVR alternative access OT - TAVR history OT - aortic stenosis OT - transcaval access COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/08/23 06:41 MHDA- 2024/08/23 06:42 PMCR- 2024/01/01 CRDT- 2024/08/23 04:16 PHST- 2024/05/24 00:00 [received] PHST- 2024/07/22 00:00 [accepted] PHST- 2024/08/23 06:42 [medline] PHST- 2024/08/23 06:41 [pubmed] PHST- 2024/08/23 04:16 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1437626 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Aug 8;11:1437626. doi: 10.3389/fcvm.2024.1437626. eCollection 2024. PMID- 39169696 OWN - NLM STAT- MEDLINE DCOM- 20241112 LR - 20250508 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 6 DP - 2024 Nov TI - Coagulation, fibrinolysis and platelet drop in patients undergoing transfemoral transcatheter aortic valve implantation. PG - 1281-1289 LID - 10.1002/ccd.31199 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) leads to transient platelet activation and hypercoagulation status, resulting in thrombocytopenia. AIMS: This study investigated the associations of coagulation/fibrinolysis status after transfemoral TAVI with valve type, post-TAVI thrombocytopenia, and complication of TAVI. METHODS: Thrombin-antithrombin complex (TAT) and fibrin/fibrinogen degradation product (FDP) levels were measured before and 1 h, 1 day, and 2 days after TAVI. A percentage drop in platelet count (DPC) was determined from the pre- and lowest post-procedural values. RESULTS: SAPIEN 3 (S3) was implanted in 158 patients and Evolut PRO/PRO+ (Evolut) in 117. Both TAT and FDP increased after TAVI. Pre-TAVI balloon dilatation was generally performed on patients undergoing implantation with Evolut. Peak TAT was then stratified into 4 quartiles (Q1 to Q4). Of all 275 study patients, 69 patients reached ultra-hypercoagulation status (Q4). S3, TAVI without pre-balloon dilatation, DPC and bleeding complications were significantly associated with the ultra-hypercoagulation status after TAVI. TAT was significantly greater 1 h after S3 implantation than Evolut (median [IQR], 43.1 [34.1-59.6] vs. 31.0 [25.0-40.4] ng/mL; p < 0.001). In contrast, FDP levels did not differ between the two at any measurement point. The difference in DPC among the peak TAT quartiles was statistically significant (p < 0.001). The occurrence of bleeding complications was significantly higher in the group with ultra-hypercoagulation status (5.8% vs. 1.0%, p = 0.036). CONCLUSIONS: The increase in coagulation status and post-TAVI thrombocytopenia were significantly greater after S3 implantation. Ultra-hypercoagulation after TAVI was related to bleeding complications. CI - (c) 2024 Wiley Periodicals LLC. FAU - Katayama, Taiga AU - Katayama T AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Yokoyama, Naoyuki AU - Yokoyama N AUID- ORCID: 0000-0002-8395-228X AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Watanabe, Yusuke AU - Watanabe Y AUID- ORCID: 0000-0003-2297-5303 AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Koyama, Shuhei AU - Koyama S AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Kawashima, Hideyuki AU - Kawashima H AUID- ORCID: 0000-0002-2847-1248 AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Hioki, Hirofumi AU - Hioki H AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Kozuma, Ken AU - Kozuma K AUID- ORCID: 0000-0003-3977-5973 AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20240821 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Biomarkers) RN - 0 (antithrombin III-protease complex) RN - EC 3.4.- (Peptide Hydrolases) RN - 9000-94-6 (Antithrombin III) RN - 0 (Fibrin Fibrinogen Degradation Products) RN - 0 (fibrin fragment D) SB - IM CIN - Catheter Cardiovasc Interv. 2024 Nov;104(6):1322-1323. doi: 10.1002/ccd.31258. PMID: 39375939 MH - Humans MH - Female MH - Male MH - Aged, 80 and over MH - *Fibrinolysis MH - *Blood Coagulation MH - Aged MH - Treatment Outcome MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Femoral Artery MH - *Biomarkers/blood MH - Risk Factors MH - *Aortic Valve Stenosis/surgery/blood/diagnostic imaging/physiopathology MH - *Thrombocytopenia/blood/etiology MH - Punctures MH - Catheterization, Peripheral/adverse effects MH - Peptide Hydrolases/blood MH - Antithrombin III MH - Blood Platelets/metabolism MH - Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Fibrin Fibrinogen Degradation Products/metabolism/analysis MH - Heart Valve Prosthesis MH - Prosthesis Design MH - Balloon Valvuloplasty/adverse effects MH - Platelet Count MH - Prospective Studies MH - Hemorrhage/etiology/blood OTO - NOTNLM OT - coagulation OT - fibrinolysis thrombocytopenia OT - transcatheter aortic valve implantation EDAT- 2024/08/22 06:42 MHDA- 2024/11/13 13:52 CRDT- 2024/08/22 02:43 PHST- 2024/07/10 00:00 [revised] PHST- 2024/03/16 00:00 [received] PHST- 2024/08/11 00:00 [accepted] PHST- 2024/11/13 13:52 [medline] PHST- 2024/08/22 06:42 [pubmed] PHST- 2024/08/22 02:43 [entrez] AID - 10.1002/ccd.31199 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Nov;104(6):1281-1289. doi: 10.1002/ccd.31199. Epub 2024 Aug 21. PMID- 39166330 OWN - NLM STAT- MEDLINE DCOM- 20240917 LR - 20240918 IS - 1941-7632 (Electronic) IS - 1941-7640 (Print) IS - 1941-7640 (Linking) VI - 17 IP - 9 DP - 2024 Sep TI - Femoral Large Bore Sheath Management: How to Prevent Vascular Complications From Vessel Puncture to Sheath Removal. PG - e014156 LID - 10.1161/CIRCINTERVENTIONS.124.014156 [doi] AB - Transfemoral access is nowadays required for an increasing number of percutaneous procedures, such as structural heart interventions, mechanical circulatory support, and interventional electrophysiology/pacing. Despite technological advancements and improved techniques, these devices necessitate large-bore (>/=12 French) arterial/venous sheaths, posing a significant risk of bleeding and vascular complications, whose occurrence has been related to an increase in morbidity and mortality. Therefore, optimizing large-bore vascular access management is crucial in endovascular interventions. Technical options, including optimized preprocedural planning and proper selection and utilization of vascular closure devices, have been developed to increase safety. This review explores the comprehensive management of large-bore accesses, from optimal vascular puncture to sheath removal. It also discusses strategies for managing closure device failure, with the goal of minimizing vascular complications. FAU - Paraggio, Lazzaro AU - Paraggio L AUID- ORCID: 0000-0001-7358-8050 AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta). FAU - Bianchini, Francesco AU - Bianchini F AUID- ORCID: 0000-0001-9043-6462 AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy (F. Bianchini, E.B., A.Z., C.T., F. Burzotta). FAU - Aurigemma, Cristina AU - Aurigemma C AUID- ORCID: 0000-0001-6391-422X AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta). FAU - Romagnoli, Enrico AU - Romagnoli E AUID- ORCID: 0000-0003-1611-7708 AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta). FAU - Bianchini, Emiliano AU - Bianchini E AUID- ORCID: 0000-0002-1266-7131 AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy (F. Bianchini, E.B., A.Z., C.T., F. Burzotta). FAU - Zito, Andrea AU - Zito A AUID- ORCID: 0000-0002-1351-6749 AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy (F. Bianchini, E.B., A.Z., C.T., F. Burzotta). FAU - Lunardi, Mattia AU - Lunardi M AUID- ORCID: 0000-0001-8344-6048 AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta). FAU - Trani, Carlo AU - Trani C AUID- ORCID: 0000-0001-9777-013X AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta). AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy (F. Bianchini, E.B., A.Z., C.T., F. Burzotta). FAU - Burzotta, Francesco AU - Burzotta F AUID- ORCID: 0000-0002-6569-9401 AD - Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (L.P., C.A., E.R., M.L., C.T., F. Burzotta). AD - Department of Cardiovascular and Pulmonary Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy (F. Bianchini, E.B., A.Z., C.T., F. Burzotta). LA - eng PT - Journal Article PT - Review DEP - 20240821 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Humans MH - *Punctures MH - *Femoral Artery MH - *Catheterization, Peripheral/adverse effects/instrumentation MH - *Vascular Closure Devices MH - *Hemostatic Techniques/instrumentation/adverse effects MH - *Device Removal/adverse effects MH - Risk Factors MH - Treatment Outcome MH - Hemorrhage/prevention & control/etiology MH - Vascular System Injuries/etiology/prevention & control MH - Vascular Access Devices MH - Equipment Design MH - Endovascular Procedures/adverse effects/instrumentation PMC - PMC11404769 OTO - NOTNLM OT - femoral artery OT - heart assist device OT - peripheral artery disease OT - transcatheter aortic valve replacement OT - vascular access devices COIS- Drs Burzotta and Trani received speaker fees from Abbott Vascular, Abiomed, Medtronic, and Terumo. Dr Paraggio received speaker fees from Abiomed and Terumo. Dr Aurigemma received speaker fees from Abbott Vascular, Abiomed, Medtronic, Terumo, and Daiichi Sankyo. Dr Romagnoli received speaker fees from Abiomed, Abbott Vascular, and Terumo. Dr Bianchini received a research grant from Abbott Vascular. The other authors report no conflicts of interest to declare. EDAT- 2024/08/21 11:41 MHDA- 2024/09/17 10:46 PMCR- 2024/09/16 CRDT- 2024/08/21 05:04 PHST- 2024/09/17 10:46 [medline] PHST- 2024/08/21 11:41 [pubmed] PHST- 2024/08/21 05:04 [entrez] PHST- 2024/09/16 00:00 [pmc-release] AID - CIRCCVINT2024014156 [pii] AID - 10.1161/CIRCINTERVENTIONS.124.014156 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2024 Sep;17(9):e014156. doi: 10.1161/CIRCINTERVENTIONS.124.014156. Epub 2024 Aug 21. PMID- 39153878 OWN - NLM STAT- MEDLINE DCOM- 20240926 LR - 20241023 IS - 1875-2128 (Electronic) IS - 1875-2128 (Linking) VI - 117 IP - 8-9 DP - 2024 Aug-Sep TI - Cardiac amyloidosis prevalence and 1-year outcome in patients with aortic stenosis undergoing transaortic valve implantation: Findings from the CAMPOS-TAVI study. PG - 461-469 LID - S1875-2136(24)00281-X [pii] LID - 10.1016/j.acvd.2024.04.007 [doi] AB - BACKGROUND: Transthyretin amyloid cardiomyopathy (ATTR-CM) can manifest as rhythm disorders, heart failure, but also valvular degeneration. Despite aortic stenosis (AS) being prevalent among the elderly, data on ATTR-CM prevalence and outcome in patients with AS undergoing transaortic valve implantation (TAVI) remain scarce. AIM: To determine ATTR-CM prevalence and evaluate 1-year survival in patients undergoing TAVI. METHODS: Between December 2020 and September 2021, 100 consecutive patients underwent TAVI and were screened prospectively for ATTR-CM using bone scintigraphy (BS). Monoclonal gammopathy was ruled out in case of cardiac uptake on BS. All patients were followed prospectively for 1year after TAVI. RESULTS: The proportion of patients aged>/=75years or with a EuroSCORE II>8% and possible femoral access was 99%. The abnormal cardiac uptake rate on BS was 7% (95% confidence interval: 2-12%); 86% of these patients were male. The RAISE (remodelling, age, injury, system and electrical) score, indicative of ATTR-CM risk, was higher in case of positive BS (P=0.04). Patients with positive BS were older and exhibited wider QRS complexes on electrocardiography (P=0.003), a higher frequency of reduced LVEF (57% vs. 17%), impaired basal LV strain (P=0.02) and a lower voltage/mass ratio (P=0.01). History of pacemaker implantation before TAVI was higher in the positive BS group (P=0.0004) and remained the only statistically significant factor after adjustment using the Holm-Bonferroni method. One-year survival of patients with positive BS did not differ from that of patients with isolated AS. CONCLUSIONS: Prevalence of ATTR-CM in patients treated with TAVI, underscoring the need for continued surveillance for potential development of ATTR-CM after TAVI. Caution is warranted regarding the 1-year survival because of the lack of study power. Further investigations are needed to define long-term prognosis of AS with ATTR-CM. CI - Copyright (c) 2024. Published by Elsevier Masson SAS. FAU - Costa, Jerome AU - Costa J AD - Cardiology Department, University Hospital of Reims, rue du General-Koenig, 51100 Reims, France. Electronic address: jcosta@chu-reims.fr. FAU - El-Ali, Ahmed AU - El-Ali A AD - Cardiology Department, University Hospital of Reims, rue du General-Koenig, 51100 Reims, France. FAU - Morland, David AU - Morland D AD - Service de Medecine Nucleaire, Institut Godinot, 51100 Reims, France; Laboratoire de Biophysique, UFR de Medecine, Universite de Reims Champagne-Ardenne, 51100 Reims, France; CReSTIC UR 3804, Universite de Reims Champagne-Ardenne, Reims, France. FAU - Dejust, Sebastien AU - Dejust S AD - Service de Medecine Nucleaire, Institut Godinot, 51100 Reims, France. FAU - Papathanassiou, Dimitri AU - Papathanassiou D AD - Service de Medecine Nucleaire, Institut Godinot, 51100 Reims, France; Laboratoire de Biophysique, UFR de Medecine, Universite de Reims Champagne-Ardenne, 51100 Reims, France; CReSTIC UR 3804, Universite de Reims Champagne-Ardenne, Reims, France. FAU - Nazeyrollas, Pierre AU - Nazeyrollas P AD - Cardiology Department, University Hospital of Reims, rue du General-Koenig, 51100 Reims, France; Laboratoire de recherche en Sante Publique, Vieillissement, Qualite de vie et Readaptation des Sujets Fragiles, EA 3797, Universite de Reims Champagne-Ardenne, Reims, France. FAU - Metz, Damien AU - Metz D AD - Cardiology Department, University Hospital of Reims, rue du General-Koenig, 51100 Reims, France. LA - eng PT - Journal Article PT - Observational Study DEP - 20240808 PL - Netherlands TA - Arch Cardiovasc Dis JT - Archives of cardiovascular diseases JID - 101465655 RN - Amyloidosis, Hereditary, Transthyretin-Related SB - IM MH - Humans MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality/physiopathology/epidemiology MH - Male MH - Female MH - Prevalence MH - Aged MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Aged, 80 and over MH - Time Factors MH - Treatment Outcome MH - *Amyloid Neuropathies, Familial/mortality/epidemiology/diagnostic imaging/complications/surgery/diagnosis MH - Risk Factors MH - Prospective Studies MH - *Cardiomyopathies/mortality/diagnostic imaging/physiopathology/epidemiology MH - Risk Assessment MH - Aortic Valve/surgery/diagnostic imaging/physiopathology OTO - NOTNLM OT - Amyloid transthyretin cardiomyopathy OT - Bone scintigraphy OT - Heart failure OT - Severe aortic stenosis OT - Transaortic valve implantation EDAT- 2024/08/18 04:43 MHDA- 2024/09/27 00:42 CRDT- 2024/08/17 21:53 PHST- 2023/12/28 00:00 [received] PHST- 2024/04/22 00:00 [revised] PHST- 2024/04/24 00:00 [accepted] PHST- 2024/09/27 00:42 [medline] PHST- 2024/08/18 04:43 [pubmed] PHST- 2024/08/17 21:53 [entrez] AID - S1875-2136(24)00281-X [pii] AID - 10.1016/j.acvd.2024.04.007 [doi] PST - ppublish SO - Arch Cardiovasc Dis. 2024 Aug-Sep;117(8-9):461-469. doi: 10.1016/j.acvd.2024.04.007. Epub 2024 Aug 8. PMID- 39141396 OWN - NLM STAT- MEDLINE DCOM- 20241009 LR - 20260830 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 9 IP - 10 DP - 2024 Oct 1 TI - Routine Protamine Administration for Bleeding in Transcatheter Aortic Valve Implantation: The ACE-PROTAVI Randomized Clinical Trial. PG - 901-908 LID - 10.1001/jamacardio.2024.2454 [doi] AB - IMPORTANCE: Vascular complications after transfemoral transcatheter aortic valve implantation (TAVI) remain an important cause of procedure-related morbidity. Routine reversal of anticoagulation with protamine at the conclusion of transfemoral TAVI could reduce complications, but data remain scarce. OBJECTIVE: To evaluate the efficacy and safety of routine protamine administration after transfemoral TAVI. DESIGN, SETTING, AND PARTICIPANTS: The ACE-PROTAVI trial was an investigator-initiated, double-blind, placebo-controlled randomized clinical trial performed at 3 Australian hospitals between December 2021 and June 2023 with a 1-year follow-up period. All patients accepted for transfemoral TAVI by a multidisciplinary heart team were eligible for enrollment. INTERVENTIONS: Eligible patients were randomized 1:1 between routine protamine administration and placebo. MAIN OUTCOMES AND MEASURES: The coprimary outcomes were the rate of hemostasis success and time to hemostasis (TTH), presented as categorical variables and compared with a chi2 test or as continuous variables as mean (SD) or median (IQR), depending on distribution. The major secondary outcome was a composite of all-cause death, major and minor bleeding complications, and major and minor vascular complications after 30 days, reported in odds ratios (ORs) with 95% CIs and P values. RESULTS: The study population consisted of 410 patients: 199 patients in the protamine group and 211 in the placebo group. The median (IQR) patient age in the protamine group was 82 (77-85) years, and 68 of 199 patients receiving protamine (34.2%) were female. The median (IQR) patient age in the placebo group was 80 (75-85) years, and 89 of 211 patients receiving the placebo (42.2%) were female. Patients receiving up-front protamine administration had a higher rate of hemostasis success (188 of 192 patients [97.9%]) than patients in the placebo group (186 of 203 patients [91.6%]; absolute risk difference, 6.3%; 95% CI, 2.0%-10.6%; P = .006); in addition, patients receiving up-front protamine had a shorter median (IQR) TTH (181 [120-420] seconds vs 279 [122-600] seconds; P = .002). Routine protamine administration resulted in a reduced risk of the composite outcome in the protamine group (10 of 192 [5.2%]) vs the placebo group (26 of 203 [12.8%]; OR, 0.37; 95% CI, 0.1-0.8; P = .01). This difference was predominantly driven by the difference in the prevalence of minor vascular complications. There were no adverse events associated with protamine use. CONCLUSIONS AND RELEVANCE: In the ACE-PROTAVI randomized clinical trial, routine administration of protamine increased the rate of hemostasis success and decreased TTH. The beneficial effect of protamine was reflected in a reduction in minor vascular complications, procedural time, and postprocedural hospital stay duration in patients receiving routine protamine compared with patients receiving placebo. TRIAL REGISTRATION: anzctr.org.au Identifier: ACTRN12621001261808. FAU - Vriesendorp, Pieter A AU - Vriesendorp PA AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Heart+Vascular Center, Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands. AD - Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands. FAU - Nanayakkara, Shane AU - Nanayakkara S AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Australia. AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. FAU - Heuts, Samuel AU - Heuts S AD - Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands. AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. FAU - Ball, Jocasta AU - Ball J AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. FAU - Chandrasekar, Jaya AU - Chandrasekar J AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. AD - Department of Cardiology, Eastern Health, Melbourne, Australia. AD - Eastern Health Clinical School, Monash University, Melbourne, Australia. FAU - Dick, Ronald AU - Dick R AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. FAU - Haji, Kawa AU - Haji K AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. FAU - Htun, Nay Min AU - Htun NM AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - McGaw, David AU - McGaw D AD - Department of Cardiology, Cabrini Health, Melbourne, Australia. FAU - Noaman, Samer AU - Noaman S AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. FAU - Palmer, Sonny AU - Palmer S AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Department of Medicine, The University of Melbourne, Melbourne, Australia. FAU - Cairo, Sesto AU - Cairo S AD - Department of Medicine, The University of Melbourne, Melbourne, Australia. AD - Cabrini Anaesthetics Department, Cabrini Health, Melbourne, Australia. FAU - Shulman, Mark AU - Shulman M AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Cabrini Anaesthetics Department, Cabrini Health, Melbourne, Australia. FAU - Lin, Enjarn AU - Lin E AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Cabrini Anaesthetics Department, Cabrini Health, Melbourne, Australia. FAU - Hastings, Stuart AU - Hastings S AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Cabrini Anaesthetics Department, Cabrini Health, Melbourne, Australia. FAU - Waldron, Benedict AU - Waldron B AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Cabrini Anaesthetics Department, Cabrini Health, Melbourne, Australia. FAU - Proimos, George AU - Proimos G AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. FAU - Soon, Kean H AU - Soon KH AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. AD - Department of Medicine, The University of Melbourne, Melbourne, Australia. FAU - Yudi, Matias B AU - Yudi MB AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. AD - Department of Cardiology, Austin Health, Melbourne, Australia. FAU - Zimmet, Adam AU - Zimmet A AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Stub, Dion AU - Stub D AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. AD - Department of Cardiology, Cabrini Health, Melbourne, Australia. FAU - Walton, Antony S AU - Walton AS AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. AD - Department of Cardiology, Epworth HealthCare, Melbourne, Australia. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 RN - 0 (Protamines) RN - 0 (Heparin Antagonists) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Protamines/therapeutic use/administration & dosage MH - Female MH - Male MH - Double-Blind Method MH - Aged, 80 and over MH - *Heparin Antagonists/therapeutic use/administration & dosage MH - Aged MH - *Postoperative Hemorrhage/epidemiology/prevention & control MH - *Aortic Valve Stenosis/surgery MH - Hemorrhage/chemically induced/epidemiology PMC - PMC11325237 COIS- Conflict of Interest Disclosures: Dr Vriesendorp reported personal fees from Abbott Vascular and Boehringer Ingelheim outside the submitted work. Dr Chandrasekhar reported speaking fees from Boston Scientific, Medtronic, and Amgen outside the submitted work. Dr Stub reported grants from the Cabrini Foundation during the conduct of the study; grants from the Australian National Health and Medical Research Council (NHMRC) and the National Heart Foundation of Australia (NHF) outside the submitted work; and serving on medical advisory boards for Edwards Lifesciences, Medtronic, and Anteris. Dr Walton reported grants from the Fox Foundation outside the submitted work. No other disclosures were reported. EDAT- 2024/08/14 12:42 MHDA- 2024/10/09 12:25 PMCR- 2025/08/14 CRDT- 2024/08/14 11:34 PHST- 2024/10/09 12:25 [medline] PHST- 2024/08/14 12:42 [pubmed] PHST- 2024/08/14 11:34 [entrez] PHST- 2025/08/14 00:00 [pmc-release] AID - 2822233 [pii] AID - hoi240045 [pii] AID - 10.1001/jamacardio.2024.2454 [doi] PST - ppublish SO - JAMA Cardiol. 2024 Oct 1;9(10):901-908. doi: 10.1001/jamacardio.2024.2454. PMID- 39136954 OWN - NLM STAT- MEDLINE DCOM- 20241021 LR - 20260622 IS - 1526-7598 (Electronic) IS - 0003-2999 (Linking) VI - 139 IP - 5 DP - 2024 Nov 1 TI - Neurological Complications After Transcatheter Aortic Valve Replacement: A Review. PG - 986-996 LID - 10.1213/ANE.0000000000007087 [doi] AB - Transcatheter aortic valve replacement (TAVR) has become the dominant procedural modality for aortic valve replacement in the United States. The reported rates of neurological complications in patients undergoing TAVR have changed over time and are dependent on diagnostic definitions and modalities. Most strokes after TAVR are likely embolic in origin, and the incidence of stroke has decreased over time. Studies have yielded conflicting results when comparing stroke rates between TAVR and surgical aortic valve replacement (SAVR), especially due to differences in diagnostic criteria and neurocognitive testing. In this narrative review, we summarize the available data on the incidence of stroke, delirium, and cognitive decline after TAVR and highlight potential areas in need of future research. We also discuss silent cerebral ischemic lesions (SCILs) and their association with a decline in postoperative neurocognitive status after TAVR. Finally, we describe that the risk of delirium and postoperative decline is increased when nonfemoral access routes are used, and we highlight the need for standardized imaging and valid, repeatable methodologies to assess cognitive changes after TAVR. CI - Copyright (c) 2024 International Anesthesia Research Society. FAU - Mangold, Adam S AU - Mangold AS AD - From the Cooper Medical School of Rowan University, Camden, New Jersey. FAU - Benincasa, Stefano AU - Benincasa S AD - From the Cooper Medical School of Rowan University, Camden, New Jersey. FAU - Sanders, Benjamin M AU - Sanders BM AD - From the Cooper Medical School of Rowan University, Camden, New Jersey. FAU - Patel, Kinjal AU - Patel K AD - From the Cooper Medical School of Rowan University, Camden, New Jersey. AD - Cooper University Healthcare, Camden, New Jersey. FAU - Mitrev, Ludmil AU - Mitrev L AD - From the Cooper Medical School of Rowan University, Camden, New Jersey. AD - Cooper University Healthcare, Camden, New Jersey. LA - eng PT - Journal Article PT - Review DEP - 20240812 PL - United States TA - Anesth Analg JT - Anesthesia and analgesia JID - 1310650 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Risk Factors MH - Delirium/etiology/diagnosis/epidemiology MH - Postoperative Complications/etiology/diagnosis/epidemiology MH - Aortic Valve Stenosis/surgery MH - Stroke/etiology/epidemiology MH - Treatment Outcome MH - Incidence MH - Aortic Valve/surgery COIS- Conflicts of Interest, Funding: See DISCLOSURES at the the end of this article. EDAT- 2024/08/13 12:43 MHDA- 2024/10/22 00:21 CRDT- 2024/08/13 11:32 PHST- 2024/10/22 00:21 [medline] PHST- 2024/08/13 12:43 [pubmed] PHST- 2024/08/13 11:32 [entrez] AID - 00000539-202411000-00014 [pii] AID - 10.1213/ANE.0000000000007087 [doi] PST - ppublish SO - Anesth Analg. 2024 Nov 1;139(5):986-996. doi: 10.1213/ANE.0000000000007087. Epub 2024 Aug 12. PMID- 39135174 OWN - NLM STAT- MEDLINE DCOM- 20240813 LR - 20241113 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 24 IP - 1 DP - 2024 Aug 13 TI - Impact of cerebral protection on observed versus predicted in-hospital stroke in a high stroke risk TAVR cohort. PG - 422 LID - 10.1186/s12872-024-04097-2 [doi] LID - 422 AB - BACKGROUND: Despite impressive improvements in the safety profile of Transcatheter aortic valve replacement (TAVR), the risk for peri-procedural stroke after TAVR has not declined substantially. In an effort to reduce periprocedural stroke, cerebral embolic protection (CEP) devices have been utilized but have yet to demonstrate benefit in all-comers. There is a paucity of data supporting the utilization of CEP in TAVR patients with an anticipated high risk for peri-procedural stroke. METHODS: The Transcatheter Aortic Valve Replacement In-Hospital Stroke (TASK) score is a clinical risk tool for predicting the in-hospital stroke risk of patients undergoing transfemoral TAVR. This score was used to identify high-risk patients and calculate the expected in-hospital stroke risk. This was a single-centre cohort study in all consecutive TAVR patients who had placement of CEP. The observed versus expected ratio for peri-procedural stroke was calculated. To obtain 95% credible intervals, we used 1000 bootstrapped samples of the original cohort sample size without replacement and recalculated the TASK predicted scores. RESULTS: The study included 103 patients. The median age was 83 (IQR 78,89). 63 were male (61.1%) and 45 (43.69%) had a history of previous Stroke or TIA. Two patients had an in-hospital stroke after TAVR (1.94%). The expected risk of in-hospital stroke based on the TASK score was 3.39% (95% CI 3.07-3.73). The observed versus expected ratio was 0.57 (95% CI 0.52-0.64). CONCLUSION: In this single-center study, we found that in patients undergoing TAVR with high stroke risk, CEP reduced the in-hospital stroke risk by 43% when compared with the risk-score predicted rate. CLINICAL TRIAL NUMBER: N/A. CI - (c) 2024. The Author(s). FAU - Marcusohn, Erez AU - Marcusohn E AD - Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. FAU - Manoragavan, Ragavie AU - Manoragavan R AD - Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. FAU - Fremes, Stephen AU - Fremes S AD - Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. AD - Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. FAU - Tarola, Christopher AU - Tarola C AD - Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. AD - Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. FAU - Sathananthan, Janarthanan AU - Sathananthan J AD - Centre for Cardiovascular Innovation, St. Paul's and Vancouver General Hospital, Vancouver, Canada. AD - Cardiovascular Translational Laboratory, Providence Research and Centre for Heart Lung Innovation, Vancouver, Canada. AD - St. Paul's Hospital, Centre for Heart Valve Innovation, University of British Columbia, Vancouver, BC, Canada. FAU - Barabash, Israel M AU - Barabash IM AD - Interventional Cardiology Unit, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Ramat Gan, Israel. AD - Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. FAU - Orbach, Ady AU - Orbach A AD - Cardiology Department, Edith Wolfson Medical Center, Holon, Israel. FAU - Sachedina, Ayaaz K AU - Sachedina AK AD - Foothills Medical Centre, Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada. FAU - Radhakrishnan, Sam AU - Radhakrishnan S AD - Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. AD - Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. FAU - Wijeysundera, Harindra C AU - Wijeysundera HC AD - Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. harindra.wijeysundera@sunnybrook.ca. AD - Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. harindra.wijeysundera@sunnybrook.ca. AD - ICES, Toronto, Canada. harindra.wijeysundera@sunnybrook.ca. AD - Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. harindra.wijeysundera@sunnybrook.ca. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240813 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Risk Factors MH - Risk Assessment MH - Aged, 80 and over MH - *Stroke/prevention & control/etiology/diagnosis/epidemiology MH - Treatment Outcome MH - *Embolic Protection Devices MH - Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Time Factors MH - Intracranial Embolism/prevention & control/etiology/epidemiology/diagnosis MH - Retrospective Studies MH - Decision Support Techniques MH - Predictive Value of Tests PMC - PMC11321055 OTO - NOTNLM OT - Aortic stenosis OT - Cerebral Embolic Protection OT - Stroke OT - Transcatheter aortic valve replacement COIS- Janarthanan Sathananthan: Consultant for Edwards Lifesciences, Abbott Vascular, Medtronic, Boston Scientific, Anteris. Research funding from Medtronic and Edwards Lifesciences. EDAT- 2024/08/13 00:42 MHDA- 2024/08/13 06:42 PMCR- 2024/08/13 CRDT- 2024/08/12 23:48 PHST- 2024/04/14 00:00 [received] PHST- 2024/08/06 00:00 [accepted] PHST- 2024/08/13 06:42 [medline] PHST- 2024/08/13 00:42 [pubmed] PHST- 2024/08/12 23:48 [entrez] PHST- 2024/08/13 00:00 [pmc-release] AID - 10.1186/s12872-024-04097-2 [pii] AID - 4097 [pii] AID - 10.1186/s12872-024-04097-2 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2024 Aug 13;24(1):422. doi: 10.1186/s12872-024-04097-2. PMID- 39132601 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240813 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 3 IP - 6 DP - 2024 Jun TI - Collagen-Based Bailout Compared to Suture-Mediated Vascular Closure Alone During Transcatheter Aortic Valve Replacement. PG - 101929 LID - 10.1016/j.jscai.2024.101929 [doi] LID - 101929 AB - BACKGROUND: Hemostasis for transfemoral transcatheter aortic valve replacement (TAVR) is typically achieved using a suture-mediated vascular closure device (VCD) prior to large-bore sheath insertion (preclosure technique). Recently, the addition of a hybrid closure technique using a preclose technique with the addition of a collagen-plug VCD after sheath removal in cases of failed hemostasis has been utilized. METHODS: Data were collected from the Northwell TAVR registry, including 3 high-volume TAVR centers. We evaluated a preclose strategy with suture-mediated vascular closure alone ("legacy strategy") and standard bailout techniques versus a contemporary hybrid strategy of suture-mediated closure with collagen-mediated closure bailout. The primary end point was major or minor vascular complications as defined by the VARC-3 criteria. RESULTS: A total of 1327 patients were included, of which 791 patients underwent TAVR with suture-mediated closure alone and 536 with contemporary strategy. The primary end point (major or minor vascular complication) was lower in the contemporary strategy (5.44% vs 1.31%; P < .001). Both minor (3.92% vs 1.12%; P = .002) and major (1.14% vs 0.19%; P = .0196) vascular complications were reduced and the total length of stay was less in the contemporary strategy (median of 3 days vs 2 days; P < .0001). Using multivariable analysis, we observed that vascular management strategy significantly improved the composite primary outcome when adjusted for sheath size, peripheral artery disease, carotid disease, and site of procedure. In the contemporary group, bailout collagen-plug VCD with an Angio-Seal (Terumo Medical) was used in 68 patients (12.69%) and bailout MANTA (Teleflex) was required in 4 patients (0.75%). There were no major or minor vascular complications among the patients who received bailout collagen-plug VCD. CONCLUSIONS: A contemporary hybrid strategy of suture-mediated closure with collagen-mediated closure bailout reduces the risk of vascular complications among patients undergoing transfemoral TAVR. CI - (c) 2024 Society for Cardiovascular Angiography and Interventions Foundation. Published by Elsevier Inc. FAU - Basman, Craig AU - Basman C AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Kodra, Arber AU - Kodra A AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Mustafa, Ahmad AU - Mustafa A AD - Department of Cardiovascular & Thoracic Surgery, Staten Island University Hospital/Northwell Health, New York, New York. FAU - Wang, Denny AU - Wang D AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Cinelli, Michael AU - Cinelli M AD - Department of Cardiovascular & Thoracic Surgery, Staten Island University Hospital/Northwell Health, New York, New York. FAU - Onyebeke, Kenenna AU - Onyebeke K AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Rutkin, Bruce AU - Rutkin B AD - Department of Cardiovascular & Thoracic Surgery, Northshore University Hospital/Northwell Health, New York, New York. FAU - Mehla, Priti AU - Mehla P AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Maniatis, Gregory AU - Maniatis G AD - Department of Cardiovascular & Thoracic Surgery, Staten Island University Hospital/Northwell Health, New York, New York. FAU - Pirelli, Luigi AU - Pirelli L AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Goldberg, Ythan AU - Goldberg Y AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Liu, Shangyi AU - Liu S AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Uttar, Sridhar AU - Uttar S AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Wilson, Sean AU - Wilson S AD - Department of Cardiovascular & Thoracic Surgery, Northshore University Hospital/Northwell Health, New York, New York. FAU - Kalimi, Robert AU - Kalimi R AD - Department of Cardiovascular & Thoracic Surgery, Southside Hospital/Northwell Health, New York, New York. FAU - Brinster, Derek AU - Brinster D AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Gandotra, Puneet AU - Gandotra P AD - Department of Cardiovascular & Thoracic Surgery, Northshore University Hospital/Northwell Health, New York, New York. FAU - Koss, Elana AU - Koss E AD - Department of Cardiovascular & Thoracic Surgery, Northshore University Hospital/Northwell Health, New York, New York. FAU - Meraj, Perwaiz AU - Meraj P AD - Department of Cardiovascular & Thoracic Surgery, Northshore University Hospital/Northwell Health, New York, New York. FAU - Mihelis, Efstathia AU - Mihelis E AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Supariwala, Azhar AU - Supariwala A AD - Department of Cardiovascular & Thoracic Surgery, Southside Hospital/Northwell Health, New York, New York. FAU - Hartman, Alan AU - Hartman A AD - Department of Cardiovascular & Thoracic Surgery, Northshore University Hospital/Northwell Health, New York, New York. FAU - Scheinerman, S Jacob AU - Scheinerman SJ AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. FAU - Kliger, Chad AU - Kliger C AD - Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York. CN - Northwell TAVR Investigators LA - eng PT - Journal Article DEP - 20240403 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC11307645 OTO - NOTNLM OT - Angio-Seal OT - Perclose OT - transcatheter aortic valve replacement OT - vascular complications EDAT- 2024/08/12 12:42 MHDA- 2024/08/12 12:43 PMCR- 2024/04/03 CRDT- 2024/08/12 06:25 PHST- 2023/12/19 00:00 [received] PHST- 2024/02/22 00:00 [revised] PHST- 2024/03/01 00:00 [accepted] PHST- 2024/08/12 12:43 [medline] PHST- 2024/08/12 12:42 [pubmed] PHST- 2024/08/12 06:25 [entrez] PHST- 2024/04/03 00:00 [pmc-release] AID - S2772-9303(24)00823-8 [pii] AID - 101929 [pii] AID - 10.1016/j.jscai.2024.101929 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2024 Apr 3;3(6):101929. doi: 10.1016/j.jscai.2024.101929. eCollection 2024 Jun. PMID- 39131636 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240813 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 2 IP - 4 DP - 2023 Jul-Aug TI - Balloon Aortic Valvuloplasty in the Modern Era: A Review of Outcomes, Indications, and Technical Advances. PG - 101002 LID - 10.1016/j.jscai.2023.101002 [doi] LID - 101002 AB - Balloon aortic valvuloplasty (BAV) improves the hemodynamics and symptoms of patients with severe aortic stenosis in the short term with low rates of complications, but has not been shown to be an effective destination therapy. Our pooled analysis of >14,300 patients from studies published between January 1, 1991, and April 31, 2022, reported intraprocedural mortality and in-hospital mortality rates as 1.94% (95% CI, 1.39%-2.59%) and 6.02% (95% CI, 4.83%-7.32%), respectively. Hence, BAV is primarily indicated as a bridge to aortic valve replacement/decision with secondary uses as bridge to noncardiac surgery and palliative therapy. Recent advancements in alternative access sites, balloon catheters, and lithotripsy for BAV have opened opportunities for expanded use and further improvements in complication rates. As the utilization of BAV has continually increased since the advent of transcatheter aortic valve replacement, reexamining the role and outcomes of BAV in the era of transcatheter aortic valve replacement has become increasingly important. This review focuses on the outcomes, indications, advances, and technical considerations for BAV. CI - (c) 2023 Published by Elsevier Inc. on behalf of Society for Cardiovascular Angiography and Interventions Foundation. FAU - Zhong, Jeffrey AU - Zhong J AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Kamp, Nicholas AU - Kamp N AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Bansal, Agam AU - Bansal A AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Kumar, Ani AU - Kumar A AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Puri, Rishi AU - Puri R AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Kapadia, Samir AU - Kapadia S AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Reed, Grant W AU - Reed GW AD - Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. LA - eng PT - Journal Article PT - Review DEP - 20230727 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC11307741 OTO - NOTNLM OT - aortic valve stenosis OT - balloon aortic valvuloplasty OT - outcomes OT - transcatheter aortic valve replacement COIS- The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2024/08/12 12:43 MHDA- 2024/08/12 12:44 PMCR- 2023/07/27 CRDT- 2024/08/12 06:14 PHST- 2023/01/01 00:00 [received] PHST- 2023/04/15 00:00 [revised] PHST- 2023/04/18 00:00 [accepted] PHST- 2024/08/12 12:44 [medline] PHST- 2024/08/12 12:43 [pubmed] PHST- 2024/08/12 06:14 [entrez] PHST- 2023/07/27 00:00 [pmc-release] AID - S2772-9303(23)00445-3 [pii] AID - 101002 [pii] AID - 10.1016/j.jscai.2023.101002 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2023 Jul 27;2(4):101002. doi: 10.1016/j.jscai.2023.101002. eCollection 2023 Jul-Aug. PMID- 39124736 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240812 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 15 DP - 2024 Jul 30 TI - SURgical vs. PERcutaneous ACCESS in Transfemoral Transcatheter Aortic Valve Implantation (SU-PER-ACCESS Study). LID - 10.3390/jcm13154471 [doi] LID - 4471 AB - Background: The transfemoral (TF) approach is the most common route in TAVI, but it is still associated with a risk of bleeding and vascular complications. The aim of this study was to compare the clinical outcomes between surgical cut-down (SC) and percutaneous (PC) approach. (2) Methods: Between January 2018 and June 2022, 774 patients underwent a transfemoral TAVI procedure. After propensity matching, 323 patients underwent TAVI in each group. (3) Results: In the matched population, 15 patients (4.6%) in the SC group vs. 34 patients in the PC group (11%) experienced minor vascular complications (p = 0.02), while no difference for major vascular complication (1.5% vs. 1.9%) were reported. The rate of minor bleeding events was higher in the percutaneous group (11% vs. 3.1%, p <.001). The SC group experienced a higher rate of non-vascular-related access complications (minor 8% vs. 1.2%; major 2.2% vs. 1.2%; p < 0.001). (4) Conclusions: SC for TF-TAVI did not alter the mortality rate at 30 days and was associated with reduced minor vascular complication and bleeding. PC showed a lower rate of non-vascular-related access complications and a lower length of stay. The specific approach should be tailored to the patient's clinical characteristics. FAU - Cammardella, Antonio Giovanni AU - Cammardella AG AUID- ORCID: 0000-0002-7957-4191 AD - Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, 00152 Rome, Italy. FAU - Russo, Marco AU - Russo M AUID- ORCID: 0000-0001-9843-2925 AD - Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, 00152 Rome, Italy. FAU - Di Mauro, Michele AU - Di Mauro M AUID- ORCID: 0000-0003-2611-5626 AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands. FAU - Romagnoni, Claudia AU - Romagnoni C AD - Department of Cardiothoracic Surgery, IRCCS Ca Granda Ospedale Maggiore Policlinico di Milano, 20122 Milano, Italy. FAU - Ceresa, Fabrizio AU - Ceresa F AUID- ORCID: 0000-0002-1286-0505 AD - Department of Cardiothoracic Surgery, Azienda Ospedaliera Papardo, 98158 Messina, Italy. FAU - Patane, Francesco AU - Patane F AUID- ORCID: 0000-0001-5023-6247 AD - Department of Cardiothoracic Surgery, Azienda Ospedaliera Papardo, 98158 Messina, Italy. FAU - Gelpi, Guido AU - Gelpi G AD - Department of Cardiothoracic Surgery, IRCCS Ca Granda Ospedale Maggiore Policlinico di Milano, 20122 Milano, Italy. FAU - Pollari, Francesco AU - Pollari F AUID- ORCID: 0000-0003-1729-532X AD - Cardiac Surgery, Klinikum Nurnberg-Paracelsus Medical University, 90471 Nuremberg, Germany. FAU - Barili, Fabio AU - Barili F AUID- ORCID: 0000-0001-9737-6087 AD - Department of Biomedical and Clinical Sciences, Universita degli Studi di Milano, 20122 Milan, Italy. AD - University Cardiac Surgery Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, 20157 Milan, Italy. AD - Harvard TH Chan School of Public Health, Boston, MA 02115, USA. FAU - Parolari, Alessandro AU - Parolari A AD - University Unit of Cardiac Surgery, IRCCS Policlinico S. Donato, S. Donato Milanese, 20097 Milan, Italy. AD - Department of Biomedical Sciences, University of Milano, 20174 Milan, Italy. FAU - Ranocchi, Federico AU - Ranocchi F AD - Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital, 00152 Rome, Italy. CN - Italian Group for Research and Outcomes in Cardiac Surgery (GIROC) of the Italian Society for Cardiac Surgery (SICCH) LA - eng PT - Journal Article DEP - 20240730 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11313030 OTO - NOTNLM OT - TAVI OT - transfemoral OT - vascular access OT - vascular closure devices (VCD) OT - vascular complications COIS- The authors declare no conflict of interest. EDAT- 2024/08/10 15:42 MHDA- 2024/08/10 15:43 PMCR- 2024/07/30 CRDT- 2024/08/10 01:09 PHST- 2024/05/30 00:00 [received] PHST- 2024/07/15 00:00 [revised] PHST- 2024/07/25 00:00 [accepted] PHST- 2024/08/10 15:43 [medline] PHST- 2024/08/10 15:42 [pubmed] PHST- 2024/08/10 01:09 [entrez] PHST- 2024/07/30 00:00 [pmc-release] AID - jcm13154471 [pii] AID - jcm-13-04471 [pii] AID - 10.3390/jcm13154471 [doi] PST - epublish SO - J Clin Med. 2024 Jul 30;13(15):4471. doi: 10.3390/jcm13154471. PMID- 39100698 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240806 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 4 IP - 6 DP - 2024 Jun TI - Brachiocephalic Artery Access Without Sternotomy in Older Asian Patients Undergoing Transcatheter Aortic Valve Replacement. PG - 495-499 LID - 10.1016/j.jacasi.2024.03.006 [doi] AB - There are numerous approaches for transcatheter aortic valve replacement (TAVR); however, access-related complications remain a point of concern. We analyzed consecutive patients who underwent TAVR for severe aortic stenosis via the brachiocephalic artery (BCA) without sternotomy (TBc group, n = 10) and via the trans-ascending aortic (TAo group, n = 8). The median BCA diameter and distance between the access point and suprasternal notch or superior margin of the clavicle were 11.3 mm and 8.3 mm, respectively. No patients in the TBc group underwent a partial sternotomy. Compared with the TAo group, the TBc group exhibited a shorter mean procedure time and lower blood loss volume as well as shorter duration of hospitalization. TAVR through the BCA may be a safe and feasible alternative for ascending aorta access. Studies with longer follow-up analysis and more patients are warranted to confirm our findings. CI - (c) 2024 The Authors. FAU - Matsuo, Takehiko AU - Matsuo T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan. AD - Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Shimamoto, Takeshi AU - Shimamoto T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan. FAU - Fuku, Yasushi AU - Fuku Y AD - Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan. FAU - Ohya, Masanobu AU - Ohya M AD - Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan. FAU - Komiya, Tatsuhiko AU - Komiya T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan. LA - eng PT - Journal Article DEP - 20240514 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC11291380 OTO - NOTNLM OT - alternative access OT - aortic valve stenosis OT - brachiocephalic artery OT - innominate artery OT - transcatheter aortic valve replacement COIS- Dr Fuku is a proctor for Medtronic and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/08/05 06:43 MHDA- 2024/08/05 06:44 PMCR- 2024/05/14 CRDT- 2024/08/05 05:08 PHST- 2024/01/11 00:00 [received] PHST- 2024/03/11 00:00 [revised] PHST- 2024/03/25 00:00 [accepted] PHST- 2024/08/05 06:44 [medline] PHST- 2024/08/05 06:43 [pubmed] PHST- 2024/08/05 05:08 [entrez] PHST- 2024/05/14 00:00 [pmc-release] AID - S2772-3747(24)00110-8 [pii] AID - 10.1016/j.jacasi.2024.03.006 [doi] PST - epublish SO - JACC Asia. 2024 May 14;4(6):495-499. doi: 10.1016/j.jacasi.2024.03.006. eCollection 2024 Jun. PMID- 39100586 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240806 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 8 IP - 4 DP - 2024 Jul TI - Simultaneous Transcatheter Aortic and Mitral Native Valve Replacement: A Step-by-Step Procedural Approach. PG - 100295 LID - 10.1016/j.shj.2024.100295 [doi] LID - 100295 AB - Multivalvular heart disease (MVHD) is present in one-third of patients with valvular heart disease (VHD). Compared to single VHD patients, these patients have a more significant hemodynamic impact and are often left under medical treatment. Most importantly, when undergoing multiple valve interventions, they show worse rates of heart failure and mortality. The guidelines-supported interventions in patients with MVHD in combined aortic regurgitation and mitral stenosis include percutaneous mitral balloon commissurotomy, open mitral commissurotomy, or surgical mitral valve replacement followed by transcatheter or surgical aortic valve replacement, trying to minimize the increased mortality risk of double-valve replacement. Simultaneous transcatheter valve replacement (STVR) for native MVHD is still off-label and not yet considered in clinical guidelines since the evidence of its results is limited to a few cases reported worldwide. However, fully percutaneous transfemoral STVR seems promising for MVHD patients thanks to its minimal invasiveness, the continuous improvement of the transcatheter heart valve devices, the likely shorter length of stay and the fastest recovery. To our knowledge, this is the first case ever reported of fully percutaneous STVR for native MVHD in aortic regurgitation and mitral stenosis. Deep understanding of both pathologies and their interactions, not only from a pathological point of view but from the procedural planning and procedural steps point of view is mandatory. Hereby we present the specific STVR procedural planning considerations, a step-by-step guide on how to perform an aortic and mitral STVR and its critical considerations, as well as the procedural and follow-up results. CI - (c) 2024 The Author(s). FAU - Farjat-Pasos, Julio I AU - Farjat-Pasos JI AD - Department of Structural Interventional Cardiology, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Kalavrouziotis, Dimitri AU - Kalavrouziotis D AD - Department of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Beaudoin, Jonathan AU - Beaudoin J AD - Department of Echocardiography, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Paradis, Jean-Michel AU - Paradis JM AD - Department of Structural Interventional Cardiology, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. LA - eng PT - Journal Article DEP - 20240313 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC11294837 OTO - NOTNLM OT - Aortic regurgitation OT - Mitral stenosis OT - Multivalvular heart disease OT - Simultaneous transcatheter valve replacement OT - Transcatheter aortic valve replacement OT - Transcatheter mitral valve replacement COIS- The authors report no conflict of interest. EDAT- 2024/08/05 06:43 MHDA- 2024/08/05 06:44 PMCR- 2024/03/13 CRDT- 2024/08/05 05:06 PHST- 2023/10/12 00:00 [received] PHST- 2024/01/17 00:00 [revised] PHST- 2024/02/01 00:00 [accepted] PHST- 2024/08/05 06:44 [medline] PHST- 2024/08/05 06:43 [pubmed] PHST- 2024/08/05 05:06 [entrez] PHST- 2024/03/13 00:00 [pmc-release] AID - S2474-8706(24)00026-5 [pii] AID - 100295 [pii] AID - 10.1016/j.shj.2024.100295 [doi] PST - epublish SO - Struct Heart. 2024 Mar 13;8(4):100295. doi: 10.1016/j.shj.2024.100295. eCollection 2024 Jul. PMID- 39095289 OWN - NLM STAT- MEDLINE DCOM- 20250503 LR - 20260516 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 73 DP - 2025 Apr TI - Peripheral intravascular lithotripsy to facilitate transfemoral transcatheter aortic valve replacement - Defining optimal treatable peripheral arterial disease burden. PG - 31-37 LID - S1553-8389(24)00582-7 [pii] LID - 10.1016/j.carrev.2024.07.005 [doi] AB - BACKGROUND: Transfemoral transcatheter aortic valve replacement (TF-TAVR) has proven superior to alternative access. However, some patients evaluated for TF-TAVR are unfit secondary to peripheral arterial disease (PAD). Peripheral intravascular lithotripsy (IVL) can facilitate femoral access. This study aimed to characterize optimal lesions that can be treated with IVL. METHODS: Single-center, retrospective analysis of an institutional database, queried from 1/2018 through 7/2023 for all patients who underwent TAVR. Patients who received IVL-facilitated transfemoral access were analyzed. RESULTS: Of 2862 TAVR cases identified, 92 (3.2 %) underwent lithotripsy. The IVL-facilitated cohort had a mean age of 78 +/- 9.2 years and 45 % were female. The right common iliac artery was most treated (47). Most IVL was performed with 7-mm balloons (73.9 %). All cases were successful. 30-day mortality was 1.1 % (1/92). CONCLUSIONS: In our cohort, complications after IVL-facilitated TF-TAVR were more common with small vessel diameter (50 % stenosis), and heavy calcium burden (arc calcification >180 degrees ). The findings support the use of IVL to expand the population of patients who can undergo TF-TAVR without the increased risks associated with the various forms of alternative access. SUMMARY FOR ANNOTATED TABLE OF CONTENTS: IVL-facilitated TF-TAVR is safe and feasible. Despite its introduction to TAVR clinical practice in 2018, IVL-facilitated TF-TAVR is not regularly performed and could increase the population of patients eligible for TF-TAVR. CI - Published by Elsevier Inc. FAU - Tom, Stephanie AU - Tom S AD - Department of Surgery, Emory University, Atlanta, GA, USA. Electronic address: stom2@emory.edu. FAU - Tully, Andy AU - Tully A AD - University of Maryland Department of Surgery, Baltimore, MD, USA. FAU - Kikuchi, Yuta AU - Kikuchi Y AD - Division of Cardiothoracic Surgery, Emory University, Atlanta, GA, USA; Structural Heart and Valve Center, Emory University, Atlanta, GA, USA. FAU - Crawford, Kaylyn AU - Crawford K AD - Emory University School of Medicine, Atlanta, GA, USA. FAU - Binongo, Jose AU - Binongo J AD - Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University, Atlanta, GA, USA. FAU - Wei, Jane Wenjing AU - Wei JW AD - Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University, Atlanta, GA, USA. FAU - Gleason, Patrick AU - Gleason P AD - Structural Heart and Valve Center, Emory University, Atlanta, GA, USA; Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Xie, Joe AU - Xie J AD - Structural Heart and Valve Center, Emory University, Atlanta, GA, USA; Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Devireddy, Chandan M AU - Devireddy CM AD - Structural Heart and Valve Center, Emory University, Atlanta, GA, USA; Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Grubb, Kendra J AU - Grubb KJ AD - Division of Cardiothoracic Surgery, Emory University, Atlanta, GA, USA; Structural Heart and Valve Center, Emory University, Atlanta, GA, USA. LA - eng PT - Journal Article DEP - 20240721 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - *Peripheral Arterial Disease/diagnostic imaging/mortality/therapy/physiopathology/complications MH - Retrospective Studies MH - Male MH - *Femoral Artery/diagnostic imaging MH - Aged MH - Aged, 80 and over MH - Treatment Outcome MH - *Catheterization, Peripheral/adverse effects/mortality MH - *Lithotripsy/adverse effects/mortality MH - Databases, Factual MH - Risk Factors MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/mortality/physiopathology MH - Time Factors MH - Punctures MH - Risk Assessment OTO - NOTNLM OT - Calcified iliofemoral access OT - Intravascular lithotripsy OT - PAD OT - TAVR OT - TAVR access COIS- Declaration of competing interest Grubb is a consultant for Abbott, Boston Scientific, Medtronic, and Edwards Lifesciences. Devireddy is a consultant for Medtronic and Recor Medical. The remaining authors have no disclosures. EDAT- 2024/08/03 10:41 MHDA- 2025/05/03 22:24 CRDT- 2024/08/02 21:55 PHST- 2024/03/11 00:00 [received] PHST- 2024/06/27 00:00 [revised] PHST- 2024/07/12 00:00 [accepted] PHST- 2025/05/03 22:24 [medline] PHST- 2024/08/03 10:41 [pubmed] PHST- 2024/08/02 21:55 [entrez] AID - S1553-8389(24)00582-7 [pii] AID - 10.1016/j.carrev.2024.07.005 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2025 Apr;73:31-37. doi: 10.1016/j.carrev.2024.07.005. Epub 2024 Jul 21. PMID- 39077114 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240731 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - Early clinical outcomes of Portico and Edwards Sapien 3 valve prosthesis in transcatheter aortic valve replacement: propensity-matched analysis. PG - 1400626 LID - 10.3389/fcvm.2024.1400626 [doi] LID - 1400626 AB - INTRODUCTION: There is a lack of real-world data directly comparing different valve prostheses for transaortic valve replacement (TAVR). We aimed to compare early clinical outcomes at 30-days between the self-expandable Portico valve (Abbott) with the balloon-expandable Edwards Sapien 3 valve (Edwards Lifesciences) (ES3). METHODS: Out of 1,901 patients undergoing TAVR between January 2018 and December 2021, all patients who received either Portico valve or ES3 valve via transfemoral TAVR were matched using nearest-neighbor (1:1) propensity scoring. Primary endpoints were single safety endpoints and early safety composite endpoints defined by Valve Academic Research Consortium-2 (VARC-2) criteria. The secondary endpoint was to analyze risk predictors for new permanent pacemaker (PPM) implantation in TAVR. RESULTS: Out of 661 complete cases, a total of 434 patients were successfully matched based on age, sex, Euro Score II and STS-score. In the matched cohort, 217 received either a Portico or valve and 217 received an ES3 valve. The VARC-2 early safety composite scores indicated a significantly greater overall 30-day safety risk in the Portico group at 9.2% (n = 20) compared to 3.7% (n = 8) in the ES3 group (p = 0.032). The requirement for new permanent pacemaker (PPM) implantation was also higher in the Portico group, at 21.2% (n = 46) vs. 13.4% (n = 29) in the ES3 group (p = 0.042). 30-day mortality was higher was 3.7% (n = 8) in Portico group compared to 0.9% in ES3 group (p = 0.11). Furthermore, implantation of the Portico valve was identified as a significant risk predictor for new PPM implantation, alongside higher age, preprocedural atrioventricular block (AVB) and longer total procedure duration. CONCLUSION: This study shows significantly higher rates of early clinical complications for Portico valve prostheses compared to ES3. These findings should be especially taken into consideration when selecting valve prosthesis for high-risk patients. CI - (c) 2024 Primessnig, Wiedenhofer, Trippel, Loddenkemper, Schrader, Brand, Spethmann, Stangl, Haghikia, Landmesser, Boldt, Blaschke, Hindricks, Sundermann, Grubitzsch, Falk, Dreger and Sherif. FAU - Primessnig, Uwe AU - Primessnig U AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. FAU - Wiedenhofer, Julia M AU - Wiedenhofer JM AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. FAU - Trippel, Tobias D AU - Trippel TD AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. FAU - Loddenkemper, Carina M AU - Loddenkemper CM AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. FAU - Schrader, Helene AU - Schrader H AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. FAU - Brand, Anna AU - Brand A AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Charite Mitte, Berlin, Germany. FAU - Spethmann, Sebastian AU - Spethmann S AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Charite Mitte, Berlin, Germany. FAU - Stangl, Karl AU - Stangl K AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Charite Mitte, Berlin, Germany. FAU - Haghikia, Arash AU - Haghikia A AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, Berlin, Germany. FAU - Landmesser, Ulf AU - Landmesser U AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, Berlin, Germany. FAU - Boldt, Leif-Hendrik AU - Boldt LH AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. FAU - Blaschke, Florian AU - Blaschke F AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. FAU - Hindricks, Gerhard AU - Hindricks G AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Charite Mitte, Berlin, Germany. FAU - Sundermann, Simon H AU - Sundermann SH AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany. FAU - Grubitzsch, Herko AU - Grubitzsch H AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany. FAU - Falk, Volkmar AU - Falk V AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany. FAU - Dreger, Henryk AU - Dreger H AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. FAU - Sherif, Mohammad AU - Sherif M AD - Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum, Berlin, Germany. AD - Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Berlin, Germany. LA - eng PT - Journal Article DEP - 20240715 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC11284094 OTO - NOTNLM OT - balloon-expandable Edwards Sapien 3 valve prothesis OT - permanent pacemaker (PPM) implantation OT - self-expandable portico valve prosthesis OT - surgical aortic valve replacement (SAVR) OT - transcatheter aortic valve replacement (TAVR) COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/07/30 06:42 MHDA- 2024/07/30 06:43 PMCR- 2024/01/01 CRDT- 2024/07/30 05:03 PHST- 2024/03/29 00:00 [received] PHST- 2024/06/25 00:00 [accepted] PHST- 2024/07/30 06:43 [medline] PHST- 2024/07/30 06:42 [pubmed] PHST- 2024/07/30 05:03 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1400626 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Jul 15;11:1400626. doi: 10.3389/fcvm.2024.1400626. eCollection 2024. PMID- 39070975 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240730 IS - 2491-0929 (Electronic) IS - 2426-3958 (Print) IS - 2426-3958 (Linking) VI - 10 IP - 2 DP - 2024 Jul TI - Transcatheter aortic valve replacement in China - a review of the available evidence. PG - 110-118 LID - 10.4244/AIJ-D-23-00049 [doi] AB - This paper discusses aortic stenosis (AS) in China, emphasising the role of transcatheter aortic valve replacement (TAVR) in treating AS in an ageing population. AS characteristics, its treatment and the clinical outcomes of transfemoral TAVR in Chinese patients are described via a systematic review. AS affects >1% of the Chinese population aged >/=65 years, with degenerative AS predominating over rheumatic AS among this age group. Chinese patients often have high aortic valve (AV) calcification with bicuspid AV morphology. In 2021, 38,000 surgical aortic valve replacements (SAVR) were reported in China, while the number of TAVR increased from 293 in 2017 to 7,357 in 2021. There are four self-expanding valves and one balloon-expandable SAPIEN 3 valve available in China. Among them, the Venus A-Valve is the most studied and widely used, whereas limited data are available for VitaFlow, TaurusOne, and SAPIEN 3. Notably, 10.0-16.5% of Venus A-Valve recipients and 0.2% of SAPIEN 3 recipients required multiple valve implantations. The rates of 30-day paravalvular leakage were 0-11.7%/0% for Venus A-Valve, 2.0%/0% for VitaFlow, and 0%/0% for SAPIEN 3, for moderate and severe leakage, respectively. Thirty-day all-cause mortality rates were 3.7-10.0% for Venus A-Valve, 0.9% for VitaFlow, and 0-3.2% for SAPIEN 3. One-year all-cause mortality rates were 5.9-13.6% for Venus A-Valve, 0-4.5% for VitaFlow, 6.7% for TaurusOne, and 6.2% for SAPIEN 3. The Venus A-Valve indicated lower 30-day permanent pacemaker implantation (PPI) rates (7.4-20.5%) than VitaFlow and TaurusOne. Outcomes for patients with bicuspid or tricuspid aortic valves were similar. AS is rising among the elderly Chinese population; SAVR is common, and TAVR is increasing. Limited device comparisons exist, but the Venus A-Valve seems to have lower PPI rates, and SAPIEN 3 has low 30-day mortality in China. FAU - Wei, Lai AU - Wei L AD - Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. FAU - Wang, Bin AU - Wang B AD - Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China. FAU - Yang, Ye AU - Yang Y AD - Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. FAU - Dong, Lili AU - Dong L AD - Department of Echocardiology, Zhongshan Hospital, Fudan University, Shanghai, China. FAU - Chen, Xiang AU - Chen X AD - Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China. FAU - Bramlage, Peter AU - Bramlage P AD - Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany. FAU - Wang, Yan AU - Wang Y AD - Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China. LA - eng PT - Journal Article PT - Review DEP - 20240726 PL - France TA - AsiaIntervention JT - AsiaIntervention JID - 101697313 PMC - PMC11261658 COIS- IPPMed Cloppenburg, represented by P. Bramlage, has received honoraria (or research funding) for consultancy from Edwards Lifesciences. The other authors have no conflicts of interest to declare. EDAT- 2024/07/29 06:42 MHDA- 2024/07/29 06:43 PMCR- 2024/07/26 CRDT- 2024/07/29 05:38 PHST- 2023/08/29 00:00 [received] PHST- 2024/04/04 00:00 [accepted] PHST- 2024/07/29 06:43 [medline] PHST- 2024/07/29 06:42 [pubmed] PHST- 2024/07/29 05:38 [entrez] PHST- 2024/07/26 00:00 [pmc-release] AID - 10.4244/AIJ-D-23-00049 [doi] PST - epublish SO - AsiaIntervention. 2024 Jul 26;10(2):110-118. doi: 10.4244/AIJ-D-23-00049. eCollection 2024 Jul. PMID- 39057621 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240728 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 11 IP - 7 DP - 2024 Jun 29 TI - Ten-Year Experience with a Transapical Approach for Transcatheter Aortic and Mitral Valve Implantation. LID - 10.3390/jcdd11070201 [doi] LID - 201 AB - BACKGROUND: The transfemoral approach represents the optimal access for TAVI due to its low invasiveness; however, up to 10-15% of TAVI candidates are considered unsuitable for femoral access because of significant peripheral vascular disease and need alternative access. METHODS: This is a single-center retrospective observational study including all consecutive adult patients undergoing transcatheter procedures through a TA approach from March 2015 to April 2024. RESULTS: 213 patients underwent transcatheter aortic or mitral valve implantation through a TA approach and were enrolled in this study. The mean age of the patients was 79.5 +/- 5.7 years, and 54% of the patients were males. The mean Euroscore II was 7.9 +/- 6.4%. One-third of the patients had previous cardiac surgery. The overall mean survival time was 5.3 +/- 0.3 years. Nine (4%) patients developed infective endocarditis (IE) during the follow-up. CONCLUSIONS: The transapical approach for transcatheter procedures is a safe and effective procedure for patients unsuitable for TF access with low periprocedural mortality and a low rate of post-procedural complications when performed by experienced surgeons and cardiologists. FAU - Galeone, Antonella AU - Galeone A AUID- ORCID: 0000-0001-5965-6571 AD - Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37126 Verona, Italy. FAU - Perrone, Fabiola AU - Perrone F AUID- ORCID: 0009-0005-8290-9406 AD - Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37126 Verona, Italy. FAU - Pesarini, Gabriele AU - Pesarini G AUID- ORCID: 0000-0002-2770-8231 AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy. FAU - Ribichini, Flavio Luciano AU - Ribichini FL AUID- ORCID: 0000-0002-6662-0304 AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy. FAU - Di Gaetano, Renato AU - Di Gaetano R AUID- ORCID: 0009-0008-1569-0071 AD - Department of Cardiology, Azienda Sanitaria dell'Alto Adige, 39100 Bolzano, Italy. FAU - Luciani, Giovanni Battista AU - Luciani GB AUID- ORCID: 0000-0003-0931-018X AD - Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37126 Verona, Italy. FAU - Onorati, Francesco AU - Onorati F AUID- ORCID: 0000-0002-0879-3557 AD - Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37126 Verona, Italy. LA - eng PT - Journal Article DEP - 20240629 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC11277261 OTO - NOTNLM OT - transapical access OT - transcatheter aortic valve implantation OT - valve-in-valve COIS- Author Renato di Gaetano was employed by the Azienda Sanitaria dell'Alto Adige. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/07/26 12:47 MHDA- 2024/07/26 12:48 PMCR- 2024/06/29 CRDT- 2024/07/26 08:46 PHST- 2024/06/16 00:00 [received] PHST- 2024/06/23 00:00 [revised] PHST- 2024/06/27 00:00 [accepted] PHST- 2024/07/26 12:48 [medline] PHST- 2024/07/26 12:47 [pubmed] PHST- 2024/07/26 08:46 [entrez] PHST- 2024/06/29 00:00 [pmc-release] AID - jcdd11070201 [pii] AID - jcdd-11-00201 [pii] AID - 10.3390/jcdd11070201 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2024 Jun 29;11(7):201. doi: 10.3390/jcdd11070201. PMID- 39052515 OWN - NLM STAT- MEDLINE DCOM- 20241204 LR - 20260516 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 36 IP - 12 DP - 2024 Dec TI - Intravascular lithotripsy-assisted transfemoral transcatheter aortic valve implantation after failed balloon angioplasty in patients with severe calcified peripheral artery disease. LID - 10.25270/jic/24.00049 [doi] AB - OBJECTIVES: Calcific peripheral artery disease (PAD) is a common finding in patients scheduled for transcatheter aortic valve implantation (TAVI) and often requires iliofemoral axis preparation. However, evidence about the use of intravascular lithotripsy (IVL) in this setting is scarce. The aim of this study was to describe in-hospital and mid-term outcomes of IVL-assisted transfemoral (TF)-TAVI in patients with severe calcific PAD.n Methods: The study included 13 patients with severe calcified PAD who were initially scheduled for balloon angioplasty (PTA)-assisted TF-TAVI but were eventually treated with peripheral IVL between October 2020 and February 2024. Accurate analysis of preoperative computed tomography scans revealed difficult TF access routes (severe calcified PAD with minimal lumen diameter /=8) was identified in 73 (11.4%). The presence of severe AWT was strongly associated with an increase in the primary outcome (OR: 8.48; 95% CI: 3.36-21.40; P < 0.001). This relationship persisted following multivariable analysis, which adjusted for comorbidities and procedural characteristics. The presence of severe AWT was also found to be associated with an increased incidence of stroke and procedural death (OR: 5.66; 95% CI: 2.00-15.30; P = 0.002 and OR: 4.66; 95% CI: 1.80-11.30; P = 0.002, respectively). CONCLUSIONS: The presence of severe AWT on preprocedural multidetector computed tomography is strongly associated with thromboembolic complications including stroke and mortality after TF TAVR. CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Bonnet, Marc AU - Bonnet M AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France; Cardiology Department, Hospital Annecy-Genevois, Metz-Tessy, France. FAU - Maxo, Ludovic AU - Maxo L AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France. FAU - Lohse, Thomas AU - Lohse T AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France. FAU - Mangin, Lionel AU - Mangin L AD - Cardiology Department, Hospital Annecy-Genevois, Metz-Tessy, France. FAU - Courand, Pierre-Yves AU - Courand PY AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France. FAU - Ricard, Cecile AU - Ricard C AD - Cardiology Department, Hospital Annecy-Genevois, Metz-Tessy, France. FAU - Bouali, Anissa AU - Bouali A AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France. FAU - Boussel, Loic AU - Boussel L AD - University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France; Radiology Department, Hospital Croix-Rousse, Hospices Civils de Lyon, Lyon, France. FAU - Aktaa, Suleman AU - Aktaa S AD - Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, United Kingdom. FAU - Ali, Noman AU - Ali N AD - Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, United Kingdom. FAU - Gerelli, Sebastien AU - Gerelli S AD - Cardiac Surgery Department, Hospital Annecy-Genevois, Metz-Tessy, France. FAU - Lantelme, Pierre AU - Lantelme P AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France. FAU - Harbaoui, Brahim AU - Harbaoui B AD - Cardiology Department, (Institut de Cardiologie) Hospital Croix-Rousse and Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15, Lyon, France. Electronic address: brahim.harbaoui@chu-lyon.fr. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Jul 22;17(14):1691-1692. doi: 10.1016/j.jcin.2024.06.017. PMID: 39048256 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation MH - Female MH - Male MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality MH - Prospective Studies MH - Risk Factors MH - Aged MH - *Femoral Artery/diagnostic imaging MH - *Thrombosis/diagnostic imaging/etiology/mortality/epidemiology MH - Treatment Outcome MH - *Thromboembolism/etiology/diagnostic imaging/mortality/prevention & control MH - Incidence MH - Risk Assessment MH - Time Factors MH - *Severity of Illness Index MH - Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Multidetector Computed Tomography MH - Catheterization, Peripheral/adverse effects/mortality MH - Aortic Diseases/diagnostic imaging/mortality MH - Punctures OTO - NOTNLM OT - aortic wall thrombus OT - outcomes OT - stroke OT - transcatheter aortic valve replacement OT - transfemoral COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/07/26 12:36 MHDA- 2024/07/26 12:37 CRDT- 2024/07/24 21:02 PHST- 2024/01/29 00:00 [received] PHST- 2024/04/05 00:00 [revised] PHST- 2024/05/21 00:00 [accepted] PHST- 2024/07/26 12:37 [medline] PHST- 2024/07/26 12:36 [pubmed] PHST- 2024/07/24 21:02 [entrez] AID - S1936-8798(24)00815-X [pii] AID - 10.1016/j.jcin.2024.05.033 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Jul 22;17(14):1680-1690. doi: 10.1016/j.jcin.2024.05.033. PMID- 39037934 OWN - NLM STAT- MEDLINE DCOM- 20240727 LR - 20260815 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 66 IP - 1 DP - 2024 Jul 1 TI - Aortic valved homograft degeneration: surgical or transcatheter approach for repeat aortic valve replacement? LID - ezae280 [pii] LID - 10.1093/ejcts/ezae280 [doi] AB - OBJECTIVES: Aortic valved allografts (homografts) have been used alternatively to mechanical or biological valve prostheses in expectation of better durability; however, homograft valves do degenerate, and redo procedures have proven challenging due to heavy wall calcification. The aim of the study was to compare the outcome of open surgical (SAVR) and transcatheter aortic valve replacement (TAVR) in degenerated homografts. METHODS: Between 1993 and 2022, 81 patients underwent repeat aortic valve procedures having previously received an aortic homograft. The redo had become necessary due to regurgitation in 85% and stenosis in 15%. Sixty-five percent underwent open surgery, 35% TAVR. RESULTS: Isolated SAVR was possible in 79%, and root procedures were necessary in 21%. TAVR was performed in 79% via transfemoral and 21% via transapical access. Median prosthetic valve size was 23 (22.3-23.2) mm in the SAVR and 26 (25.2-26.9) in the TAVR group. Thirty-day mortality was 0% in the TAVR and 7% in the SAVR group (P = n.s.). TAVR showed a significantly better outcome concerning prolonged ventilation (0 vs 21%, P = 0.013) as well as ICU (1 vs 2 days; P < 0.001) and in-hospital stay (10.5 vs 13 days; P = 0.028). Five-year survival was statistically comparable between groups, and no severe leakage was observed. CONCLUSIONS: SAVR following structural homograft degeneration shows acceptable results, but the perioperative risk remains substantial and poorly predictable. TAVR presents a reasonable and more easily accessible alternative and is associated with good short- and mid-term results. In the absence of relevant contraindications, TAVR is presently the preferred treatment option for these patients at our center. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Peterss, Sven AU - Peterss S AUID- ORCID: 0000-0003-1880-152X AD - University Aortic Centre Munich, LMU University Hospital, Munich, Germany. AD - Department of Cardiac Surgery, LMU University Hospital, Munich, Germany. FAU - Fabry, Thomas G AU - Fabry TG AD - University Aortic Centre Munich, LMU University Hospital, Munich, Germany. AD - Department of Cardiac Surgery, LMU University Hospital, Munich, Germany. FAU - Steffen, Julius AU - Steffen J AUID- ORCID: 0000-0002-8807-7365 AD - Department of Cardiology, LMU University Hospital, Munich, Germany. AD - German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Orban, Martin AU - Orban M AUID- ORCID: 0000-0001-9830-1941 AD - Department of Cardiology, LMU University Hospital, Munich, Germany. FAU - Buech, Joscha AU - Buech J AUID- ORCID: 0000-0002-8749-2962 AD - University Aortic Centre Munich, LMU University Hospital, Munich, Germany. AD - Department of Cardiac Surgery, LMU University Hospital, Munich, Germany. AD - German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Radner, Caroline AU - Radner C AUID- ORCID: 0000-0002-0782-1456 AD - University Aortic Centre Munich, LMU University Hospital, Munich, Germany. AD - Department of Cardiac Surgery, LMU University Hospital, Munich, Germany. AD - German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Theiss, Hans D AU - Theiss HD AUID- ORCID: 0000-0002-7298-1990 AD - Department of Cardiology, LMU University Hospital, Munich, Germany. FAU - Pichlmaier, Maximilian AU - Pichlmaier M AUID- ORCID: 0000-0002-2903-2490 AD - University Aortic Centre Munich, LMU University Hospital, Munich, Germany. AD - Department of Cardiac Surgery, LMU University Hospital, Munich, Germany. FAU - Massberg, Steffen AU - Massberg S AUID- ORCID: 0000-0001-7387-3986 AD - Department of Cardiology, LMU University Hospital, Munich, Germany. AD - German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Hagl, Christian AU - Hagl C AD - University Aortic Centre Munich, LMU University Hospital, Munich, Germany. AD - Department of Cardiac Surgery, LMU University Hospital, Munich, Germany. AD - German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Deseive, Simon AU - Deseive S AUID- ORCID: 0000-0001-8768-1184 AD - Department of Cardiology, LMU University Hospital, Munich, Germany. LA - eng PT - Journal Article PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Humans MH - Male MH - Female MH - *Aortic Valve/surgery MH - Aged MH - *Transcatheter Aortic Valve Replacement/methods MH - *Reoperation/statistics & numerical data MH - *Heart Valve Prosthesis MH - Aged, 80 and over MH - Aortic Valve Stenosis/surgery MH - Allografts MH - Heart Valve Prosthesis Implantation/methods/statistics & numerical data MH - Prosthesis Failure MH - Treatment Outcome MH - Retrospective Studies MH - Bioprosthesis MH - Middle Aged OTO - NOTNLM OT - Aortic valved allograft OT - Homograft OT - Homograft degeneration OT - Repeat aortic valve replacement OT - Structural valve deterioration OT - Valve-in-valve transcatheter aortic valve replacement EDAT- 2024/07/22 18:42 MHDA- 2024/07/28 14:51 CRDT- 2024/07/22 13:04 PHST- 2024/04/07 00:00 [received] PHST- 2024/06/26 00:00 [revised] PHST- 2024/07/19 00:00 [accepted] PHST- 2024/07/28 14:51 [medline] PHST- 2024/07/22 18:42 [pubmed] PHST- 2024/07/22 13:04 [entrez] AID - 7717981 [pii] AID - 10.1093/ejcts/ezae280 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2024 Jul 1;66(1):ezae280. doi: 10.1093/ejcts/ezae280. PMID- 39032585 OWN - NLM STAT- MEDLINE DCOM- 20240825 LR - 20260421 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 276 DP - 2024 Oct TI - Predicted prosthesis-patient mismatch and long-term clinical outcomes after transcatheter aortic valve replacement: A SWEDEHEART study. PG - 70-82 LID - S0002-8703(24)00175-3 [pii] LID - 10.1016/j.ahj.2024.07.009 [doi] AB - BACKGROUND: The impact of prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is uncertain. This study was performed to investigate the risk of all-cause mortality, heart failure hospitalization, and aortic valve reintervention in patients with and without predicted PPM after TAVR. METHODS: This nationwide, population-based cohort study included all patients who underwent transfemoral primary TAVR in Sweden from 2008 to 2022 in the SWEDEHEART register. PPM was defined according to published effective orifice areas for each valve model and size. The patients were divided into those with and without PPM. Additional baseline characteristics and outcome data were obtained from other national health data registers. Regression standardization was used to adjust for intergroup differences. RESULTS: Of 8485 patients, 7879 (93%) had no PPM and 606 (7%) had PPM. The crude cumulative incidence of all-cause mortality at 1, 5, and 10 years in patients with versus without PPM was 7% versus 9%, 40% versus 44%, and 80% versus 85%, respectively. After regression standardization, there was no between-group difference in long-term mortality, and the absolute difference at 10 years was 1.5% (95% confidence interval, -2.9%-6.0%). The mean follow-up was 3.0 years (maximum, 14 years). There was no difference in the risk of heart failure hospitalization or aortic valve reintervention. CONCLUSIONS: The risk of all-cause mortality, heart failure hospitalization, or aortic valve reintervention was not higher in patients with than without predicted PPM following TAVR. Furthermore, PPM was present in only 7% of patients, and severe PPM was almost nonexistent. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Ellfors, Emma AU - Ellfors E AD - Department of Cardiology, Stockholm South General Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. Electronic address: Emma.Ellfors@ki.se. FAU - Dismorr, Michael AU - Dismorr M AD - Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden. FAU - Ruck, Andreas AU - Ruck A AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Settergren, Magnus AU - Settergren M AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Sartipy, Ulrik AU - Sartipy U AD - Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden. FAU - Glaser, Natalie AU - Glaser N AD - Department of Cardiology, Stockholm South General Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240718 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Male MH - Female MH - Sweden/epidemiology MH - *Aortic Valve Stenosis/surgery MH - Aged, 80 and over MH - *Heart Valve Prosthesis MH - Aged MH - Heart Failure MH - Registries MH - Aortic Valve/surgery MH - Postoperative Complications/epidemiology MH - Reoperation/statistics & numerical data MH - Cause of Death MH - Risk Factors MH - Prosthesis Design COIS- Conflict of Interest Dr Ruck reports grants and personal fees from Boston Scientific Corporation; and personal fees from Edwards Lifesciences, Abbott, and Anteris Technologies, outside the submitted work. Dr Settergren serves as a proctor/advisory board member for Boston Scientific Corporation, Abbott Vascular, Edwards Lifesciences, and Anteris Technologies, outside of the submitted work. The remaining authors have nothing to disclose. EDAT- 2024/07/21 15:42 MHDA- 2024/08/26 12:41 CRDT- 2024/07/20 19:27 PHST- 2024/05/23 00:00 [received] PHST- 2024/07/07 00:00 [revised] PHST- 2024/07/15 00:00 [accepted] PHST- 2024/08/26 12:41 [medline] PHST- 2024/07/21 15:42 [pubmed] PHST- 2024/07/20 19:27 [entrez] AID - S0002-8703(24)00175-3 [pii] AID - 10.1016/j.ahj.2024.07.009 [doi] PST - ppublish SO - Am Heart J. 2024 Oct;276:70-82. doi: 10.1016/j.ahj.2024.07.009. Epub 2024 Jul 18. PMID- 39017671 OWN - NLM STAT- MEDLINE DCOM- 20250106 LR - 20250106 IS - 0301-1526 (Print) IS - 0301-1526 (Linking) VI - 54 IP - 1 DP - 2025 Jan TI - Importance of pseudoaneurysms after TAVI - a retrospective analysis of 2063 patients. PG - 50-58 LID - 10.1024/0301-1526/a001135 [doi] AB - Background: Bifemoral arterial access is common in patients undergoing transcatheter aortic valve implantation (TAVI), with a primary treatment access (TAVI access) and a secondary non-TAVI access. Pseudoaneurysm (PSA) is an important complication of femoral arterial puncture. Major vascular complications after TAVI are well described, but little is known about PSA. Patients and methods: A total of 2063 patients underwent transfemoral TAVI between January 2014 and January 2020. Vascular ultrasound of the common femoral artery was assessed before and after TAVI. We compared patient characteristics, periprocedural risk scores, procedural characteristics, and access site bleeding events according to Valve Academic Research Consortium 3 (VARC-3) criteria, length of stay (LOS), and all-cause mortality at one year between patients with (46) and without (2017) PSA. Results: The incidence of PSA after TAVI was 2.2% (46/2063). All PSA were successfully treated with ultrasound-guided manual compression (UGMC) or thrombin injection (UGTI) without complications. Patients with PSA had lower platelet counts (210x1000/mul vs. 234x1000/mul; p<0.05), more heart failure symptoms on admission (91% vs. 25%; p<0.05), were more often treated with (N)OACs for atrial fibrillation (AF; 54% vs. 38%; p <0.05), and were less often treated with aspirin (35% vs. 51%; p<0.03). Multivariate analysis identified secondary access site (odds ratio [OR] 8.11; p<0.001) and (N)OAC therapy (OR 1.31; p = 0.037) as risk factors for PSA development. PSA is associated with VARC-3 type 1-3 access site bleeding and longer LOS (15.2 +/- 11.3 d vs. 11.6 +/- 8.9 d; p<0.01), but this did not affect one year mortality (17% vs. 14%; p = 0.53). Conclusions: Pseudoaneurysms are an important complication after TAVI and are associated with access site bleeding and prolonged hospital stay. (N)OAC therapy and secondary access are important risk factors. Pseudoaneurysms can be safely and effectively treated with thrombin injection and do not affect one-year mortality. FAU - Wischmann, Patricia AU - Wischmann P AUID- ORCID: 0000-0002-7442-6915 AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. AD - CARID, Cardiovascular Research Institute Dusseldorf, Medical Faculty, and University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Germany. FAU - Stern, Manuel AU - Stern M AUID- ORCID: 0000-0001-5834-2757 AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Baasen, Sven AU - Baasen S AUID- ORCID: 0000-0002-1307-7803 AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Schillings, Miriam AU - Schillings M AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Schremmer, Johanna AU - Schremmer J AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Oliver Stern, Marc AU - Oliver Stern M AUID- ORCID: 0009-0001-1642-7418 AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Klein, Kathrin AU - Klein K AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Jung, Christian AU - Jung C AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. AD - CARID, Cardiovascular Research Institute Dusseldorf, Medical Faculty, and University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Germany. FAU - Zeus, Tobias AU - Zeus T AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. FAU - Heiss, Christian AU - Heiss C AUID- ORCID: 0000-0002-3212-8995 AD - Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom. AD - Department of Vascular Medicine, Surrey and Sussex NHS Healthcare Trust, Redhill, United Kingdom. FAU - Kelm, Malte AU - Kelm M AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. AD - CARID, Cardiovascular Research Institute Dusseldorf, Medical Faculty, and University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Germany. FAU - Busch, Lucas AU - Busch L AD - Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany. LA - eng PT - Journal Article DEP - 20240717 PL - Switzerland TA - Vasa JT - VASA. Zeitschrift fur Gefasskrankheiten JID - 0317051 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Male MH - Female MH - *Femoral Artery/diagnostic imaging MH - Retrospective Studies MH - Aged, 80 and over MH - *Aneurysm, False/etiology/diagnostic imaging/mortality/therapy MH - Risk Factors MH - Aged MH - *Punctures MH - Treatment Outcome MH - *Catheterization, Peripheral/adverse effects/mortality MH - Time Factors MH - Incidence MH - Risk Assessment MH - Aortic Valve Stenosis/surgery/diagnostic imaging/mortality MH - Ultrasonography, Interventional MH - Length of Stay OTO - NOTNLM OT - Access site complications OT - femoral artery pseudoaneurysm OT - transfemoral aortic valve implantation OT - vascular closure devices EDAT- 2024/07/17 12:43 MHDA- 2025/01/07 00:21 CRDT- 2024/07/17 10:54 PHST- 2025/01/07 00:21 [medline] PHST- 2024/07/17 12:43 [pubmed] PHST- 2024/07/17 10:54 [entrez] AID - 10.1024/0301-1526/a001135 [doi] PST - ppublish SO - Vasa. 2025 Jan;54(1):50-58. doi: 10.1024/0301-1526/a001135. Epub 2024 Jul 17. PMID- 38996897 OWN - NLM STAT- MEDLINE DCOM- 20240829 LR - 20260424 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 227 DP - 2024 Sep 15 TI - Next-Day Discharge After Transcatheter Aortic Valve Implantation With the ACURATE neo/neo2 Self-Expanding Aortic Bioprosthesis. PG - 65-74 LID - S0002-9149(24)00511-3 [pii] LID - 10.1016/j.amjcard.2024.07.005 [doi] AB - Previous studies have shown the safety of early discharge pathways in selected patients and using selected transcatheter heart valves. Hence, we sought to evaluate the safety of next-day discharge (NDD) in patients who underwent transfemoral transcatheter aortic valve implantation (TF-TAVI) with the ACURATE neo/neo2 (Boston Scientific, Marlborough, Massachusetts) self-expanding aortic bioprosthesis. Patients who underwent TF-TAVI between January 2018 and April 2023 were prospectively included. Patients were stratified into 3 groups according to discharge times within 24 hours (NDD), between 24 and 48 hours, and those discharged >48 hours after TAVI. The primary outcome was the first unplanned readmission at 30 days after TAVI. Log-rank test was used to assess the differences in the outcome of interest between the groups. A total of 368 all-comers were included in this study. According to discharge times, 204 patients followed NDD, 69 patients 24 to 48 hours discharge, and 95 patients >48 hours discharge after TAVI. The mean age was 84 +/- 6.3 years and 61% were women, without differences between the groups. The mean Society of Thoracic Surgeons score was lower in those with NDD versus 24 to 48 hours and >48 hours (2.9 +/- 1.0, 3.2 +/- 1.2, and 3.4 +/- 1.4, respectively, p = 0.014). There were no differences between the groups in terms of preprocedural right bundle branch block or pacemaker. The need for new permanent pacemaker implantation was the leading postprocedural complication; it occurred more frequently in the >48 hours group than the 24 to 48 hours, and <24 hours groups (24% vs 8.6% and 2.2%, p <0.001). There were 5 strokes (1.4%) and all of them occurred in the >48 hours group (p = 0.005). At 30 days after discharge, there were no deaths and no differences in all-cause readmissions (9.3% in <24 hours, 8.6% in 24 to 48 hours, and 19% in >48 hours, log-rank p = 0.087). The readmission rates for new permanent pacemaker implantation requirement were 3.3% (n = 6) in NDD, 0% in 24 to 48 hours, and 1.6% (n = 5) in the >48 hours groups (p = 0.27). In conclusion, in unselected patients who underwent TF-TAVI with the ACURATE neo/neo2 self-expanding bioprosthesis, the NDD pathway is feasible and appears to be safe, without an increased risk of death or all-cause rehospitalization through 30 days after hospital discharge. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Ordonez, Santiago AU - Ordonez S AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Chu, Michael W A AU - Chu MWA AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Diamantouros, Pantelis AU - Diamantouros P AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Valdis, Matthew AU - Valdis M AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Chaumont, Gloria AU - Chaumont G AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Vila, Rocio Consuelo Baro AU - Vila RCB AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Teefy, Patrick AU - Teefy P AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Bagur, Rodrigo AU - Bagur R AD - Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada. Electronic address: rodrigobagur@yahoo.com. LA - eng PT - Journal Article DEP - 20240710 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2024 Oct 15;229:69-71. doi: 10.1016/j.amjcard.2024.07.032. PMID: 39094947 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Female MH - Male MH - *Bioprosthesis MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery MH - *Patient Discharge MH - *Heart Valve Prosthesis MH - Prospective Studies MH - Patient Readmission/statistics & numerical data MH - Prosthesis Design MH - Aged MH - Postoperative Complications/epidemiology MH - Time Factors MH - Aortic Valve/surgery OTO - NOTNLM OT - TAVI OT - TAVR OT - aortic stenosis OT - early discharge OT - next-day discharge COIS- Declaration of competing interest Dr. Chu has received speaker's honoraria from Medtronic, Edwards Lifesciences, Terumo Aortic, and Artivion Inc. Dr. Diamantouros is a proctor for Boston Scientific. Dr. Bagur is a consultant for Medtronic. The remaining authors have no competing interest to declare. EDAT- 2024/07/13 07:46 MHDA- 2024/08/31 09:51 CRDT- 2024/07/12 19:55 PHST- 2023/09/18 00:00 [received] PHST- 2024/06/29 00:00 [revised] PHST- 2024/07/08 00:00 [accepted] PHST- 2024/08/31 09:51 [medline] PHST- 2024/07/13 07:46 [pubmed] PHST- 2024/07/12 19:55 [entrez] AID - S0002-9149(24)00511-3 [pii] AID - 10.1016/j.amjcard.2024.07.005 [doi] PST - ppublish SO - Am J Cardiol. 2024 Sep 15;227:65-74. doi: 10.1016/j.amjcard.2024.07.005. Epub 2024 Jul 10. PMID- 38996738 OWN - NLM STAT- MEDLINE DCOM- 20240816 LR - 20240816 IS - 1872-7727 (Electronic) IS - 0720-048X (Linking) VI - 178 DP - 2024 Sep TI - Prospective ECG-gated High-Pitch Photon-Counting CT Angiography: Evaluation of measurement accuracy for aortic annulus sizing in TAVR planning. PG - 111604 LID - S0720-048X(24)00320-6 [pii] LID - 10.1016/j.ejrad.2024.111604 [doi] AB - PURPOSE: In planning transcatheter aortic valve replacement (TAVR), retrospective cardiac spiral-CT is recommended to measure aortic annulus with subsequent CT-angiography (CTA) to evaluate access routes. Photon-counting detector (PCD)-CT enables to assess the aortic annulus in desired cardiac phases, using prospective ECG-gated high-pitch CTA. The aim of this study was to evaluate the measurement accuracy of aortic annulus using prospective ECG-gated high-pitch CTA against retrospective spiral-CT reference. METHOD: Thirty patients underwent cardiac spiral-CT and prospective ECG-gated (30% R-R on aortic valve level) high-pitch CTA. Using propensity score matching, another 30 patients were identified whose CTA was performed using high-pitch mode without ECG-synchronization. Two investigators measured annular diameter, perimeter, and area on cardiac spiral-CT and high-pitch CTA. RESULTS: The aortic valve was imaged in systole in 90 % of prospective ECG-gated CTA cases but only 50 % of non-ECG-gated CTA cases (p = 0.002). There was a strong correlation (r >/= 0.94) without significant differences (p >/= 0.09) between cardiac spiral-CT and prospective ECG-gated high-pitch CTA for all annulus measurements. In contrast, significant differences were found in annular short-axis diameter and area between cardiac spiral-CT and non-ECG-gated high-pitch CTA (p /=75 age, left ventricular ejection fraction >/=50%, or longer life expectancy. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Krasniqi, Lytfi AU - Krasniqi L AUID- ORCID: 0000-0002-8048-9779 AD - Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark. AD - Department of Clinical Research, University of Southern Denmark, Odense, Denmark. FAU - Brandes, Axel AU - Brandes A AUID- ORCID: 0000-0001-9145-6887 AD - Department of Clinical Research, University of Southern Denmark, Odense, Denmark. AD - Department of Cardiology, Esbjerg Hospital-University Hospital of Southern Denmark, Esbjerg, Denmark. FAU - Mortensen, Poul Erik AU - Mortensen PE AD - Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark. FAU - Gerke, Oke AU - Gerke O AUID- ORCID: 0000-0001-6335-3303 AD - Department of Clinical Research, University of Southern Denmark, Odense, Denmark. AD - Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark. FAU - Riber, Lars AU - Riber L AUID- ORCID: 0000-0001-6898-2715 AD - Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark. AD - Department of Clinical Research, University of Southern Denmark, Odense, Denmark. LA - eng GR - University of Southern Denmark/ PT - Journal Article PL - England TA - Interdiscip Cardiovasc Thorac Surg JT - Interdisciplinary cardiovascular and thoracic surgery JID - 9918540787006676 SB - IM CIN - Interdiscip Cardiovasc Thorac Surg. 2024 Dec 3;39(6):ivae198. doi: 10.1093/icvts/ivae198. PMID: 39607784 PMC - PMC11229432 OTO - NOTNLM OT - 5-year mortality OT - Observational OT - Propensity score-matched OT - Surgical aortic valve replacement OT - Transcatheter aortic valve implantation EDAT- 2024/06/30 00:42 MHDA- 2024/06/30 00:43 PMCR- 2024/06/29 CRDT- 2024/06/29 18:23 PHST- 2024/04/02 00:00 [received] PHST- 2024/05/02 00:00 [revised] PHST- 2024/06/25 00:00 [accepted] PHST- 2024/06/30 00:43 [medline] PHST- 2024/06/30 00:42 [pubmed] PHST- 2024/06/29 18:23 [entrez] PHST- 2024/06/29 00:00 [pmc-release] AID - 7701782 [pii] AID - ivae122 [pii] AID - 10.1093/icvts/ivae122 [doi] PST - ppublish SO - Interdiscip Cardiovasc Thorac Surg. 2024 Jul 3;39(1):ivae122. doi: 10.1093/icvts/ivae122. PMID- 38936601 OWN - NLM STAT- MEDLINE DCOM- 20250428 LR - 20260325 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 169 IP - 5 DP - 2025 May TI - Five-year outcomes of transcarotid transcatheter aortic valve replacement. PG - 1452-1459.e4 LID - S0022-5223(24)00539-7 [pii] LID - 10.1016/j.jtcvs.2024.06.017 [doi] AB - BACKGROUND: Transcarotid transcatheter aortic valve replacement (TC-TAVR) has emerged as an alternative access route for transcatheter aortic valve replacement (TAVR). However, scarce data exist on long-term outcomes following TC-TAVR. This study aimed to evaluate clinical outcomes at 5 years after TC-TAVR. METHODS: A total of 110 consecutive patients who underwent TC-TAVR were included. Baseline, procedural, and follow-up data were collected prospectively in a dedicated database. The primary endpoint was the incidence of a composite outcome of all-cause mortality, stroke, and repeat hospitalization at 5-year follow-up. Echocardiography results, New York Heart Association (NYHA) class, and quality of life (QoL) as assessed with the EuroQol visual analog scale (EQ-VAS) were examined over the 5-year follow-up. RESULTS: The median patient age was 77 years (interquartile range [IQR], 72-82.2 years), 42.3% were women, and the median Society of Thoracic Surgeons (STS) risk score was 5.02% (IQR, 3.4%-7.5%). The incidence of the composite primary endpoint was 54.5%. Death from any cause occurred in 45.6% of patients (11.9 per 100 patient-years); stroke in 8.2% (1.9 per 100 patient-years); disabling stroke in 2.7% (0.7 per 100 patient-years); and rehospitalization in 27.2%. The improvements in valve hemodynamics, NYHA class, and EQ-VAS following the procedure persisted at 5-year follow-up (P < .001). The incidence of bioprosthetic valve failure was 0.9%. CONCLUSIONS: About half of the moderate-to high-risk patients undergoing TC-TAVR survived with no major cardiovascular events at the 5-year follow-up. The yearly incidence of stroke events was low, and early improvements in valve hemodynamics, functional status, and QoL persisted at 5 years. These results suggest the long-term safety and efficacy of TC-TAVR and would support this approach as an alternative to surgery in non-transfemoral candidates. CI - Copyright (c) 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. FAU - Del Portillo, Juan Hernando AU - Del Portillo JH AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Kalavrouziotis, Dimitri AU - Kalavrouziotis D AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Dumont, Eric AU - Dumont E AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Paradis, Jean-Michel AU - Paradis JM AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Poulin, Anthony AU - Poulin A AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Beaupre, Frederic AU - Beaupre F AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Avvedimento, Marisa AU - Avvedimento M AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Mas-Peiro, Silvia AU - Mas-Peiro S AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Cepas-Guillen, Pedro AU - Cepas-Guillen P AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Mengi, Siddhartha AU - Mengi S AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Mohammadi, Siamak AU - Mohammadi S AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Departments of Cardiology and Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca. LA - eng PT - Journal Article DEP - 20240625 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM MH - Humans MH - Female MH - Male MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/methods MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery/mortality/physiopathology/diagnostic imaging MH - Quality of Life MH - Time Factors MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Risk Factors MH - Stroke/epidemiology/etiology MH - Postoperative Complications/epidemiology/mortality MH - Patient Readmission MH - Heart Valve Prosthesis OTO - NOTNLM OT - aortic valve OT - long-term OT - transcarotid OT - transcatheter valve replacement COIS- Conflict of Interest Statement Dr Rodes-Cabau has received institutional research grants and consultant/speaker fees from Edwards Lifesciences and Medtronic, and holds the Research Chair "Fondation Famille Jacques Lariviere" for the Development of Structural Heart Interventions (Laval University). Dr del Portillo has received a scholarship from "Fundacion Cardioinfantil-Instituto de Cardiologia" and "Colfuturo" (Colombia). Dr Mas-Peiro and Dr Cepas-Guillen have received research grants from the "Fundacion Alfonso Martin Escudero" (Madrid, Spain). The rest of authors did not report any potential conflict of interest relevant to the content of this manuscript. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest. EDAT- 2024/06/28 00:42 MHDA- 2025/04/28 06:27 CRDT- 2024/06/27 19:28 PHST- 2024/03/26 00:00 [received] PHST- 2024/06/12 00:00 [revised] PHST- 2024/06/18 00:00 [accepted] PHST- 2025/04/28 06:27 [medline] PHST- 2024/06/28 00:42 [pubmed] PHST- 2024/06/27 19:28 [entrez] AID - S0022-5223(24)00539-7 [pii] AID - 10.1016/j.jtcvs.2024.06.017 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2025 May;169(5):1452-1459.e4. doi: 10.1016/j.jtcvs.2024.06.017. Epub 2024 Jun 25. PMID- 38929915 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260922 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 12 DP - 2024 Jun 9 TI - Alternative Access for TAVR: Choosing the Right Pathway. LID - 10.3390/jcm13123386 [doi] LID - 3386 AB - Transcatheter aortic valve replacement (TAVR) has emerged as an alternative treatment option for patients with severe aortic stenosis regardless of surgical risk, particularly in those with a high and prohibitive risk. Since the advent of TAVR, transfemoral access has been the standard of care. However, given comorbidities and anatomical limitations, a proportion of patients are not good candidates for a transfemoral approach. Alternative access, including transapical, transaortic, transaxillary, transsubclavian, transcarotid, and transcaval, can be considered. Each alternative access has advantages and disadvantages, so the vascular route should be tailored to the patient's characteristics. However, there is no standardized algorithm when choosing the optimal alternative vascular access. In this review, we analyzed the evolution and current evidence for the most common alternative access for TAVR and proposed an algorithm for choosing the optimal vascular access in this patient population. FAU - Lutz, Katherine AU - Lutz K AUID- ORCID: 0000-0002-0685-8273 AD - Division of Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Asturias, Karla M AU - Asturias KM AD - Division of Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Garg, Jasmine AU - Garg J AD - Department of Medicine, Westchester Medical Center, Valhalla, NY 10595, USA. FAU - Poudyal, Abhushan AU - Poudyal A AD - Division of Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Lantz, Gurion AU - Lantz G AD - Division of Cadiothoracic Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Golwala, Harsh AU - Golwala H AD - Division of Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Doberne, Julie AU - Doberne J AD - Division of Cadiothoracic Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Politano, Amani AU - Politano A AD - Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Song, Howard K AU - Song HK AD - Division of Cadiothoracic Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. FAU - Zahr, Firas AU - Zahr F AUID- ORCID: 0000-0001-8448-8880 AD - Division of Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97201, USA. LA - eng PT - Journal Article PT - Review DEP - 20240609 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11203974 OTO - NOTNLM OT - alternative access OT - transaortic OT - transapical OT - transaxillary OT - transcarotid OT - transcatheter aortic valve replacement OT - transsubclavian OT - vascular access COIS- Zahr is a consultant and receives research and educational grants from Edwards and Medtronic. Lantz is a consultant to Edwards and Medtronic. Golwala is a consultant to Edwards and Medtronic and serves on the advisory board for Boston Scientific. Song is a consultant to Edwards and Medtronic. All other authors declare no conflicts of interest. EDAT- 2024/06/27 06:43 MHDA- 2024/06/27 06:44 PMCR- 2024/06/09 CRDT- 2024/06/27 01:15 PHST- 2024/05/11 00:00 [received] PHST- 2024/05/31 00:00 [revised] PHST- 2024/06/01 00:00 [accepted] PHST- 2024/06/27 06:44 [medline] PHST- 2024/06/27 06:43 [pubmed] PHST- 2024/06/27 01:15 [entrez] PHST- 2024/06/09 00:00 [pmc-release] AID - jcm13123386 [pii] AID - jcm-13-03386 [pii] AID - 10.3390/jcm13123386 [doi] PST - epublish SO - J Clin Med. 2024 Jun 9;13(12):3386. doi: 10.3390/jcm13123386. PMID- 38928674 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240629 IS - 2075-4418 (Print) IS - 2075-4418 (Electronic) IS - 2075-4418 (Linking) VI - 14 IP - 12 DP - 2024 Jun 14 TI - Surgical Therapy of Infective Prosthesis Endocarditis following TAVI: A Single Center's Experience. LID - 10.3390/diagnostics14121259 [doi] LID - 1259 AB - BACKGROUND/OBJECTIVES: Infective prosthesis endocarditis (IE) following transcatheter aortic valve implantation (TAVI) presents significant management challenges, marked by high mortality rates. This study reviews our center's experience with surgical interventions for IE in patients post-TAVI, focusing on outcomes, challenges, and procedural complexities, and providing an overview of the limited literature surrounding this subject. METHODS: This study was executed as a comprehensive retrospective analysis, targeting the clinical outcomes of surgical treatment in patients presenting with PVE following TAVI procedures at our institution. From July 2017 to July 2022, we identified five patients who had previously undergone transfemoral transcatheter aortic valve implantation and were later diagnosed with PVE needing surgery, strictly adhering to the modified Duke criteria. RESULTS: All surgical procedures were reported successful with no intra- or postoperative mortality. Patients were predominantly male (80%), with an average age of 76 +/- 8.6 years, presenting mostly with dyspnea (NYHA Class II). The mean follow-up was between 121 and 1973 days, with outcomes showing no occurrences of stroke, myocardial infarction, or major bleeding. One patient expired from unrelated causes 3.7 years post-surgery. The operative and postoperative protocols demonstrated effective disease management with enhanced survival and minimal complications. CONCLUSIONS: The surgical treatment of IE following TAVI, though challenging, can be successfully achieved with careful patient selection and a multidisciplinary approach. The favorable outcomes suggest that surgical intervention remains a viable option for managing this high-risk patient group. Our study also highlights the scarce literature available on this topic, suggesting an urgent need for more comprehensive research to enhance understanding and improve treatment strategies. Future studies with larger cohorts are needed to further validate these findings and refine surgical strategies for this growing patient population. FAU - Weymann, Alexander AU - Weymann A AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. FAU - Merzah, Ali Saad AU - Merzah AS AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. FAU - Arjomandi Rad, Arian AU - Arjomandi Rad A AUID- ORCID: 0000-0002-4931-4049 AD - Medical Sciences Division, University of Oxford, Oxford OX1 2JD, UK. FAU - Amanov, Lukman AU - Amanov L AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. FAU - Athanasiou, Thanos AU - Athanasiou T AD - Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK. FAU - Schmack, Bastian AU - Schmack B AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. FAU - Popov, Aron-Frederik AU - Popov AF AUID- ORCID: 0000-0003-4226-3004 AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. FAU - Ruhparwar, Arjang AU - Ruhparwar A AUID- ORCID: 0000-0003-2725-9912 AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. FAU - Zubarevich, Alina AU - Zubarevich A AD - Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. LA - eng PT - Journal Article DEP - 20240614 PL - Switzerland TA - Diagnostics (Basel) JT - Diagnostics (Basel, Switzerland) JID - 101658402 PMC - PMC11203229 OTO - NOTNLM OT - TAVI OT - TAVI prosthesis endocarditis OT - prosthesis endocarditis OT - surgical aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2024/06/27 06:42 MHDA- 2024/06/27 06:43 PMCR- 2024/06/14 CRDT- 2024/06/27 01:08 PHST- 2024/04/17 00:00 [received] PHST- 2024/05/17 00:00 [revised] PHST- 2024/06/13 00:00 [accepted] PHST- 2024/06/27 06:43 [medline] PHST- 2024/06/27 06:42 [pubmed] PHST- 2024/06/27 01:08 [entrez] PHST- 2024/06/14 00:00 [pmc-release] AID - diagnostics14121259 [pii] AID - diagnostics-14-01259 [pii] AID - 10.3390/diagnostics14121259 [doi] PST - epublish SO - Diagnostics (Basel). 2024 Jun 14;14(12):1259. doi: 10.3390/diagnostics14121259. PMID- 38907200 OWN - NLM STAT- MEDLINE DCOM- 20240621 LR - 20241108 IS - 1471-2253 (Electronic) IS - 1471-2253 (Linking) VI - 24 IP - 1 DP - 2024 Jun 21 TI - Impact of proficiency in the transcatheter aortic valve implantation procedure on clinical outcomes: a single center retrospective study. PG - 209 LID - 10.1186/s12871-024-02594-7 [doi] LID - 209 AB - BACKGROUND: We used transcatheter aortic valve implantation (TAVI) procedure time to investigate the association between surgical team maturity and outcome. METHODS: Among patients who underwent TAVI between October 2015 and November 2019, those who had Sapien implanted with the transfemoral artery approach were included in the analysis. We used TAVI procedure time and surgery number to draw a learning curve. Then, we divided the patients into two groups before and after the number of cases where the sigmoid curve reaches a plateau. We compared the two groups regarding the surveyed factors and investigated the correlation between the TAVI procedure time and survey factors. RESULTS: Ninety-nine of 149 patients were analysed. The sigmoid curve had an inflection point in 23.2 cases and reached a plateau in 43.0 cases. Patients in the Late group had a shorter operating time, less contrast media, less radiation exposure, and less myocardial escape enzymes than the Early group. Surgical procedure time showed the strongest correlation with the surgical case number. CONCLUSION: The number of cases required for surgeon proficiency for isolated Sapien valve implantation was 43. This number may serve as a guideline for switching the anesthesia management of TAVI from general to local anesthesia. CI - (c) 2024. The Author(s). FAU - Miyoshi, Hirotsugu AU - Miyoshi H AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. h-miyoshi@hiroshima-u.ac.jp. FAU - Kamiya, Satoshi AU - Kamiya S AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Ikeda, Tsuyoshi AU - Ikeda T AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Narasaki, Soshi AU - Narasaki S AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Kondo, Takashi AU - Kondo T AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Syourin, Daiki AU - Syourin D AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Sumii, Ayako AU - Sumii A AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Kido, Kenshiro AU - Kido K AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Otsuki, Sachiko AU - Otsuki S AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Kato, Takahiro AU - Kato T AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Nakamura, Ryuji AU - Nakamura R AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. FAU - Tsutsumi, Yasuo M AU - Tsutsumi YM AD - Department of Anesthesiology and Critical Care, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. LA - eng PT - Journal Article DEP - 20240621 PL - England TA - BMC Anesthesiol JT - BMC anesthesiology JID - 100968535 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Retrospective Studies MH - Male MH - Female MH - Aged, 80 and over MH - *Operative Time MH - Aged MH - *Learning Curve MH - Clinical Competence MH - Treatment Outcome MH - Aortic Valve Stenosis/surgery PMC - PMC11191309 OTO - NOTNLM OT - General anesthesia OT - Learning curve OT - Local anesthesia OT - Transcatheter aortic valve implantation COIS- The authors declare no competing interests. EDAT- 2024/06/22 05:43 MHDA- 2024/06/22 05:44 PMCR- 2024/06/21 CRDT- 2024/06/21 23:31 PHST- 2024/03/31 00:00 [received] PHST- 2024/06/10 00:00 [accepted] PHST- 2024/06/22 05:44 [medline] PHST- 2024/06/22 05:43 [pubmed] PHST- 2024/06/21 23:31 [entrez] PHST- 2024/06/21 00:00 [pmc-release] AID - 10.1186/s12871-024-02594-7 [pii] AID - 2594 [pii] AID - 10.1186/s12871-024-02594-7 [doi] PST - epublish SO - BMC Anesthesiol. 2024 Jun 21;24(1):209. doi: 10.1186/s12871-024-02594-7. PMID- 38906782 OWN - NLM STAT- MEDLINE DCOM- 20241128 LR - 20250324 IS - 1878-4046 (Electronic) IS - 1076-6332 (Linking) VI - 31 IP - 12 DP - 2024 Dec TI - Photon-Counting Versus Dual-Source CT for Transcatheter Aortic Valve Implantation Planning. PG - 4780-4789 LID - S1076-6332(24)00372-6 [pii] LID - 10.1016/j.acra.2024.06.014 [doi] AB - BACKGROUND: Cardiovascular CT is required for planning transcatheter aortic valve implantation (TAVI). PURPOSE: To compare image quality, suitability for TAVI planning, and radiation dose of photon-counting CT (PCCT) with that of dual-source CT (DSCT). MATERIAL AND METHODS: Retrospective study on consecutive TAVI candidates with aortic valve stenosis who underwent contrast-enhanced aorto-ilio-femoral PCCT and/or DSCT between 01/2022 and 07/2023. Signal-to-noise (SNR) and contrast-to-noise ratio (CNR) were calculated by standardized ROI analysis. Image quality and suitability for TAVI planning were assessed by four independent expert readers (two cardiac radiologists, two cardiologists) on a 5-point-scale. CT dose index (CTDI) and dose-length-product (DLP) were used to calculate effective radiation dose (eRD). RESULTS: 300 patients (136 female, median age: 81 years, IQR: 76-84) underwent 302 CT examinations, with PCCT in 202, DSCT in 100; two patients underwent both. Although SNR and CNR were significantly lower in PCCT vs. DSCT images (33.0 +/- 10.5 vs. 47.3 +/- 16.4 and 47.3 +/- 14.8 vs. 59.3 +/- 21.9, P < .001, respectively), visual image quality was higher in PCCT vs. DSCT (4.8 vs. 3.3, P < .001), with moderate overall interreader agreement among radiologists and among cardiologists (kappa = 0.60, respectively). Image quality was rated as "excellent" in 160/202 (79.2%) of PCCT vs. 5/100 (5%) of DSCT cases. Readers found images suitable to depict the aortic valve hinge points and to map the femoral access path in 99% of PCCT vs. 85% of DSCT (P < 0.01), with suitability ranked significantly higher in PCCT vs. DSCT (4.8 vs. 3.3, P < .001). Mean CTDI and DLP, and thus eRD, were significantly lower for PCCT vs. DSCT (22.4 vs. 62.9; 519.4 vs. 895.5, and 8.8 +/- 4.5 mSv vs. 15.3 +/- 5.8 mSv; all P < .001). CONCLUSION: PCCT improves image quality, effectively avoids non-diagnostic CT imaging for TAVI planning, and is associated with a lower radiation dose compared to state-of-the-art DSCT. Radiologists and cardiologists found PCCT images more suitable for TAVI planning. CI - Copyright (c) 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. FAU - Dirrichs, Timm AU - Dirrichs T AD - Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. Electronic address: tdirrichs@ukaachen.de. FAU - Schroder, Jorg AU - Schroder J AD - Department of Cardiology, Angiology and Internal Intensive Care, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. FAU - Frick, Michael AU - Frick M AD - Department of Cardiology, Angiology and Internal Intensive Care, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. FAU - Huppertz, Marc AU - Huppertz M AD - Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. FAU - Iwa, Roman AU - Iwa R AD - Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. FAU - Allmendinger, Thomas AU - Allmendinger T AD - Siemens Healthcare, Computed Tomography Division, Forchheim, Germany. FAU - Mecking, Ines AU - Mecking I AD - Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. FAU - Kuhl, Christiane K AU - Kuhl CK AD - Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20240621 PL - United States TA - Acad Radiol JT - Academic radiology JID - 9440159 RN - 0 (Contrast Media) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Aged, 80 and over MH - Female MH - Male MH - Retrospective Studies MH - Aged MH - *Tomography, X-Ray Computed/methods MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Radiation Dosage MH - Photons MH - Contrast Media MH - Signal-To-Noise Ratio OTO - NOTNLM OT - Aortic Valve Stenosis OT - Cardiac CT OT - Photon Counting Computed Tomography OT - TAVI OT - TAVR COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/06/22 05:43 MHDA- 2024/11/29 05:20 CRDT- 2024/06/21 21:59 PHST- 2024/05/02 00:00 [received] PHST- 2024/06/07 00:00 [revised] PHST- 2024/06/07 00:00 [accepted] PHST- 2024/11/29 05:20 [medline] PHST- 2024/06/22 05:43 [pubmed] PHST- 2024/06/21 21:59 [entrez] AID - S1076-6332(24)00372-6 [pii] AID - 10.1016/j.acra.2024.06.014 [doi] PST - ppublish SO - Acad Radiol. 2024 Dec;31(12):4780-4789. doi: 10.1016/j.acra.2024.06.014. Epub 2024 Jun 21. PMID- 38900378 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240623 IS - 1869-4101 (Print) IS - 1869-4101 (Electronic) IS - 1869-4101 (Linking) VI - 15 IP - 1 DP - 2024 Jun 20 TI - CT imaging post-TAVI: Murphy's first law in action-preparing to recognize the unexpected. PG - 157 LID - 10.1186/s13244-024-01729-1 [doi] LID - 157 AB - Transfemoral aortic valve implantation (TAVI) has been long considered the standard of therapy for high-risk patients with severe aortic-stenosis and is now effectively employed in place of surgical aortic valve replacement also in intermediate-risk patients. The potential lasting consequences of minor complications, which might have limited impact on elderly patients, could be more noteworthy in the longer term when occurring in younger individuals. That's why a greater focus on early diagnosis, correct management, and prevention of post-procedural complications is key to achieve satisfactory results. ECG-triggered multidetector computed tomography angiography (CTA) is the mainstay imaging modality for pre-procedural planning of TAVI and is also used for post-interventional early detection of both acute and long-term complications. CTA allows detailed morphological analysis of the valve and its movement throughout the entire cardiac cycle. Moreover, stent position, coronary artery branches, and integrity of the aortic root can be precisely evaluated. Imaging reliability implies the correct technical setting of the computed tomography scan, knowledge of valve type, normal post-interventional findings, and awareness of classic and life-threatening complications after a TAVI procedure. This educational review discusses the main post-procedural complications of TAVI with a specific imaging focus, trying to clearly describe the technical aspects of CTA Imaging in post-TAVI and its clinical applications and challenges, with a final focus on future perspectives and emerging technologies. CRITICAL RELEVANCE STATEMENT: This review undertakes an analysis of the role computed tomography angiography (CTA) plays in the assessment of post-TAVI complications. Highlighting the educational issues related to the topic, empowers radiologists to refine their clinical approach, contributing to enhanced patient care. KEY POINTS: Prompt recognition of TAVI complications, ranging from value issues to death, is crucial. Adherence to recommended scanning protocols, and the optimization of tailored protocols, is essential. CTA is central in the diagnosis of TAVI complications and functions as a gatekeeper to treatment. CI - (c) 2024. The Author(s). FAU - Lisi, Costanza AU - Lisi C AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Catapano, Federica AU - Catapano F AUID- ORCID: 0000-0002-1004-5451 AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. federica.catapano@hunimed.eu. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. federica.catapano@hunimed.eu. FAU - Brilli, Federica AU - Brilli F AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Scialo, Vincenzo AU - Scialo V AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Corghi, Eleonora AU - Corghi E AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Figliozzi, Stefano AU - Figliozzi S AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Cozzi, Ottavia Francesca AU - Cozzi OF AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Monti, Lorenzo AU - Monti L AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Stefanini, Giulio Giuseppe AU - Stefanini GG AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. FAU - Francone, Marco AU - Francone M AD - Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy. AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Milan, Rozzano, Italy. LA - eng PT - Journal Article PT - Review DEP - 20240620 PL - Germany TA - Insights Imaging JT - Insights into imaging JID - 101532453 PMC - PMC11189851 OTO - NOTNLM OT - Cardiac imaging OT - Complications OT - Computed tomography angiography (CTA) OT - Transfemoral aortic valve implantation (TAVI) COIS- The authors declare that they have no competing interests. EDAT- 2024/06/20 12:44 MHDA- 2024/06/20 12:45 PMCR- 2024/06/20 CRDT- 2024/06/20 11:20 PHST- 2024/01/26 00:00 [received] PHST- 2024/05/16 00:00 [accepted] PHST- 2024/06/20 12:45 [medline] PHST- 2024/06/20 12:44 [pubmed] PHST- 2024/06/20 11:20 [entrez] PHST- 2024/06/20 00:00 [pmc-release] AID - 10.1186/s13244-024-01729-1 [pii] AID - 1729 [pii] AID - 10.1186/s13244-024-01729-1 [doi] PST - epublish SO - Insights Imaging. 2024 Jun 20;15(1):157. doi: 10.1186/s13244-024-01729-1. PMID- 38892875 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240620 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 11 DP - 2024 May 28 TI - German Experience with a Novel Balloon-Expandable Heart Valve Prosthesis for Transcatheter Aortic Valve Implantation-Outcomes of the MYLAND (MYvaL germAN stuDy) Study. LID - 10.3390/jcm13113163 [doi] LID - 3163 AB - Background: The primary objective of this study was to evaluate the initial experience in Germany with the Meril Myval (MM) transcatheter heart valve (THV) system for the treatment of severe symptomatic aortic valve stenosis. The MM THV is a novel balloon-expandable valve with an expanded sizing matrix. Contemporary patients undergoing TAVI with the established Edwards Sapien (ES) THV served as the comparator group. Methods: Between 1st March and 31 August 2020 a total of 134 patients (33% female, 80.1 +/- 6.7 years; EuroScore II 4.7 +/- 4.8) underwent TAVI with an MM (95% transfemoral) for severe aortic stenosis at six German tertiary care centers. Results: Correct positioning of the THV was achieved in 98.5% (n = 132). Mean aortic gradients (MPG) were reduced from 42 +/- 14 mmHg to 11 +/- 5 mmHg. Mild postprocedural paravalvular leak (PVL) was observed in 62% (n = 82) patients, whereas only one patient had more than mild PVL. New permanent pacemaker implantation (PPI) was indicated in 15 patients (11%). Major vascular complications occurred in 6.7% (n = 9) patients. The in-hospital combined incidence of all-cause death and stroke was 4.5% (n = 6). In the comparator group that included 268 patients, the 30-day incidences of PPI, major vascular complications, and the composite of all-cause death and stroke were 16%, 1.9%, and 7.1%, respectively; MPGs were reduced from 44 +/- 15 mmHg to 12.8 +/- 4.6 mmHg and the more than mild PVL occurred in 0.7%. Conclusions: The MM is a promising novel THV system, with performance comparable to the established ES THVs. These findings await confirmation by ongoing randomized trials. FAU - Ubben, Timm AU - Ubben T AD - Department of Cardiology, Asklepios Clinic St. Georg, 20099 Hamburg, Germany. FAU - Tigges, Eike AU - Tigges E AUID- ORCID: 0009-0007-4112-3727 AD - Department of Cardiology, Asklepios Clinic St. Georg, 20099 Hamburg, Germany. FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - Department of Cardiology and Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Holzamer, Andreas AU - Holzamer A AUID- ORCID: 0000-0002-1838-3033 AD - Department of Cardiothoracic Surgery, University of Regensburg Heart Center, 93053 Regensburg, Germany. FAU - Breitenbach, Ingo AU - Breitenbach I AUID- ORCID: 0000-0002-5308-1655 AD - Department of Cardiothoracic Surgery and Vascular Surgery, Clinic of Braunschweig, 38120 Braunschweig, Germany. FAU - Sodian, Ralf AU - Sodian R AD - Department of Cardiovascular Surgery, MediClin Herzzentrum Lahr/Baden, 77933 Lahr, Germany. FAU - Rothe, Jurgen AU - Rothe J AUID- ORCID: 0009-0002-5361-3049 AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Center-University Heart Freiburg, University of Freiburg, 79189 Bad Krozingen, Germany. FAU - Hochholzer, Willibald AU - Hochholzer W AD - Department of Cardiology and Intensive Care Medicine, Klinikum Wurzburg Mitte, 97070 Wurzburg, Germany. FAU - Hakmi, Samer AU - Hakmi S AD - Department of Cardiothoracic Surgery, Asklepios Clinic St. Georg, 20099 Hamburg, Germany. FAU - Neumann, Franz-Josef AU - Neumann FJ AD - Department of Cardiology and Angiology, Faculty of Medicine, Medical Center-University Heart Freiburg, University of Freiburg, 79189 Bad Krozingen, Germany. LA - eng GR - #12374/Meril Life Sciences (India)/ PT - Journal Article DEP - 20240528 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11172926 OTO - NOTNLM OT - aortic stenosis OT - self-expanding THV OT - transcatheter aortic valve replacement COIS- T. Ubben received travel support from Edwards Lifesciences. E. Tigges received honoraria and/or travel/support from Edwards Lifesciences and Medtronic. W. Kim is a proctor for Abbott, Boston Scientific, and Meril Life Sciences, received speaker fees from Abbott, Boston Scientific, Edwards Lifesciences, and Meril Life Sciences, advisory board member to Boston Scientific, HID Imaging. I. Breitenbach received travel support and honoraria from Meril. J. Rothe received consultancy honoraria from Medtronic, and travel support from Edwards Lifesciences, Abbott, Medtronic, Meril, and Boston. W. Hochholzer received consultancy honoraria from Daiichi Sankyo, The Medicines Company, and Ferrer and reports speaker honoraria from AstraZeneca, Bayer Vital, Bristol-Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, and feo GmbH as well as research grants paid to his former institution from German Heart Foundation, Novartis, and Sysmex. S. Hakmi received honoraria and/or travel/support from Edwards Lifesciences. F.-J. Neumann received consultancy honoraria from Novartis and Meril, speaker honoraria from Boston, Amgen, Daiichi-Sankyo, and Meril and reports speaker honoraria paid to his institution from BMS/Pfizer, Daiichi-Sankyo, Boston, Siemens, Amgen as well as research grants paid to his institution from Boston and Abbott. EDAT- 2024/06/19 06:42 MHDA- 2024/06/19 06:43 PMCR- 2024/05/28 CRDT- 2024/06/19 01:13 PHST- 2024/03/02 00:00 [received] PHST- 2024/04/10 00:00 [revised] PHST- 2024/05/24 00:00 [accepted] PHST- 2024/06/19 06:43 [medline] PHST- 2024/06/19 06:42 [pubmed] PHST- 2024/06/19 01:13 [entrez] PHST- 2024/05/28 00:00 [pmc-release] AID - jcm13113163 [pii] AID - jcm-13-03163 [pii] AID - 10.3390/jcm13113163 [doi] PST - epublish SO - J Clin Med. 2024 May 28;13(11):3163. doi: 10.3390/jcm13113163. PMID- 38860614 OWN - NLM STAT- MEDLINE DCOM- 20241114 LR - 20250507 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 3 DP - 2024 Sep TI - Outcomes of transfemoral TAVR using two new-generation devices in patients with horizontal aorta. PG - 591-599 LID - 10.1002/ccd.31094 [doi] AB - BACKGROUND: Challenging anatomies and comorbidities have impact on success in transcatheter aortic valve replacement (TAVR). There is controversy whether the extent of the aortic angle (AA) has an impact on procedural outcomes. Matched comparative outcome data of new generation transcatheter heart valves (THVs) in horizontal aorta (HA) are scarce. METHODS: A total of 1582 patients with severe native aortic stenosis (AS) treated with the SAPIEN3 Ultra (Ultra; n = 526) or ACURATE Neo2 (Neo2; n = 1056) THVs from January 2017 to January 2023 were analyzed. Patients with non-horizontal aortas (AA < 51.7 degrees , n = 841) were excluded. The population was matched by 1-to-1 nearest-neighbor matching (Ultra, n = 246; Neo2, n = 246). Clinical and procedural outcome were evaluated according to VARC-3 recommendations. RESULTS: Technical success (93.1% vs. 94.7%, p = 0.572) was high after Ultra and Neo2. Device success (80.5% vs. 89.8%, p = 0.05) was inferior with Ultra. Neo2 reveals superior hemodynamic properties with lower rate of severe prosthesis patient mismatch (12.0% vs. 3.7%, p = 0.001) and elevated gradients ( >/= 20 mmHg: 11.9% vs. 1.7%, p < 0.001). Ultra showed a lower rate of relevant paravalvular regurgitation ( > mild paravalvular regurgitation or Valve-in-Valve due to paravalvular regurgitation: 0.0% vs. 3.7%, p = 0.004). The rate of procedural bailout maneuvers (0.8% vs. 0.4%, p = 1.000) and thirty-day all-cause mortality (1.3% vs. 2.2%, p = 0.496) was similar. CONCLUSION: Transfemoral TAVR in patients with severe aortic stenosis and HA, using the balloon expandable Sapien3 Ultra and self-expanding ACURATE Neo2 prosthesis, is feasible and safe. Therefore, valve selection between these platforms should be made irrespective of the aortic angle by a team experienced with both valves based on their specific advantages. Large, randomized trials in this sub-group of patients would be necessary to compare long term outcomes. CI - (c) 2024 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Eckel, Clemens AU - Eckel C AUID- ORCID: 0000-0002-8853-8096 AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany. AD - Carl von Ossietzky Universitat Oldenburg, School VI, School of Medicine and Health Sciences, Oldenburg, Germany. FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Wasif, Botros AU - Wasif B AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany. FAU - Grothusen, Christina AU - Grothusen C AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany. AD - Department of Cardiac Surgery, University of Kiel, Kiel, Germany. FAU - Elsasser, Albrecht AU - Elsasser A AD - Carl von Ossietzky Universitat Oldenburg, School VI, School of Medicine and Health Sciences, Oldenburg, Germany. FAU - Dohmen, Guido AU - Dohmen G AD - Department of Cardiac Surgery, St. Johannes Hospital, Dortmund, Germany. FAU - Charitos, Efstratios I AU - Charitos EI AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Sossalla, Samuel AU - Sossalla S AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany. FAU - Blumenstein, Johannes AU - Blumenstein J AUID- ORCID: 0000-0003-1032-7472 AD - Department of Cardiology, St. Johannes Hospital, Dortmund, Germany. AD - Carl von Ossietzky Universitat Oldenburg, School VI, School of Medicine and Health Sciences, Oldenburg, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20240611 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects/mortality MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging/mortality MH - *Heart Valve Prosthesis MH - Female MH - Treatment Outcome MH - Male MH - *Prosthesis Design MH - Aged, 80 and over MH - Aged MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - *Femoral Artery/physiopathology MH - *Hemodynamics MH - Time Factors MH - Risk Factors MH - *Severity of Illness Index MH - Retrospective Studies MH - Catheterization, Peripheral/adverse effects/instrumentation MH - Recovery of Function MH - Punctures OTO - NOTNLM OT - Acurate OT - Neo2 OT - Sapien OT - TAVR OT - horizontal aorta OT - ultra EDAT- 2024/06/11 12:44 MHDA- 2024/11/14 18:30 CRDT- 2024/06/11 07:33 PHST- 2024/04/10 00:00 [revised] PHST- 2024/02/13 00:00 [received] PHST- 2024/05/15 00:00 [accepted] PHST- 2024/11/14 18:30 [medline] PHST- 2024/06/11 12:44 [pubmed] PHST- 2024/06/11 07:33 [entrez] AID - 10.1002/ccd.31094 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Sep;104(3):591-599. doi: 10.1002/ccd.31094. Epub 2024 Jun 11. PMID- 38845242 OWN - NLM STAT- MEDLINE DCOM- 20240912 LR - 20240912 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 33 IP - 9 DP - 2024 Sep TI - Post-Procedure Monocyte Count Levels Predict Major Adverse Cardiovascular Events (MACE) Following Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis. PG - 1340-1347 LID - S1443-9506(24)00196-3 [pii] LID - 10.1016/j.hlc.2024.03.013 [doi] AB - BACKGROUND: Aortic stenosis has recently been characterised as having an inflammatory aetiology, beyond the traditional degenerative model. Recruitment of monocytes has been associated with inflammation contributing to progression of calcific aortic-valve disease. Prior research has demonstrated that pre-procedure inflammatory biomarkers do not consistently discriminate poorer outcomes in those with aortic stenosis. It remains, however, unclear if postprocedure inflammatory biomarkers, which are influenced by intraprocedural pro-inflammatory insults, can predict major adverse cardiovascular events (MACE) post transcatheter aortic valve implantation (TAVI). METHOD: All patients with postprocedure monocyte levels undergoing transcatheter aortic valve implantation at The Alfred Hospital, Melbourne, Australia (2008-2019) were included. The highest monocyte count from postprocedure days 1 to 3 was used. Patients were divided into "high" or "low" postprocedure monocyte count groups using the Youden Index. The incidence of 30-day MACE a composite of stroke, acute myocardial infarction, and death) was then compared. RESULTS: In total, 472 patients were included (54% men, median age 84 years). Fourteen (14) patients (3%) suffered a 30-day MACE. Those with high postprocedure monocyte count were more likely to: be hypertensive (p=0.049); have a higher Society of Thoracic Surgeons risk score (p=0.032); and, undergo non-transfemoral access (p=0.018). A high (>/=0.975) postprocedure monocyte count was significantly associated with 30-day MACE (odds ratio [OR] 1.16 for each 0.1 increase in monocyte, p=0.025). This association remained present on multivariable analysis adjusted for age, sex, Society of Thoracic Surgeons risk score, and self-expanding valve prosthesis type (OR 1.17, p=0.028). CONCLUSIONS: The association between postprocedure monocytosis and 30-day MACE suggests that minimising peri-procedural inflammatory insults may improve outcomes. This inexpensive and readily available biomarker may also aid in tailored risk stratification for patients. CI - Copyright (c) 2024 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Navani, Rohan V AU - Navani RV AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. Electronic address: https://www.twitter.com/RohanNavani. FAU - Dayawansa, Nalin H AU - Dayawansa NH AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Atherothrombosis and Vascular Biology Laboratory, Baker Heart & Diabetes Institute, Melbourne, Vic, Australia; School of Translational Medicine, Monash University, Melbourne, Vic, Australia. FAU - Nanayakkara, Shane AU - Nanayakkara S AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Atherothrombosis and Vascular Biology Laboratory, Baker Heart & Diabetes Institute, Melbourne, Vic, Australia; School of Translational Medicine, Monash University, Melbourne, Vic, Australia. FAU - Palmer, Sonny AU - Palmer S AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Medicine, The University of Melbourne, Melbourne, Vic, Australia. FAU - Noaman, Samer AU - Noaman S AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. FAU - Htun, Nay M AU - Htun NM AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. FAU - Walton, Antony S AU - Walton AS AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; School of Translational Medicine, Monash University, Melbourne, Vic, Australia. FAU - Peter, Karlheinz AU - Peter K AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Atherothrombosis and Vascular Biology Laboratory, Baker Heart & Diabetes Institute, Melbourne, Vic, Australia; School of Translational Medicine, Monash University, Melbourne, Vic, Australia. FAU - Stub, Dion AU - Stub D AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; School of Translational Medicine, Monash University, Melbourne, Vic, Australia. Electronic address: d.stub@alfred.org.au. LA - eng PT - Journal Article DEP - 20240606 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 0 (Biomarkers) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery/blood MH - Male MH - Female MH - *Monocytes MH - Aged, 80 and over MH - Leukocyte Count MH - *Postoperative Complications/blood/epidemiology/diagnosis MH - Retrospective Studies MH - Risk Factors MH - Follow-Up Studies MH - Aged MH - Aortic Valve/surgery MH - Incidence MH - Australia/epidemiology MH - Biomarkers/blood OTO - NOTNLM OT - Aortic stenosis OT - Biomarker OT - Inflammation OT - Monocyte count OT - TAVI COIS- Conflicts of Interest There are no conflicts of interest to disclose. EDAT- 2024/06/07 06:42 MHDA- 2024/09/13 00:46 CRDT- 2024/06/07 02:04 PHST- 2024/01/03 00:00 [received] PHST- 2024/03/23 00:00 [revised] PHST- 2024/03/25 00:00 [accepted] PHST- 2024/09/13 00:46 [medline] PHST- 2024/06/07 06:42 [pubmed] PHST- 2024/06/07 02:04 [entrez] AID - S1443-9506(24)00196-3 [pii] AID - 10.1016/j.hlc.2024.03.013 [doi] PST - ppublish SO - Heart Lung Circ. 2024 Sep;33(9):1340-1347. doi: 10.1016/j.hlc.2024.03.013. Epub 2024 Jun 6. PMID- 38842977 OWN - NLM STAT- MEDLINE DCOM- 20240828 LR - 20260709 IS - 2405-5018 (Electronic) IS - 2405-500X (Linking) VI - 10 IP - 8 DP - 2024 Aug TI - Machine Learning of Cardiac Anatomy and the Risk of New-Onset Atrial Fibrillation After TAVR. PG - 1873-1884 LID - S2405-500X(24)00284-6 [pii] LID - 10.1016/j.jacep.2024.04.006 [doi] AB - BACKGROUND: New-onset atrial fibrillation (NOAF) occurs in 5% to 15% of patients who undergo transfemoral transcatheter aortic valve replacement (TAVR). Cardiac imaging has been underutilized to predict NOAF following TAVR. OBJECTIVES: The objective of this analysis was to compare and assess standard, manual echocardiographic and cardiac computed tomography (cCT) measurements as well as machine learning-derived cCT measurements of left atrial volume index and epicardial adipose tissue as risk factors for NOAF following TAVR. METHODS: The study included 1,385 patients undergoing elective, transfemoral TAVR for severe, symptomatic aortic stenosis. Each patient had standard and machine learning-derived measurements of left atrial volume and epicardial adipose tissue from cardiac computed tomography. The outcome of interest was NOAF within 30 days following TAVR. We used a 2-step statistical model including random forest for variable importance ranking, followed by multivariable logistic regression for predictors of highest importance. Model discrimination was assessed by using the C-statistic to compare the performance of the models with and without imaging. RESULTS: Forty-seven (5.0%) of 935 patients without pre-existing atrial fibrillation (AF) experienced NOAF. Patients with pre-existing AF had the largest left atrial volume index at 76.3 +/- 28.6 cm(3)/m(2) followed by NOAF at 68.1 +/- 26.6 cm(3)/m(2) and then no AF at 57.0 +/- 21.7 cm(3)/m(2) (P < 0.001). Multivariable regression identified the following risk factors in association with NOAF: left atrial volume index >/=76 cm(2) (OR: 2.538 [95% CI: 1.165-5.531]; P = 0.0191), body mass index <22 kg/m(2) (OR: 4.064 [95% CI: 1.500-11.008]; P = 0.0058), EATv (OR: 1.007 [95% CI: 1.000-1.014]; P = 0.043), aortic annulus area >/=659 mm(2) (OR: 6.621 [95% CI: 1.849-23.708]; P = 0.004), and sinotubular junction diameter >/=35 mm (OR: 3.891 [95% CI: 1.040-14.552]; P = 0.0435). The C-statistic of the model was 0.737, compared with 0.646 in a model that excluded imaging variables. CONCLUSIONS: Underlying cardiac structural differences derived from cardiac imaging may be useful in predicting NOAF following transfemoral TAVR, independent of other clinical risk factors. CI - Copyright (c) 2024 American College of Cardiology Foundation. All rights reserved. FAU - Brahier, Mark S AU - Brahier MS AD - Duke University Hospital, Durham North Carolina, USA; Georgetown University Medical Center, Washington, DC, USA; Electrophysiology Section, Duke Heart Center, Duke University Hospital & Duke Clinical Research Institute, Durham, North Carolina, USA. Electronic address: mark.brahier1@gmail.com. FAU - Kochi, Shwetha AU - Kochi S AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Huang, Julia AU - Huang J AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Piliponis, Emma AU - Piliponis E AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Smith, Andrew AU - Smith A AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Johnson, Adam AU - Johnson A AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Poian, Suraya AU - Poian S AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Abdulkareem, Musa AU - Abdulkareem M AD - Barts Heart Centre, Barts Health National Health Service (NHS) Trust, London, United Kingdom; National Institute for Health Research (NIHR) Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Health Data Research UK, London, United Kingdom. FAU - Ma, Xiaoyang AU - Ma X AD - Georgetown University Medical Center, Washington, DC, USA. FAU - Wu, Colin AU - Wu C AD - National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA. FAU - Piccini, Jonathan P AU - Piccini JP AD - Electrophysiology Section, Duke Heart Center, Duke University Hospital & Duke Clinical Research Institute, Durham, North Carolina, USA. FAU - Petersen, Steffen AU - Petersen S AD - Barts Heart Centre, Barts Health National Health Service (NHS) Trust, London, United Kingdom; National Institute for Health Research (NIHR) Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Health Data Research UK, London, United Kingdom; The Alan Turing Institute, London, United Kingdom. FAU - Vargas, Jose D AU - Vargas JD AD - Veterans Affairs Medical Center, Washington, DC, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240605 PL - United States TA - JACC Clin Electrophysiol JT - JACC. Clinical electrophysiology JID - 101656995 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Atrial Fibrillation/surgery/diagnostic imaging MH - *Machine Learning MH - Female MH - Male MH - Aged MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/diagnostic imaging MH - Risk Factors MH - Echocardiography MH - Tomography, X-Ray Computed MH - Heart Atria/diagnostic imaging/anatomy & histology MH - Postoperative Complications/diagnostic imaging/epidemiology OTO - NOTNLM OT - TAVR OT - cardiac imaging OT - machine learning OT - new-onset atrial fibrillation COIS- Funding Support and Author Disclosures This work was supported by the National Institute for Health and Care Research Barts Biomedical Research Centre (NIHR203330); a delivery partnership of Barts Health NHS Trust, Queen Mary University of London, St George's University Hospitals NHS Foundation Trust and St George's University of London. Drs Abdulkareem and Petersen receive support from the CAP-AI programme (led by Capital Enterprise in partnership with Barts Health NHS Trust and Digital Catapult and funded by the European Regional Development Fund and Barts Charity) and Health Data Research UK (HDR UK-an initiative funded by UK Research and Innovation, Department of Health and Social Care (England) and the devolved administrations, and leading medical research charities). Dr Petersen also receives support from the SmartHeart EPSRC programme grant (EP/P001009/1) and the London Medical Imaging and AI Center for Value-Based Healthcare; and has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 825903 (euCanSHare project). DrPiccini is supported by National Institutes of Aging grant R01AG074185. He has also received grants for clinical research from Abbott, the American Heart Association, the Association for the Advancement of Medical Instrumentation, Bayer, Boston Scientific, iRhythm, and Philips; and serves as a consultant to Abbott, Abbvie, ARCA biopharma, Bayer, Boston Scientific, Bristol Myers Squibb (Myokardia), Element Science, Itamar Medical, LivaNova, Medtronic, Milestone, ElectroPhysiology Frontiers, ReCor, Sanofi, Philips, and Up-to-Date. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/06/06 19:05 MHDA- 2024/08/31 09:53 CRDT- 2024/06/06 12:16 PHST- 2023/10/24 00:00 [received] PHST- 2024/03/01 00:00 [revised] PHST- 2024/04/09 00:00 [accepted] PHST- 2024/08/31 09:53 [medline] PHST- 2024/06/06 19:05 [pubmed] PHST- 2024/06/06 12:16 [entrez] AID - S2405-500X(24)00284-6 [pii] AID - 10.1016/j.jacep.2024.04.006 [doi] PST - ppublish SO - JACC Clin Electrophysiol. 2024 Aug;10(8):1873-1884. doi: 10.1016/j.jacep.2024.04.006. Epub 2024 Jun 5. PMID- 38837174 OWN - NLM STAT- MEDLINE DCOM- 20240917 LR - 20250902 IS - 1941-7632 (Electronic) IS - 1941-7640 (Print) IS - 1941-7640 (Linking) VI - 17 IP - 9 DP - 2024 Sep TI - Impact of Cerebral Embolic Protection Devices on Disabling Stroke After TAVR: Updated Results From the STS/ACC TVT Registry. PG - e013697 LID - 10.1161/CIRCINTERVENTIONS.123.013697 [doi] AB - BACKGROUND: Cerebral embolic protection devices (EPDs) were developed to mitigate the risk of stroke during transcatheter aortic valve replacement (TAVR), but their benefit remains unproven. In the PROTECTED-TAVR trial (Stroke Protection With Sentinel During Transcatheter), EPD use did not reduce periprocedural stroke (primary study outcome) but led to a 62% reduction in the secondary end point of disabling stroke. Given these results, the impact of EPDs during TAVR remains unclear. METHODS: We used STS/ACC TVT registry data to examine the association between EPD use and a proxy for disabling stroke among transfemoral TAVR patients between January 2018 and June 2023. The primary outcome was in-hospital disabling stroke-defined as stroke associated with either in-hospital death or discharge to a nonhome location. We evaluated the association between EPD use and disabling stroke using instrumental variable analysis with a site-level preference for EPD use as the instrument-a quasi-experimental approach that can support causal inference. In addition, we performed a propensity score-based comparison using overlap weighting as a secondary analysis. RESULTS: The study population consisted of 414 649 patients of whom 53 389 (12.9%) received an EPD. The unadjusted rate of in-hospital disabling stroke was 0.7% among the EPD group and 0.9% in the no-EPD group. EPD use was associated with a reduction in disabling stroke in both instrumental variable analysis (relative risk, 0.87 [95% CI, 0.73-1.00]) and propensity-weighted analysis (odds ratio, 0.79 [95% CI, 0.70-0.90]) but was not associated with a reduction in nondisabling stroke. In subgroup analyses, the benefit of EPD was greater among those with versus without prior stroke (P(interaction)<0.05 for both instrumental variable and propensity-weighted analyses). CONCLUSIONS: In the largest study to date, among patients undergoing TAVR, EPD use was associated with a small, borderline significant reduction in stroke associated with death or discharge to a nonhome location (a proxy for disabling stroke) that is likely to be causal in nature. Taken together with previous mechanistic and clinical studies, these findings provide credible evidence that EPDs benefit patients undergoing TAVR. FAU - Butala, Neel M AU - Butala NM AUID- ORCID: 0000-0001-6937-4041 AD - Rocky Mountain Regional VA Medical Center, Aurora, CO (N.M.B.). AD - University of Colorado School of Medicine, Aurora (N.M.B., J.C.M.). FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Cleveland Clinic Foundation, OH (S.K.). FAU - Secemsky, Eric A AU - Secemsky EA AUID- ORCID: 0000-0003-3861-3163 AD - Richard and Susan Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., R.W.Y.). FAU - Gallup, Dianne AU - Gallup D AUID- ORCID: 0009-0000-1763-6687 AD - Duke Clinical Research Institute, Durham, NC (D.G., A.S.K., S.V.). FAU - Kosinski, Andrzej S AU - Kosinski AS AUID- ORCID: 0000-0003-4151-5185 AD - Duke Clinical Research Institute, Durham, NC (D.G., A.S.K., S.V.). FAU - Vemulapalli, Sreekanth AU - Vemulapalli S AUID- ORCID: 0000-0003-1599-2957 AD - Duke Clinical Research Institute, Durham, NC (D.G., A.S.K., S.V.). FAU - Messenger, John C AU - Messenger JC AUID- ORCID: 0000-0003-0501-1000 AD - University of Colorado School of Medicine, Aurora (N.M.B., J.C.M.). FAU - Yeh, Robert W AU - Yeh RW AUID- ORCID: 0000-0002-0564-4468 AD - Richard and Susan Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., R.W.Y.). FAU - Cohen, David J AU - Cohen DJ AUID- ORCID: 0000-0001-9163-724X AD - Cardiovascular Research Foundation, New York (D.J.C.). AD - St. Francis Hospital, Roslyn, NY (D.J.C.). LA - eng GR - K23 HL150290/HL/NHLBI NIH HHS/United States GR - K24 HL150321/HL/NHLBI NIH HHS/United States GR - R01 HL136708/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study DEP - 20240605 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM CIN - Circ Cardiovasc Interv. 2024 Sep;17(9):e014374. doi: 10.1161/CIRCINTERVENTIONS.124.014374. PMID: 38837134 MH - Humans MH - *Registries MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Male MH - *Embolic Protection Devices MH - Female MH - Aged, 80 and over MH - Aged MH - Risk Factors MH - Treatment Outcome MH - Risk Assessment MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality/physiopathology MH - Time Factors MH - United States/epidemiology MH - Hospital Mortality MH - Intracranial Embolism/prevention & control/etiology/mortality MH - Disability Evaluation MH - Stroke/prevention & control/mortality/etiology/diagnosis MH - Protective Factors MH - Retrospective Studies PMC - PMC11408089 MID - NIHMS1996837 OTO - NOTNLM OT - clinical studies OT - death OT - instrumental variable OT - outcomes research OT - stroke OT - transcatheter aortic valve replacement COIS- The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the US Government, or the National Institutes of Health. Dr Butala is supported by grants from the Boettcher Foundation and the American Heart Association and reports consulting fees from Shockwave Medical and Boston Scientific and consulting fees and ownership interest in HiLabs and Catch Bio, outside the current work. Dr Yeh is a Special Government Employee of the US Food and Drug Administration. He has institutional research grants with the US FDA, Boston Scientific, Abbott Vascular and Medtronic. He is a consultant for Abbott Vascular, Boston Scientific, Elixir Medical, InfraRedx, Medtronic, Shockwave Medical, and Zoll. Dr Messenger reports institutional grant support from Philips Medical Systems and Medtronic. Dr Cohen reports institutional research grants from Boston Scientific, Edwards Lifesciences, Medtronic, Abbott, Zoll, IRhythm, Corvia, Philips, CathWorks, and Ancora. He is a consultant to Abbott, Boston Scientific, Edwards Lifesciences, and Heartbeam. Dr Vemulapalli reports grants/contracts from: American College of Cardiology, Society of Thoracic Surgeons, National Institutes of Health (R01 and UG3), Cytokinetics, Abbott Vascular, Boston Scientific. Consulting/Advisory Board: Astra Zeneca, Medtronic, Boehringer Ingelheim, Veralox Therapeutics, Icon, HeartFlow, TotalCME. EDAT- 2024/06/05 13:12 MHDA- 2024/09/17 10:44 PMCR- 2025/09/01 CRDT- 2024/06/05 11:42 PHST- 2024/09/17 10:44 [medline] PHST- 2024/06/05 13:12 [pubmed] PHST- 2024/06/05 11:42 [entrez] PHST- 2025/09/01 00:00 [pmc-release] AID - 10.1161/CIRCINTERVENTIONS.123.013697 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2024 Sep;17(9):e013697. doi: 10.1161/CIRCINTERVENTIONS.123.013697. Epub 2024 Jun 5. PMID- 38829939 OWN - NLM STAT- MEDLINE DCOM- 20240603 LR - 20260310 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 25 IP - 7 DP - 2024 Jul 1 TI - Mitral regurgitation carries greater prognostic significance than mitral stenosis in patients undergoing transcatheter aortic valve replacement. PG - 529-538 LID - 10.2459/JCM.0000000000001629 [doi] AB - AIMS: This study assessed the outcomes of concomitant mitral valve disease and severe aortic stenosis in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: Echocardiographic data of 813 patients with severe aortic stenosis undergoing transfemoral TAVR were collected, and clinical outcomes were analyzed for individuals with mitral stenosis and mitral regurgitation. RESULTS: The final cohort includes 788 patients with severe calcific aortic stenosis. Among single parameters of mitral stenosis, a smaller baseline mitral valve area (MVA) by the continuity equation and higher postprocedural mean mitral gradients (MMG) were associated with an increased risk of death at 1 year (P-values 0.02 and <0.01, respectively), but no correlation with outcomes was demonstrated after multivariate adjustment for major prognosticators. Mitral stenosis (based on MVA + MMG) was not associated with complications or mortality. Mitral regurgitation was present in 94.6% of the population at baseline and regressed by at least one grade post-TAVR in 28% of the patients. The improvement in mitral regurgitation was associated with a greater prosthetic effective orifice area (P-value 0.03). Significant (at least moderate) residual mitral regurgitation was correlated with short-term complications and shown to be an independent predictor of 1-year mortality (P-value 0.02, odds ratio (OR) 5.37, confidence interval 1.34-21.5). CONCLUSION: Mitral regurgitation has a greater impact on TAVR patients than mitral stenosis as assessed by functional methods. CI - Copyright (c) 2024 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Polizzi, Giovanni AU - Polizzi G AD - Department of Cardiology, The Texas Heart Institute, Houston, TX, USA. FAU - Campos, Karla AU - Campos K AD - Center for Women's Heart and Vascular Health, The Texas Heart Institute, Houston, TX, USA. FAU - Coulter, Stephanie Alyse AU - Coulter SA AD - Department of Cardiology, The Texas Heart Institute, Houston, TX, USA. AD - Center for Women's Heart and Vascular Health, The Texas Heart Institute, Houston, TX, USA. LA - eng PT - Journal Article DEP - 20240514 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - Aortic Valve, Calcification of SB - IM MH - Humans MH - Male MH - Female MH - *Mitral Valve Stenosis/surgery/diagnostic imaging/mortality/physiopathology/complications MH - *Mitral Valve Insufficiency/surgery/physiopathology/mortality/diagnostic imaging/complications MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology/complications MH - Aged MH - Treatment Outcome MH - Severity of Illness Index MH - Retrospective Studies MH - Prognosis MH - Risk Factors MH - Aortic Valve/surgery/diagnostic imaging/physiopathology/pathology MH - Calcinosis/mortality/diagnostic imaging/complications MH - Mitral Valve/diagnostic imaging/surgery/physiopathology MH - Echocardiography EDAT- 2024/06/03 18:42 MHDA- 2024/06/03 18:43 CRDT- 2024/06/03 14:03 PHST- 2024/06/03 18:43 [medline] PHST- 2024/06/03 18:42 [pubmed] PHST- 2024/06/03 14:03 [entrez] AID - 01244665-202407000-00007 [pii] AID - 10.2459/JCM.0000000000001629 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2024 Jul 1;25(7):529-538. doi: 10.2459/JCM.0000000000001629. Epub 2024 May 14. PMID- 40791951 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250816 IS - 1523-3855 (Print) IS - 2167-6275 (Electronic) IS - 1523-3855 (Linking) VI - 14 IP - 2 DP - 2024 Jun TI - Postoperative Acute Kidney Injury After Transcatheter Aortic Valve Replacement. PG - 312-317 LID - 10.1007/s40140-024-00626-z [doi] AB - PURPOSE OF REVIEW: The purpose of this review serves to briefly summarize the current literature surveying the incidence of posttranscatheter aortic valve replacement acute kidney injury (TAVR AKI). Furthermore, this review extends itself to evaluate and potentially address modifiable risk factors, while acknowledging non-modifiable risk factors in the perioperative setting. These modifiable risk factors include but are not limited to access method, perioperative hypotension events, and need for blood transfusion in the setting of preoperative anemia. RECENT FINDINGS: Recent retrospective studies have highlighted the incidence of post-TAVR AKI, citing as high as 1 in 6 patients. Despite exclusion of patients with end-stage renal disease (ESRD) from pivotal TAVR trials, data shows that over 50% of high-risk patients suffer > 3a chronic kidney disease (CKD) and about 10% of them suffer > 4 CKD, with the risk of AKI increasing significantly at each stage of CKD advancement. Meta-analyses have shown that patients who underwent TAVR via transfemoral (TF) approach compared to those who had transapical (TA) or transaortic (TaO) approach had significantly less AKI post-TAVR. Furthermore, in patients who developed post-TAVR AKI, 55% of them had received packed red blood cell (pRBC) transfusion, while only 21% of the patients who did not receive pRBCs develop post-TAVR AKI (p = .002). Post-TAVR AKI has been shown in multiple studies that it is an independent risk factor for increased short term and long-term mortality. These findings together highlight both the clinical significance and continued perioperative vigilance to further improve clinical outcomes. SUMMARY: This review aims to summarize recent literature regarding the association of AKI in the perioperative setting of TAVR. In addition, it parses the risk factors into both modifiable and non-modifiable risk factors. Furthermore, it provides some recommendations including procedure approach, appreciating transfusion implication, and most importantly, preventing hypotension events in the perioperative period. FAU - Ayala, Sebastian AU - Ayala S AD - Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USA. FAU - Ma, Zhengmin AU - Ma Z AD - The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. FAU - Peng, Ke AU - Peng K AD - The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. FAU - Ji, Fuhai AU - Ji F AD - The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. FAU - Li, David AU - Li D AD - Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USA. LA - eng GR - UL1 TR000002/TR/NCATS NIH HHS/United States PT - Journal Article DEP - 20240401 PL - United States TA - Curr Anesthesiol Rep JT - Current anesthesiology reports JID - 100888957 PMC - PMC12338116 MID - NIHMS2045606 OTO - NOTNLM OT - Acute kidney injury OT - Cardiac OT - TAVR COIS- Competing Interests The authors declare no competing interests. EDAT- 2024/06/01 00:00 MHDA- 2024/06/01 00:01 PMCR- 2025/08/11 CRDT- 2025/08/12 05:21 PHST- 2024/06/01 00:01 [medline] PHST- 2024/06/01 00:00 [pubmed] PHST- 2025/08/12 05:21 [entrez] PHST- 2025/08/11 00:00 [pmc-release] AID - 10.1007/s40140-024-00626-z [doi] PST - ppublish SO - Curr Anesthesiol Rep. 2024 Jun;14(2):312-317. doi: 10.1007/s40140-024-00626-z. Epub 2024 Apr 1. PMID- 38817364 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240601 IS - 2056-5623 (Print) IS - 2056-5623 (Electronic) IS - 2056-5623 (Linking) VI - 10 IP - 1 DP - 2024 TI - Trans-femoral versus trans-carotid access for transcatheter aortic valve replacement: an updated systematic review and meta-analysis. PG - FSO930 LID - 10.2144/fsoa-2023-0101 [doi] LID - FSO930 AB - Aim: This meta-analysis aims to shed light on any primacy the trans-carotid (TC-TAVR) access may have over the trans-femoral access (TF-TAVR) for those undergoing transcatheter aortic valve replacement (TAVR). Methods: PubMed/MEDLINE and Cochrane Library were searched, from inception to March 2023 retrieving seven adjusted studies with a total of 6609 patients, of which 5048 underwent TF-TAVR while 1561 underwent TC-TAVR. Results: No divergence in risk of mortality, major bleeding or stroke/transient ischemic attack in TC-TAVR when compared with TF-TAVR was found. In TC-TAVR, the risk of vascular complications was low (OR: 0.51, 95% CI: 0.32-0.83, p = 0.003) as compared with TF-TAVR. Conclusion: As of this analysis, the viability of TC-TAVR as first alternative to TF-TAVR is plausible. CI - (c) 2024 The Authors. FAU - Yamani, Naser AU - Yamani N AD - Division of Cardiology, University of Arizona Phoenix Medical Center, AZ 85721, USA. FAU - Ali, Syed Hasham AU - Ali SH AUID- ORCID: 0000-0001-8452-4052 AD - Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Sadiq, Mahnoor AU - Sadiq M AUID- ORCID: 0000-0001-6280-8492 AD - Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Ahmed, Afeera B AU - Ahmed AB AUID- ORCID: 0000-0002-3280-9723 AD - Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Bhojwani, Kapil D AU - Bhojwani KD AD - Faculty of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Lohana, Vivek P AU - Lohana VP AUID- ORCID: 0000-0002-2119-2182 AD - Faculty of Medicine, Dow International Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Fatmah, Saba AU - Fatmah S AUID- ORCID: 0000-0002-6555-7796 AD - Faculty of Medicine, Karachi Medical & Dental College, Karachi, 74700, Pakistan. FAU - Khalid, Shazra AU - Khalid S AUID- ORCID: 0000-0003-4003-8321 AD - Faculty of Medicine, Sindh Medical College, Jinnah Sindh Medical University, Karachi, 75510, Pakistan. FAU - Shamsi, Hammad R AU - Shamsi HR AUID- ORCID: 0000-0001-7685-4369 AD - Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Zehra, Batool AU - Zehra B AUID- ORCID: 0000-0002-8738-7898 AD - Faculty of Medicine, Karachi Medical & Dental College, Karachi, 74700, Pakistan. FAU - Fatima, Kaneez AU - Fatima K AD - Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan. FAU - Baloch, Zulfiqar Q AU - Baloch ZQ AD - Division of Cardiology, Sparrow Hospital, Michigan State University, MI 48912, USA. LA - eng PT - Journal Article PT - Review DEP - 20240515 PL - England TA - Future Sci OA JT - Future science OA JID - 101665030 PMC - PMC11137775 OTO - NOTNLM OT - cardiology OT - cardiovascular OT - outcomes research OT - surgery COIS- The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. EDAT- 2024/05/31 06:42 MHDA- 2024/05/31 06:43 PMCR- 2024/05/15 CRDT- 2024/05/31 03:45 PHST- 2024/05/31 06:43 [medline] PHST- 2024/05/31 06:42 [pubmed] PHST- 2024/05/31 03:45 [entrez] PHST- 2024/05/15 00:00 [pmc-release] AID - 2341468 [pii] AID - 10.2144/fsoa-2023-0101 [doi] PST - epublish SO - Future Sci OA. 2024 May 15;10(1):FSO930. doi: 10.2144/fsoa-2023-0101. eCollection 2024. PMID- 38797283 OWN - NLM STAT- MEDLINE DCOM- 20241129 LR - 20261002 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 40 IP - 11 DP - 2024 Nov TI - Outcomes and Safety of Transcaval Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. PG - 2054-2062 LID - S0828-282X(24)00407-0 [pii] LID - 10.1016/j.cjca.2024.05.016 [doi] AB - BACKGROUND: The transcaval (TCv) vascular approach is increasingly used in transcatheter aortic valve replacement (TAVR) in patients unsuitable for the gold-standard transfemoral approach. We aimed to evaluate the efficacy, safety, and clinical outcomes associated with TCv-TAVR. METHODS: A systematic review and meta-analysis was conducted by searching PubMed/Medline, Embase, and the Cochrane Library for all articles assessing the TCv approach published through December 2023. Outcomes included 30-day and 1-year all-cause mortality (ACM), 30-day rehospitalisation, perioperative complications and postoperative complications at 30 days. The meta-analysis was registered on the PROSPERO database with the identifier CRD42024501921. RESULTS: A total of 8 studies with 467 patients were included. TCv-TAVR procedures achieved a success rate of 98.5%. TCv-TAVR was associated with a 30-day ACM rate of 6.1% (95% confidence interval [CI]: 3.9%-8.2%), a 1-year ACM rate of 14.9% (95% CI 2.3%-27.6%) and a 30-day rehospitalisation rate of 4.2% (95% CI -2.2% to 10.6%). Postoperative stroke or transient ischemic attack, major vascular complications, and major or life-threatening bleeding occurred in 3.3%, 8.7%, and 7.5% of cases, respectively. Cumulative meta-analyses showed a temporal trend of decreasing rates of vascular complications. CONCLUSIONS: The TCv approach in TAVR demonstrated a reassuring efficacy and safety profile, with mortality and postoperative complication rates similar to those reported for supra-aortic alternative TAVR access routes. The temporal decrease in vascular complications suggests potential improvements in procedural techniques and device technology. These findings further support the TCv approach as a viable option in patients ineligible for the transfemoral access. PROSPERO: CRD42024501921. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Salihu, Adil AU - Salihu A AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Ferlay, Clemence AU - Ferlay C AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Adult Intensive Care Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Division of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Kirsch, Matthias AU - Kirsch M AD - Division of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Shah, Pinak B AU - Shah PB AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Skali, Hicham AU - Skali H AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Fournier, Stephane AU - Fournier S AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Meier, David AU - Meier D AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Hugelshofer, Sarah AU - Hugelshofer S AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Skalidis, Ioannis AU - Skalidis I AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Tzimas, Georgios AU - Tzimas G AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Monney, Pierre AU - Monney P AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Eeckhout, Eric AU - Eeckhout E AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Arangalage, Dimitri AU - Arangalage D AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Cardiology Department, AP-HP, Bichat Hospital and Universite de Paris, Paris, France. FAU - Rancati, Valentina AU - Rancati V AD - Division of Anaesthesiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Antiochos, Panagiotis AU - Antiochos P AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Lu, Henri AU - Lu H AD - Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: henri.lu@chuv.ch. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20240524 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Aortic Valve Stenosis/surgery MH - *Postoperative Complications/epidemiology MH - Treatment Outcome EDAT- 2024/05/27 00:42 MHDA- 2024/11/30 11:17 CRDT- 2024/05/26 19:14 PHST- 2024/04/23 00:00 [received] PHST- 2024/05/17 00:00 [revised] PHST- 2024/05/21 00:00 [accepted] PHST- 2024/11/30 11:17 [medline] PHST- 2024/05/27 00:42 [pubmed] PHST- 2024/05/26 19:14 [entrez] AID - S0828-282X(24)00407-0 [pii] AID - 10.1016/j.cjca.2024.05.016 [doi] PST - ppublish SO - Can J Cardiol. 2024 Nov;40(11):2054-2062. doi: 10.1016/j.cjca.2024.05.016. Epub 2024 May 24. PMID- 38773853 OWN - NLM STAT- MEDLINE DCOM- 20241114 LR - 20250507 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 3 DP - 2024 Sep TI - The PIGTAIL paradigm for a fast and safe transfemoral transcatheter aortic valve replacement. PG - 600-613 LID - 10.1002/ccd.31090 [doi] AB - Transfemoral transcatheter aortic valve replacement is the preferred primary access route whenever possible. Despite advancements in expertise and delivery system profiles, complications associated with the primary femoral access still significantly affect procedural morbidity and outcomes. The current standard for accurate main access planning involves proper preprocedural evaluation guided by computed tomography. Several baseline clinical and anatomical features serve as predictors for the risk of vascular injury occurring during or after transcatheter aortic valve replacement. In this paper, we aimed at reviewing the most up-to-date knowledge of the topic for a safe transfemoral access approach according to a paradigm we have called "PIGTAIL." CI - (c) 2024 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Gennari, Marco AU - Gennari M AD - IRCCS Centro Cardiologico Monzino, Interventional, Valvular and Structural Heart Cardiology, Milan, Italy. FAU - Biroli, Matteo AU - Biroli M AUID- ORCID: 0000-0002-3373-7741 AD - IRCCS Centro Cardiologico Monzino, Interventional, Valvular and Structural Heart Cardiology, Milan, Italy. AD - University of Milan, Milan, Italy. FAU - Severgnini, Gaia AU - Severgnini G AD - University of Milan, Milan, Italy. AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. FAU - Olivares, Paolo AU - Olivares P AD - IRCCS Centro Cardiologico Monzino, Interventional, Valvular and Structural Heart Cardiology, Milan, Italy. FAU - Ferrari, Cristina AU - Ferrari C AD - IRCCS Centro Cardiologico Monzino, Interventional, Valvular and Structural Heart Cardiology, Milan, Italy. FAU - Giacari, Carlo Maria AU - Giacari CM AD - IRCCS Centro Cardiologico Monzino, Interventional, Valvular and Structural Heart Cardiology, Milan, Italy. FAU - Agrifoglio, Marco AU - Agrifoglio M AD - University of Milan, Milan, Italy. AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. FAU - De Marco, Federico AU - De Marco F AD - IRCCS Centro Cardiologico Monzino, Interventional, Valvular and Structural Heart Cardiology, Milan, Italy. FAU - Taramasso, Maurizio AU - Taramasso M AUID- ORCID: 0000-0001-7295-1153 AD - Herzzentrum Hirslander Zurich, Zurich, Switzerland. LA - eng PT - Journal Article PT - Review DEP - 20240521 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Femoral Artery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - *Catheterization, Peripheral/adverse effects MH - Treatment Outcome MH - *Punctures MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Risk Factors MH - Heart Valve Prosthesis MH - Vascular System Injuries/etiology/diagnostic imaging/prevention & control MH - Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Prosthesis Design MH - Risk Assessment OTO - NOTNLM OT - aortic valve disease OT - percutaneous intervention OT - transcatheter valve implantation OT - vascular access complications EDAT- 2024/05/22 06:42 MHDA- 2024/11/14 18:29 CRDT- 2024/05/22 02:33 PHST- 2024/04/03 00:00 [revised] PHST- 2024/02/22 00:00 [received] PHST- 2024/05/08 00:00 [accepted] PHST- 2024/11/14 18:29 [medline] PHST- 2024/05/22 06:42 [pubmed] PHST- 2024/05/22 02:33 [entrez] AID - 10.1002/ccd.31090 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Sep;104(3):600-613. doi: 10.1002/ccd.31090. Epub 2024 May 21. PMID- 38769727 OWN - NLM STAT- MEDLINE DCOM- 20240712 LR - 20250506 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 1 DP - 2024 Jul TI - Temporal trends with the Evolut family of self-expanding transcatheter heart valves: A single-center experience. PG - 125-133 LID - 10.1002/ccd.31088 [doi] AB - BACKGROUND: The Evolut self-expanding valve (SEV) systems (Medtronic), were designed to accommodate varying valve sizes and reduce paravalvular leak (PVL) while maintaining a low delivery profile. These systems have evolved between product generations, alongside valve deployment techniques changing over time. AIMS: This study aimed to examine whether these changes impacted clinical outcomes. METHODS: EPROMPT is a prospective, investigator-initiated, postmarketing registry of consecutive patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) using the Evolut PRO/PRO+ SEV system. A total of 300 patients were divided into three consecutive cohorts of 100 patients according to implantation date (January to October 2018, November 2018 to July 2020, and August 2020 to November 2021). Procedural and clinical outcomes over these time periods were compared. RESULTS: Valve Academic Research Consortium (VARC)-2 device implantation success improved over time (70.0% vs. 78.0% vs. 88.8%, p = 0.01), with a similar trend for VARC-3 device success (94.7% vs. 81.7% vs. 96.8%, p < 0.001). PVL (all degrees) frequency was likewise reduced over time (31.0% vs. 17.0% vs. 19.2%, p = 0.04). Furthermore, a trend was noticed toward shorter procedure times and shorter length of stay. However, postprocedural pacemaker implantation rates did not significantly differ (15.2% vs. 21.1% vs. 14.0%, p = 0.43). CONCLUSION: During a 3-year period, we demonstrated better TAVR outcomes with newer SEV iterations, alongside changes in implantation techniques, which might result in better procedural and clinical outcomes. However, we did not see a significant change in peri-procedural pacemaker rates for SEV. CI - (c) 2024 Wiley Periodicals LLC. FAU - Merdler, Ilan AU - Merdler I AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Case, Brian C AU - Case BC AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Bhogal, Sukhdeep AU - Bhogal S AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Reddy, Pavan K AU - Reddy PK AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Zhang, Cheng AU - Zhang C AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Ali, Syed AU - Ali S AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Gallino, Paige E AU - Gallino PE AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Jackman, Caroline AU - Jackman C AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Ben-Dor, Itsik AU - Ben-Dor I AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Satler, Lowell F AU - Satler LF AUID- ORCID: 0000-0001-6446-2683 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Cohen, Jeffery E AU - Cohen JE AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. FAU - Rogers, Toby AU - Rogers T AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. AD - Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Waksman, Ron AU - Waksman R AUID- ORCID: 0000-0002-4063-9226 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA. LA - eng SI - ClinicalTrials.gov/NCT03423459 GR - Medtronic/ PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240520 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Heart Valve Prosthesis MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - *Registries MH - *Prosthesis Design MH - Time Factors MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Aged MH - Treatment Outcome MH - Aged, 80 and over MH - Prospective Studies MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Risk Factors MH - Recovery of Function MH - Product Surveillance, Postmarketing MH - Postoperative Complications/etiology/prevention & control MH - Hemodynamics OTO - NOTNLM OT - TAVR OT - aortic stenosis OT - self-expanding valve EDAT- 2024/05/21 06:44 MHDA- 2024/07/12 06:42 CRDT- 2024/05/21 01:32 PHST- 2024/03/29 00:00 [revised] PHST- 2023/09/01 00:00 [received] PHST- 2024/05/08 00:00 [accepted] PHST- 2024/07/12 06:42 [medline] PHST- 2024/05/21 06:44 [pubmed] PHST- 2024/05/21 01:32 [entrez] AID - 10.1002/ccd.31088 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Jul;104(1):125-133. doi: 10.1002/ccd.31088. Epub 2024 May 20. PMID- 38738226 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240514 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 16 IP - 4 DP - 2024 Apr 30 TI - Health-related quality of life after minimal-invasive treatment of aortic valve stenosis in the elderly. PG - 2274-2284 LID - 10.21037/jtd-23-1509 [doi] AB - BACKGROUND: Although transfemoral transcatheter aortic valve implantation (TF-TAVI) offers superior early outcome over open surgical aortic valve replacement (SAVR) in the elderly, a comparison of TF-TAVI with surgery performed through partial upper mini sternotomy (PUMS) hasn't yet been validated. The aim of the present study is to evaluate the clinical outcome and quality of life of patients subjected to TF-TAVI and open surgical aortic valve replacement through partial upper mini sternotomy (PUMS-SAVR). METHODS: Baseline, procedural and post-treatment data of 197 consecutive patients: 137 TF-TAVI and 60 PUMS-SAVR treated at Philipps University of Marburg, were retrospectively collected. The propensity score method was used to create two groups in a 1:1 fashion. Questionnaire assessment (SF36_LQ) of quality of life of the matched patients was carried out at the ambulant routine control presentation. A competing risk regression model is used to evaluate the impact of the clinical outcome on health-related quality of life (HrQoL). RESULTS: After propensity matching, TF-TAVI remained associated with lower procedural time (136+/-50 vs. 298+/-36 min, P<0.01), intensive care unit stay (2.68+/-2.70 vs. 4.29+/-2.43 days, P<0.01), transfusion of packed red cell units (0.46+/-2.05 vs. 1.60+/-2.00 U, P=0.02) and higher heart block (42.86% vs. 0%, P<0.01) and permanent pacemaker implantation rates (14.29% vs. 0%, P=0.05) compared to PUMS-SAVR. TF-TAVI is associated with less complains, superior HrQoL (excellent 40% and very good 60% vs. very good 100% in PUMS). Partial sternotomy is the main predictor of the inferior HrQoL, with the regression coefficient of -1.11 (95% confidential interval, -1.503 to -0.726; R(2)=0.324, P<0.0001). Transfusion (P=0.26), paravalvular leakage (0.618), pacemaker implantation (P=0.19) and delirium (P=0.92) did not influence HrQoL after the minimal-invasive treatment of aortic valve stenosis in elderly patients. CONCLUSIONS: Although PUMS-SAVR offers better technical outcomes with less permanent pacemaker implantation and less paravalvular leakage than TF-TAVI, it is still associated with more need for transfusion, longer ventilation-and intensive care unit-times, and prolonged hospital stay. In the elderly, PUMS-SAVR achieves inferior quality of life compared to TF-TAVI. Partial sternotomy reveals as the strongest risk factor of perceived health-level post-treatment. It remains to be revealed whether fast-track open heart surgery that maintains a fully intact sternum and allows immediate postoperative extubation-as performed through video-assisted mini-thoracotomy or thoracoscopic robotic procedures with percutaneous cannulation - should be favored against PUMS-SAVR. CI - 2024 Journal of Thoracic Disease. All rights reserved. FAU - Andrasi, Terezia B AU - Andrasi TB AUID- ORCID: 0000-0001-7808-9226 AD - Department of Cardiac and Cardiovascular Surgery, Philipps University of Marburg, Marburg, Germany. FAU - Schellenberg, Celine AU - Schellenberg C AD - Department of Cardiac and Cardiovascular Surgery, Philipps University of Marburg, Marburg, Germany. FAU - Vasiloi, Alina AU - Vasiloi A AD - Department of Cardiac and Cardiovascular Surgery, Philipps University of Marburg, Marburg, Germany. AD - Department of Geriatric Medicine, Burgerspital Solothurn, Solothurn, Switzerland. FAU - Gluck, Alannah C AU - Gluck AC AD - Department of Cardiac and Cardiovascular Surgery, Philipps University of Marburg, Marburg, Germany. LA - eng PT - Journal Article DEP - 20240410 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC11087604 OTO - NOTNLM OT - Aortic OT - mini-sternotomy OT - patient satisfaction OT - quality of life OT - stenosis OT - transcatheter valve implantation COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1509/coif). The authors have no conflicts of interest to declare. EDAT- 2024/05/13 06:42 MHDA- 2024/05/13 06:43 PMCR- 2024/04/30 CRDT- 2024/05/13 04:29 PHST- 2023/09/26 00:00 [received] PHST- 2024/01/26 00:00 [accepted] PHST- 2024/05/13 06:43 [medline] PHST- 2024/05/13 06:42 [pubmed] PHST- 2024/05/13 04:29 [entrez] PHST- 2024/04/30 00:00 [pmc-release] AID - jtd-16-04-2274 [pii] AID - 10.21037/jtd-23-1509 [doi] PST - ppublish SO - J Thorac Dis. 2024 Apr 30;16(4):2274-2284. doi: 10.21037/jtd-23-1509. Epub 2024 Apr 10. PMID- 38736247 OWN - NLM STAT- MEDLINE DCOM- 20240712 LR - 20250507 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 1 DP - 2024 Jul TI - Transfemoral-only transcatheter aortic valve replacement: A single center experience of 400 consecutive patients. PG - 134-144 LID - 10.1002/ccd.31077 [doi] AB - BACKGROUND: In transcatheter aortic valve replacement (TAVR), transfemoral (TF) access offers several advantages over alternative access routes. Advances in sheaths and valve delivery technology have catalyzed the feasibility of TF-TAVR, even in challenging anatomies. AIMS: Report procedural characteristics and outcomes of a TAVR program aiming for a 100% TF access rate. METHODS: Consecutive patients undergoing TAVR were enrolled in a prospective registry. Equipment used to facilitate TF-access in challenging anatomies included low-profile sheaths, dilatators, peripheral balloons, covered and uncovered self-expanding and balloon-expandable stents, and intravascular lithotripsy (IVL). RESULTS: A total of 400 patients with a mean age of 81 +/- 6 years (42% female) were analyzed. Minimal iliofemoral artery diameter (MLD) of the main access side was <5 mm in 42 (10.5%), extreme tortuosity was present in 65 (16.3%), and severe calcification in 59 (14.8%). TF-access was successful in 399 (99.8%) patients. A transaxillary access was used in one patient. In multivariable analysis, an MLD < 5 mm was the strongest predictor for vascular complications (11.9% vs. 3.9%, OR: 3.86, 95% CI: 1.38-10.8, p = 0.01). Such patients also had more major/life-threatening bleeding (14.2% vs. 3.1%, p < 0.001) and required more planned and unplanned peripheral interventions to enable TF access (35.8% vs. 3.4%, p < 0.001). CONCLUSION: Our study shows that utilization of dedicated sheaths, peripheral balloons, stents, and IVL enables TAVR via TF access in >99% of patients. However, rates of vascular and bleeding complications in patients with narrow iliofemoral arteries (MLD < 5 mm) were high. CI - (c) 2024 Wiley Periodicals LLC. FAU - Moccetti, Federico AU - Moccetti F AUID- ORCID: 0000-0002-5794-5676 AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Wolfrum, Mathias AU - Wolfrum M AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Bossard, Matthias AU - Bossard M AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Attinger-Toller, Adrian AU - Attinger-Toller A AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Loretz, Lucca AU - Loretz L AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Cuculi, Florim AU - Cuculi F AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. LA - eng PT - Journal Article DEP - 20240512 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2024 Jul;104(1):174-175. doi: 10.1002/ccd.31118. PMID: 38838185 MH - Humans MH - Female MH - Male MH - *Femoral Artery/diagnostic imaging MH - Aged, 80 and over MH - *Registries MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - Treatment Outcome MH - Aged MH - *Catheterization, Peripheral/adverse effects MH - Risk Factors MH - *Punctures MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Prospective Studies MH - Time Factors MH - Heart Valve Prosthesis OTO - NOTNLM OT - alternative access OT - aortic stenosis OT - bleeding complications OT - peripheral intervention OT - vascular complications EDAT- 2024/05/13 06:42 MHDA- 2024/07/12 06:42 CRDT- 2024/05/13 01:43 PHST- 2024/03/05 00:00 [received] PHST- 2024/04/30 00:00 [accepted] PHST- 2024/07/12 06:42 [medline] PHST- 2024/05/13 06:42 [pubmed] PHST- 2024/05/13 01:43 [entrez] AID - 10.1002/ccd.31077 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Jul;104(1):134-144. doi: 10.1002/ccd.31077. Epub 2024 May 12. PMID- 38731245 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240514 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 9 DP - 2024 May 6 TI - Endovascular Recanalization and Carotid Stenting: The New Approach to Restore Cerebral Perfusion during Aortic Dissection. LID - 10.3390/jcm13092716 [doi] LID - 2716 AB - A type A aortic dissection (TAAD) is a dangerous condition requiring emergency surgery. Due to the similarity of the symptoms of cerebral malperfusion in TAAD and the signs of ischemic stroke, a differential diagnosis of these diseases is not always available. Patients with TAAD after cerebral malperfusion can have a neurological deficit. Thrombolysis is performed in this case. It can worsen the patient's condition and increase the risk of mortality and disability. The aim of the study is to evaluate the new approach to restoring cerebral perfusion during aortic dissection. This approach includes endovascular recanalization and carotid stenting. METHODS: Two clinical cases of TAAD complicated by cerebral malperfusion are described. The first patient is 73 years old and was admitted as planned to perform transcatheter aortic valve implantation (TAVI) for grade III aortic stenosis. The patient underwent transcatheter aortic valve implantation (TAVI) on the second day after admission. The second patient is 60 years old and was hospitalized by an ambulance with strong hypertension and ischemia. The surgical correction of aortic dissection was postponed until the neurological status assessment in both patients. RESULTS: The surgery to correct the aorta dissection was deemed inappropriate. The carotid arteries have been reanalyzed, and cerebral perfusion has been restored in a short time in both patients. CONCLUSION: Acute bilateral internal carotid occlusion is a potentially fatal TAAD outcome. Emergency endovascular recanalization and carotid stenting may be considered one of the few ways to restore cerebral perfusion. FAU - Agarkov, Maxim AU - Agarkov M AD - Interventional Radiology Gusev Central District Hospital, 56, Moskovskaya Str., Gusev, 238051 Kaliningrad Oblast, Russia. FAU - Kozlov, Kirill AU - Kozlov K AD - Military Medical Academy of Ministry of Defense of the Russian Federation, 6, Akademica Lebedeva Str., 194044 St. Petersburg, Russia. AD - St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia. FAU - Senkina, Ekaterina AU - Senkina E AUID- ORCID: 0009-0000-1165-0285 AD - Alexander's Hospital, 4, Solidarnosti Ave., 193312 St. Petersburg, Russia. FAU - Gornov, Sergey AU - Gornov S AD - The Federal Medical-Biological Agency of Russia, 30, Volocolamskoye Highway, 123182 Moscow, Russia. FAU - Linkova, Natalia AU - Linkova N AUID- ORCID: 0000-0001-5156-5421 AD - St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia. AD - St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia. FAU - Kechaeva, Elena AU - Kechaeva E AD - St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia. FAU - Medvedev, Dmitrii AU - Medvedev D AUID- ORCID: 0000-0001-7401-258X AD - St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia. FAU - Krasichkov, Alexander AU - Krasichkov A AD - Department of Radio Engineering Systems of Electrotechnical University LETI, 5F Prof. Popova Str., 197022 St. Petersburg, Russia. FAU - Dyatlova, Anastasiia AU - Dyatlova A AD - St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia. AD - St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia. FAU - Polyakova, Victoria AU - Polyakova V AUID- ORCID: 0000-0001-8682-9909 AD - St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia. AD - St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia. LA - eng GR - Agreement No. 075-15-2022-291 dated 15 April 2022/Ministry of Science and Higher Education of the Russian Federation/ PT - Journal Article DEP - 20240506 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC11084725 OTO - NOTNLM OT - aortic dissection after TAVI OT - cerebral malperfusion OT - complication aortic dissection type A OT - emergency bilateral carotid stenting OT - retrograde endovascular carotid recanalization COIS- The authors declare no conflicts of interest. EDAT- 2024/05/11 19:44 MHDA- 2024/05/11 19:45 PMCR- 2024/05/06 CRDT- 2024/05/11 01:05 PHST- 2024/04/14 00:00 [received] PHST- 2024/05/03 00:00 [revised] PHST- 2024/05/03 00:00 [accepted] PHST- 2024/05/11 19:45 [medline] PHST- 2024/05/11 19:44 [pubmed] PHST- 2024/05/11 01:05 [entrez] PHST- 2024/05/06 00:00 [pmc-release] AID - jcm13092716 [pii] AID - jcm-13-02716 [pii] AID - 10.3390/jcm13092716 [doi] PST - epublish SO - J Clin Med. 2024 May 6;13(9):2716. doi: 10.3390/jcm13092716. PMID- 38719632 OWN - NLM STAT- MEDLINE DCOM- 20241121 LR - 20260514 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 68 DP - 2024 Nov TI - Conduction disorders following transcatheter aortic valve replacement using acurate Neo2 transcatheter heart valve: A propensity matched analysis. PG - 17-22 LID - S1553-8389(24)00460-3 [pii] LID - 10.1016/j.carrev.2024.05.002 [doi] AB - BACKGROUND: The ACURATE neo2 transcatheter aortic valve was developed to improve paravalvular leak (PVL) rates while maintaining low rates of conduction disturbances and permanent pacemaker implantation (PPMI) seen with its predecessor. We aimed to compare conduction disturbances rates of transcatheter aortic valve replacement (TAVR) using ACURATE Neo2 with other commonly used valves. METHODS: A retrospective analysis of the Israeli TAVR registry between the years 2014-2023 was performed to compare conduction disturbances and PVL rates, and procedural outcomes, among patients treated with ACURATE neo2, Edwards Sapien 3 (S3), and Evolut PRO valves. Propensity score matching was performed to compare groups with similar characteristics. RESULTS: Following exclusion of patients with non-femoral access, unknown valve type, older-generation valves, and less commonly used valves or (n = 4387), our analysis included 3208 patients undergoing TAVR using ACURATE neo2, Edwards S3, and Evolut PRO valves. Propensity matched groups comprised 169 patients each. Rates of any conduction disturbances [left bundle branch block (LBBB), atrioventricular block, or PPMI] were lower in the ACURATE neo2 group compared to both other valves [15.8 %, S3-37.5 % (p < 0.001), Evolut PRO-27.5 % (p = 0.02)] as were LBBB rates [9.0 %, S3-31.3 % (p < 0.001); Evolut PRO-20.1 % (p = 0.01). Atrioventricular block and PPMI rates were lower without statistical significance, as were rates of above-moderate PVL. CONCLUSIONS: In this analysis, TAVR using ACURATE neo2 was associated with a lower composite rate of conduction disturbances in comparison to the Evolut PRO and Edwards S3 valves, mainly due to lower left bundle branch block rates, with non-significantly lower rates of PPMI and PVL. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Loewenstein, Itamar AU - Loewenstein I AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Finkelstein, Ariel AU - Finkelstein A AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Banai, Shmuel AU - Banai S AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Halkin, Amir AU - Halkin A AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Konigstein, Maayan AU - Konigstein M AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Ben-Shoshan, Jeremy AU - Ben-Shoshan J AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Arbel, Yaron AU - Arbel Y AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Barbash, Israel AU - Barbash I AD - Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Segev, Amit AU - Segev A AD - Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - David, Planner AU - David P AD - Cardiology Department, Hadassah Medical Center, Jerusalem, Israel; Affiliated to the Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Elbaz-Greener, Gabby AU - Elbaz-Greener G AD - Cardiology Department, Hadassah Medical Center, Jerusalem, Israel; Affiliated to the Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Assa-Vaknin, Hana AU - Assa-Vaknin H AD - Cardiology Department, Rabin Medical Center, Petach Tikva, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Kornowski, Ran AU - Kornowski R AD - Cardiology Department, Rabin Medical Center, Petach Tikva, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Dvir, Danny AU - Dvir D AD - Cardiology Department, Sha'arei Zedek Medical Center, Jerusalem, Israel; Affiliated to the Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Asher, Elad AU - Asher E AD - Cardiology Department, Sha'arei Zedek Medical Center, Jerusalem, Israel; Affiliated to the Hebrew University of Jerusalem, Jerusalem, Israel. FAU - Steinvil, Arie AU - Steinvil A AD - Cardiology Department, Tel Aviv Sourasky Medical Center, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: arikst@tlvmc.gov.il. LA - eng PT - Comparative Study PT - Journal Article DEP - 20240505 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Male MH - Female MH - Retrospective Studies MH - Treatment Outcome MH - *Prosthesis Design MH - Aged, 80 and over MH - Aged MH - *Heart Valve Prosthesis MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - *Registries MH - Israel MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging MH - Risk Factors MH - Time Factors MH - *Cardiac Pacing, Artificial MH - Risk Assessment MH - Atrioventricular Block/diagnosis/etiology/physiopathology/therapy MH - Bundle-Branch Block/physiopathology/diagnosis/etiology/therapy MH - Arrhythmias, Cardiac/diagnosis/physiopathology/therapy/etiology MH - Heart Rate MH - Propensity Score OTO - NOTNLM OT - AVB OT - Conduction disturbances OT - LBBB OT - Pacemaker OT - TAVR COIS- Declaration of competing interest Prof. Ariel Finkelstein reports a relationship with Medtronic Inc. that includes: consulting or advisory. Prof. Ariel Finkelstein reports a relationship with Edwards Lifesciences Corporation that includes: consulting or advisory. Prof. Amir Halkin reports a relationship with Abbott Laboratories that includes: consulting or advisory. Prof. Amir Halkin reports a relationship with Boston Scientific Corp that includes: consulting or advisory. Other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/05/09 00:48 MHDA- 2024/11/22 00:22 CRDT- 2024/05/08 22:01 PHST- 2024/02/14 00:00 [received] PHST- 2024/04/15 00:00 [revised] PHST- 2024/05/01 00:00 [accepted] PHST- 2024/11/22 00:22 [medline] PHST- 2024/05/09 00:48 [pubmed] PHST- 2024/05/08 22:01 [entrez] AID - S1553-8389(24)00460-3 [pii] AID - 10.1016/j.carrev.2024.05.002 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 Nov;68:17-22. doi: 10.1016/j.carrev.2024.05.002. Epub 2024 May 5. PMID- 38702030 OWN - NLM STAT- MEDLINE DCOM- 20240530 LR - 20260714 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 408 DP - 2024 Aug 1 TI - Stroke risk after transcatheter aortic valve replacement in patients with carotid stenosis: A systematic review and meta-analysis. PG - 132085 LID - S0167-5273(24)00707-1 [pii] LID - 10.1016/j.ijcard.2024.132085 [doi] AB - BACKGROUND: Stroke is a feared complication of transcatheter aortic valve replacement (TAVR). Patients undergoing TAVR typically have multiple comorbidities, such as carotid artery stenosis (CAS). We conducted the present meta-analysis to determine the risk of stroke and mortality following TAVR in patients with CAS. METHODS: We searched PubMed/Medline, Scopus, ScienceDirect, and Cochrane Clinical Trials databases for clinical studies that compared CAS >/=50% and CAS >/=70% versus non-CAS TAVR population. The endpoints included the 30-day incidence of stroke or transient ischemic attack (TIA) and 30-day all-cause of mortality. RESULTS: We identified seven studies that included 12,418 patients in the CAS group and 102,316 in the control group. CAS >/=50% was not associated with an increased risk of 30-day stroke or TIA after TAVR [risk ratio (RR): 1.38; 95% confidence interval (95% CI): 0.95-2.02; p = 0.09]. However, patients with CAS >/=70% had an increased risk of stroke or TIA (RR: 1.43; 95% CI: 1.02-2.01; p = 0.04). No difference in 30-day all-cause mortality was observed between CAS >/=50% or CAS >/=70% and control groups (RR: 1.09; 95% CI: 0.79-1.52; p = 0.59 and RR: 1.11; 95% CI: 0.85-1.45; p = 0.43, respectively). CONCLUSIONS: CAS >/=70% was associated with an increased risk of stroke or TIA following TAVR compared with patients without CAS. CI - Copyright (c) 2024 Elsevier B.V. All rights reserved. FAU - Garagoli, Fernando AU - Garagoli F AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: fernando.garagoli@hospitalitaliano.org.ar. FAU - Chiabrando, Juan Guido AU - Chiabrando JG AD - Department of Interventional Cardiology, Sanatorio Anchorena, Buenos Aires, Argentina. FAU - Seropian, Ignacio Miguel AU - Seropian IM AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Lombardi, Marco AU - Lombardi M AD - Department of Internal Medicine and Medical Specialties (DIMI), Universita di Genova, Largo R. Benzi, 10, 16132 Genova, Italy. FAU - Agatiello, Carla Romina AU - Agatiello CR AD - Department of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Fernandez Recalde, Maria Luz AU - Fernandez Recalde ML AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Vergallo, Rocco AU - Vergallo R AD - Department of Internal Medicine and Medical Specialties (DIMI), Universita di Genova, Largo R. Benzi, 10, 16132 Genova, Italy; Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 6, 16132 Genova, Italy. FAU - Porto, Italo AU - Porto I AD - Department of Internal Medicine and Medical Specialties (DIMI), Universita di Genova, Largo R. Benzi, 10, 16132 Genova, Italy; Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 6, 16132 Genova, Italy. FAU - Bluro, Ignacio Martin AU - Bluro IM AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20240501 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Stroke/etiology/epidemiology MH - *Carotid Stenosis/surgery/epidemiology MH - *Aortic Valve Stenosis/surgery/mortality MH - Risk Factors MH - Postoperative Complications/epidemiology/etiology OTO - NOTNLM OT - Aortic valve stenosis OT - Carotid artery stenosis OT - Stroke OT - Transcatheter aortic valve implantation OT - Transcatheter aortic valve replacement EDAT- 2024/05/04 11:51 MHDA- 2024/05/31 00:42 CRDT- 2024/05/03 19:22 PHST- 2024/01/07 00:00 [received] PHST- 2024/04/02 00:00 [revised] PHST- 2024/04/19 00:00 [accepted] PHST- 2024/05/31 00:42 [medline] PHST- 2024/05/04 11:51 [pubmed] PHST- 2024/05/03 19:22 [entrez] AID - S0167-5273(24)00707-1 [pii] AID - 10.1016/j.ijcard.2024.132085 [doi] PST - ppublish SO - Int J Cardiol. 2024 Aug 1;408:132085. doi: 10.1016/j.ijcard.2024.132085. Epub 2024 May 1. PMID- 38663573 OWN - NLM STAT- MEDLINE DCOM- 20240613 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 222 DP - 2024 Jul 1 TI - Off-Label Use of Balloon-Expandable Transcatheter Valves to Treat Pure Aortic Regurgitation. PG - 20-22 LID - S0002-9149(24)00312-6 [pii] LID - 10.1016/j.amjcard.2024.04.030 [doi] AB - Transcatheter aortic valve implantation (TAVI) in native pure aortic regurgitation (AR) with off-label use of balloon-expandable valves (BEV) has been reported. However, there are scant data regarding optimal oversizing and its safety, and our study assessed BEV oversizing and outcomes of TAVI. Thirteen consecutive tricuspid aortic valve patients who underwent transfemoral TAVIs for pure AR with Sapien BEV at our center between 2019 and 2023 (69.2% males, mean age 80.8 years, Society of Thoracic Surgeons 4.0%) were divided into small annulus (SA) group (/=20% oversizing is achievable based on published data on BEV overexpansion, and larger annulus (LA) group (>618 mm(2)). Overexpansion and actual oversizing were measured on postprocedural computed tomography scan. Technical success was 92.3% with 1 valve embolization in the LA group. The postprocedural computed tomography showed a mean 28.3% oversizing, significantly higher in SA (31.2%) than in LA group (19.4%), p = 0.0092. Oversizing >/=20% was achieved in 100% SA versus 33.3% LA patients (p = 0.046). In conclusion, TAVI in pure AR with oversized Sapien BEV showed good procedural and short-term outcomes when >/=20% oversizing was predictably achievable. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Orzalkiewicz, Mateusz AU - Orzalkiewicz M AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Foroni, Marco AU - Foroni M AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Chietera, Francesco AU - Chietera F AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Bendandi, Francesco AU - Bendandi F AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Mazzapicchi, Alessandro AU - Mazzapicchi A AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Bruno, Antonio Giulio AU - Bruno AG AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Ghetti, Gabriele AU - Ghetti G AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Taglieri, Nevio AU - Taglieri N AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Marrozzini, Cinzia AU - Marrozzini C AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Galie, Nazzareno AU - Galie N AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy. Electronic address: francesco.saia@unibo.it. LA - eng PT - Journal Article DEP - 20240423 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Male MH - Female MH - *Aortic Valve Insufficiency/surgery MH - Aged, 80 and over MH - *Prosthesis Design MH - *Heart Valve Prosthesis MH - Aged MH - Retrospective Studies MH - Off-Label Use MH - Treatment Outcome MH - Tomography, X-Ray Computed COIS- Declaration of competing interest Francesco Saia reports a relationship with Edwards Lifesciences, Abbott Vascular and Medtronic that includes consulting or advisory and speaking and lecture fees. Tullio Palmerini reports a relationship with Edwards Lifesciences and Medtronic that includes speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/04/26 00:51 MHDA- 2024/06/14 00:42 CRDT- 2024/04/25 19:28 PHST- 2023/12/07 00:00 [received] PHST- 2024/04/11 00:00 [revised] PHST- 2024/04/19 00:00 [accepted] PHST- 2024/06/14 00:42 [medline] PHST- 2024/04/26 00:51 [pubmed] PHST- 2024/04/25 19:28 [entrez] AID - S0002-9149(24)00312-6 [pii] AID - 10.1016/j.amjcard.2024.04.030 [doi] PST - ppublish SO - Am J Cardiol. 2024 Jul 1;222:20-22. doi: 10.1016/j.amjcard.2024.04.030. Epub 2024 Apr 23. PMID- 38658128 OWN - NLM STAT- MEDLINE DCOM- 20240424 LR - 20260702 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 8 DP - 2024 Apr 22 TI - Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement. PG - 992-1003 LID - S1936-8798(24)00456-4 [pii] LID - 10.1016/j.jcin.2024.02.011 [doi] AB - BACKGROUND: Extravalvular cardiac damage caused by aortic stenosis affects prognosis after transcatheter aortic valve replacement (TAVR). The long-term impact of changes in cardiac damage in response to relief from mechanical obstruction has not been fully investigated. OBJECTIVES: The authors aimed to investigate changes in cardiac damage early after TAVR and the prognostic impact of the cardiac damage classification after TAVR. METHODS: In this single-center observational study, patients undergoing transfemoral TAVR were retrospectively evaluated for cardiac damage before and after TAVR and classified into 5 stages of cardiac damage (0-4). RESULTS: Among 1,863 patients undergoing TAVR between January 2007 and June 2022, 56 patients (3.0%) were classified as stage 0, 225 (12.1%) as stage 1, 729 (39.1%) as stage 2, 388 (20.8%) as stage 3, and 465 (25.0%) as stage 4. Cardiac stage changed in 47.7% of patients (improved: 30.1% in stages 1-4 and deteriorated: 24.7% in stages 0-3) early after TAVR. Five-year all-cause mortality was associated with cardiac damage both at baseline (HR(adjusted): 1.34; 95% CI: 1.24-1.44; P < 0.001 for linear trend) and after TAVR (HR(adjusted): 1.40; 95% CI: 1.30-1.51; P < 0.001 for linear trend). Five-year all-cause mortality was stratified by changes in cardiac damage (improved, unchanged, or worsened) in patients with cardiac stage 2, 3, and 4 (log-rank P < 0.001 for stage 2, 0.005 for stage 3, and <0.001 for stage 4). CONCLUSIONS: The extent of extra-aortic valve cardiac damage before and after TAVR and changes in cardiac stage early after TAVR have important prognostic implications during long-term follow-up. (SwissTAVI Registry; NCT01368250). CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Nakase, Masaaki AU - Nakase M AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/masaaki0825. FAU - Tomii, Daijiro AU - Tomii D AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/DaijiroTomii. FAU - Heg, Dik AU - Heg D AD - Clinical Trials Unit" Bern, University of Bern, Bern, Switzerland. FAU - Praz, Fabien AU - Praz F AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Reineke, David AU - Reineke D AD - Department of Cardiac Surgery, Inselspital, University of Bern, Bern, Switzerland. FAU - Samim, Daryoush AU - Samim D AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Lanz, Jonas AU - Lanz J AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. LA - eng SI - ClinicalTrials.gov/NCT01368250 PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Apr 22;17(8):1004-1006. doi: 10.1016/j.jcin.2024.03.004. PMID: 38658115 CIN - Cardiovasc Diagn Ther. 2025 Feb 28;15(1):32-36. doi: 10.21037/cdt-24-380. PMID: 40115108 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology/mortality MH - Male MH - Female MH - Retrospective Studies MH - Time Factors MH - Aged, 80 and over MH - Aged MH - Risk Factors MH - Treatment Outcome MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Risk Assessment OTO - NOTNLM OT - aortic stenosis OT - cardiac damage staging classification OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Heg has no personal conflicts; his employer, Clinical Trials Unit Bern, University of Bern, has a staff policy of not accepting honoraria or consultancy fees. However, Clinical Trials Unit Bern is involved in the design, conduct, or analysis of clinical studies funded by not-for-profit and for-profit organizations. In particular, pharmaceutical and medical device companies provide direct funding to some of these studies. Dr Praz has received travel expenses from Abbott, Edwards Lifesciences, and Polares Medical. Dr Stortecky has reported research grants to the institution from Edwards Lifesciences and Medtronic; and has received personal fees from Boston Scientific, Teleflex, and BTG. Dr Samim has received funding for an online course from Edwards Lifesciences. Dr Windecker has reported research, travel, or educational grants to the institution without personal remuneration from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, Corflow Therapeutics, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Farapulse Inc, Fumedica, Guerbet, Idorsia, Inari Medical, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medalliance, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech, Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave. Dr Windecker has served as an Advisory Board member and/or member of the Steering/Executive Group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave with payments to the institution but no personal payments; and is a member of the Steering/Executive Committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Pilgrim has reported research grants to the institution from Edwards Lifesciences, Boston Scientific, and Biotronik; and has received speaker fees/consultancy from Biotronik, Medtronic, Abbott, Edwards Lifesciences, and HighLife SAS. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/04/25 00:54 MHDA- 2024/04/25 00:55 CRDT- 2024/04/24 20:59 PHST- 2023/11/09 00:00 [received] PHST- 2024/01/24 00:00 [revised] PHST- 2024/02/11 00:00 [accepted] PHST- 2024/04/25 00:55 [medline] PHST- 2024/04/25 00:54 [pubmed] PHST- 2024/04/24 20:59 [entrez] AID - S1936-8798(24)00456-4 [pii] AID - 10.1016/j.jcin.2024.02.011 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Apr 22;17(8):992-1003. doi: 10.1016/j.jcin.2024.02.011. PMID- 38658126 OWN - NLM STAT- MEDLINE DCOM- 20240424 LR - 20260702 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 8 DP - 2024 Apr 22 TI - Quality of Life 5 Years Following Transfemoral TAVR or SAVR in Intermediate Risk Patients. PG - 979-988 LID - S1936-8798(24)00459-X [pii] LID - 10.1016/j.jcin.2024.02.014 [doi] AB - BACKGROUND: Symptomatic patients with severe aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR) sustain comparable improvements in health status over 5 years after transcatheter aortic valve replacement (TAVR) or SAVR. Whether a similar long-term benefit is observed among intermediate-risk AS patients is unknown. OBJECTIVES: The purpose of this study was to assess health status outcomes through 5 years in intermediate risk patients treated with a self-expanding TAVR prosthesis or SAVR using data from the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial. METHODS: Intermediate-risk patients randomized to transfemoral TAVR or SAVR in the SURTAVI trial had disease-specific health status assessed at baseline, 30 days, and annually to 5 years using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Health status was compared between groups using fixed effects repeated measures modelling. RESULTS: Of the 1,584 patients (TAVR, n = 805; SAVR, n = 779) included in the analysis, health status improved more rapidly after TAVR compared with SAVR. However, by 1 year, both groups experienced large health status benefits (mean change in KCCQ-Overall Summary Score (KCCQ-OS) from baseline: TAVR: 20.5 +/- 22.4; SAVR: 20.5 +/- 22.2). This benefit was sustained, albeit modestly attenuated, at 5 years (mean change in KCCQ-OS from baseline: TAVR: 15.4 +/- 25.1; SAVR: 14.3 +/- 24.2). There were no significant differences in health status between the cohorts at 1 year or beyond. Similar findings were observed in the KCCQ subscales, although a substantial attenuation of benefit was noted in the physical limitation subscale over time in both groups. CONCLUSIONS: In intermediate-risk AS patients, both transfemoral TAVR and SAVR resulted in comparable and durable health status benefits to 5 years. Further research is necessary to elucidate the mechanisms for the small decline in health status noted at 5 years compared with 1 year in both groups. (Safety and Efficacy Study of the Medtronic CoreValve(R) System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI]; NCT01586910). CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Kleiman, Neal S AU - Kleiman NS AD - Department of Interventional Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. Electronic address: nkleiman@houstonmethodist.org. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Thoraxcenter, Erasmus University, Rotterdam, the Netherlands. FAU - Reardon, Michael J AU - Reardon MJ AD - Department of Cardiothoracic Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Gada, Hemal AU - Gada H AD - Department of Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle, Wormleysburg, Pennsylvania, USA. FAU - Mumtaz, Mubashir AU - Mumtaz M AD - Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center Pinnacle Health, Harrisburg, Pennsylvania, USA. FAU - Olsen, Peter Skov AU - Olsen PS AD - Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Heiser, John AU - Heiser J AD - Department of Interventional Cardiology, Corewell Health, Grand Rapids, Michigan, USA. FAU - Merhi, William AU - Merhi W AD - Department of Cardiothoracic Surgery, Corewell Health, Grand Rapids, Michigan, USA. FAU - Chetcuti, Stanley AU - Chetcuti S AD - Interventional Cardiology, University of Michigan, Ann Arbor, Michigan, USA. FAU - Deeb, G Michael AU - Deeb GM AD - Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA. FAU - Chawla, Atul AU - Chawla A AD - Department of Cardiology, Iowa Heart Center, Des Moines, Iowa, USA. FAU - Kiaii, Bob AU - Kiaii B AD - Division of Cardiac Surgery, University of California-Davis Health, Sacramento, California, USA. FAU - Teefy, Patrick AU - Teefy P AD - Divisions of Cardiology and Cardiac Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Chu, Michael W A AU - Chu MWA AD - Divisions of Cardiology and Cardiac Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - Yakubov, Steven J AU - Yakubov SJ AD - Interventional Cardiology, OhioHealth Riverside Methodist Hospital, Columbus, Ohio, USA. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Althouse, Andrew D AU - Althouse AD AD - Medtronic, Minneapolis, Minnesota, USA. FAU - Baron, Suzanne J AU - Baron SJ AD - Massachusetts General Hospital, Boston, Massachusetts, USA; Baim Institute for Clinical Research, Boston, Massachusetts, USA. LA - eng SI - ClinicalTrials.gov/NCT01586910 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Apr 22;17(8):989-991. doi: 10.1016/j.jcin.2024.03.006. PMID: 38658127 MH - Humans MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Female MH - *Quality of Life MH - Male MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Treatment Outcome MH - Aged MH - Aged, 80 and over MH - Risk Factors MH - *Health Status MH - *Aortic Valve/surgery/physiopathology/diagnostic imaging MH - Risk Assessment MH - *Recovery of Function MH - *Severity of Illness Index MH - *Heart Valve Prosthesis MH - *Femoral Artery MH - Heart Valve Prosthesis Implantation/instrumentation/adverse effects MH - Catheterization, Peripheral/adverse effects MH - Punctures MH - Prosthesis Design OTO - NOTNLM OT - Kansas City Cardiomyopathy Questionnaire OT - quality of life OT - surgical aortic valve replacement OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Medtronic funded the trial. Dr Kleiman is a consultant for Medtronic, Abbott, and Boston Scientific; and receives grant support from Medtronic. Dr Van Mieghem has received grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Medtronic; and advisory fees from Abbott, Boston Scientific, Pulse Cath BV, and Medtronic. Dr Reardon has received institutional fees from Medtronic for consulting and providing educational services. Dr Gada serves as a consultant to Abbott Vascular, Bard, Inc., Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Mumtaz serves as a consultant to and receives honoraria and research grants from Edwards Lifesciences, the Japanese Organization for Medical Device Development, Medtronic, Triflex, and Foldax. Dr Chetcuti has received personal fees from Medtronic; has received grants from Edwards Lifesciences, Boston Scientific, and Jena; and serves on advisory boards for Biotrace and Jena Valve. Dr Deeb has received grant support from Medtronic; and personal fees from Medtronic outside the submitted work. Dr Chawla is a proctor for Medtronic. Dr Kiaii is a consultant and speaker for Medtronic, Johnson & Johnson, and Abbott. Dr Chu has received speaker honoraria from Medtronic, Edwards Lifesciences, Terumo Aortic, and Artivion. Dr Yakubov has received grants from Boston Scientific and Medtronic. Dr Windecker has received institutional research, travel, or educational grants from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, Corflow Therapeutics, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Farapulse Inc. Fumedica, Guerbet, Idorsia, Inari Medical, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medalliance, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech. Pfizer, Polares, Regeneron, Sanofi, Servier, Sinomed, Terumo, Vifor, and V-Wave; has served as an advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave with payments to the institution; and is also member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Althouse is a shareholder and employee of Medtronic plc. Dr Baron has received research support from Boston Scientific and Abiomed, consulting/advisory board fees from Medtronic, Biotronik, Shockwave, and Zoll Medical; and speaker honoraria from Zoll Medical, Edwards Lifesciences, Boston Scientific, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/04/25 00:54 MHDA- 2024/04/25 00:55 CRDT- 2024/04/24 20:59 PHST- 2023/04/26 00:00 [received] PHST- 2024/01/12 00:00 [revised] PHST- 2024/02/04 00:00 [accepted] PHST- 2024/04/25 00:55 [medline] PHST- 2024/04/25 00:54 [pubmed] PHST- 2024/04/24 20:59 [entrez] AID - S1936-8798(24)00459-X [pii] AID - 10.1016/j.jcin.2024.02.014 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Apr 22;17(8):979-988. doi: 10.1016/j.jcin.2024.02.014. PMID- 38654860 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240426 IS - 1658-354X (Print) IS - 0975-3125 (Electronic) VI - 18 IP - 2 DP - 2024 Apr-Jun TI - The association between different anesthetic techniques and outcomes in patients undergoing transfemoral aortic valve replacement. PG - 197-204 LID - 10.4103/sja.sja_826_23 [doi] AB - BACKGROUND: There is an increasing number of patients undergoing transfemoral aortic valve replacement (TAVR) with sedation. There is limited data assessing the efficacy and safety of the different types of sedative drugs. The objective was to compare two sedation techniques with regard to the need for vasoactive support, respiratory support, rate of conversion to general anesthesia (GA), common perioperative morbidities, intensive care unit (ICU) stay, and in-hospital mortality. METHODS: A retrospective chart review study conducted among patients who underwent TAVR at a specialized cardiac center between January 2016 and December 2019. Data collection included patient diagnosis, preoperative comorbidities, intraoperative outcomes, and postoperative outcomes. RESULTS: A total of 289 patients received local anesthesia; 210 received propofol infusion and 79 received a mixed propofol-ketamine infusion (Ketofol). The average age was 75.5 +/- 8.9 years and 58.1% of the patients were females. Comparing propofol and ketofol groups, 31.2% and 34.2% of the patients required drug support, 7.6% and 6.3% required conversion to GA, 46.7% and 59.5% required respiratory support, respectively. These intraoperative outcomes were not significantly different between groups, P = 0.540, P = 0.707, and P = 0.105, respectively. In-hospital 30-day mortality in propofol and ketofol groups were 1.9% and 3.8%, respectively, P = 0.396. In both groups, the median post-procedure coronary care unit stay was 26 hours while post-procedure hospital stay was 3 days. CONCLUSIONS: There were no significant differences in perioperative or postoperative outcomes in TAVR patients receiving either propofol or ketofol. Propofol infusion, either alone or with ketamine, is reliable and safe, with minimal side effects. CI - Copyright: (c) 2024 Saudi Journal of Anesthesia. FAU - Abuzaid, Ahmad AU - Abuzaid A AD - Cardiac Anesthesia Department, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia. FAU - AbdelAal, Ibrahim AU - AbdelAal I AD - Cardiac Anesthesia Department, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia. FAU - Galal, Ahmed AU - Galal A AD - Cardiac Anesthesia Department, Prince Sultan Cardiac Centre, Riyadh, Saudi Arabia. LA - eng PT - Journal Article DEP - 20240314 PL - India TA - Saudi J Anaesth JT - Saudi journal of anaesthesia JID - 101500601 PMC - PMC11033899 OTO - NOTNLM OT - Hemodynamic OT - ketamine OT - mortality OT - postoperative outcome OT - procedural sedation OT - propofol OT - respiratory depression OT - transcatheter aortic valve replacement COIS- There are no conflicts of interest. EDAT- 2024/04/24 14:20 MHDA- 2024/04/24 14:21 PMCR- 2024/04/01 CRDT- 2024/04/24 03:38 PHST- 2023/10/12 00:00 [received] PHST- 2023/10/15 00:00 [revised] PHST- 2023/10/21 00:00 [accepted] PHST- 2024/04/24 14:21 [medline] PHST- 2024/04/24 14:20 [pubmed] PHST- 2024/04/24 03:38 [entrez] PHST- 2024/04/01 00:00 [pmc-release] AID - SJA-18-197 [pii] AID - 10.4103/sja.sja_826_23 [doi] PST - ppublish SO - Saudi J Anaesth. 2024 Apr-Jun;18(2):197-204. doi: 10.4103/sja.sja_826_23. Epub 2024 Mar 14. PMID- 38654777 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241208 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 16 IP - 3 DP - 2024 Mar TI - Intraoperative Corticosteroids and Pacemaker Implantation After Transcatheter Aortic Valve Replacement. PG - e56824 LID - 10.7759/cureus.56824 [doi] LID - e56824 AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis. However, conduction disturbances leading to pacemaker implantation remain a common complication, increasing morbidity and mortality in these patients. Hence, measures to lower its incidence should be taken, and corticosteroid therapy could be effective by reducing inflammation caused by direct mechanical trauma to the conduction system. METHODS: A retrospective cohort study was conducted at the Centro Hospitalar de Vila Nova de Gaia/Espinho, analyzing the medical records of patients with native severe aortic stenosis who underwent transfemoral TAVR in 2022. The Chi-square test was used to compare the rate of pacemaker implantation in patients who received corticosteroids with patients who didn't. The statistical significance was considered for a p-value <0.05. RESULTS: A total of 341 patients were included in this study. Monitored anesthesia care was the preferred anesthetic technique (99.1%). Sixty-three point three percent (63.3%) of patients received corticosteroids at the beginning of the procedure. Corticosteroid administration did not significantly affect the incidence of permanent pacemaker implantation (p=0.277), vascular complications on the access site (p=0.765), or in-hospital mortality (p=0.909). Male gender, 1st-degree atrioventricular block, and right branch block were the only identified predictors of permanent pacemaker implantation after transfemoral TAVR (p=0.041 <0.001 and <0.001, respectively). CONCLUSION: Corticosteroid administration at the beginning of TAVR doesn't seem to influence the incidence of permanent pacemaker implantation, which can suggest that other factors play a more important role in the development of conduction disturbances leading to pacemaker implantation. CI - Copyright (c) 2024, Tiago et al. FAU - Tiago, Catarina AU - Tiago C AD - Anesthesiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. FAU - Dias Vaz, Marta AU - Dias Vaz M AD - Anesthesiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. FAU - Marques, Ana AU - Marques A AD - Anesthesiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. FAU - Barata, Melanie AU - Barata M AD - Anesthesiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. FAU - Braga, Jose Pedro AU - Braga JP AD - Cardiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. FAU - Boa, Ana AU - Boa A AD - Anesthesiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. FAU - Carvalho, Ana Filipa AU - Carvalho AF AD - Anesthesiology, Centro Hospitalar de Vila Nova de Gaia - Espinho, Porto, PRT. LA - eng PT - Journal Article DEP - 20240324 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC11037441 OTO - NOTNLM OT - cardiac dysrhythmia OT - glucocorticoids OT - pacemaker OT - transcatheter aortic valve replacement OT - vascular system injuries COIS- The authors have declared that no competing interests exist. EDAT- 2024/04/24 14:20 MHDA- 2024/04/24 14:21 PMCR- 2024/03/24 CRDT- 2024/04/24 03:36 PHST- 2024/03/22 00:00 [accepted] PHST- 2024/04/24 14:21 [medline] PHST- 2024/04/24 14:20 [pubmed] PHST- 2024/04/24 03:36 [entrez] PHST- 2024/03/24 00:00 [pmc-release] AID - 10.7759/cureus.56824 [doi] PST - epublish SO - Cureus. 2024 Mar 24;16(3):e56824. doi: 10.7759/cureus.56824. eCollection 2024 Mar. PMID- 38653922 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240714 IS - 1568-5888 (Print) IS - 1876-6250 (Electronic) IS - 1568-5888 (Linking) VI - 32 IP - 7-8 DP - 2024 Aug TI - Upper extremity versus lower extremity for secondary access during transcatheter aortic valve implantation: rationale and design of the randomised TAVI XS trial. PG - 270-275 LID - 10.1007/s12471-024-01869-5 [doi] AB - BACKGROUND: During transcatheter aortic valve implantation (TAVI), secondary access is required for angiographic guidance and temporary pacing. The most commonly used secondary access sites are the femoral artery (angiographic guidance) and the femoral vein (temporary pacing). An upper extremity approach using the radial artery and an upper arm vein instead of the lower extremity approach using the femoral artery and femoral vein may reduce clinically relevant secondary access site-related bleeding complications, but robust evidence is lacking. TRIAL DESIGN: The TAVI XS trial is a multicentre, randomised, open-label clinical trial with blinded evaluation of endpoints. A total of 238 patients undergoing transfemoral TAVI will be included. The primary endpoint is the incidence of clinically relevant bleeding (i.e. Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding) of the randomised secondary access site (either diagnostic or pacemaker access, or both) within 30 days after TAVI. Secondary endpoints include time to mobilisation after TAVI, duration of hospitalisation, any BARC type 2, 3 or 5 bleeding, and early safety at 30 days according to Valve Academic Research Consortium‑3 criteria. CONCLUSION: The TAVI XS trial is the first randomised trial comparing an upper extremity approach to a lower extremity approach with regard to clinically relevant secondary access site-related bleeding complications. The results of this trial will provide important insights into the safety and efficacy of an upper extremity approach in patients undergoing transfemoral TAVI. CI - (c) 2024. The Author(s). FAU - Rooijakkers, Maxim J P AU - Rooijakkers MJP AD - Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - Versteeg, Geert A A AU - Versteeg GAA AD - Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - Hemelrijk, Kimberley I AU - Hemelrijk KI AD - Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands. FAU - Aarts, Hugo M AU - Aarts HM AD - Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands. FAU - Overduin, Daniel C AU - Overduin DC AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. FAU - van Ginkel, Dirk-Jan AU - van Ginkel DJ AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. FAU - Vlaar, Pieter J AU - Vlaar PJ AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - van Wely, Marleen H AU - van Wely MH AD - Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - van Nunen, Lokien X AU - van Nunen LX AD - Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - van Geuns, Robert Jan AU - van Geuns RJ AD - Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - van Garsse, Leen A F M AU - van Garsse LAFM AD - Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - Geuzebroek, Guillaume S C AU - Geuzebroek GSC AD - Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - Verkroost, Michel W A AU - Verkroost MWA AD - Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - Rodwell, Laura AU - Rodwell L AD - Department of Health Sciences, Section Biostatistics, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. FAU - Heijmen, Robin H AU - Heijmen RH AD - Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. FAU - Tonino, Pim A L AU - Tonino PAL AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Ten Berg, Jurrien M AU - Ten Berg JM AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. AD - Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands. FAU - Delewi, Ronak AU - Delewi R AD - Department of Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. niels.vanroyen@radboudumc.nl. LA - eng GR - A 1678426/SVZ/Medtronic/ PT - Journal Article DEP - 20240423 PL - Netherlands TA - Neth Heart J JT - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation JID - 101095458 PMC - PMC11239632 OTO - NOTNLM OT - Aortic stenosis OT - Bleeding complications OT - Complications OT - Pacemaker OT - Transcatheter aortic valve implantation OT - Valve Academic Research Consortium 3 COIS- M.H. van Wely has been a proctor and consultant for Abbott Vascular. R.H. Heijmen has been a consultant for Medtronic. P.A.L. Tonino and R. Delewi are Associate Editors of the Netherlands Heart Journal. N. van Royen has received research funding from Abbott, Philips, Medtronic and Biotronik, has served as a consultant for RainMed, Castor and Medtronic and has received speaker fees from Abbott and Bayer. M.J.P. Rooijakkers, G.A.A. Versteeg, K.I. Hemelrijk, H.M. Aarts, D.C. Overduin, D.-J. van Ginkel, P.J. Vlaar, , L.X. van Nunen, R.J. van Geuns, L.A.F.M. van Garsse, G.S.C. Geuzebroek, M.W.A. Verkroost, L. Rodwell and J.M. ten Berg declare that they have no competing interests. EDAT- 2024/04/24 01:43 MHDA- 2024/04/24 01:44 PMCR- 2024/04/23 CRDT- 2024/04/23 23:24 PHST- 2024/03/08 00:00 [accepted] PHST- 2024/04/24 01:44 [medline] PHST- 2024/04/24 01:43 [pubmed] PHST- 2024/04/23 23:24 [entrez] PHST- 2024/04/23 00:00 [pmc-release] AID - 10.1007/s12471-024-01869-5 [pii] AID - 1869 [pii] AID - 10.1007/s12471-024-01869-5 [doi] PST - ppublish SO - Neth Heart J. 2024 Aug;32(7-8):270-275. doi: 10.1007/s12471-024-01869-5. Epub 2024 Apr 23. PMID- 38653674 OWN - NLM STAT- MEDLINE DCOM- 20240919 LR - 20260514 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 67 DP - 2024 Oct TI - Cerebral embolic protection device utilization and outcomes in transcatheter aortic valve replacement: A nationally representative propensity matched analysis. PG - 112-114 LID - S1553-8389(24)00147-7 [pii] LID - 10.1016/j.carrev.2024.04.003 [doi] AB - INTRODUCTION: In patients undergoing transcatheter aortic valve replacement (TAVR), cerebral embolic protection devices (CEPD) are used to possibly diminish the risk of periprocedural stroke. Trends and outcomes of CEPD usage in TAVR are not well characterized. METHODS: National readmission databases (NRD) 2017-2019 was used to identify hospital admissions for TAVR using ICD-10 codes, with versus without Sentinel CEPD. Primary outcomes of the study were in-hospital and 30-day stroke. Secondary outcomes include in-hospital mortality, 30-day mortality, 30-day readmission rate, and other procedural complications. We matched both cohorts using propensity score matching (PSM) and performed logistic regression to compute the odds ratios (ORs) and corresponding 95 % confidence intervals (CI). RESULTS: Out of 190,837 TAVR admissions in the United States, 10,643 (5.6 %) patients had TAVR with Sentinel CEPD. After propensity score matching, our cohort included 10,503 patients with CEPD and 10,541 without CEPD. Trends in CEPD utilization are noted in Fig. 1. In the PSM cohort, Sentinel CEPD was not associated with decreased risk of in-hospital stroke (1.9 % vs. 1.8 %, OR: 0.98, 95 % CI: 0.76-1.26, p = 0.88), 30-day stroke (2.1 % vs. 2.1 %, OR: 1.01, 95 % CI: 0.78-1.30, p = 0.96), or 30-day mortality (1.3 % vs. 1.0 %, OR: 0.74, 95 % CI: 0.51-1.07, p = 0.11) when compared to TAVR without CEPD. Other in-hospital and short-term outcomes post-TAVR were not impacted by Sentinel CEPD usage, including acute kidney injury, vascular complications, paravalvular leak, cardiogenic shock, circulatory support, or permanent pacemaker (Table 1). CONCLUSION: In this nationally representative cohort, Sentinel CEPD utilization during transfemoral TAVR for stroke prevention was not associated with reduced odds of in-hospital stroke, 30-day stroke, or 30-day mortality. Future studies should focus on optimizing patient selection for CEPD and establishing predictive models to identify the subset of TAVR patients with higher risk for periprocedural stroke who might benefit from CEPD. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Altibi, Ahmed M AU - Altibi AM AD - Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA. Electronic address: altibi@ohsu.edu. FAU - Alhuneafat, Laith AU - Alhuneafat L AD - Department of Cardiovascular Disease, University of Minnesota, Minneapolis, MN, USA. FAU - Jabri, Ahmad AU - Jabri A AD - Department of Cardiovascular Disease, Henry Ford, Detroit, MI, USA. FAU - Al-Abdouh, Ahmad AU - Al-Abdouh A AD - Department of Medicine, University of Kentucky, Lexington, KY, USA. FAU - Ghanem, Fares AU - Ghanem F AD - Department of Cardiovascular Medicine, Southern Illinois University, Springfield, IL, USA. LA - eng PT - Journal Article DEP - 20240404 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/mortality/instrumentation MH - Male MH - Female MH - United States MH - Aged, 80 and over MH - *Embolic Protection Devices MH - Risk Factors MH - Aged MH - Treatment Outcome MH - *Databases, Factual MH - Time Factors MH - *Hospital Mortality MH - Risk Assessment MH - Retrospective Studies MH - Aortic Valve Stenosis/surgery/mortality/diagnostic imaging MH - Intracranial Embolism/prevention & control/mortality MH - Patient Readmission MH - Propensity Score MH - Stroke/mortality/prevention & control/etiology MH - Aortic Valve/surgery/physiopathology COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/04/24 01:43 MHDA- 2024/09/20 01:06 CRDT- 2024/04/23 22:01 PHST- 2023/10/22 00:00 [received] PHST- 2024/04/01 00:00 [revised] PHST- 2024/04/03 00:00 [accepted] PHST- 2024/09/20 01:06 [medline] PHST- 2024/04/24 01:43 [pubmed] PHST- 2024/04/23 22:01 [entrez] AID - S1553-8389(24)00147-7 [pii] AID - 10.1016/j.carrev.2024.04.003 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 Oct;67:112-114. doi: 10.1016/j.carrev.2024.04.003. Epub 2024 Apr 4. PMID- 38641438 OWN - NLM STAT- MEDLINE DCOM- 20240830 LR - 20260513 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 66 DP - 2024 Sep TI - Outcomes and treatment strategy of transcatheter aortic valve replacement with balloon-expandable valve in borderline-size annulus. PG - 6-14 LID - S1553-8389(24)00118-0 [pii] LID - 10.1016/j.carrev.2024.03.030 [doi] AB - BACKGROUND: Candidates for transcatheter aortic valve replacement (TAVR) occasionally have a "borderline-size" aortic annulus between 2 transcatheter heart valve sizes, based on the manufacturer's sizing chart. Data on TAVR outcomes in such patients are limited. METHODS: We retrospectively reviewed 1816 patients who underwent transfemoral-TAVR with balloon-expandable valve (BEV) at our institution between 2016 and 2020. We divided patients into borderline and non-borderline groups based on computed tomography-derived annular measurements and compared outcomes. Furthermore, we analyzed procedural characteristics and compared outcomes between the smaller- and larger-valve strategies in patients with borderline-size annulus. RESULTS: During a median follow-up of 23.3 months, there was no significant difference between the borderline (n = 310, 17.0 %) and non-borderline (n = 1506) groups in mortality (17.3 % vs. 19.5 %; hazard ratio [HR] = 0.86 [95% CI = 0.62-1.20], p = 0.39), major adverse cardiac/cerebrovascular events (MACCE: death/myocardial infarction/stroke, 21.2 % vs. 21.5 %; HR = 0.97 [0.71-1.32], p = 0.85), paravalvular leak (PVL: mild 21.8 % vs. 20.6 %, p = 0.81; moderate 0 % vs. 1.2 %; p = 0.37), or mean gradient (12.9 +/- 5.8 vs. 12.6 +/- 5.2 mmHg, p = 0.69) at 1 year. There was no significant difference between the larger-(n = 113) and smaller-valve(n = 197) subgroups in mortality (23.7 % vs. 15.2 %; HR = 1.57 [0.89-2.77], p = 0.12), MACCE (28.1 % vs. 18.4 %; HR = 1.52 [0.91-2.54], p = 0.11), mild PVL (13.3 % vs. 25.9 %; p = 0.12), or mean gradient (12.3 +/- 4.5 vs. 13.6 +/- 5.3 mmHg, p = 0.16); however, the rate of permanent pacemaker implantation (PPI) was higher in the larger-valve subgroup (15.9 % vs. 2.6 %, p < 0.001). CONCLUSION: Borderline-size annulus is not associated with higher risk of adverse outcomes after BEV-TAVR. However, the larger-valve strategy for borderline-size annulus is associated with higher PPI risk, suggesting a greater risk of injury to the conduction system. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Isogai, Toshiaki AU - Isogai T AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Spilias, Nikolaos AU - Spilias N AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Bakhtadze, Beka AU - Bakhtadze B AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Sabbak, Nabil AU - Sabbak N AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Denby, Kara J AU - Denby KJ AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Layoun, Habib AU - Layoun H AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Agrawal, Ankit AU - Agrawal A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Shekhar, Shashank AU - Shekhar S AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Yun, James J AU - Yun JJ AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Harb, Serge C AU - Harb SC AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Reed, Grant W AU - Reed GW AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: kapadis@ccf.org. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240328 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality MH - Female MH - Male MH - *Heart Valve Prosthesis MH - Retrospective Studies MH - Aged, 80 and over MH - *Prosthesis Design MH - *Aortic Valve/diagnostic imaging/surgery/physiopathology MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/mortality/physiopathology MH - Treatment Outcome MH - Aged MH - *Balloon Valvuloplasty/adverse effects MH - Risk Factors MH - Time Factors MH - Postoperative Complications/etiology MH - Risk Assessment MH - Recovery of Function MH - Hemodynamics OTO - NOTNLM OT - Balloon-expandable valve OT - Borderline-size annulus OT - Outcome OT - Transcatheter aortic valve replacement OT - Transcatheter heart valve size COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/04/20 00:43 MHDA- 2024/08/31 09:49 CRDT- 2024/04/19 21:56 PHST- 2024/03/23 00:00 [received] PHST- 2024/03/27 00:00 [accepted] PHST- 2024/08/31 09:49 [medline] PHST- 2024/04/20 00:43 [pubmed] PHST- 2024/04/19 21:56 [entrez] AID - S1553-8389(24)00118-0 [pii] AID - 10.1016/j.carrev.2024.03.030 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 Sep;66:6-14. doi: 10.1016/j.carrev.2024.03.030. Epub 2024 Mar 28. PMID- 38639140 OWN - NLM STAT- MEDLINE DCOM- 20240603 LR - 20250506 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 103 IP - 7 DP - 2024 Jun TI - Single suture-mediated closure system after transfemoral transcatheter aortic valve implantation: A single-center real-world experience. PG - 1125-1137 LID - 10.1002/ccd.31054 [doi] AB - BACKGROUND: Despite the use of two crossed Perclose ProGlide (Abbott Vascular Devices) is the most widespread technique to close the main arterial access in transfemoral transcatheter aortic valve implantation (TF-TAVI), the safest and most effective strategy still remains much debated. AIMS: The aim of the present study was to evaluate the performance of a single Perclose ProGlide suture-mediated closure device to obtain femoral hemostasis after sheathless implantation of self-expanding transcatheter heart valves through their 14 F-equivalent fix delivery systems. METHODS: This prospective observational study included 439 patients undergoing TF-TAVI at the "Montevergine" Clinic of Mercogliano, Italy. All patients underwent hemostasis of the large-bore access using a single Perclose ProGlide with preclose technique, after sheathless implantation of self-expanding transcatheter heart valves through 14 F-equivalent fix delivery systems. A multidetector computed tomography analysis of size, tortuosity, atherosclerotic, and calcification burdens of the ilio-femoral access route was made by a dedicated corelab. Vascular complications (VCs), percutaneous closure device (PCD) failure, and bleedings were adjudicated by a clinical events committee. RESULTS: A total of 81 different VCs were observed in 60 patients (13.7%); among these, 41 (5% of patients) were categorized as major. PCD failure occurred in 14 patients (3.2%). At the logistic regression analysis, no predictors of PCD failure have been identified. CONCLUSION: This registry suggests that the use of a single suture-mediated closure device could be considered a safe and efficient technique to achieve access site hemostasis in patients undergoing TF-TAVI through 14 F-equivalent fix delivery systems. CI - (c) 2024 Wiley Periodicals LLC. FAU - Iacovelli, Fortunato AU - Iacovelli F AUID- ORCID: 0000-0002-4620-678X AD - Division of University Cardiology, Cardiothoracic Department, Policlinico University Hospital, Bari, Italy. AD - Division of Cardiology, "SS. Annunziata" Hospital, Taranto, Italy. FAU - Burattini, Osvaldo AU - Burattini O AUID- ORCID: 0000-0002-6904-5528 AD - Division of Cardiology, "SS. Annunziata" Hospital, Taranto, Italy. FAU - Sturda, Francesca AU - Sturda F AUID- ORCID: 0000-0003-3480-6806 AD - Division of University Cardiology, Cardiothoracic Department, Policlinico University Hospital, Bari, Italy. FAU - Branca, Mattia AU - Branca M AUID- ORCID: 0000-0002-8063-7882 AD - Clinical Trials Unit, School of Medicine, University of Bern, Bern, Switzerland. FAU - Stabile, Eugenio AU - Stabile E AUID- ORCID: 0000-0001-9125-8813 AD - School of Medicine, University of Basilicata, Potenza, Italy. FAU - Fimiani, Luigi AU - Fimiani L AUID- ORCID: 0000-0002-4835-4188 AD - Division of Cardiology, "Papardo" Hospital, Messina, Italy. FAU - Salemme, Luigi AU - Salemme L AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Cioppa, Angelo AU - Cioppa A AUID- ORCID: 0000-0003-4324-4227 AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Pucciarelli, Armando AU - Pucciarelli A AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. FAU - Cafaro, Alessandro AU - Cafaro A AUID- ORCID: 0000-0002-2068-7351 AD - Division of Cardiology, "V. Fazzi" Hospital, Lecce, Italy. FAU - Bortone, Alessandro Santo AU - Bortone AS AD - Division of University Heart Surgery, Cardiothoracic Department, Policlinico University Hospital, Bari, Italy. FAU - Contegiacomo, Gaetano AU - Contegiacomo G AD - Interventional Cardiology Service, "Anthea" Clinic, GVM Care & Research, Bari, Italy. FAU - Pignatelli, Antonio AU - Pignatelli A AD - Interventional Cardiology Service, "Anthea" Clinic, GVM Care & Research, Bari, Italy. FAU - Tesorio, Tullio AU - Tesorio T AD - Interventional Cardiology Service, "Montevergine" Clinic, GVM Care & Research, Mercogliano, Italy. LA - eng PT - Journal Article PT - Observational Study DEP - 20240419 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Femoral Artery/diagnostic imaging MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - Prospective Studies MH - Aged, 80 and over MH - Treatment Outcome MH - *Catheterization, Peripheral/adverse effects MH - Aged MH - *Hemostatic Techniques/instrumentation/adverse effects MH - *Suture Techniques/adverse effects/instrumentation MH - *Punctures MH - Risk Factors MH - *Vascular Closure Devices MH - Time Factors MH - Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Italy MH - Equipment Design MH - Aortic Valve Stenosis/surgery/diagnostic imaging/physiopathology MH - Hemorrhage/etiology/prevention & control OTO - NOTNLM OT - Perclose ProGlide OT - percutaneous closure device failure OT - self-expanding OT - transcatheter aortic valve implantation OT - transfemoral OT - vascular complications EDAT- 2024/04/19 06:43 MHDA- 2024/06/03 06:42 CRDT- 2024/04/19 05:33 PHST- 2024/03/27 00:00 [revised] PHST- 2024/01/05 00:00 [received] PHST- 2024/04/09 00:00 [accepted] PHST- 2024/06/03 06:42 [medline] PHST- 2024/04/19 06:43 [pubmed] PHST- 2024/04/19 05:33 [entrez] AID - 10.1002/ccd.31054 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Jun;103(7):1125-1137. doi: 10.1002/ccd.31054. Epub 2024 Apr 19. PMID- 38617787 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240416 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 16 IP - 3 DP - 2024 Mar 29 TI - Choice of anesthesia technique is associated with earlier hospital discharge and reduced costs after transcatheter transfemoral aortic valve implantation. PG - 1836-1842 LID - 10.21037/jtd-23-1739 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a viable alternative to palliation in patients with severe aortic stenosis. We compared general anesthesia to conscious sedation for TAVI procedures with respect to post operative morbidity, hospital length of stay, and financial burden. METHODS: We conducted a retrospective review of prospectively collected data in patients undergoing transfemoral TAVI procedures from 2012 to 2017. Patients were matched based on age and sex and classed into either general anesthesia or conscious sedation groups respectively. Conscious sedation was provided with a dexmedetomidine infusion, and patients in general anesthesia group received a standard induction, tracheal intubation, and maintenance with sevoflurane. The hospital case costs were compared between the two groups before and after adjustment for inflation. RESULTS: We matched 124 pairs for a total of 248 patients. Both groups were similar with respect to demographic data, past medical history, medications, and intraoperative characteristics. There was no difference in postoperative morbidity and mortality between the two groups. The median hospital length of stay was 5 [interquartile range (IQR): 3, 10] and 7 (IQR: 4, 12) days, P=0.01, and after adjustment for inflation, the total hospital case costs were $48,984 (IQR: $44,802, $61,438) Canadian (CAD) vs. $55,333 (IQR: $46,832, $68,702) CAD, P=0.01, in the conscious sedation and general anesthesia groups, respectively. CONCLUSIONS: Advancements in TAVI technologies, conscious sedation and a collaborative, multidisciplinary team approach reduces overall length of hospital stay and procedure costs. CI - 2024 Journal of Thoracic Disease. All rights reserved. FAU - Luzzi, Carla AU - Luzzi C AD - Department of Anesthesia and Pain Management, Toronto General Hospital, University of Toronto, Toronto, ON, Canada. FAU - Orlov, David AU - Orlov D AD - Department of Anesthesia, Mackenzie Health, Richmond Hill, ON, Canada. FAU - Foley, Karen AU - Foley K AD - Department of Anesthesia and Pain Management, Toronto General Hospital, University of Toronto, Toronto, ON, Canada. FAU - Horlick, Eric AU - Horlick E AD - Division of Cardiology, Toronto General Hospital, University of Toronto, Toronto, ON, Canada. FAU - Osten, Mark AU - Osten M AD - Division of Cardiology, Toronto General Hospital, University of Toronto, Toronto, ON, Canada. FAU - Cusimano, Robert James AU - Cusimano RJ AD - Division of Cardiovascular Surgery, Toronto General Hospital, University of Toronto, Toronto, ON, Canada. FAU - Djaiani, George AU - Djaiani G AD - Department of Anesthesia and Pain Management, Toronto General Hospital, University of Toronto, Toronto, ON, Canada. LA - eng PT - Journal Article DEP - 20240327 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC11009576 OTO - NOTNLM OT - Transcatheter aortic valve implantation (TAVI) OT - conscious sedation OT - costs OT - general anesthesia OT - length of stay COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1739/coif). The authors have no conflicts of interest to declare. EDAT- 2024/04/15 06:43 MHDA- 2024/04/15 06:44 PMCR- 2024/03/29 CRDT- 2024/04/15 04:23 PHST- 2023/11/12 00:00 [received] PHST- 2024/01/18 00:00 [accepted] PHST- 2024/04/15 06:44 [medline] PHST- 2024/04/15 06:43 [pubmed] PHST- 2024/04/15 04:23 [entrez] PHST- 2024/03/29 00:00 [pmc-release] AID - jtd-16-03-1836 [pii] AID - 10.21037/jtd-23-1739 [doi] PST - ppublish SO - J Thorac Dis. 2024 Mar 29;16(3):1836-1842. doi: 10.21037/jtd-23-1739. Epub 2024 Mar 27. PMID- 38616934 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240425 IS - 1734-9338 (Print) IS - 1897-4295 (Electronic) IS - 1734-9338 (Linking) VI - 20 IP - 1 DP - 2024 Mar TI - The role of external iliac artery diameter indexed to BSA score in predicting vascular access complications after transfemoral transcatheter aortic valve implantation. PG - 76-83 LID - 10.5114/aic.2024.136407 [doi] AB - INTRODUCTION: Aortic stenosis is the most common primary valve disease and requires invasive treatment. Transcatheter aortic valve implantation (TAVI) from a transfemoral access is a routine intervention worldwide. AIM: To investigate the correlation between external iliac artery diameter (EIAD) indexed to body surface area (BSA) (EIAD-BSA) and access site complications in patients undergoing TAVI via transfemoral access (TF) (TF-TAVI). MATERIAL AND METHODS: Patients underwent TF-TAVI in 2017-2019 at the Upper-Silesian Medical Center in Katowice. Based on the preoperative multi-slice computed tomography (MSCT), pre-specified measurements of the ilio-femoral vessels were performed. The results were indexed to BSA and body mass index (BMI). Complications after TAVI were defined by Valve Academic Research Consortium 3 (VARC-3). The primary outcome regarding the adverse events after TAVI was the composite of access site complications requiring surgical intervention or blood transfusion. RESULTS: The registry included 193 unselected patients with severe symptomatic aortic stenosis. Vascular and access-related complications including bleeding occurred in 17.1% of patients. Major TAVI access site complications (VARC-3) were reported in 5.7% of patients, while minor complications (VARC-3) occurred in 2.6%. EIAD-BSA demonstrated a positive correlation with the access site complications primary endpoint. Patients with greater EIAD-BSA had a numerically higher number of access site adverse events requiring surgical intervention or blood transfusion: n = 12 (5%) vs. n = 4 (4%), p = 0.011. CONCLUSIONS: External iliac artery diameter indexed to BSA could be an underestimated indicator of unfavorable outcomes after TF-TAVI, predicting periprocedural access site complications. CI - Copyright: (c) 2024 Termedia Sp. z o. o. FAU - Gruz-Kwapisz, Monika AU - Gruz-Kwapisz M AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Gasior, Tomasz AU - Gasior T AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. AD - Collegium Medicum - Faculty of Medicine, WSB University, Dabrowa Gornicza, Poland. FAU - Hajder, Adrianna AU - Hajder A AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Wanha, Wojciech AU - Wanha W AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Ciosek, Joanna AU - Ciosek J AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Ochala, Andrzej AU - Ochala A AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Parma, Radoslaw AU - Parma R AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Gocol, Radoslaw AU - Gocol R AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. FAU - Wojakowski, Wojciech AU - Wojakowski W AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Hudziak, Damian AU - Hudziak D AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. LA - eng PT - Journal Article DEP - 20240315 PL - Poland TA - Postepy Kardiol Interwencyjnej JT - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology JID - 101272671 PMC - PMC11008513 OTO - NOTNLM OT - aortic stenosis OT - transcatheter aortic valve implantation OT - transfemoral access OT - vascular complications COIS- Tomasz Gasior is an employee of Boehringer Ingelheim. Other authors declare no conflict of interest. EDAT- 2024/04/15 06:42 MHDA- 2024/04/15 06:43 PMCR- 2024/03/01 CRDT- 2024/04/15 04:08 PHST- 2023/08/03 00:00 [received] PHST- 2024/02/12 00:00 [accepted] PHST- 2024/04/15 06:43 [medline] PHST- 2024/04/15 06:42 [pubmed] PHST- 2024/04/15 04:08 [entrez] PHST- 2024/03/01 00:00 [pmc-release] AID - 52666 [pii] AID - 10.5114/aic.2024.136407 [doi] PST - ppublish SO - Postepy Kardiol Interwencyjnej. 2024 Mar;20(1):76-83. doi: 10.5114/aic.2024.136407. Epub 2024 Mar 15. PMID- 38600556 OWN - NLM STAT- MEDLINE DCOM- 20240412 LR - 20240425 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 19 IP - 1 DP - 2024 Apr 10 TI - Transcarotid vascular access for transcatheter aortic valve implantation: is choosing the left side always right? PG - 196 LID - 10.1186/s13019-024-02661-7 [doi] LID - 196 AB - BACKGROUND: The transcarotid (TC) vascular access for transcatheter aortic valve implantation (TAVI) has emerged as the first-choice alternative to the transfemoral access, in patients unsuitable for the latter. The use of both the left and right common carotid arteries (CCAs) for TC-TAVI has been described, but the optimal side is subject to debate. We conducted this pilot study to compare the level of vessel tortuosity and plaque burden from either the left CCA to the aortic annulus, or the right CCA to the aortic annulus, considering them as surrogates for technical and procedural complexity. METHODS: Consecutive patients who underwent TC-TAVI between 2018 and 2021 in our institution were included. Using three-dimensional reconstruction, pre-TAVI neck and chest computed tomography angiography exams were reviewed to assess the tortuosity index (TI), sum of angles metric, as well as plaque burden, between each CCA and the aortic annulus. RESULTS: We included 46 patients who underwent TC-TAVI. No significant difference regarding the mean TIs between the left and right sides (respectively 1.20 and 1.19, p = 0.82), the mean sum of angles (left side: 396 degrees , right side: 384 degrees , p = 0.27), and arterial plaque burden (arterial plaque found in 30% of left CCAs and 45% of right CCAs, p = 0.19) was found. CONCLUSIONS: We found no convincing data favoring the use of one particular access side over the other one. The choice of the CCA side in TC-TAVI should to be made on a case-by-case basis, in a multidisciplinary fashion, and may also depend on the operators' experience. CI - (c) 2024. The Author(s). FAU - Salihu, Adil AU - Salihu A AD - Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland. FAU - Rotzinger, David C AU - Rotzinger DC AD - Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland. FAU - Fahrni, Guillaume AU - Fahrni G AD - Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland. FAU - Nowacka, Anna AU - Nowacka A AD - Division of Cardiovascular Surgery, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland. FAU - Antiochos, Panagiotis AU - Antiochos P AD - Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland. FAU - Fournier, Stephane AU - Fournier S AD - Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland. FAU - Kirsch, Matthias AU - Kirsch M AD - Division of Cardiovascular Surgery, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland. FAU - Lu, Henri AU - Lu H AUID- ORCID: 0000-0002-9074-6505 AD - Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland. henri.lu@chuv.ch. LA - eng PT - Journal Article DEP - 20240410 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery/etiology MH - Pilot Projects MH - Carotid Artery, Common/surgery MH - Treatment Outcome PMC - PMC11008044 OTO - NOTNLM OT - Computational vascular modeling OT - TAVI OT - TAVR OT - Transcarotid OT - Vascular access, Vessel tortuosity COIS- Olivier Muller reports grants from Abbott and Edwards. The other authors have no relevant financial or non-financial interests to disclose. EDAT- 2024/04/11 00:42 MHDA- 2024/04/12 06:44 PMCR- 2024/04/10 CRDT- 2024/04/10 23:45 PHST- 2023/11/21 00:00 [received] PHST- 2024/03/20 00:00 [accepted] PHST- 2024/04/12 06:44 [medline] PHST- 2024/04/11 00:42 [pubmed] PHST- 2024/04/10 23:45 [entrez] PHST- 2024/04/10 00:00 [pmc-release] AID - 10.1186/s13019-024-02661-7 [pii] AID - 2661 [pii] AID - 10.1186/s13019-024-02661-7 [doi] PST - epublish SO - J Cardiothorac Surg. 2024 Apr 10;19(1):196. doi: 10.1186/s13019-024-02661-7. PMID- 38594159 OWN - NLM STAT- MEDLINE DCOM- 20241121 LR - 20260514 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 68 DP - 2024 Nov TI - Transcarotid versus transfemoral transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 92-97 LID - S1553-8389(24)00151-9 [pii] LID - 10.1016/j.carrev.2024.04.008 [doi] AB - BACKGROUND: In the 2021 Transcatheter Valve Therapy (TVT) registry, 8.9 % of patients underwent TAVR via access sites other than the femoral artery. Transthoracic approaches may be contraindicated in some patients and may be associated with poorer outcomes. Therefore other alternative access routes are increasingly being performed. We conducted a systematic review of the literature on transcarotid transcatheter aortic valve replacement (TC-TAVR) and meta-analysis comparing outcomes of TC-TAVR and other access routes. METHODS: We comprehensively searched for controlled randomized and non-randomized studies from 4 online databases. We presented data using risk ratios (95 % confidence intervals) and measured heterogeneity using Higgins' I(2). RESULTS: Sixteen observational studies on transcarotid TAVR were included in the analysis; 4 studies compared TC-TAVR vs TF-TAVR. The mean age and STS score for patients undergoing TC-TAVR were 80 years and 7.6 respectively. For TF-TAVR patients, mean age and STS score were 81.2 years and 6.5 respectively. There was no difference between patients undergoing TC-TAVR and TF-TAVR in the following 30-day outcomes: MACE [8.4 % vs 6.7 %; OR 1.32 (95 % CI 0.71-2.46 p = 0.38) I(2) = 0 %], mortality [5.6 % vs 4.0 %; OR 0.42 (95 % CI 0.60-3.37, P = 0.42) I(2) = 0 %] and stroke [0.7 % vs 2.3 %; OR 0.49 (95 % CI 0.09-2.56, P = 0.40) I(2) = 0 %]. There was no difference in 30-day major vascular complications [0.7 % vs 3 %; OR 0.55 (95 % CI 0.06-5.29, P = 0.61) I(2) = 39 %], major bleeding [0.7 % vs 3.8 %; OR 0.39 (95 % CI 0.09-1.67, P = 0.21) I(2) = 0 %], and moderate or severe aortic valve regurgitation [8.6 % vs 9.9 %; OR 0.89 (95 % CI 0.48-1.65, P = 0.72) I(2) = 0 %]. CONCLUSION: There are no significant differences in mortality, stroke MACE and major or life-threatening bleeding or vascular complications when TC-TAVR is compared to TF-TAVR approaches. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Munguti, Cyrus AU - Munguti C AD - Department of Internal Medicine, University of Kansas School of Medicine, Wichita, KS, USA; Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS, USA. Electronic address: cmunguti@kumc.edu. FAU - Ndunda, Paul M AU - Ndunda PM AD - Division of Cardiology, Louisiana State University in Shreveport, Shreveport, LA, USA. FAU - Abukar, Abdullah AU - Abukar A AD - Department of Internal Medicine, University of California San Francisco, San Francisco, CA, USA. FAU - Jawad, Mohammed Abdel AU - Jawad MA AD - Division of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, KS, USA. FAU - Vindhyal, Mohinder R AU - Vindhyal MR AD - Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS, USA. Electronic address: mvindhyal@kumc.edu. FAU - Fanari, Zaher AU - Fanari Z AD - Department of Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Division of Cardiology, University of California San Francisco, Fresno, CA, USA. Electronic address: zaher.fanari@ucsf.edu. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20240404 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Aged MH - Aged, 80 and over MH - Humans MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology MH - Carotid Arteries/surgery/diagnostic imaging MH - *Catheterization, Peripheral/adverse effects/methods/mortality MH - *Femoral Artery/diagnostic imaging/surgery MH - Observational Studies as Topic MH - Postoperative Complications/epidemiology/etiology MH - *Punctures MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods/mortality MH - Treatment Outcome OTO - NOTNLM OT - Transcarotid OT - Transcatheter aortic valve replacement OT - Transfemoral COIS- Declaration of competing interest All the authors have no declarations to make. EDAT- 2024/04/10 00:43 MHDA- 2024/11/22 00:23 CRDT- 2024/04/09 22:03 PHST- 2024/02/09 00:00 [received] PHST- 2024/04/03 00:00 [revised] PHST- 2024/04/03 00:00 [accepted] PHST- 2024/11/22 00:23 [medline] PHST- 2024/04/10 00:43 [pubmed] PHST- 2024/04/09 22:03 [entrez] AID - S1553-8389(24)00151-9 [pii] AID - 10.1016/j.carrev.2024.04.008 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 Nov;68:92-97. doi: 10.1016/j.carrev.2024.04.008. Epub 2024 Apr 4. PMID- 38592382 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240411 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 5 DP - 2024 Mar 6 TI - See It Best: A Propensity-Matched Analysis of Ultrasound-Guided versus Blind Femoral Artery Puncture in Balloon-Expandable TAVI. LID - 10.3390/jcm13051514 [doi] LID - 1514 AB - Background: Currently, transcatheter aortic valve implantation (TAVI) is the standard procedure recommended for patients over 75 years of age with symptomatic aortic valve stenosis. Percutaneous transfemoral (TF) access is the main route used to perform the procedure. Among periprocedural complications, access-related ones are the most frequent, potentially leading to prolonged in-hospital stays and transfusions. Methods: We performed a retrospective analysis of prospectively collected data on consecutive patients undergoing TF-TAVI with the latest generation balloon-expandable transcatheter valve between 2013 and 2022. Results: A total of 600 patients were analyzed, differentiating the population between ultrasound-guided and blind common femoral artery puncture. Valve Academic Research Consortium 3 (VARC-3)criteria were used to report at 30 days and follow-up. In our propensity-matched comparison of the two groups, we found a strong reduction in access-related complications in the echo-guided group, particularly in terms of reduction of major and minor bleedings. We also found a significant trend in reduction of local complications, such as pseudoaneurysms, hematomas, arterio-venous fistulas, dissection of the femoral or iliac arteries, and stenosis. Conclusions: Although there is a lack of consensus on the role of ultrasound-guided puncture, we found better outcomes for patients having an echo-guided puncture of the main access, particularly with regard to access-related complications, early mobilization, and early discharge home. FAU - Gennari, Marco AU - Gennari M AUID- ORCID: 0000-0001-9079-3275 AD - Centro Cardiologico Monzino IRCCS, Department of Invasive Cardiology, Structural and Valvular Interventional Cardiology Unit, 20138 Milan, Italy. FAU - Maccarana, Agnese AU - Maccarana A AD - Centro Cardiologico Monzino IRCCS, Department of Cardiovascular Surgery, 20138 Milan, Italy. FAU - Severgnini, Gaia AU - Severgnini G AD - Centro Cardiologico Monzino IRCCS, Department of Cardiovascular Surgery, 20138 Milan, Italy. FAU - Iennaco, Vittoria AU - Iennaco V AD - Centro Cardiologico Monzino IRCCS, Department of Cardiovascular Surgery, 20138 Milan, Italy. FAU - Bonomi, Alice AU - Bonomi A AD - Centro Cardiologico Monzino IRCCS, Department of Biostatistics, 20138 Milan, Italy. FAU - Capra, Nicolo AU - Capra N AUID- ORCID: 0000-0003-1974-2015 AD - Centro Cardiologico Monzino IRCCS, Department of Biostatistics, 20138 Milan, Italy. FAU - De Marco, Federico AU - De Marco F AUID- ORCID: 0000-0003-3554-6938 AD - Centro Cardiologico Monzino IRCCS, Department of Invasive Cardiology, Structural and Valvular Interventional Cardiology Unit, 20138 Milan, Italy. FAU - Muratori, Manuela AU - Muratori M AD - Centro Cardiologico Monzino IRCCS, Department of Imaging, 20138 Milan, Italy. FAU - Fusini, Laura AU - Fusini L AUID- ORCID: 0000-0003-0309-6231 AD - Centro Cardiologico Monzino IRCCS, Department of Imaging, 20138 Milan, Italy. FAU - Polvani, Gianluca AU - Polvani G AD - Centro Cardiologico Monzino IRCCS, Department of Cardiovascular Surgery, 20138 Milan, Italy. AD - Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20100 Milan, Italy. FAU - Agrifoglio, Marco AU - Agrifoglio M AD - Centro Cardiologico Monzino IRCCS, Department of Cardiovascular Surgery, 20138 Milan, Italy. AD - Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20100 Milan, Italy. LA - eng PT - Journal Article DEP - 20240306 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10935327 OTO - NOTNLM OT - TAVI OT - transfemoral OT - ultrasound OT - vascular complications COIS- The authors state no conflicts of interests for this study. EDAT- 2024/04/09 12:42 MHDA- 2024/04/09 12:43 PMCR- 2024/03/06 CRDT- 2024/04/09 11:05 PHST- 2023/12/20 00:00 [received] PHST- 2024/02/13 00:00 [revised] PHST- 2024/02/20 00:00 [accepted] PHST- 2024/04/09 12:43 [medline] PHST- 2024/04/09 12:42 [pubmed] PHST- 2024/04/09 11:05 [entrez] PHST- 2024/03/06 00:00 [pmc-release] AID - jcm13051514 [pii] AID - jcm-13-01514 [pii] AID - 10.3390/jcm13051514 [doi] PST - epublish SO - J Clin Med. 2024 Mar 6;13(5):1514. doi: 10.3390/jcm13051514. PMID- 38592323 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240411 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 5 DP - 2024 Mar 4 TI - Intravascular Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Implantation in Patients with Severe Iliofemoral Calcifications: Expanding Transfemoral Indications. LID - 10.3390/jcm13051480 [doi] LID - 1480 AB - (1) Background: Transfemoral transcatheter aortic valve implantation (TAVI) has become the standard treatment for most patients with severe symptomatic aortic stenosis. Intravascular lithotripsy may facilitate transfemoral TAVI (IVL-TAVI) even in patients with severely calcified iliofemoral disease. We assessed technical aspects and clinical outcomes of this novel approach compared to alternative transaxillary access (TAX-TAVI). (2) Methods: IVL-TAVI was performed for severe iliofemoral calcifications precluding standard transfemoral access in 30 patients from 2019 to 2022 at a single academic heart center. IVL was performed as part of the TAVI procedure in all cases. Results were compared to a control group of 44 TAX-TAVI procedures performed for the same indication from 2016 to 2021. The safety outcome was a composite of all-cause death, stroke, access-related bleeding >/= type 2 within 24 h and major vascular access site complications at 30 days. The efficacy outcome was defined as a technical success according to VARC-3. (3) Results: Median age was 78.2 [74.3, 82.6] years, 45.9% were female and mean STS-PROM was 3.6% [2.3, 6.0]. Iliofemoral calcifications were more severe in the IVL-TAVI vs. TAX-TAVI groups (lesion length: 63.0 mm [48.6, 80.3] vs. 48.5 mm [33.1, 68.8]; p = 0.043, severe calcification at target lesion: 90.0% vs. 68.2%; p = 0.047, and median arc calcification 360.0 degrees [297.5, 360.0] vs. 360.0 degrees [180.0, 360.0]; p = 0.033). Technical success was achieved in 93.3% vs. 81.8% (p = 0.187) in IVL- and TAX-TAVI and the safety outcome occurred in 10.0% vs. 31.8% in IVL- and TAX-TAVI (p = 0.047), respectively. (4) Conclusions: IVL-assisted transfemoral TAVI was feasible and safe with favorable outcomes compared to TAX-TAVI. IVL may further expand the number of patients eligible for transfemoral TAVI and may help overcome limitations of an alternative access. FAU - Linder, Matthias AU - Linder M AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. AD - Department of Cardiology, Regio Kliniken Pinneberg GmbH, Fahltskamp 74, 25421 Pinneberg, Germany. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Kellner, Caroline AU - Kellner C AUID- ORCID: 0009-0000-9693-4622 AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. AD - Centre for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. FAU - Demal, Till AU - Demal T AUID- ORCID: 0000-0001-8978-9914 AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, 24105 Kiel, Germany. FAU - Waldschmidt, Lara AU - Waldschmidt L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Bhadra, Oliver AU - Bhadra O AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Ludwig, Sebastian AU - Ludwig S AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Voigtlander, Lisa AU - Voigtlander L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, 24105 Kiel, Germany. FAU - von der Heide, Ina AU - von der Heide I AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Nebel, Nicole AU - Nebel N AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Hannen, Laura AU - Hannen L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Schirmer, Johannes AU - Schirmer J AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AUID- ORCID: 0000-0001-6488-2362 AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. AD - Centre for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, 24105 Kiel, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Schafer, Andreas AU - Schafer A AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. FAU - Seiffert, Moritz AU - Seiffert M AUID- ORCID: 0000-0002-3940-9079 AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246 Hamburg, Germany. AD - Centre for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lubeck/Kiel, 24105 Kiel, Germany. AD - Department of Cardiology and Angiology, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Burkle de la Camp-Platz 1, 44789 Bochum, Germany. LA - eng PT - Journal Article DEP - 20240304 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10932192 OTO - NOTNLM OT - IVL OT - TAVI OT - aortic stenosis OT - intravascular lithotripsy OT - transaxillary OT - transfemoral COIS- M.S. received speaker or advisory fees from Abbott Vascular, Abiomed, Amgen, Astra Zeneca, Boston Scientific, Bristol-Myers Squibb, Daichii Sankyo, Edwards Lifesciences, Inari Medical, Medtronic, Pfizer, Shockwave Medical, Siemens Healthineers and a research grant from Boston Scientific-all unrelated to the submitted work. LW received speaker honoraria from Medtronic and AstraZeneca. L.C. is an advisory board member for Abbott, Medtronic and JenaValve, and is a consultant for Edwards Lifesciences, BostonScientific, Venus Medtech, MicroPort, Neovasc and PiCardia. N.S. has received speaking honoraria, travel compensation and proctor fees from Edwards Lifesciences, travel compensation from Abbott, speaking honoraria and travel compensation from Boston scientific and speaking honoraria form Highlife SAS. A.S. received speaker honoraria from Abbott and Boston Scientific and received travel compensation from Edwards Lifesciences. S.L. received travel compensation from Edwards Lifesciences, speaker honoraria from Abbott, advisory fees from Bayer, and is a consultant for New Valve Technology (NVT). All other authors report no conflicts of interest. EDAT- 2024/04/09 12:44 MHDA- 2024/04/09 12:45 PMCR- 2024/03/04 CRDT- 2024/04/09 10:56 PHST- 2024/02/05 00:00 [received] PHST- 2024/02/25 00:00 [revised] PHST- 2024/02/28 00:00 [accepted] PHST- 2024/04/09 12:45 [medline] PHST- 2024/04/09 12:44 [pubmed] PHST- 2024/04/09 10:56 [entrez] PHST- 2024/03/04 00:00 [pmc-release] AID - jcm13051480 [pii] AID - jcm-13-01480 [pii] AID - 10.3390/jcm13051480 [doi] PST - epublish SO - J Clin Med. 2024 Mar 4;13(5):1480. doi: 10.3390/jcm13051480. PMID- 38591014 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240410 IS - 2468-4287 (Print) IS - 2468-4287 (Electronic) IS - 2468-4287 (Linking) VI - 10 IP - 3 DP - 2024 Jun TI - Early results of transcatheter electrosurgical aortic septotomy for endovascular repair of chronic dissecting aortoiliac aneurysms. PG - 101467 LID - 10.1016/j.jvscit.2024.101467 [doi] LID - 101467 AB - OBJECTIVE: Endovascular repair of chronic dissecting aortoiliac aneurysms is challenging given the rigid septum, compressed true lumen (TL), and target vessels frequently originating in the false lumen. We have used transcatheter electrosurgical aortic septotomy (TEAS) before stent graft implantation under intravascular ultrasound (IVUS) and fusion guidance. The purpose of this study is to assess the outcomes of TEAS during complex endovascular repair of dissecting aneurysms. METHODS: From 2021 to 2023, 17 patients underwent TEAS. The primary end point was technical success, with secondary end points of proximal and distal seals, target vessel instability, aortic and iliac TL and cross-sectional area (CSA) expansion, and aortic-related death. During the procedure, the aortic septum is crossed through a pre-existing entry or via electrocautery-activated 0.018-in. Astato XS20 wire (Asahi-Intecc) under IVUS and fusion guidance. The penetrated wire is then snared in the false lumen and pulled through the ipsilateral femoral access. A 1-cm length of the middle of the Astato wire coating is kinked in a three-sided polygonal configuration, denuded the inner surface of the wire using a no. 15 blade, and positioned at the apex of the septum. Both ends of the Astato wire are insulated with 0.018-in. microcatheters, and the back end of the wire is denuded and connected to cautery. Gentle traction is applied to the wire, and short bursts of electrocautery cutting are applied at 60 to 80 W. RESULTS: The technical success of the septotomy was 100%. No incidence of visceral or lower extremity malperfusion, vascular injury, or distal embolization occurred. Of the 17 patients, 4 underwent thoracic endovascular aneurysm repair, 2 underwent endovascular aortic repair, and 11 underwent fenestrated/branched endovascular aneurysm repair after septotomy. All target vessels were successfully stented. A distal landing zone seal with exclusion of the false lumen was achieved in 16 of the 17 patients (94.1%). One patient required embolization of the false lumen of the celiac artery after septotomy. The TL mean diameter and CSA of the descending thoracic aorta after septotomy was expanded by 7.01 +/- 1.9 mm (relative mean diameter expansion, 42.3%; P < .0001) and 2.71 +/- 0.4 cm(2) (relative mean CSA expansion, 57.3%, P<.0001). For patients who required septotomy through the common iliac arteries, the mean TL was expanded by 8.1 +/- 3.7 mm (relative mean diameter expansion, 76%; P < .0001) and 1.76 +/- 0.91 cm(2) (relative mean CSA expansion, 209%; P < .0001). The 1-year freedom from target vessel instability was 91%. CONCLUSIONS: The use of IVUS and fusion-guided TEAS offers a promising technique to facilitate TL expansion and false lumen exclusion in chronic dissecting aortic aneurysms before repair. The durability and long-term outcomes of this technique in a larger cohort remain to be elucidated. CI - (c) 2024 The Author(s). FAU - Tanenbaum, Mira T AU - Tanenbaum MT AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Figueroa, Andres V AU - Figueroa AV AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Lee, K Benjamin AU - Lee KB AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Costa Filho, Jose Eduardo AU - Costa Filho JE AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Gonzalez, Marilisa Soto AU - Gonzalez MS AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Baig, Mirza S AU - Baig MS AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Timaran, Carlos H AU - Timaran CH AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. LA - eng PT - Journal Article DEP - 20240229 PL - United States TA - J Vasc Surg Cases Innov Tech JT - Journal of vascular surgery cases and innovative techniques JID - 101701125 PMC - PMC10999806 OTO - NOTNLM OT - Aortic aneurysm OT - Aortic septotomy OT - Chronic aortic dissection OT - Endovascular aortic repair OT - Transcatheter electrosurgery COIS- M.S.B. and C.H.T. have been consultants for, and received research support from, 10.13039/100010479Cook Medical Inc, W.L. Gore & Associates, Inc, and Phillips Healthcare. The remaining authors report no conflicts. EDAT- 2024/04/09 06:45 MHDA- 2024/04/09 06:46 PMCR- 2024/02/29 CRDT- 2024/04/09 03:57 PHST- 2024/02/01 00:00 [received] PHST- 2024/02/22 00:00 [accepted] PHST- 2024/04/09 06:46 [medline] PHST- 2024/04/09 06:45 [pubmed] PHST- 2024/04/09 03:57 [entrez] PHST- 2024/02/29 00:00 [pmc-release] AID - S2468-4287(24)00051-0 [pii] AID - 101467 [pii] AID - 10.1016/j.jvscit.2024.101467 [doi] PST - epublish SO - J Vasc Surg Cases Innov Tech. 2024 Feb 29;10(3):101467. doi: 10.1016/j.jvscit.2024.101467. eCollection 2024 Jun. PMID- 38588595 OWN - NLM STAT- MEDLINE DCOM- 20240514 LR - 20260127 IS - 1366-5804 (Electronic) IS - 1354-750X (Linking) VI - 29 IP - 4 DP - 2024 Jun TI - The role of Matrix Metalloproteinase-2 and Galectin-3 as predictive biomarkers for all-cause mortality in patients undergoing transfemoral transcatheter aortic valve implantation. PG - 205-210 LID - 10.1080/1354750X.2024.2341409 [doi] AB - BACKGROUND: Currently available risk scores fail to accurately predict morbidity and mortality in patients with severe symptomatic aortic stenosis who undergo transcatheter aortic valve implantation (TAVI). In this context, biomarkers like matrix metalloproteinase-2 (MMP-2) and Galectin-3 (Gal-3) may provide additional prognostic information. METHODS: Patients with severe aortic stenosis undergoing consecutive, elective, transfemoral TAVI were included. Baseline demographic data, functional status, echocardiographic findings, clinical outcomes and biomarker levels were collected and analysed. RESULTS: The study cohort consisted of 89 patients (age 80.4 +/- 5.1 years, EuroScore II 7.1 +/- 5.8%). During a median follow-up period of 526 d, 28 patients (31.4%) died. Among those who died, median baseline MMP-2 (alive: 221.6 [170.4; 263] pg/mL vs. deceased: 272.1 [225; 308.8] pg/mL, p < 0.001) and Gal-3 levels (alive: 19.1 [13.5; 24.6] pg/mL vs. deceased: 25 [17.6; 29.5] pg/mL, p = 0.006) were higher than in survivors. In ROC analysis, MMP-2 reached an acceptable level of discrimination to predict mortality (AUC 0.733, 95% CI [0.62; 0.83], p < 0.001), but the predictive value of Gal-3 was poor (AUC 0.677, 95% CI [0.56; 0.79], p = 0.002). Kaplan-Meier and Cox regression analyses showed that patients with MMP-2 and Gal-3 concentrations above the median at baseline had significantly impaired long-term survival (p = 0.004 and p = 0.02, respectively). CONCLUSIONS: In patients with severe aortic stenosis undergoing transfemoral TAVI, MMP-2 and to a lesser extent Gal-3, seem to have additive value in optimizing risk prediction and streamlining decision-making. FAU - Piayda, Kerstin AU - Piayda K AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Heilemann, Julian Tim AU - Heilemann JT AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Keranov, Stanislav AU - Keranov S AUID- ORCID: 0000-0002-4379-4424 AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Schulz, Luisa AU - Schulz L AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Arsalan, Mani AU - Arsalan M AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Department of Cardiothoracic Surgery, Medical Faculty, Goethe-University Frankfurt, Frankfurt, Germany. FAU - Liebetrau, Christoph AU - Liebetrau C AD - Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. FAU - Hofmann, Felix J AU - Hofmann FJ AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Bauer, Pascal AU - Bauer P AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Voss, Sandra AU - Voss S AD - Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. FAU - Troidl, Christian AU - Troidl C AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. FAU - Sossalla, Samuel T AU - Sossalla ST AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. FAU - Nef, Holger M AU - Nef HM AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. FAU - Dorr, Oliver AU - Dorr O AD - Department of Cardiology, Justus-Liebig-University Giessen, Medical Clinic I, Giessen, Germany. AD - Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany. AD - Kerckhoff Herzforschungsinstitut, Bad Nauheim, Germany. LA - eng PT - Journal Article DEP - 20240415 PL - England TA - Biomarkers JT - Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals JID - 9606000 RN - EC 3.4.24.24 (Matrix Metalloproteinase 2) RN - 0 (Biomarkers) RN - 0 (Galectin 3) RN - 0 (Galectins) RN - 0 (Blood Proteins) SB - IM MH - Humans MH - *Matrix Metalloproteinase 2/blood MH - *Transcatheter Aortic Valve Replacement/mortality MH - *Biomarkers/blood MH - Male MH - Female MH - *Aortic Valve Stenosis/surgery/mortality/blood MH - *Galectin 3/blood MH - Aged, 80 and over MH - Aged MH - Prognosis MH - Galectins MH - Blood Proteins/analysis/metabolism OTO - NOTNLM OT - Galectin-3 OT - MMP-2 OT - TAVI OT - biomarkers OT - survival prediction EDAT- 2024/04/08 18:42 MHDA- 2024/05/15 05:44 CRDT- 2024/04/08 17:53 PHST- 2024/05/15 05:44 [medline] PHST- 2024/04/08 18:42 [pubmed] PHST- 2024/04/08 17:53 [entrez] AID - 10.1080/1354750X.2024.2341409 [doi] PST - ppublish SO - Biomarkers. 2024 Jun;29(4):205-210. doi: 10.1080/1354750X.2024.2341409. Epub 2024 Apr 15. PMID- 38585677 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241118 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 6 IP - 2Part A DP - 2024 Feb TI - A Systematic Review of Delayed High-Grade Atrioventricular Block After Transcatheter Aortic Valve Implantation. PG - 86-95 LID - 10.1016/j.cjco.2023.10.003 [doi] AB - BACKGROUND: High-grade atrioventricular block (HGAVB) is common after transcatheter aortic valve implantation (TAVI), often necessitating permanent pacemaker (PPM) implantation. Delayed HGAVB has varying definitions but typically refers to onset 48 hours after TAVI or following discharge and may cause syncope and sudden cardiac death. This review estimates the incidence of delayed HGAVB and identifies limitations of current literature. METHODS: A systematic review was performed of the following online databases: Medline, Cochrane, Web of Science, and Scopus. Studies that labelled the outcome of "delayed" or "late" atrioventricular block after TAVI were included; patients with previous PPM or aortic valve surgery were excluded. Initial search yielded 775 studies, which, after screening, was narrowed to 19 studies. RESULTS: Nineteen studies with 14,898 patients were included. Mean age was 81.7 years, and 46.3% were male. Mean Society of Thoracic Surgeons (STS) score was 5.6%, and 31.3% of patients had known atrial fibrillation. The most common access site was transfemoral (84.8%), whereas balloon-expandable valves were used in 62.1%, self-expanding valves in 34.0%, and mechanically expanding valves in 3.9% of cases. The incidence of delayed HGAVB ranged from 1.7% to 14.6%, with significant methodologic heterogeneity noted among the included studies. CONCLUSIONS: Delayed HGAVB is a common and potentially serious complication of TAVI, with similar risk factors to acute HGAVB. With a move toward an early discharge strategy post-TAVI, further prospective study of delayed HGAVB is warranted to improve understanding of predisposing factors, incidence, timing, and implications. CI - (c) 2023 The Authors. FAU - Rao, Karan AU - Rao K AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia. AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. AD - University of Sydney, Sydney, Australia. FAU - Chan, Bernard AU - Chan B AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia. AD - University of Sydney, Sydney, Australia. FAU - Baer, Alexandra AU - Baer A AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. FAU - Hansen, Peter AU - Hansen P AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia. AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. FAU - Bhindi, Ravinay AU - Bhindi R AD - Department of Cardiology, Royal North Shore Hospital, Sydney, Australia. AD - Department of Cardiology, North Shore Private Hospital, Sydney, Australia. AD - University of Sydney, Sydney, Australia. LA - eng PT - Journal Article PT - Review DEP - 20231009 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC10994975 EDAT- 2024/04/08 06:43 MHDA- 2024/04/08 06:44 PMCR- 2023/10/09 CRDT- 2024/04/08 04:34 PHST- 2023/08/07 00:00 [received] PHST- 2023/10/03 00:00 [accepted] PHST- 2024/04/08 06:44 [medline] PHST- 2024/04/08 06:43 [pubmed] PHST- 2024/04/08 04:34 [entrez] PHST- 2023/10/09 00:00 [pmc-release] AID - S2589-790X(23)00290-1 [pii] AID - 10.1016/j.cjco.2023.10.003 [doi] PST - epublish SO - CJC Open. 2023 Oct 9;6(2Part A):86-95. doi: 10.1016/j.cjco.2023.10.003. eCollection 2024 Feb. PMID- 38555216 OWN - NLM STAT- MEDLINE DCOM- 20240505 LR - 20260610 IS - 1532-8422 (Electronic) IS - 1053-0770 (Linking) VI - 38 IP - 6 DP - 2024 Jun TI - The Influence of Audiovisual Distraction on Pain Reduction During Transcatheter Aortic Valve Implantation Under Monitored Anesthesia Care: A Prospective Randomized Trial. PG - 1353-1360 LID - S1053-0770(23)00949-7 [pii] LID - 10.1053/j.jvca.2023.11.041 [doi] AB - OBJECTIVES: To investigate the effect of an audiovisual distraction system on the dose of remifentanil for perioperative sedation during transcatheter aortic valve implantation under monitored anesthesia care. DESIGN: Single-center prospective randomized nonblinded study. SETTING: Tertiary referral academic hospital. PARTICIPANTS: Ninety patients who underwent transfemoral transcatheter aortic valve implantation between July 2019 and July 2021. INTERVENTIONS: Patients were randomized to use either a novel audiovisual distraction system during the intervention (n = 45) or standard care without an audiovisual distraction system (n = 45). MEASUREMENTS AND MAIN RESULTS: Standardized questionnaires were given to each patient at admission and before and after the intervention to assess their levels of anxiety. Primary endpoints were the average and peak infusion rates of remifentanil. All patients were considered for the final analysis according to an intention-to-treat design. No relevant differences in pre- and postinterventional anxiety status were observed between the groups. Similarly, there were no significant differences in reported pain scores (p = 0.364). The average infusion rate (p = 0.028) and peak infusion rate (p = 0.025) of remifentanil were lower in the group with an audiovisual distraction system. CONCLUSIONS: Audiovisual distraction is a useful adjunct to reduce the dose of remifentanil under monitored anesthesia care during transcatheter aortic valve implantation. Larger studies are needed to evaluate potential positive effects on patient satisfaction, incidence of delirium, and possible economic benefits. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Pitts, Leonard AU - Pitts L AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany; Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany. Electronic address: leonard.pitts@dhzc-charite.de. FAU - Hellner, Nicolas AU - Hellner N AD - Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany. FAU - Kofler, Markus AU - Kofler M AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany; Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; German Center for Cardiovascular Research, Berlin, Germany. FAU - Ryschka, Martin AU - Ryschka M AD - Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany. FAU - Unbehaun, Axel AU - Unbehaun A AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany; Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany. FAU - O'Brien, Benjamin AU - O'Brien B AD - Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany; German Center for Cardiovascular Research, Berlin, Germany. FAU - Kempfert, Jorg AU - Kempfert J AD - Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany; Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; German Center for Cardiovascular Research, Berlin, Germany. FAU - Hommel, Matthias AU - Hommel M AD - Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20231201 PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 RN - P10582JYYK (Remifentanil) SB - IM MH - Humans MH - Female MH - Prospective Studies MH - Male MH - *Transcatheter Aortic Valve Replacement/methods MH - Aged MH - Aged, 80 and over MH - Remifentanil/administration & dosage MH - Pain Management/methods MH - Audiovisual Aids MH - Anesthesia/methods OTO - NOTNLM OT - HappyMed OT - audiovisual distraction OT - monitored anesthesia care OT - remifentanil OT - transcatheter aortic valve implantation COIS- Declaration of competing interest None. EDAT- 2024/03/31 00:42 MHDA- 2024/05/06 00:52 CRDT- 2024/03/30 22:58 PHST- 2023/09/08 00:00 [received] PHST- 2023/11/26 00:00 [revised] PHST- 2023/11/27 00:00 [accepted] PHST- 2024/05/06 00:52 [medline] PHST- 2024/03/31 00:42 [pubmed] PHST- 2024/03/30 22:58 [entrez] AID - S1053-0770(23)00949-7 [pii] AID - 10.1053/j.jvca.2023.11.041 [doi] PST - ppublish SO - J Cardiothorac Vasc Anesth. 2024 Jun;38(6):1353-1360. doi: 10.1053/j.jvca.2023.11.041. Epub 2023 Dec 1. PMID- 38552656 OWN - NLM STAT- MEDLINE DCOM- 20240415 LR - 20250224 IS - 1474-547X (Electronic) IS - 0140-6736 (Linking) VI - 403 IP - 10435 DP - 2024 Apr 13 TI - Transcatheter aortic valve implantation in patients with high-risk symptomatic native aortic regurgitation (ALIGN-AR): a prospective, multicentre, single-arm study. PG - 1451-1459 LID - S0140-6736(23)02806-4 [pii] LID - 10.1016/S0140-6736(23)02806-4 [doi] AB - BACKGROUND: Surgery remains the only recommended intervention for patients with native aortic regurgitation. A transcatheter therapy to treat patients at high risk for mortality and complications with surgical aortic valve replacement represents an unmet need. Commercial transcatheter heart valves in pure aortic regurgitation are hampered by unacceptable rates of embolisation and paravalvular regurgitation. The Trilogy transcatheter heart valve (JenaValve Technology, Irvine, CA, USA) provides a treatment option for these patients. We report outcomes with transfemoral transcatheter aortic valve implantation (TAVI) in patients with pure aortic regurgitation using this dedicated transcatheter heart valve. METHODS: The ALIGN-AR trial is a prospective, multicentre, single-arm study. We recruited symptomatic patients (aged >/=18 years) with moderate-to-severe or severe aortic regurgitation at high risk for mortality and complications after surgical aortic valve replacement at 20 US sites for treatment with the Trilogy transcatheter heart valve. The 30-day composite primary safety endpoint was compared for non-inferiority with a prespecified performance goal of 40.5%. The primary efficacy endpoint was 1-year all-cause mortality compared for non-inferiority with a performance goal of 25%. This trial is registered with ClinicalTrials.gov, NCT04415047, and is ongoing. FINDINGS: Between June 8, 2018, and Aug 29, 2022, we screened 346 patients. We excluded 166 (48%) patients and enrolled 180 (52%) patients with symptomatic aortic regurgitation deemed high risk by the heart team and independent screening committee assessments. The mean age of the study population was 75.5 years (SD 10.8), and 85 (47%) were female, 95 (53%) were male, and 131 (73%) were White. Technical success was achieved in 171 (95%) patients. At 30 days, four (2%) deaths, two (1%) disabling strokes, and two (1%) non-disabling strokes occurred. Using standard Valve Academic Research Consortium-2 definitions, the primary safety endpoint was achieved, with events occurring in 48 (27% [97.5% CI 19.2-34.0]) patients (p(non-inferiority)<0.0001), with new pacemaker implantation in 36 (24%) patients. The primary efficacy endpoint was achieved, with mortality in 14 (7.8% [3.3-12.3]) patients at 1 year (p(non-inferiority)<0.0001). INTERPRETATION: This study shows the safety and effectiveness of treating native aortic regurgitation using a dedicated transcatheter heart valve to treat patients with symptomatic moderate-to-severe or severe aortic regurgitation who are at high risk for mortality or complications after surgical aortic valve replacement. The observed short-term clinical and haemodynamic outcomes are promising as are signs of left ventricular remodelling, but long-term follow-up is necessary. FUNDING: JenaValve Technology. CI - Copyright (c) 2024 Elsevier Ltd. All rights reserved. FAU - Vahl, Torsten P AU - Vahl TP AD - Columbia University Irving Medical Center, New York, NY, USA. Electronic address: tv2193@columbia.edu. FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, GA, USA. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars Sinai Medical Center, Los Angeles, CA, USA. FAU - Hamid, Nadira AU - Hamid N AD - Minneapolis Heart Institute, Minneapolis, MN, USA. FAU - Khalique, Omar K AU - Khalique OK AD - St Francis Hospital and Heart Center, Roslyn, NY, USA. FAU - Daniels, David AU - Daniels D AD - California Pacific Medical Center, San Francisco, CA, USA. FAU - McCabe, James M AU - McCabe JM AD - University of Washington, Seattle, WA, USA. FAU - Satler, Lowell AU - Satler L AD - Medstar Washington Hospital Center, Washington, DC, USA. FAU - Russo, Mark AU - Russo M AD - Rutgers University, New Brunswick, NJ, USA. FAU - Cheng, Wen AU - Cheng W AD - Cedars Sinai Medical Center, Los Angeles, CA, USA. FAU - George, Isaac AU - George I AD - Columbia University Irving Medical Center, New York, NY, USA. FAU - Aldea, Gabriel AU - Aldea G AD - University of Washington, Seattle, WA, USA. FAU - Sheridan, Brett AU - Sheridan B AD - California Pacific Medical Center, San Francisco, CA, USA. FAU - Kereiakes, Dean AU - Kereiakes D AD - Christ Hospital, Cincinnati, OH, USA. FAU - Golwala, Harsh AU - Golwala H AD - Oregon Health Sciences, Portland, OR, USA. FAU - Zahr, Firas AU - Zahr F AD - Oregon Health Sciences, Portland, OR, USA. FAU - Chetcuti, Stanley AU - Chetcuti S AD - University of Michigan, Ann Arbor, MI, USA. FAU - Yadav, Pradeep AU - Yadav P AD - Piedmont Heart Institute, Atlanta, GA, USA. FAU - Kodali, Susheel K AU - Kodali SK AD - Columbia University Irving Medical Center, New York, NY, USA. FAU - Treede, Hendrik AU - Treede H AD - University Medical Center of the Johannes Gutenberg University, Mainz, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Clinic III for Internal Medicine, University Hospital Cologne, Cologne, Germany. FAU - Amoroso, Nicholas AU - Amoroso N AD - Medical University of South Carolina, Charleston, SC, USA. FAU - Ranard, Lauren S AU - Ranard LS AD - Columbia University Irving Medical Center, New York, NY, USA. FAU - Pinto, Duane S AU - Pinto DS AD - Beth Israel Deaconess Medical Center, Interventional Cardiology Section, Division of Cardiology, Boston, MA, USA. FAU - Leon, Martin B AU - Leon MB AD - Columbia University Irving Medical Center, New York, NY, USA. LA - eng SI - ClinicalTrials.gov/NCT04415047 PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20240326 PL - England TA - Lancet JT - Lancet (London, England) JID - 2985213R SB - IM CIN - Lancet. 2024 Apr 13;403(10435):1420-1421. doi: 10.1016/S0140-6736(24)00062-X. PMID: 38552657 MH - Adolescent MH - Adult MH - Aged MH - Female MH - Humans MH - Male MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Insufficiency/etiology/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Prospective Studies MH - Prosthesis Design MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome COIS- Declaration of interests TPV reports institutional funding to Columbia University Irving Medical Center from JenaValve Technology, Abbott Vascular, Boston Scientific, Edwards Lifesciences, and Medtronic; and he personally received consulting fees from 4C Medical and Philips. OKK reports that he is part of a core laboratory contracting with JenaValve Technology but he has not received any direct compensation; he further reports consulting fees from Edwards Lifesciences, VDyne, Siemens, Philips, Laralab, and Restore Medical. NH reports that she is part of a core laboratory contracting with JenaValve Technology but she has not received any direct compensation. JMM reports consulting fees and honoraria from Edwards Lifesciences, Medtronic, Abbott, Shockwave, and Equity in Excision Medical, and Conkay Medical. IG reports consulting fees from Edwards Lifesciences, Medtronic, Boston Scientific, Abbott SJM, and Atricure. SKK reports consultant fees (honoraria) from Admedus, Meril Lifesciences, JenaValve Technology, and Abbott Vascular; scientific advisory board participation (equity) with Dura Biotech, MicroInterventional Devices, Thubrikar Aortic Valve, Supira, and Admedus; and institutional funding to Columbia University and the Cardiovascular Research Foundation from Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, and JenaValve Technology. NA reports medical advisory board fees and consultant and proctor fees from Nininger Medical, Edwards Lifesciences, V-wave, JenaValve Technology, Abbott, Vdyne, and Boston Scientific, and participation in industry-sponsored trials and research funding from Edwards Lifesciences, JenaValve Technology, Boston Scientific, V-wave, AccuCinch, Highlife, Tendyne, and preCardia. DSP is the Chief Medical officer of JenaValve Technology and a consultant for Abiomed, Abbott Vascular, Magenta, NuPulseCV, and Terumo. MBL reports institutional clinical research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and JenaValve Technology. HG reports consulting fees from Medtronic and Boston Scientific. All other authors declare no competing interests. EDAT- 2024/03/30 11:43 MHDA- 2024/04/15 06:43 CRDT- 2024/03/29 19:55 PHST- 2023/10/08 00:00 [received] PHST- 2023/11/11 00:00 [revised] PHST- 2023/12/12 00:00 [accepted] PHST- 2024/04/15 06:43 [medline] PHST- 2024/03/30 11:43 [pubmed] PHST- 2024/03/29 19:55 [entrez] AID - S0140-6736(23)02806-4 [pii] AID - 10.1016/S0140-6736(23)02806-4 [doi] PST - ppublish SO - Lancet. 2024 Apr 13;403(10435):1451-1459. doi: 10.1016/S0140-6736(23)02806-4. Epub 2024 Mar 26. PMID- 38533944 OWN - NLM STAT- MEDLINE DCOM- 20240403 LR - 20260630 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 13 IP - 7 DP - 2024 Apr 2 TI - Risk Score for Prediction of Dialysis After Transcatheter Aortic Valve Replacement. PG - e032955 LID - 10.1161/JAHA.123.032955 [doi] LID - e032955 AB - BACKGROUND: Dialysis is a rare but serious complication after transcatheter aortic valve replacement. We analyzed the large multicenter TRITAVI (transfusion requirements in transcatheter aortic valve implantation) registry in order to develop and validate a clinical score assessing this risk. METHODS AND RESULTS: A total of 10 071 consecutive patients were enrolled in 19 European centers. Patients were randomly assigned (2:1) to a derivation and validation cohort. Two scores were developed, 1 including only preprocedural variables (TRITAVIpre) and 1 also including procedural variables (TRITAVIpost). In the 6714 patients of the derivation cohort (age 82+/-6 years, 48% men), preprocedural factors independently associated with dialysis and included in the TRITAVIpre score were male sex, diabetes, prior coronary artery bypass graft, anemia, nonfemoral access, and creatinine clearance <30 mL/min per m(2). Additional independent predictors among procedural features were volume of contrast, need for transfusion, and major vascular complications. Both scores showed a good discrimination power for identifying risk for dialysis with C-statistic 0.78 for TRITAVIpre and C-statistic 0.88 for TRITAVIpost score. Need for dialysis increased from the lowest to the highest of 3 risk score groups (from 0.3% to 3.9% for TRITAVIpre score and from 0.1% to 6.2% for TRITAVIpost score). Analysis of the 3357 patients of the validation cohort (age 82+/-7 years, 48% men) confirmed the good discrimination power of both scores (C-statistic 0.80 for TRITAVIpre and 0.81 for TRITAVIpost score). Need for dialysis was associated with a significant increase in 1-year mortality (from 6.9% to 54.4%; P=0.0001). CONCLUSIONS: A simple preprocedural clinical score can help predict the risk of dialysis after transcatheter aortic valve replacement. FAU - Pasceri, Vincenzo AU - Pasceri V AUID- ORCID: 0000-0001-7409-5792 AD - San Filippo Neri Hospital Rome Italy. FAU - Pelliccia, Francesco AU - Pelliccia F AD - Department of Cardiovascular Sciences University Sapienza Rome Italy. FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - Icahn School of Medicine at Mount Sinai New York NY. FAU - Dangas, George AU - Dangas G AUID- ORCID: 0000-0001-7502-8049 AD - Icahn School of Medicine at Mount Sinai New York NY. FAU - Porto, Italo AU - Porto I AUID- ORCID: 0000-0002-9854-5046 AD - Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy. AD - Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy. FAU - Radico, Francesco AU - Radico F AUID- ORCID: 0000-0001-9177-9547 AD - Department of Cardiology ASL2 Abruzzo Chieti Italy. FAU - Biancari, Fausto AU - Biancari F AUID- ORCID: 0000-0001-5028-8186 AD - Department of Medicine South Karelia Central Hospital, University of Helsinki Lappeenranta Finland. FAU - D'Ascenzo, Fabrizio AU - D'Ascenzo F AUID- ORCID: 0000-0002-6646-9317 AD - Department of Internal Medicine Citta della Salute e della Scienza Turin Italy. FAU - Saia, Francesco AU - Saia F AUID- ORCID: 0000-0001-9969-2649 AD - Department of Cardiothoracic Vascular Surgery University Hospital Bologna Italy. FAU - Luzi, Giampaolo AU - Luzi G AUID- ORCID: 0009-0005-3881-168X AD - Cardiovascular Department Azienda Ospedaliera Regionale "San Carlo" Potenza Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy. FAU - Amat Santos, Ignacio J AU - Amat Santos IJ AUID- ORCID: 0000-0002-2311-4129 AD - CIBERCV, Interventional Cardiology Hospital Clinico Universitario de Valladolid Valladolid Spain. FAU - De Marzo, Vincenzo AU - De Marzo V AD - Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy. AD - Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy. AD - Department of Cardiology ASL2 Abruzzo Chieti Italy. FAU - Dimagli, Arnaldo AU - Dimagli A AUID- ORCID: 0000-0003-0055-8656 AD - Department of Cardiothoracic Surgery Weill Cornell Medicine New York NY. FAU - Makikallio, Timo AU - Makikallio T AUID- ORCID: 0000-0002-6593-116X AD - Department of Medicine South Karelia Central Hospital, University of Helsinki Lappeenranta Finland. FAU - Stabile, Eugenio AU - Stabile E AD - Cardiovascular Department Azienda Ospedaliera Regionale "San Carlo" Potenza Italy. FAU - Blasco-Turrion, Sara AU - Blasco-Turrion S AUID- ORCID: 0000-0002-6682-6636 AD - CIBERCV, Interventional Cardiology Hospital Clinico Universitario de Valladolid Valladolid Spain. FAU - Testa, Luca AU - Testa L AUID- ORCID: 0000-0003-4687-3686 AD - Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy. FAU - Barbanti, Marco AU - Barbanti M AUID- ORCID: 0000-0002-4903-5437 AD - Universita degli Studi di Enna "Kore" Enna Italy. FAU - Tamburino, Corrado AU - Tamburino C AUID- ORCID: 0000-0002-4940-9742 AD - Division of Cardiology A.O.U. Policlinico "G. Rodolico-San Marco" Catania Italy. FAU - Fabiocchi, Franco AU - Fabiocchi F AD - Centro Cardiologico Monzino, IRCCS Milan Italy. AD - Galeazzi-Sant'Ambrogio Hospital, I.R.C.C.S Milan Italy. FAU - Chilmeran, Ahmed AU - Chilmeran A AD - Department of Cardiology Royal Sussex County Hospital Brighton UK. FAU - Conrotto, Federico AU - Conrotto F AD - Department of Internal Medicine Citta della Salute e della Scienza Turin Italy. FAU - Costa, Giuliano AU - Costa G AUID- ORCID: 0000-0003-3770-8988 AD - Division of Cardiology A.O.U. Policlinico "G. Rodolico-San Marco" Catania Italy. FAU - Stefanini, Giulio AU - Stefanini G AUID- ORCID: 0000-0002-3558-6967 AD - IRCCS Humanitas Research Hospital Rozzano-Milan Italy. FAU - Spaccarotella, Carmen AU - Spaccarotella C AD - Division of Cardiology University Magna Graecia Catanzaro Italy. FAU - Macchione, Andrea AU - Macchione A AD - Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy. AD - Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy. FAU - La Torre, Michele AU - La Torre M AD - Department of Internal Medicine Citta della Salute e della Scienza Turin Italy. FAU - Bendandi, Francesco AU - Bendandi F AUID- ORCID: 0000-0002-8314-5146 AD - Department of Cardiothoracic Vascular Surgery University Hospital Bologna Italy. FAU - Juvonen, Tatu AU - Juvonen T AD - Heart and Lung Center, Helsinki University Central Hospital University of Helsinki Finland. FAU - Wanha, Wojciech AU - Wanha W AUID- ORCID: 0000-0003-1220-9496 AD - Division of Cardiology and Structural Heart Diseases Medical University of Silesia Katowice Poland. FAU - Wojakowski, Wojtek AU - Wojakowski W AUID- ORCID: 0000-0002-3681-5207 AD - Division of Cardiology and Structural Heart Diseases Medical University of Silesia Katowice Poland. FAU - Benedetto, Umberto AU - Benedetto U AD - Department of Cardiac Surgery University "G. d'Annunzio" Chieti Italy. FAU - Indolfi, Ciro AU - Indolfi C AUID- ORCID: 0000-0003-1241-6487 AD - Division of Cardiology University Magna Graecia Catanzaro Italy. FAU - Hildick-Smith, David AU - Hildick-Smith D AUID- ORCID: 0000-0002-1147-1436 AD - Department of Cardiology Royal Sussex County Hospital Brighton UK. FAU - Zimarino, Marco AU - Zimarino M AUID- ORCID: 0000-0001-5455-6010 AD - Department of Cardiology ASL2 Abruzzo Chieti Italy. AD - Department of Neuroscience, Imaging and Clinical Sciences 'G. D'Annunzio' University of Chieti-Pescara Italy. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240327 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Diabetes Mellitus MH - Registries MH - Renal Dialysis MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - Multicenter Studies as Topic PMC - PMC11179782 OTO - NOTNLM OT - acute kidney injury OT - dialysis OT - mortality OT - risk score OT - transcatheter aortic valve replacement EDAT- 2024/03/27 12:50 MHDA- 2024/04/03 06:44 PMCR- 2024/04/02 CRDT- 2024/03/27 07:53 PHST- 2024/04/03 06:44 [medline] PHST- 2024/03/27 12:50 [pubmed] PHST- 2024/03/27 07:53 [entrez] PHST- 2024/04/02 00:00 [pmc-release] AID - JAH39425 [pii] AID - 10.1161/JAHA.123.032955 [doi] PST - ppublish SO - J Am Heart Assoc. 2024 Apr 2;13(7):e032955. doi: 10.1161/JAHA.123.032955. Epub 2024 Mar 27. PMID- 38506741 OWN - NLM STAT- MEDLINE DCOM- 20240321 LR - 20250319 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 20 IP - 6 DP - 2024 Mar 18 TI - A study of bailout plug-based closure after failed suture-based closure in patients undergoing transfemoral TAVI. PG - e344-e353 LID - EIJ-D-23-00750 [pii] LID - 10.4244/EIJ-D-23-00750 [doi] AB - BACKGROUND: Percutaneous suture-based arterial access site closure (ProGlide) is commonly applied in patients undergoing transfemoral transcatheter aortic valve implantation (TAVI). However, the failure of a suture-based vascular closure device (VCD) may require additional treatment. AIMS: We aimed to evaluate the efficacy and safety of bailout access site closure using a large-bore plug-based device (MANTA) in patients with failed suture-based closure during transfemoral TAVI. METHODS: Patients undergoing a bailout attempt with the MANTA VCD were identified from a prospectively enrolling, institutional registry. Efficacy was defined as haemostasis at the access site without the need for alternative treatment other than manual compression or endovascular ballooning. Safety was defined as freedom from vascular dissection, stenosis and occlusion requiring intervention. RESULTS: Of 2,505 patients, 66 underwent a bailout attempt with MANTA as a result of ProGlide failure, which occurred before the large-bore sheath insertion in 16.7% of patients and after the sheath removal in 83.3% of patients. Bailout MANTA was deemed effective in 75.8% of patients (50/66), and the technique was considered safe in 86.4% (57/66) of patients. Failure of bailout MANTA occurred because of its superficial application, resulting in persistent bleeding in 18.2% of patients (12/66), and because of its deep application, resulting in stenosis or occlusion in 6.1% of patients (4/66). Operator experience with the technique (odds ratio [OR] 12.29, 95% confidence interval [CI]: 1.99-75.99; p=0.007) and prior use of three ProGlides (OR 0.02, 95% CI: <0.01-0.39; p=0.010) were the only independent predictors of the efficacy endpoint. CONCLUSIONS: Bailout MANTA after ProGlide failure was effective and safe, but operator experience seems to be crucial. Further technological refinements to facilitate accurate placement appear necessary. FAU - Dumpies, Oliver AU - Dumpies O AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Abdelhafez, Ahmed AU - Abdelhafez A AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Rotta Detto Loria, Johannes AU - Rotta Detto Loria J AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Richter, Ines AU - Richter I AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Feistritzer, Hans-Josef AU - Feistritzer HJ AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Majunke, Nicolas AU - Majunke N AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Desch, Steffen AU - Desch S AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Noack, Thilo AU - Noack T AD - Department of Structural Heart Disease/Cardiac Surgery, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Thiele, Holger AU - Thiele H AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. LA - eng PT - Journal Article DEP - 20240318 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Constriction, Pathologic MH - *Transcatheter Aortic Valve Replacement MH - Odds Ratio MH - Patients PMC - PMC10941667 COIS- M. Abdel-Wahab reports that his hospital receives speaker honoraria and/or consultancy fees on his behalf from Boston Scientific, Abbott, and Medtronic. The other authors have no conflicts of interest to declare. EDAT- 2024/03/20 12:46 MHDA- 2024/03/21 12:43 PMCR- 2025/03/18 CRDT- 2024/03/20 11:13 PHST- 2024/03/21 12:43 [medline] PHST- 2024/03/20 12:46 [pubmed] PHST- 2024/03/20 11:13 [entrez] PHST- 2025/03/18 00:00 [pmc-release] AID - EIJ-D-23-00750 [pii] AID - 10.4244/EIJ-D-23-00750 [doi] PST - epublish SO - EuroIntervention. 2024 Mar 18;20(6):e344-e353. doi: 10.4244/EIJ-D-23-00750. PMID- 38506737 OWN - NLM STAT- MEDLINE DCOM- 20240321 LR - 20250319 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 20 IP - 6 DP - 2024 Mar 18 TI - Comparison of two self-expanding transcatheter heart valves for degenerated surgical bioprostheses: the AVENGER multicentre registry. PG - e363-e375 LID - EIJ-D-23-00779 [pii] LID - 10.4244/EIJ-D-23-00779 [doi] AB - BACKGROUND: There is a lack of comparative data on transcatheter aortic valve implantation (TAVI) in degenerated surgical prostheses (valve-in-valve [ViV]). AIMS: We sought to compare outcomes of using two self-expanding transcatheter heart valve (THV) systems for ViV. METHODS: In this retrospective multicentre registry, we included consecutive patients undergoing transfemoral ViV using either the ACURATE neo/neo2 (ACURATE group) or the Evolut R/PRO/PRO+ (EVOLUT group). The primary outcome measure was technical success according to Valve Academic Research Consortium (VARC)-3. Secondary outcomes were 30-day all-cause mortality, device success (VARC-3), coronary obstruction (CO) requiring intervention, rates of severe prosthesis-patient mismatch (PPM), and aortic regurgitation (AR) >/=moderate. Comparisons were made after 1:1 propensity score matching. RESULTS: The study cohort comprised 835 patients from 20 centres (ACURATE n=251; EVOLUT n=584). In the matched cohort (n=468), technical success (ACURATE 92.7% vs EVOLUT 88.9%; p=0.20) and device success (69.7% vs 73.9%; p=0.36) as well as 30-day mortality (2.8% vs 1.6%; p=0.392) were similar between the two groups. The mean gradients and rates of severe PPM, AR >/=moderate, or CO did not differ between the groups. Technical and device success were higher for the ACURATE platform among patients with a true inner diameter (ID) >19 mm, whereas a true ID 19 mm was associated with higher device success among ACURATE recipients, whereas in patients with a true ID /= 15 %. There were significant baseline differences between groups (Society of Thoracic Surgeons - Predicted Risk of Mortality score 3.18 %[interquartile range 1.87-5.47] vs. 6.63 %[4.12-10.54] p < 0.001; hemoglobin 13.2 g/dL[11.8-14.1] vs. 10.4 g/dL[9.8-12.2], p < 0.001, RDW-normal vs. RDW-high, respectively). Age was not distinct (80.2 years [77.5-84.1] vs 81.2[71.3-84.7], p = 0.78). 1-year-all-cause mortality was not different (7.9 % vs. 9.4 %, p = 0.79). The RDW-high group showed markedly higher NT-proBNP levels after 1 year (647 ng/ml[283-1265] vs. 1893 ng/ml[744-5109], p = 0.005), and experienced more clinical endpoints (hazard ratio 2.57[1.28-5.16] for the composite endpoint, p = 0.006). RDW remained an independent predictor of the composite endpoint when accounting for all baseline differences in multivariable regression. CONCLUSION: Elevated preprocedural RDW identifies patients at risk for impaired functional outcome after TAVI and may represent a useful low-cost parameter to guide intensity of outpatient surveillance strategies. CI - (c) 2024 The Authors. FAU - Stachel, Georg AU - Stachel G AD - Medical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Jentzsch, Madlen AU - Jentzsch M AD - Medical Clinic and Policlinic I - Hematology, Cell Therapy and Hemostaseology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Oehring, Michelle AU - Oehring M AD - Medical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Antoniadis, Marios AU - Antoniadis M AD - Medical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Schwind, Sebastian AU - Schwind S AD - Medical Clinic and Policlinic I - Hematology, Cell Therapy and Hemostaseology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Noack, Thilo AU - Noack T AD - University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany. FAU - Platzbecker, Uwe AU - Platzbecker U AD - Medical Clinic and Policlinic I - Hematology, Cell Therapy and Hemostaseology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Borger, Michael AU - Borger M AD - University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany. FAU - Laufs, Ulrich AU - Laufs U AD - Medical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, Germany. FAU - Lenk, Karsten AU - Lenk K AD - Medical Clinic and Policlinic IV - Cardiology, University of Leipzig Medical Center, Leipzig, Germany. LA - eng PT - Journal Article DEP - 20240310 PL - Ireland TA - Int J Cardiol Heart Vasc JT - International journal of cardiology. Heart & vasculature JID - 101649525 PMC - PMC10940133 OTO - NOTNLM OT - Aortic stenosis OT - CHIP OT - RDW OT - Transcatheter Aortic Valve Implantation COIS- Thilo Noack, MD: speaker's honoraria and/ or consulting fees from Edwards Lifesciences and Abbott Vascular Michael Borger, MD, PhD: speaker's honoraria paid to his hospital on his behalf from Edwards Lifesciences, Medtronic, Artivion and Abbott Vascular. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/03/18 06:44 MHDA- 2024/03/18 06:45 PMCR- 2024/03/10 CRDT- 2024/03/18 04:34 PHST- 2023/11/19 00:00 [received] PHST- 2024/02/07 00:00 [revised] PHST- 2024/03/06 00:00 [accepted] PHST- 2024/03/18 06:45 [medline] PHST- 2024/03/18 06:44 [pubmed] PHST- 2024/03/18 04:34 [entrez] PHST- 2024/03/10 00:00 [pmc-release] AID - S2352-9067(24)00049-6 [pii] AID - 101383 [pii] AID - 10.1016/j.ijcha.2024.101383 [doi] PST - epublish SO - Int J Cardiol Heart Vasc. 2024 Mar 10;51:101383. doi: 10.1016/j.ijcha.2024.101383. eCollection 2024 Apr. PMID- 38483121 OWN - NLM STAT- MEDLINE DCOM- 20240426 LR - 20240724 IS - 1897-9483 (Electronic) IS - 0032-3772 (Linking) VI - 134 IP - 4 DP - 2024 Apr 26 TI - Analysis of complications in transfemoral transcatheter aortic valve implantation: a single-center study. LID - 16696 [pii] LID - 10.20452/pamw.16696 [doi] AB - INTRODUCTION: Transfemoral access is a prevailing approach for transcatheter aortic valve implantation (TAVI) in contemporary practice, with a shift from surgical arteriotomy to a percutaneous arterial approach. OBJECTIVES: This study assessed long- and short‑term mortality, along with Valve Academic Research Consortium-2-defined complications in percutaneous transfemoral approach (PTA) TAVI. Furthermore, it explored the impact of a learning curve on procedural outcomes. PATIENTS AND METHODS: The study included 600 patients undergoing PTA TAVI at the National Institute of Cardiology, Warsaw, Poland, from January 2009 to September 2020. Retrospective data comparison involved 2 groups: early experience (first 200 patients) and late experience (next 400 patients). RESULTS: The primary end point (composite of life‑threatening bleeding, major vascular complication, or death at 30 days) occurred less often in the late experience group (28% vs 17.5%; P = 0.003). The late experience group also showed fewer cases of vascular complications (19% vs 10.7%; P = 0.005) and major bleeding (17.5% vs 8.5%; P = 0.001). Propensity matching yielded similar trends, including reduced frequency of pacemaker implantation (22.8% vs 10.9%; P = 0.03) and shorter median (interquartile range) hospitalization (11 [8-18] vs 7 [6-12] days; P <0.001) in the late experience group. CONCLUSIONS: The late experience group rated with PTA TAVI exhibited significantly reduced periprocedural complications, indicating a positive impact of accumulated expertise. FAU - Pylko, Anna AU - Pylko A AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland FAU - Dabrowski, Maciej AU - Dabrowski M AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland. macidabro@gmail.com FAU - Kowalik, Ilona AU - Kowalik I AD - Department of Statistics, National Institute of Cardiology, Warsaw, Poland FAU - Chmielak, Zbigniew AU - Chmielak Z AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland FAU - Kukula, Krzysztof AU - Kukula K AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland FAU - Wolny, Rafal AU - Wolny R AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland FAU - Kwiecinski, Jacek AU - Kwiecinski J AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland FAU - Stoklosa, Patrycjusz AU - Stoklosa P AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland FAU - Grabowski, Maciej AU - Grabowski M AD - Department of Valvular Heart Disease, National Institute of Cardiology, Warsaw, Poland FAU - Michalowska, Ilona AU - Michalowska I AD - Department of Radiology, National Institute of Cardiology, Warsaw, Poland FAU - Kusmierski, Krzysztof AU - Kusmierski K AD - Department of Cardiac Surgery and Transplantation, National Institute of Cardiology, Warsaw, Poland FAU - Witkowski, Adam AU - Witkowski A AD - Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland LA - eng PT - Journal Article DEP - 20240314 PL - Poland TA - Pol Arch Intern Med JT - Polish archives of internal medicine JID - 101700960 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Female MH - Male MH - Aged MH - Aged, 80 and over MH - Retrospective Studies MH - Poland MH - *Postoperative Complications/epidemiology/etiology MH - *Aortic Valve Stenosis/surgery MH - *Femoral Artery MH - Treatment Outcome EDAT- 2024/03/14 12:44 MHDA- 2024/04/26 13:22 CRDT- 2024/03/14 08:51 PHST- 2024/04/26 13:22 [medline] PHST- 2024/03/14 12:44 [pubmed] PHST- 2024/03/14 08:51 [entrez] AID - 16696 [pii] AID - 10.20452/pamw.16696 [doi] PST - ppublish SO - Pol Arch Intern Med. 2024 Apr 26;134(4):16696. doi: 10.20452/pamw.16696. Epub 2024 Mar 14. PMID- 38481717 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240315 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 8 IP - 2 DP - 2024 Mar TI - Femoral Arterial Calcification and Plug- vs. Suture-Based Closure Device Strategies Post-Transcatheter Aortic Valve Implantation: Insights From CHOICE-CLOSURE. PG - 100236 LID - 10.1016/j.shj.2023.100236 [doi] LID - 100236 AB - BACKGROUND: The location and severity of vascular calcification may influence closure device success in transfemoral transcatheter aortic valve implantation. The aim of this study was to analyze effects of vascular access-site calcification on vascular and bleeding outcomes post-transcatheter aortic valve implantation. METHODS: The Randomized Comparison of CatHeter-based Strategies fOr Interventional ACcess SitE CLOSURE during Transfemoral Transcatheter Aortic Valve Implantation (CHOICE-CLOSURE) trial assigned 516 patients to access site closure using a pure plug-based technique (MANTA, Teleflex) or a primary suture-based technique (ProGlide, Abbott Vascular). The principal finding of the overall study was that access-site or access-related complications were more common after the plug-based strategy compared to percutaneous closure with a suture-based strategy. In this predefined subgroup analysis, the overall cohort was split into patients with and without anterior calcification at the access site and divided by degree of calcification severity using the classification system developed in the MANTA vs. suture-based vascular closure after transcatHeter aortic valve replacement (MASH) trial. Differences in bleeding and vascular complications were compared. The primary endpoint consisted of access-site- or access-related major and minor vascular complications. RESULTS: There were more access-site-related major and minor vascular complications for patients with anterior wall vascular calcification and MASH severe calcification. No significant interaction with choice of closure technique in terms of access-site-related major and minor vascular complications was observed (odds ratio 1.70, 95% CI 0.77-3.78, p = 0.19 for the primary endpoint in plug- vs. suture-based strategy in patients with anterior calcification, odds ratio 1.78, 95% CI 0.56-5.65, p = 0.33 for primary endpoint in plug- vs. suture-based strategy with MASH severe calcification, p(int) = 0.97 for anterior calcification, p(int) = 0.95 for MASH severe calcification). CONCLUSIONS: The total number of vascular complications was found to be greater in the presence of anterior and MASH severe calcification. Overall, the presence of anterior or severe calcification does not significantly modify the efficacy of the suture-based strategy compared to the plug-based strategy. CI - (c) 2023 The Authors. FAU - Fitzgerald, Sean AU - Fitzgerald S AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Dumpies, Oliver AU - Dumpies O AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Shibata, Masafumi AU - Shibata M AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Hartung, Philipp AU - Hartung P AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Obradovic, Danilo AU - Obradovic D AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Boekstegers, Peter AU - Boekstegers P AD - Department of Cardiology, Helios Clinic Siegburg, Siegburg, Germany. AD - Witten Herdecke University, Witten, Germany. FAU - Vorpahl, Marc AU - Vorpahl M AD - Witten Herdecke University, Witten, Germany. AD - Department of Cardiology, Helios University Hospital Wuppertal, Wuppertal, Germany. FAU - Rotta Detto Loria, Johannes AU - Rotta Detto Loria J AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Kiefer, Philipp AU - Kiefer P AD - Department of Cardiac Surgery, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Desch, Steffen AU - Desch S AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Thiele, Holger AU - Thiele H AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany. LA - eng PT - Journal Article DEP - 20231207 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC10927440 OTO - NOTNLM OT - Access site OT - Aortic stenosis OT - Bleeding OT - Femoral OT - Transcatheter aortic valve implantation (TAVI) OT - Vascular access closure device COIS- M. Abdel-Wahab declares that his hospital receives speakers' honoraria and/or consulting fees on his behalf from Medtronic and Boston Scientific. S. Desch declares that his hospital receives speakers' honoraria and/or consulting fees on his behalf from Medtronic. All other authors report no disclosures relevant to this work. EDAT- 2024/03/14 06:47 MHDA- 2024/03/14 06:48 PMCR- 2023/12/07 CRDT- 2024/03/14 04:12 PHST- 2022/12/11 00:00 [received] PHST- 2023/09/23 00:00 [revised] PHST- 2023/10/11 00:00 [accepted] PHST- 2024/03/14 06:48 [medline] PHST- 2024/03/14 06:47 [pubmed] PHST- 2024/03/14 04:12 [entrez] PHST- 2023/12/07 00:00 [pmc-release] AID - S2474-8706(23)00130-6 [pii] AID - 100236 [pii] AID - 10.1016/j.shj.2023.100236 [doi] PST - epublish SO - Struct Heart. 2023 Dec 7;8(2):100236. doi: 10.1016/j.shj.2023.100236. eCollection 2024 Mar. PMID- 38481710 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241031 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 8 IP - 2 DP - 2024 Mar TI - A Simple Technique for Deploying the SENTINEL Cerebral Protection System in Bovine Aortic Arch Anatomy. PG - 100228 LID - 10.1016/j.shj.2023.100228 [doi] LID - 100228 AB - The SENTINEL Cerebral Protection System is one of the most commonly used devices for embolic protection during transcatheter aortic valve replacement. However, successful deployment of the SENTINEL device is often challenging in patients with a bovine aortic arch anatomy using the standard technique and requires extensive manipulation in the aortic arch increasing the risk of stroke. We describe a novel and simple technique of 2-filter deployment of SENTINEL device in patients with bovine arch anatomy. In this technique, after the deployment of the proximal filter, the device is hyperflexed on itself facing the lateral aspect of the ascending aorta instead of facing the descending aorta, with its tip pointing toward the common origin of the left common carotid artery (LCCA) and brachiocephalic trunk. The guidewire is then advanced to the LCCA. Since the guidewire can pass either anterior or posterior to the device shaft, the device needs to be untwisted either by clockwise or counterclockwise motion, before pulling the device shaft back to engage the LCCA, after which the distal filter can be deployed. Computed tomography scans obtained for planning transcatheter aortic valve replacement should be reviewed for the presence of bovine aortic arch anatomy so that this technique can be deployed directly, thereby reducing manipulations in the aortic arch, saving time, and not requiring additional equipment. CI - (c) 2023 The Author(s). FAU - Kattoor, Ajoe John AU - Kattoor AJ AD - Division of Structural Cardiology, University at Buffalo, Kaleida Health, Gates Vascular Institute, Buffalo, New York, USA. FAU - Manion, Christopher AU - Manion C AD - Division of Structural Cardiology, University at Buffalo, Kaleida Health, Gates Vascular Institute, Buffalo, New York, USA. FAU - Iyer, Vijay AU - Iyer V AD - Division of Structural Cardiology, University at Buffalo, Kaleida Health, Gates Vascular Institute, Buffalo, New York, USA. LA - eng PT - Journal Article DEP - 20231016 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC10927443 OTO - NOTNLM OT - Bovine arch embolic protection OT - Sentinel embolic protection OT - Sentinel in bovine arch COIS- Vijay Iyer reports a relationship with Boston Scientific Corp that includes consulting or advisory and with Edwards Lifesciences Corporation that includes speaking and lecture fees. All other authors report no conflicts of interest. EDAT- 2024/03/14 06:46 MHDA- 2024/03/14 06:47 PMCR- 2023/10/16 CRDT- 2024/03/14 04:12 PHST- 2023/05/08 00:00 [received] PHST- 2023/09/04 00:00 [revised] PHST- 2023/09/14 00:00 [accepted] PHST- 2024/03/14 06:47 [medline] PHST- 2024/03/14 06:46 [pubmed] PHST- 2024/03/14 04:12 [entrez] PHST- 2023/10/16 00:00 [pmc-release] AID - S2474-8706(23)00122-7 [pii] AID - 100228 [pii] AID - 10.1016/j.shj.2023.100228 [doi] PST - epublish SO - Struct Heart. 2023 Oct 16;8(2):100228. doi: 10.1016/j.shj.2023.100228. eCollection 2024 Mar. PMID- 38479968 OWN - NLM STAT- MEDLINE DCOM- 20240315 LR - 20260704 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 5 DP - 2024 Mar 11 TI - Evolut PRO and SAPIEN ULTRA Performance in Small Aortic Annuli: The OPERA-TAVI Registry. PG - 681-692 LID - S1936-8798(24)00008-6 [pii] LID - 10.1016/j.jcin.2024.01.006 [doi] AB - BACKGROUND: The performance of latest iteration transcatheter aortic valve replacement platforms in patients with small aortic anatomy remains underexplored. OBJECTIVES: The aim of this study was to evaluate effectiveness and performance between the self-expanding (SE) Evolut PRO and PRO+ and the balloon-expandable (BE) SAPIEN ULTRA in patients with small aortic annuli. METHODS: Data from the OPERA-TAVI (Comparative Analysis of Evolut PRO vs. SAPIEN 3 ULTRA Valves for Transfemoral Transcatheter Aortic Valve Implantation) registry were used, with 1:1 propensity score matching. Primary endpoints included 1-year effectiveness composite (all-cause mortality, disabling stroke, or heart failure hospitalization) and 30-day device-related (hemodynamic structural valve dysfunction and nonstructural valve dysfunction) outcomes. RESULTS: Among 3,516 patients, 251 matched pairs with aortic annular area <430 mm(2) were assessed. The 1-year primary effectiveness outcome did not differ significantly between cohorts (SE 10.8% vs BE 11.2%; P = 0.91). The 30-day device-oriented composite outcome was more favorable in the Evolut PRO group (SE 4.8% vs BE 10.4%; P = 0.027). Notably, SE valve recipients showed higher rates of disabling stroke (SE 4.0% vs BE 0.0%; P < 0.01) and paravalvular leaks (mild or greater: SE 48.5% vs BE 18.6% [P < 0.001]; moderate: SE 4.5% vs BE 1.2% [P = 0.070]). The BE group had higher rates of prosthesis-patient mismatch (moderate or greater: SE 16.0% vs BE 47.1% [P < 0.001]; severe: SE 1.3% vs BE 5.7% [P = 0.197]) and more patients with residual mean gradients >20 mm Hg (SE 1.0% vs BE 13.5%; P < 0.001). CONCLUSIONS: In patients with small aortic annuli, transcatheter aortic valve replacement with latest iteration devices is safe. SE platforms are associated with more favorable device performance in terms of hemodynamic structural and nonstructural dysfunction. Randomized data are needed to validate these findings and guide informed device selection. CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Sturla, Matteo AU - Sturla M AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Saia, Francesco AU - Saia F AD - Dipartimento Cardiovascolare, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Herzzentrum, Leipzig, Germany. FAU - Garot, Philippe AU - Garot P AD - Institute Cardiovasculaire Paris Sud, Massy, France. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy. FAU - Branca, Luca AU - Branca L AD - Spedali Civili, Brescia, Italy. FAU - Santos, Ignacio Amat AU - Santos IA AD - Division of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Mylotte, Darren AU - Mylotte D AD - Galway University Hospital, Galway, Ireland. FAU - Bedogni, Francesco AU - Bedogni F AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Nombela Franco, Luis AU - Nombela Franco L AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Webb, John AU - Webb J AD - St. Paul Hospital, Vancouver, British Columbia, Canada. FAU - Ribichini, Flavio Luciano AU - Ribichini FL AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Mainardi, Andrea AU - Mainardi A AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Andreaggi, Stefano AU - Andreaggi S AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Mazzapicchi, Alessandro AU - Mazzapicchi A AD - Dipartimento Cardiovascolare, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Tomii, Daijiro AU - Tomii D AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Laforgia, Pietro AU - Laforgia P AD - Institute Cardiovasculaire Paris Sud, Massy, France. FAU - Cannata, Stefano AU - Cannata S AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy. FAU - Fiorina, Claudia AU - Fiorina C AD - Spedali Civili, Brescia, Italy. FAU - Fezzi, Simone AU - Fezzi S AD - Galway University Hospital, Galway, Ireland. FAU - Criscione, Enrico AU - Criscione E AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Poletti, Enrico AU - Poletti E AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Italy. FAU - Mazzucca, Mattia AU - Mazzucca M AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Italy. FAU - Quagliana, Angelo AU - Quagliana A AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Montarello, Nicholas AU - Montarello N AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Hennessey, Breda AU - Hennessey B AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Mon-Noboa, Matias AU - Mon-Noboa M AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Akodad, Myriam AU - Akodad M AD - Institute Cardiovasculaire Paris Sud, Massy, France; St. Paul Hospital, Vancouver, British Columbia, Canada. FAU - Meier, David AU - Meier D AD - St. Paul Hospital, Vancouver, British Columbia, Canada; Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - De Marco, Federico AU - De Marco F AD - Interventional Cardiology Department, IRCSS Centro Cardiologico Monzino, Milan, Italy. FAU - Adamo, Marianna AU - Adamo M AD - Spedali Civili, Brescia, Italy. FAU - Sgroi, Carmelo AU - Sgroi C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Reddavid, Claudia Maria AU - Reddavid CM AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Valvo, Roberto AU - Valvo R AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Italy. FAU - Strazzieri, Orazio AU - Strazzieri O AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Motta, Silvia Crescenzia AU - Motta SC AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Melfa, Chiara AU - Melfa C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Cali, Mariachiara AU - Cali M AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Sammartino, Sofia AU - Sammartino S AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Laterra, Giulia AU - Laterra G AD - Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Ospedale Umberto I, ASP 4 di Enna, Enna, Italy. FAU - Thiele, Holger AU - Thiele H AD - Herzzentrum, Leipzig, Germany. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Universita Degli Studi di Enna "Kore," Enna, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: alatib@gmail.com. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Mar 11;17(5):693-695. doi: 10.1016/j.jcin.2024.01.282. PMID: 38479969 CIN - JACC Cardiovasc Interv. 2024 Jun 24;17(12):1509. doi: 10.1016/j.jcin.2024.04.034. PMID: 38925754 CIN - JACC Cardiovasc Interv. 2024 Jun 24;17(12):1510. doi: 10.1016/j.jcin.2024.05.008. PMID: 38925755 MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Prosthesis Design MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement MH - Registries MH - *Stroke/etiology OTO - NOTNLM OT - aortic stenosis OT - balloon expandable OT - self-expanding OT - small annuli OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Scotti has served as a consultant for Edwards Lifesciences and NeoChord. Dr Pilgrim has received research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; and has received speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr Meier has received an institutional grant from Edwards Lifesciences. Dr Barbanti is a consultant for Boston Scientifics, Edwards Lifesciences, and Medtronic. Dr Latib has served on advisory boards for Medtronic, Abbott Vascular, Boston Scientific, Edwards Lifesciences, Shifamed, NeoChord, VDyne, and Philips. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/03/14 00:43 MHDA- 2024/03/15 06:44 CRDT- 2024/03/13 21:59 PHST- 2023/08/26 00:00 [received] PHST- 2023/12/20 00:00 [revised] PHST- 2024/01/02 00:00 [accepted] PHST- 2024/03/15 06:44 [medline] PHST- 2024/03/14 00:43 [pubmed] PHST- 2024/03/13 21:59 [entrez] AID - S1936-8798(24)00008-6 [pii] AID - 10.1016/j.jcin.2024.01.006 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Mar 11;17(5):681-692. doi: 10.1016/j.jcin.2024.01.006. PMID- 38479966 OWN - NLM STAT- MEDLINE DCOM- 20240315 LR - 20260918 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 5 DP - 2024 Mar 11 TI - The Impact of Cerebral Embolic Protection Devices on Characteristics and Outcomes of Stroke Complicating TAVR. PG - 666-677 LID - S1936-8798(23)01692-8 [pii] LID - 10.1016/j.jcin.2023.12.033 [doi] AB - BACKGROUND: Acute ischemic stroke remains a serious complication of transcatheter aortic valve replacement (TAVR). Cerebral embolic protection devices (CEPD) were developed to mitigate the risk of acute ischemic stroke complicating TAVR (AISCT). However, the existing body of evidence does not clearly support CEPD efficacy in AISCT prevention. OBJECTIVES: In a cohort of patients with AISCT, we aimed to compare the characteristics and outcomes of patients who have had unprotected TAVR (CEPD-) vs CEPD-protected TAVR (CEPD+). METHODS: Data were derived from an international multicenter registry focusing on AISCT. We included all patients who experienced ischemic stroke within 72 hours of TAVR. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Primary outcomes were neurologic disability status according to the modified Rankin Score at 30 days, and 6-month all-cause death. Propensity score matched analysis was used to control for differences between groups. RESULTS: In 18,725 TAVR procedures, 416 AISCT (2.2%) within 72 hours were documented, of which 376 were in the CEPD- TAVR group and 40 in the CEPD+ TAVR group. Although the middle cerebral artery stroke rate was similar in both groups (29.7% CEPD- vs 33.3% CEPD+; P = 0.71), AISCT in the CEPD+ group was characterized by a lower rate of internal carotid artery occlusion (0% vs 4.7%) and higher rate of vertebrobasilar system strokes (15.4% vs 5.7%; P = 0.04). AISCT was severe (NIHSS >/=15) in 21.6% CEPD- and 23.3% CEPD+ AISCT (P = 0.20). Disabling stroke rates (modified Rankin Score >1 at 30 days) were 47.3% vs 42.5% (P = 0.62), and 6-month mortality was 31.3% vs 23.3% (P = 0.61), in the CEPD- and CEPD+ groups, respectively. In the propensity score matched cohort, disabling stroke rates were 56.5% vs 41.6% (P = 0.16), and 6-month mortality was 33% vs 19.5% (P = 0.35), in the CEPD- and CEPD+ groups, respectively. CONCLUSIONS: In a large cohort of patients with AISCT, the use of CEPD had little effect on stroke distribution, severity, and outcomes. CI - Copyright (c) 2024 American College of Cardiology Foundation. All rights reserved. FAU - Levi, Amos AU - Levi A AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. Electronic address: drlevi.amos@gmail.com. FAU - Linder, Matthias AU - Linder M AD - University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Witberg, Guy AU - Witberg G AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Inselspital, Bern University Hospital, Bern, Switzerland. FAU - Tomii, Daijiro AU - Tomii D AD - Inselspital, Bern University Hospital, Bern, Switzerland. FAU - Barkan, Yeela Tamlor AU - Barkan YT AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Adrichem, Rik AU - Adrichem R AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Codner, Pablo AU - Codner P AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Hildick-Smith, David AU - Hildick-Smith D AD - Sussex Cardiac Center, University Hospitals Sussex NHS Foundation Trust, Brighton, UK. FAU - Arunothayaraj, Sandeep AU - Arunothayaraj S AD - Sussex Cardiac Center, University Hospitals Sussex NHS Foundation Trust, Brighton, UK. FAU - Perl, Leor AU - Perl L AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Finkelstein, Ariel AU - Finkelstein A AD - Tel Aviv University, Tel-Aviv Israel; Tel-Aviv Medical Center, Tel-Aviv, Israel. FAU - Loewenstein, Itamar AU - Loewenstein I AD - Tel Aviv University, Tel-Aviv Israel; Tel-Aviv Medical Center, Tel-Aviv, Israel. FAU - De Backer, Ole AU - De Backer O AD - Rigshospitalet, Copenhagen, Denmark. FAU - Barnea, Rani AU - Barnea R AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Tarantini, Giuseppe AU - Tarantini G AD - University of Padua, Padua, Italy. FAU - Fovino, Luca Nai AU - Fovino LN AD - University of Padua, Padua, Italy. FAU - Vaknin-Assa, Hana AU - Vaknin-Assa H AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Mylotte, Darren AU - Mylotte D AD - University Hospital and University of Galway, Galway, Ireland. FAU - Wagener, Max AU - Wagener M AD - University Hospital and University of Galway, Galway, Ireland. FAU - Webb, John G AU - Webb JG AD - St. Paul's Hospital, Vancouver, BC, Canada. FAU - Akodad, Mariama AU - Akodad M AD - St. Paul's Hospital, Vancouver, BC, Canada. FAU - Colombo, Antonio AU - Colombo A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York, USA. FAU - Kargoli, Faraj AU - Kargoli F AD - Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York, USA. FAU - Giannini, Francesco AU - Giannini F AD - Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - Istituto Clinico Sant'Ambrogio, Milan, Italy. FAU - Sondergaard, Lars AU - Sondergaard L AD - Abbott, Santa Clara, California, USA. FAU - Aviram, Itay AU - Aviram I AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Lerman, Tsahi T AU - Lerman TT AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Kheifets, Mark AU - Kheifets M AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Auriel, Eitan AU - Auriel E AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. FAU - Kornowski, Ran AU - Kornowski R AD - Rabin Medical Center, Petah-Tikva, Israel; Tel Aviv University, Tel-Aviv Israel. CN - ASTRO-TAVI Study Group LA - eng SI - ClinicalTrials.gov/NCT05241821 PT - Journal Article PT - Multicenter Study PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Mar 11;17(5):678-680. doi: 10.1016/j.jcin.2024.01.068. PMID: 38479967 CIN - JACC Cardiovasc Interv. 2024 Jun 10;17(11):1404. doi: 10.1016/j.jcin.2024.04.016. PMID: 38866460 CIN - JACC Cardiovasc Interv. 2024 Jun 10;17(11):1405. doi: 10.1016/j.jcin.2024.04.029. PMID: 38866461 MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Ischemic Stroke/etiology MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Treatment Outcome MH - *Stroke/diagnostic imaging/etiology/prevention & control MH - *Embolic Protection Devices MH - Risk Factors MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - SENTINEL OT - cerebral embolic protection device OT - complications OT - registry OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Seiffert has received speaker or advisory fees from Abbott Vascular, Abiomed, Amgen, AstraZeneca, Boston Scientific, Bristol Myers Squibb, Daiichi-Sankyo, Edwards Lifesciences, Inari Medical, Medtronic, Pfizer, Shockwave Medical, and Siemens Healthineers; and a research grant from Boston Scientific-all unrelated to the submitted work. Dr Pilgrim has received institutional research grants from Edwards Lifesciences, Boston Scientific, and Biotronik; and personal fees from Biotronik, Boston Scientific, Medtronic, Abbott, and Edwards Lifesciences. Dr Van Mieghem has received research grant support from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Daiichi-Sankyo, and AstraZeneca, and advisory/consultancy/speaker fees from JenaValve, Anteris, Siemens, Pie Medical, Materialise, Amgen, Abbott Vascular, Boston Scientific, Medtronic, Daiichi-Sankyo, Teleflex, and PulseCath BV. Dr Perl is a consultant for Edwards Lifesciences. Dr De Backer has received research grants and consultant fees from Abbott and Boston Scientific. Dr Wagener has received educational support from Medtronic. Dr Webb has been a consultant to, and has received research funding from Edwards Lifesciences, Medtronic, and Boston Scientific. Dr Akodad has received research funding from Medtronic, Biotronik, MUSE Explore, and Federation Francaise de Cardiologie; and is a consultant for Medtronic and Edwards Lifesciences. Dr Mangieri has received an institutional research grant from Boston Scientific; and has served on a medical advisory board for Boston Scientific. Dr Latib has served on advisory boards for Medtronic and Abbott; and has been a consultant to Edwards Lifesciences. Dr Sondergaard is chief medical officer at Abbott Structural Heart; and has received consultant fees and/or institutional research funding from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and SMT. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/03/14 00:43 MHDA- 2024/03/15 06:44 CRDT- 2024/03/13 21:59 PHST- 2023/09/10 00:00 [received] PHST- 2023/11/21 00:00 [revised] PHST- 2023/12/18 00:00 [accepted] PHST- 2024/03/15 06:44 [medline] PHST- 2024/03/14 00:43 [pubmed] PHST- 2024/03/13 21:59 [entrez] AID - S1936-8798(23)01692-8 [pii] AID - 10.1016/j.jcin.2023.12.033 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Mar 11;17(5):666-677. doi: 10.1016/j.jcin.2023.12.033. PMID- 38479438 OWN - NLM STAT- MEDLINE DCOM- 20250916 LR - 20260624 IS - 1940-1574 (Electronic) IS - 0003-3197 (Linking) VI - 76 IP - 9 DP - 2025 Oct TI - Carotid Artery Stenosis as a Predictor for Stroke Following Transcatheter Aortic Valve Implantation. PG - 848-856 LID - 10.1177/00033197241239687 [doi] AB - Stroke remains a clinical risk in the long-term follow-up of patients after transcatheter aortic valve implantation (TAVI). We aimed to investigate the association between existing carotid artery stenosis (CS) and the risk of stroke after TAVI. The study participants were consecutive patients who underwent TAVI between 2008 and 2020 and were screened for CS at baseline and at the 30-day follow-up. Hemodynamically relevant CS was defined as a reduction of the carotid artery caliber by >50% in relation to the distal segment. The primary endpoint of this study was ischemic stroke or transient ischemic attack (TIA) within 30 days of TAVI. Stroke-related death was also assessed. Of the 1,537 patients included, 220 (14.3%) patients had CS >/=50%. Within 30 days following TAVI, 41 patients (2.7%) experienced an ischemic stroke or TIA, and seven had stroke-related death. The median time from TAVI to stroke/TIA was 3.0 days. Patients with CS >/=50% had a 2.56-fold increased risk of stroke/TIA after TAVI (95%CI: 1.29-5.10, P = .006). The association was consistent in the multivariable model after adjusting for sex, atrial fibrillation, and estimated glomerular filtration rate. Investigations are needed to mitigate the risk of stroke in patients with CS >/=50%. FAU - Taube, Leonard AU - Taube L AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Sugiura, Atsushi AU - Sugiura A AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Hartmann, Arthur AU - Hartmann A AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Schaefer, Christian AU - Schaefer C AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Hamiko, Marwan AU - Hamiko M AD - Department of Cardiac Surgery, Heart Center, University Hospital Bonn, Bonn, Germany. FAU - Zimmer, Sebastian AU - Zimmer S AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Schahab, Nadjib AU - Schahab N AUID- ORCID: 0000-0002-0579-9435 AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. LA - eng PT - Journal Article DEP - 20240313 PL - United States TA - Angiology JT - Angiology JID - 0203706 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Carotid Stenosis/complications/diagnostic imaging MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery/complications/mortality MH - Risk Factors MH - Risk Assessment MH - *Ischemic Attack, Transient/etiology MH - *Stroke/etiology MH - Time Factors MH - Retrospective Studies MH - *Ischemic Stroke/etiology OTO - NOTNLM OT - carotid artery stenosis OT - stroke OT - stroke-related death OT - transcatheter aortic valve implantation COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2024/03/14 00:42 MHDA- 2025/09/16 18:32 CRDT- 2024/03/13 20:23 PHST- 2025/09/16 18:32 [medline] PHST- 2024/03/14 00:42 [pubmed] PHST- 2024/03/13 20:23 [entrez] AID - 10.1177/00033197241239687 [doi] PST - ppublish SO - Angiology. 2025 Oct;76(9):848-856. doi: 10.1177/00033197241239687. Epub 2024 Mar 13. PMID- 38466346 OWN - NLM STAT- MEDLINE DCOM- 20250422 LR - 20250513 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 114 IP - 3 DP - 2025 Mar TI - Transcatheter aortic valve implantation in patients with significant septal hypertrophy. PG - 332-340 LID - 10.1007/s00392-024-02432-3 [doi] AB - BACKGROUND: Previous reports suggest septal hypertrophy with an interventricular septum depth (IVSD) >/= 14 mm may adversely affect outcomes after transcatheter aortic valve implantation (TAVI) due to suboptimal valve placement, valve migration, or residual increased LVOT pressure gradients. AIMS: This analysis investigates the impact of interventricular septal hypertrophy on acute outcomes after TAVI. METHODS: Between 2009 and 2021, 1033 consecutive patients (55.8% male, 80.5 +/- 6.7 years, EuroSCORE II 6.3 +/- 6.5%) with documented IVSD underwent TAVI at our center and were included for analysis. Baseline, periprocedural, and 30-day outcome parameters of patients with normal IVSD (< 14 mm; group 1) and increased IVSD (>/= 14 mm; group 2) were compared. Data were retrospectively analyzed according to updated Valve Academic Research Consortium-3 (VARC-3) definitions. Comparison of outcome parameters was adjusted for baseline differences between groups using logistic and linear regression analyses. RESULTS: Of 1033 patients, 585 and 448 patients were allocated to groups 1 and 2, respectively. There was no significant difference between groups regarding transfemoral access rate (82.6% (n = 478) vs. 86.0% (n = 381), p = 0.157). Postprocedural mean transvalvular pressure gradient was significantly increased in group 2 (group 1, 7.8 +/- 4.1 mmHg, vs. group 2, 8.9 +/- 4.9 mmHg, p = 0.046). Despite this finding, there was no significant difference between groups regarding the rates of VARC-3 adjudicated composite endpoint device success (90.0% (n = 522) vs. 87.6% (n = 388), p = 0.538) or technical success (92.6% (n = 542) vs. 92.6% (n = 415), p = 0.639). Moreover, the groups showed no significant differences regarding the rates of paravalvular leakage >/= moderate (3.1% (n = 14) vs. 2.6% (n = 9), p = 0.993), postprocedural permanent pacemaker implantation (13.4% (n = 77) vs. 13.8% (n = 61), p = 0.778), or 30-day mortality (5.1% (n = 30) vs. 4.5% (n = 20), p = 0.758). CONCLUSION: Although transvalvular mean pressure gradients were significantly higher in patients with increased IVSD after TAVI, acute outcomes were comparable between groups suggesting no early impact of adverse hemodynamics due to elevated IVSD. However, how these differences in hemodynamic findings may affect mid- and long-term outcomes, especially in terms of valve durability, needs to be evaluated in further investigations. CI - (c) 2024. The Author(s). FAU - Beyer, Martin AU - Beyer M AUID- ORCID: 0000-0003-0925-7067 AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. ma.beyer@uke.de. FAU - Demal, Till Joscha AU - Demal TJ AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Linder, Matthias AU - Linder M AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Ludwig, Sebastian AU - Ludwig S AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Voigtlaender-Buschmann, Lisa AU - Voigtlaender-Buschmann L AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Waldschmidt, Lara AU - Waldschmidt L AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Schirmer, Johannes AU - Schirmer J AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Pecha, Simon AU - Pecha S AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - Department of Cardiology, University Heart & Vascular Center Hamburg, 20246, Hamburg, Germany. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. LA - eng PT - Journal Article DEP - 20240311 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - Retrospective Studies MH - *Aortic Valve Stenosis/surgery/diagnosis/complications MH - Aged, 80 and over MH - Treatment Outcome MH - Aged MH - *Aortic Valve/surgery MH - *Ventricular Septum/pathology/diagnostic imaging MH - Risk Factors MH - Echocardiography MH - Follow-Up Studies PMC - PMC11914327 OTO - NOTNLM OT - Aortic valve stenosis OT - Septal hypertrophy OT - TAVI OT - TAVR COIS- Declarations. Ethical approval: This study is a retrospective analysis of anonymized data. Therefore, due to German law, ethical approval is not necessary. Consent to participate: All patients provided written informed consent for device implantation and data acquisition. Conflict of interest: Martin Beyer received travel compensation from Abbott. Sebastian Ludwig received travel compensation from Edwards Lifesciences Inc. Hermann Reichenspurner received travel compensation and lecture remunerations from Edwards Lifesciences Inc. and Medtronic Inc. Lenard Conradi serves on the advisory board for Medtronic, Abbott, and JenaValve and is consultant for Edwards Lifesciences, Boston Scientific, MicroPort, PiCardia, Neovasc, and MicroInterventions. Moritz Seifert reports personal fees and non-financial support from Abbott Vascular; personal fees from Abiomed; personal fees from AstraZeneca; personal fees from Bayer Healthcare; personal fees from Boehringer Ingelheim; grants, personal fees, and non-financial support from Boston Scientific; personal fees from Bristol-Myers Squibb; personal fees and non-financial support from Edwards Lifesciences; grants and personal fees from Philips; personal fees from Medtronic; personal fees from Amgen; personal fees from Shockwave Medical; personal fees from Daiichi Sankyo; personal fees from Pfizer; personal fees from Siemens Healthineers; and personal fees from Inari Medical. Andreas Schafer received travel compensation from Edwards Lifesciences Inc. and lecture fees from Abbott and Boston Scientific. All other authors declared no conflict of interest. EDAT- 2024/03/11 18:42 MHDA- 2025/03/17 18:31 PMCR- 2024/03/11 CRDT- 2024/03/11 12:03 PHST- 2023/10/06 00:00 [received] PHST- 2024/02/29 00:00 [accepted] PHST- 2025/03/17 18:31 [medline] PHST- 2024/03/11 18:42 [pubmed] PHST- 2024/03/11 12:03 [entrez] PHST- 2024/03/11 00:00 [pmc-release] AID - 10.1007/s00392-024-02432-3 [pii] AID - 2432 [pii] AID - 10.1007/s00392-024-02432-3 [doi] PST - ppublish SO - Clin Res Cardiol. 2025 Mar;114(3):332-340. doi: 10.1007/s00392-024-02432-3. Epub 2024 Mar 11. PMID- 38464846 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240312 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - The efficacy of different types of cerebral embolic protection device during transcatheter aortic valve implantation: a meta-analysis. PG - 1205943 LID - 10.3389/fcvm.2024.1205943 [doi] LID - 1205943 AB - AIMS: Perioperative stroke remains a devastating complication after transcatheter aortic valve implantation (TAVI), and using a cerebral embolic protection device (CEPD) during TAVI may reduce the occurrence of stroke according to some studies. Therefore, we conducted this meta-analysis to determine whether CEPD should be routinely used during TAVI. METHODS AND RESULTS: The inclusion criteria for this study were randomized controlled trials (RCTs) that examined the outcome of stroke with or without CEPD during TAVI, with a minimum follow-up period of 30 days. The primary endpoint was the occurrence of stroke (including both cerebrovascular accidents and death due to cerebrovascular accidents). The risk of stroke was lower in the CEPD group: RR 0.68, 95% CI 0.49-0.96, p = 0.03, I(2 )= 0%. A subgroup analysis was conducted according to the type of CEPD. The risk of stroke was lower in the I&LCCA (filter cover the innominate and the left common carotid arteries) type CEPD group: RR 0.66, 95% CI 0.49-0.96, p = 0.03, I(2 )= 36%. However, there was no statistically significant difference in the risk of stroke in the TMCA [filter cover the three major cerebral arteries (innominate, left common carotid, and subclavian arteries)] type CEPD group: RR 0.81, 95% CI 0.36-1.80, p = 0.60, I(2 )= 0%. CONCLUSIONS: In this meta-analysis, the I&LCCA-type CEPD can reduce the risk of stroke within 30 days following TAVI, but the TMCA type cannot. CI - (c) 2024 Wang, Han, Lu, Qiu, Fu and Zheng. FAU - Wang, Chao AU - Wang C AD - Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. AD - Department of Thoracic and Cardiac Surgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China. FAU - Han, Jingjun AU - Han J AD - Department of Thoracic and Cardiac Surgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China. FAU - Lu, Liuyi AU - Lu L AD - Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. FAU - Qiu, Junxiong AU - Qiu J AD - Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. FAU - Fu, Yuan AU - Fu Y AD - Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. FAU - Zheng, Junmeng AU - Zheng J AD - Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. LA - eng PT - Journal Article PT - Review DEP - 20240223 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10924301 OTO - NOTNLM OT - CEPD OT - Meta-analysis OT - Stroke OT - TAVI OT - TAVR COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/03/11 06:44 MHDA- 2024/03/11 06:45 PMCR- 2024/01/01 CRDT- 2024/03/11 04:42 PHST- 2023/04/14 00:00 [received] PHST- 2024/01/08 00:00 [accepted] PHST- 2024/03/11 06:45 [medline] PHST- 2024/03/11 06:44 [pubmed] PHST- 2024/03/11 04:42 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1205943 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Feb 23;11:1205943. doi: 10.3389/fcvm.2024.1205943. eCollection 2024. PMID- 38460099 OWN - NLM STAT- MEDLINE DCOM- 20240915 LR - 20261010 IS - 1863-6713 (Electronic) IS - 1863-6705 (Linking) VI - 72 IP - 10 DP - 2024 Oct TI - Right transaxillary transcatheter aortic valve replacement is comparable to left despite challenges. PG - 641-648 LID - 10.1007/s11748-024-02015-z [doi] AB - OBJECTIVES: Transaxillary access is the most popular alternative to transfemoral transcatheter aortic valve replacement. Although left transaxillary access is generally preferred, right transaxillary transcatheter aortic valve replacement could be challenging because of the opposing axillary artery and aortic curvatures, which may warrant procedural modifications to improve alignment. Our aim is to compare our single center's outcomes for left and right transaxillary access groups and to evaluate procedural modifications for facilitating right transaxillary transcatheter aortic valve replacement. METHODS: Patient characteristics and outcomes were compared for consecutive left or right axillary TAVRs performed from 6/2016 to 6/2022 with SAPIEN 3. The effects of our previously reported "flip-n-flex" technique on procedural efficiency and new conduction disturbances were subanalyzed in the right axillary group. RESULTS: Right and left transaxillary transcatheter aortic valve replacement were performed in 25 (18 with the "flip-n-flex" technique) and 26 patients, respectively. There were no significant differences between patient characteristics or outcomes. Right axillary subanalysis showed the "flip-n-flex" technique group had significantly shorter fluoroscopy times (21.2 +/- 6.2 vs 29.6 +/- 12.4 min, p = 0.03) and a trend towards less permanent pacemaker implantation (6.3% vs. 42.9%, p = 0.07) compared to the group without "flip-n-flex". CONCLUSIONS: In our study, despite anatomical challenges, right transaxillary transcatheter aortic valve replacement is comparable to left access. The "flip-n-flex" technique advances right transaxillary as an appealing access for patients with few options. CI - (c) 2024. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery. FAU - McGrath, Daniel AU - McGrath D AD - Tufts University School of Medicine, Boston, MA, USA. FAU - Lee, Hansuh AU - Lee H AD - Tufts University School of Medicine, Boston, MA, USA. FAU - Sun, Charley AU - Sun C AD - Tufts University School of Medicine, Boston, MA, USA. FAU - Kawabori, Masashi AU - Kawabori M AD - Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA. FAU - Zhan, Yong AU - Zhan Y AUID- ORCID: 0000-0003-4144-9915 AD - Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA. yong.zhan@tuftsmedicine.org. LA - eng PT - Comparative Study PT - Journal Article DEP - 20240309 PL - Japan TA - Gen Thorac Cardiovasc Surg JT - General thoracic and cardiovascular surgery JID - 101303952 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Male MH - Female MH - *Axillary Artery MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery MH - Aged MH - Treatment Outcome MH - *Aortic Valve/surgery/diagnostic imaging MH - Retrospective Studies MH - Catheterization, Peripheral/methods MH - Time Factors MH - Heart Valve Prosthesis OTO - NOTNLM OT - Alternative access OT - Fluoroscopy OT - Pacemaker OT - Transaxillary OT - Transcatheter aortic valve replacement EDAT- 2024/03/09 20:42 MHDA- 2024/09/15 14:11 CRDT- 2024/03/09 11:11 PHST- 2023/10/20 00:00 [received] PHST- 2024/02/03 00:00 [accepted] PHST- 2024/09/15 14:11 [medline] PHST- 2024/03/09 20:42 [pubmed] PHST- 2024/03/09 11:11 [entrez] AID - 10.1007/s11748-024-02015-z [pii] AID - 10.1007/s11748-024-02015-z [doi] PST - ppublish SO - Gen Thorac Cardiovasc Surg. 2024 Oct;72(10):641-648. doi: 10.1007/s11748-024-02015-z. Epub 2024 Mar 9. PMID- 38455779 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240309 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 16 IP - 2 DP - 2024 Feb TI - Accuracy of Transcutaneous Carbon Dioxide Measurement During Transcatheter Aortic Valve Replacement Under Monitored Anesthesia Care: A Prospective Observational Study. PG - e53661 LID - 10.7759/cureus.53661 [doi] LID - e53661 AB - Background Transcutaneous carbon dioxide tension (PtcCO(2)) measurement is a promising alternative to arterial carbon dioxide tension (PaCO(2)) measurement. PaCO(2) measurement is invasive and intermittent, whereas PtcCO(2) measurement is non-invasive and continuous. However, previous studies evaluating PtcCO(2)measurements did not include patients undergoing transcatheter aortic valve replacement (TAVR), who experience anticipated hemodynamic changes, particularly before and after valve placement. Therefore, we investigated whether PtcCO(2) measurement could provide an alternative to PaCO(2) measurement during transfemoral TAVR under monitored anesthesia care (MAC) with local anesthesia. Methodology We conducted a prospective observational study. We included all consecutive patients with severe aortic stenosis who were scheduled to undergo a transfemoral TAVR under MAC at our institution from November 1, 2020, to April 30, 2021. During the procedures, PaCO(2) and PtcCO(2) were concurrently monitored six times as a reference standard and index test, respectively. PtcCO(2) was monitored continuously using a non-invasive earlobe sensor. The agreement between PtcCO(2) and PaCO(2) measurements was assessed using the Bland-Altman method, and the 95% limits of agreement were calculated. Based on previous studies, we determined that 95% limits of agreement of +/-6.0 mmHg would be clinically acceptable to define PtcCO(2) as an alternative to PaCO(2). Results We obtained 88 measurement pairs from 15 patients. The lower and upper 95% limits of agreement between the PtcCO(2) and PaCO(2) measurements were -4.22 mmHg and 6.56 mmHg, respectively. Conclusions During TAVR under MAC with local anesthesia, PtcCO(2) measurement could not provide a viable alternative to PaCO(2) measurement to reduce high PaCO2 events. This study focused on comparing intraoperative periods before and after valve implantation. Therefore, further investigation is warranted to assess the impact of various factors, including the prosthetic valve type and the hemodynamic effects of balloon aortic valvuloplasty, on PtcCO(2) measurement in TAVR. CI - Copyright (c) 2024, Okazawa et al. FAU - Okazawa, Yuki AU - Okazawa Y AD - Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JPN. AD - Department of Anesthesia, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, JPN. FAU - Kataoka, Yuki AU - Kataoka Y AD - Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, JPN. AD - Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JPN. AD - Department of Systematic Reviewers, Scientific Research Works Peer Support Group, Osaka, JPN. AD - Department of Internal Medicine, Kyoto Min-iren Asukai Hospital, Kyoto, JPN. FAU - Shindo, Kazuo AU - Shindo K AD - Department of Anesthesia, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, JPN. LA - eng PT - Journal Article DEP - 20240205 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC10917651 OTO - NOTNLM OT - monitored anesthesia care (mac) OT - non-invasive monitoring OT - procedural sedation and analgesia OT - transcatheter aortic valve repair OT - transcutaneous carbon dioxide tension COIS- The authors have declared that no competing interests exist. EDAT- 2024/03/08 06:42 MHDA- 2024/03/08 06:43 PMCR- 2024/02/05 CRDT- 2024/03/08 04:05 PHST- 2024/02/01 00:00 [accepted] PHST- 2024/03/08 06:43 [medline] PHST- 2024/03/08 06:42 [pubmed] PHST- 2024/03/08 04:05 [entrez] PHST- 2024/02/05 00:00 [pmc-release] AID - 10.7759/cureus.53661 [doi] PST - epublish SO - Cureus. 2024 Feb 5;16(2):e53661. doi: 10.7759/cureus.53661. eCollection 2024 Feb. PMID- 38451155 OWN - NLM STAT- MEDLINE DCOM- 20240415 LR - 20250506 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 103 IP - 5 DP - 2024 Apr TI - Ultrasound-guided deployment of ProGlide device in transfemoral transcatheter aortic valve implantation and risk reduction of vascular complications: A propensity-matched cohort study. PG - 771-781 LID - 10.1002/ccd.30999 [doi] AB - BACKGROUND: ProGlide is a percutaneous suture-mediated closure device used in arterial and venous closure following percutaneous intervention. Risk of vascular complications from use, particularly related to failure in hemostasis, or acute vessel closure, remains significant and often related to improper suture deployment. We describe a technique of ultrasound-guided ProGlide deployment in transfemoral transcatheter aortic valve implantation (TF-TAVI). AIMS: The aim of this study is to assess vascular outcomes for ultrasound-guided deployment of ProGlide vascular closure devices in patients undergoing TF-TAVI. METHODS: We collected relevant clinical data of patients undergoing TAVI in a large volume centre. PRIMARY OUTCOME: main access Valve Academic Research Consortium 3 (VARC-3) major vascular complication. SECONDARY OUTCOME: any major/minor VARC-3 vascular complication, its type (bleed or ischemia), and treatment required (medical, percutaneous, or surgical). We performed inverse weighting propensity score analysis to compare the population undergoing ultrasound-guided versus conventional ProGlide deployment for main TAVI access. Ultrasound technique for ProGlide insertion was performed as described below. RESULTS: Five hundred and seventeen patients undergoing TF-TAVI were included. PRIMARY OUTCOME: In 126 (ultrasound-guided) and 391 (conventional ProGlide insertion), 0% versus 1.8% (p < 0.001) had a major VARC-3 vascular complication, respectively. SECONDARY OUTCOME: 0.8% (one minor VARC-3 bleed) vs 4.1% (13 bleeds and three occlusions) had any VARC-3 vascular complication (major and minor) (p < 0.001). Surgical treatment of vascular complication was required in 0.8% versus 1.3% (p = NS). CONCLUSIONS: Ultrasound-guided deployment of ProGlide for vascular closure reduced the risk of major vascular complications in a large population undergoing TAVI. CI - (c) 2024 Wiley Periodicals LLC. FAU - Ross, Daniel S AU - Ross DS AUID- ORCID: 0009-0002-9442-2732 AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. AD - Imperial College Healthcare NHS Trust, London, UK. FAU - Nogic, Jason AU - Nogic J AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Cong, Hey AU - Cong H AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Nuzzi, Vincenzo AU - Nuzzi V AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. AD - Clinical Cardiology and Heart Failure Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy. FAU - Thanikachalam, Prakash AU - Thanikachalam P AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Veenuraju, Shree AU - Veenuraju S AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Gruner-Hegge, Nicolai AU - Gruner-Hegge N AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Anwar, Majid AU - Anwar M AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - O'Sullivan, Michael AU - O'Sullivan M AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Costopoulos, Charis AU - Costopoulos C AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Davies, Willaim R AU - Davies WR AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. FAU - Costanzo, Pierluigi AU - Costanzo P AUID- ORCID: 0000-0003-3503-9696 AD - Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK. LA - eng PT - Journal Article DEP - 20240307 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Cohort Studies MH - Femoral Artery/diagnostic imaging/surgery MH - Treatment Outcome MH - Hemorrhage/etiology MH - *Vascular Closure Devices MH - Risk Reduction Behavior MH - Ultrasonography, Interventional/adverse effects MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - percutaneous intervention OT - transcatheter aortic valve implantation OT - ultrasound OT - vascular access OT - vascular closure device OT - vascular complications EDAT- 2024/03/07 12:42 MHDA- 2024/04/15 06:44 CRDT- 2024/03/07 09:34 PHST- 2023/12/15 00:00 [revised] PHST- 2023/08/28 00:00 [received] PHST- 2024/02/19 00:00 [accepted] PHST- 2024/04/15 06:44 [medline] PHST- 2024/03/07 12:42 [pubmed] PHST- 2024/03/07 09:34 [entrez] AID - 10.1002/ccd.30999 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Apr;103(5):771-781. doi: 10.1002/ccd.30999. Epub 2024 Mar 7. PMID- 38437633 OWN - NLM STAT- MEDLINE DCOM- 20240318 LR - 20260518 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 45 IP - 11 DP - 2024 Mar 14 TI - Reducing length of stay after transfemoral transcatheter aortic valve implantation: the FAST-TAVI II trial. PG - 952-962 LID - 10.1093/eurheartj/ehae081 [doi] AB - BACKGROUND AND AIMS: The length of stay (LOS) after transcatheter aortic valve implantation (TAVI) remains extremely variable whereas early discharge has been shown to be feasible and safe. The study objective was to evaluate the efficacy and safety of an intervention aimed at reducing LOS after transfemoral TAVI. METHODS: FAST-TAVI II is a prospective, multicentre, cluster, randomized, controlled study including patients with severe symptomatic aortic stenosis, who had transfemoral TAVI. The intervention consisted in a dedicated training programme to implement 10 quality of care measures to reduce LOS with an implementation phase of eight weeks. The primary endpoint was the proportion of patients discharged early within 3 days. Secondary endpoints included: LOS, 30-day mortality and 30-day incidence of readmission for cardiovascular events. RESULTS: During the study period, 969 patients were enrolled in the intervention group and 860 patients in the control group. Mean age was 81.9 +/- 6.6 years and mean EuroSCORE II was 4.4 +/- 4.5%. Early discharge was achieved in 563 (58.1%) patients in the intervention group vs. 364 (42.3%) patients in the control group (P < .0001). Median LOS was significantly reduced in the intervention group compared to the control group [3 (IQR: 3) vs. 4 days (IQR: 3), P < .0001]. Thirty-day mortality was low and similar in the two groups (0.5% vs. 0.9%, P = .30), as were 30-day readmissions (4.6% vs. 2.8%, P = .28). CONCLUSIONS: The intervention was simple and fast to implement, and was effective and safe to reduce LOS and increase the proportion of patients discharged early after TAVI (NCT04503655). CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Durand, Eric AU - Durand E AUID- ORCID: 0000-0001-8171-7959 AD - Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France. FAU - Beziau-Gasnier, Delphine AU - Beziau-Gasnier D AD - Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France. FAU - Michel, Morgane AU - Michel M AUID- ORCID: 0000-0001-6090-8211 AD - Universite Paris Cite, Paris, France. AD - Inserm, ECEVE, Paris, France. AD - Clinical Epidemiology Unit, Robert Debre Hospital, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Iung, Bernard AU - Iung B AD - Cardiology Department, Bichat-Claude-Bernard Hospital Cardiology Service, Paris, France. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. FAU - Bonnet, Guillaume AU - Bonnet G AUID- ORCID: 0000-0002-3027-1771 AD - Unite medico-chirurgicale des valvulopathies, CHU de Bordeaux, 33600 Pessac, France. FAU - Lhermusier, Thibault AU - Lhermusier T AUID- ORCID: 0000-0002-4260-2339 AD - CHU de Toulouse, Pole Cardiovasculaire et Metabolique, Toulouse, France. FAU - Gilard, Martine AU - Gilard M AD - Department of Cardiology, CHRU Brest, 29200 Brest, France. FAU - Souteyrand, Geraud AU - Souteyrand G AD - CHU de Clermont-Ferrand, Clermont-Ferrand, France. FAU - Bouleti, Claire AU - Bouleti C AD - Clinical Investigation Center (INSERM 1204), Cardiology Department, ACTION and FACT study groups, University of Poitiers, Poitiers Hospital, France. FAU - Ohlmann, Patrick AU - Ohlmann P AUID- ORCID: 0000-0002-8021-2737 AD - Universite de Strasbourg, Pole d'Activite Medico-Chirurgicale Cardio-Vasculaire, Nouvel Hopital Civil, Centre Hospitalier Universitaire, Strasbourg, France. FAU - Lefevre, Thierry AU - Lefevre T AD - Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques Cartier, Ramsay Generale de sante, Massy, France. FAU - Beygui, Farzin AU - Beygui F AUID- ORCID: 0000-0003-2170-8983 AD - Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France. FAU - Chassaing, Stephan AU - Chassaing S AD - Cardiology Department, Clinique NCT+-Saint Gatien-Alliance, Tours, France. FAU - Chevreul, Karine AU - Chevreul K AD - Universite Paris Cite, Paris, France. AD - Inserm, ECEVE, Paris, France. AD - Clinical Epidemiology Unit, Robert Debre Hospital, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Eltchaninoff, Helene AU - Eltchaninoff H AD - Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France. CN - FAST-TAVI II CN - STOP-AS investigators LA - eng SI - ClinicalTrials.gov/NCT04503655 GR - French Government/ GR - National Research Agency/ GR - ANR-16-RHUS-0003_STOP-AS/ANR/ PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/surgery MH - Length of Stay MH - Prospective Studies MH - Patient Discharge MH - Treatment Outcome MH - Aortic Valve/surgery MH - Risk Factors OTO - NOTNLM OT - Aortic stenosis OT - Length of stay OT - TAVI FIR - Alos, Benjamin IR - Alos B FIR - Arnould, Marc-Antoine IR - Arnould MA FIR - Bar, Olivier IR - Bar O FIR - Barbey, Christophe IR - Barbey C FIR - Bertrand, Bernard IR - Bertrand B FIR - Beygui, Farzin IR - Beygui F FIR - Bignon, Mathieu IR - Bignon M FIR - Bouchat, Marine IR - Bouchat M FIR - Bouisset, Frederic IR - Bouisset F FIR - Bouleti, Claire IR - Bouleti C FIR - Campelo-Parada, Fransisco IR - Campelo-Parada F FIR - Chassaing, Stephan IR - Chassaing S FIR - Combaret, Nicolas IR - Combaret N FIR - Darodes, Nicole IR - Darodes N FIR - Delepine, Stephane IR - Delepine S FIR - Didier, Romain IR - Didier R FIR - Dongay, Bruno IR - Dongay B FIR - Dumonteil, Nicolas IR - Dumonteil N FIR - Fouassier, David IR - Fouassier D FIR - Gallet de Saint Aurin, Romain IR - Gallet de Saint Aurin R FIR - Gilard, Martine IR - Gilard M FIR - Gouffran, Guillaume IR - Gouffran G FIR - Himbert, Dominique IR - Himbert D FIR - Le Bivic, Louis IR - Le Bivic L FIR - Lefevre, Thierry IR - Lefevre T FIR - Lemaitre, Adrien IR - Lemaitre A FIR - Leroux, Lionel IR - Leroux L FIR - Levy, Gilles IR - Levy G FIR - Lhermusier, Thibaut IR - Lhermusier T FIR - Lorgis, Luc IR - Lorgis L FIR - Morelle, Jean-Francois IR - Morelle JF FIR - Ohlmann, Patrick IR - Ohlmann P FIR - Piot, Christophe IR - Piot C FIR - Pommier, Thibaut IR - Pommier T FIR - Rebouh, Idir IR - Rebouh I FIR - Roule, Vincent IR - Roule V FIR - Rusinaru, Dan IR - Rusinaru D FIR - Souteyrand, Geraud IR - Souteyrand G FIR - Spaulding, Christian IR - Spaulding C FIR - Tchetche, Didier IR - Tchetche D FIR - Teiger, Emmanuel IR - Teiger E FIR - Tribouilloy, Christophe IR - Tribouilloy C FIR - Eltchaninoff, Helene IR - Eltchaninoff H FIR - Bellien, Jeremy IR - Bellien J FIR - Bertrand, Benjamin IR - Bertrand B FIR - Beygui, Farzin IR - Beygui F FIR - Beziau-Gasnier, Delphine IR - Beziau-Gasnier D FIR - Brakenhielm, Ebba IR - Brakenhielm E FIR - Caligiuri, Giuseppina IR - Caligiuri G FIR - Chevreul, Karine IR - Chevreul K FIR - Debroucker, Frederique IR - Debroucker F FIR - Durand, Eric IR - Durand E FIR - Fraschini, Christophe IR - Fraschini C FIR - Gilard, Martine IR - Gilard M FIR - Iung, Bernard IR - Iung B FIR - Kamel, Said IR - Kamel S FIR - Laschet, Jamila IR - Laschet J FIR - Manrique, Alain IR - Manrique A FIR - Messas, Emmanuel IR - Messas E FIR - Messika-Zeitoun, David IR - Messika-Zeitoun D FIR - Pinet, Florence IR - Pinet F FIR - Richard, Vincent IR - Richard V FIR - Saloux, Eric IR - Saloux E FIR - Thoenes, Martin IR - Thoenes M FIR - Tribouilloy, Christophe IR - Tribouilloy C FIR - Vezier, Claire IR - Vezier C EDAT- 2024/03/04 18:42 MHDA- 2024/03/18 06:42 CRDT- 2024/03/04 16:23 PHST- 2023/06/30 00:00 [received] PHST- 2023/11/22 00:00 [revised] PHST- 2024/01/29 00:00 [accepted] PHST- 2024/03/18 06:42 [medline] PHST- 2024/03/04 18:42 [pubmed] PHST- 2024/03/04 16:23 [entrez] AID - 7618769 [pii] AID - 10.1093/eurheartj/ehae081 [doi] PST - ppublish SO - Eur Heart J. 2024 Mar 14;45(11):952-962. doi: 10.1093/eurheartj/ehae081. PMID- 38436739 OWN - NLM STAT- MEDLINE DCOM- 20250317 LR - 20260924 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 114 IP - 3 DP - 2025 Mar TI - Non-femoral focused transaxillary access in TAVI: GARY data analysis and future trends. PG - 323-331 LID - 10.1007/s00392-024-02402-9 [doi] AB - BACKGROUND: In patients not suitable for transfemoral transcatheter aortic valve implantation (TAVI), several access strategies can be chosen. AIM: To evaluate the use and patient outcomes of transaxillary (TAx), transapical (TA), and transaortic (TAo) as alternative access for TAVI in Germany; to further evaluate surgical cutdown vs. percutaneous TAx access. METHODS: All patients entered the German Aortic Valve Registry (GARY) between 2011 and 2019 who underwent non-transfemoral TAVI were included in this analysis. Patients with TA, TAo, or TAx TAVI were compared using a weighted propensity score model. Furthermore, a subgroup analysis was performed for TAx regarding the percutaneous or surgical cutdown approach. RESULTS: Overall, 9686 patients received a non-transfemoral access. A total of 8918 patients (92.1%) underwent TA, 398 (4.1%) TAo, and 370 (3.8%) TAx approaches. Within the TAx subgroup, 141 patients (38.1%) received subclavian cutdown, while 200 (54.1%) underwent a percutaneous approach. The TA patients had a significantly lower 30-day survival than TAx patients (TA 90.92% vs. TAx 95.59%, p = 0.006; TAo 92.22% vs. TAx 95.59%, p = 0.102). Comparing percutaneous and cutdown TAx approaches, no significant differences were seen. However, more vascular complications occurred (TA 1.8%, TAo 2.4%, TAx 12.2%; p < .001), and the hospital length of stay was shorter (TA 12.9 days, TAo 14.1 days, TAx 12 days; p < .001) after TAx access. CONCLUSION: It may be reasonable to consider TAx access first in patients not suitable for TF-TAVI, because the 30-day survival was higher compared with TA access and the 1-year survival was higher compared with TAo access. It remains important for the heart teams to offer alternative access modalities for patients not amenable to the standard TF-TAVI approaches. CI - (c) 2024. The Author(s). FAU - Meertens, Max M AU - Meertens MM AUID- ORCID: 0000-0002-7746-8723 AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. max.meertens@me.com. FAU - Adam, Matti AU - Adam M AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Beckmann, Andreas AU - Beckmann A AD - Department of Cardiac and Pediatric Cardiac Surgery, Evanglish Clinical Center Niederrhein, Heart Center Duisburg, Duisburg, Germany. FAU - Ensminger, Stephan AU - Ensminger S AD - Department of Cardiac and Thoracic Vascular Surgery, University Heart Center Lubeck, University Hospital of Schleswig Holstein, Lubeck, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Sie Hamburg-Kiel-Lubeck, Berlin, Germany. FAU - Frerker, Christian AU - Frerker C AD - German Center for Cardiovascular Research (DZHK), Partner Sie Hamburg-Kiel-Lubeck, Berlin, Germany. AD - Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lubeck, University Hospital Schleswig-Holstein, Lubeck, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - German Center for Cardiovascular Research (DZHK), Partner Sie Hamburg-Kiel-Lubeck, Berlin, Germany. AD - University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Sinning, Jan-Malte AU - Sinning JM AD - Department of Cardiology, St Vinzenz Hospital, Cologne, Germany. FAU - Bekeredjian, Raffi AU - Bekeredjian R AD - Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany. FAU - Walther, Thomas AU - Walther T AD - Department of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, Frankfurt a. M., Germany. FAU - Beyersdorf, Friedhelm AU - Beyersdorf F AD - Department of Cardiovascular Surgery, Heart Centre Freiburg University, Freiburg, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - The Department of Internal Medicine, St.-Johannes-Hospital Dortmund, Dortmund, Germany. FAU - Balaban, Umniye AU - Balaban U AD - Institute of Biostatistics and Mathematical Modelling, Goethe-University, Frankfurt, Frankfurt a. M., Germany. FAU - Eghbalzadeh, Kaveh AU - Eghbalzadeh K AD - Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Department for General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia Bochum, University Hospital of the Ruhr University, Bad Oeynhausen, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, University Hospital Ruhr-University Bochum, Bad Oeynhausen, Germany. sbleiziffer@hdz-nrw.de. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20240304 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/trends MH - Male MH - Female MH - *Registries MH - Germany/epidemiology MH - *Aortic Valve Stenosis/surgery/mortality MH - Aged, 80 and over MH - Aged MH - Axillary Artery MH - Treatment Outcome MH - Retrospective Studies MH - Femoral Artery MH - Survival Rate/trends MH - *Aortic Valve/surgery MH - Propensity Score PMC - PMC11913932 OTO - NOTNLM OT - GARY OT - TAVI OT - Transaortic OT - Transapical OT - Transaxillary OT - Transfemoral OT - Transsubclavian COIS- Declarations. Conflict of interest: Max M. Meertens, Raffi Bekeredjian, Andreas Beckmann, Stephan Ensminger, Friedhelm Beyersdorf, Umniye Balaban, Kaveh Eghbalzadeh, Sabine Bleiziffer, and Thomas Walther reported to have no conflicts of interest for this manuscript. Christian Frerker received lecture honoraria and travel support from Medtronic Inc., Edwards Lifesciences, and Biosensors within the last 12 months. Helge Mollmann received proctor fees/honoraria from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and SMT. Matti Adam has received personal and consulting fees from Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic. Moritz Seiffert reports personal fees from Abbott Vascular, personal fees from Abiomed, personal fees from AstraZeneca, grants, personal fees and non-financial support from Boston Scientific, personal fees from Bristol-Myers Squibb, personal fees from Edwards Lifesciences, personal fees from Medtronic, personal fees from Amgen, personal fees from Shockwave Medical, personal fees from Daichii Sankyo, personal fees from Pfizer, personal fees from Siemens Healthineers, personal fees from Inari Medical, outside the submitted work. Jan-Malte Sinning received grants or research support from Boston Scientific, Edwards Lifesciences, and Medtronic, proctor fees from Boston Scientific, Scientific Advisory Board fees from Abbott, Abiomed, Boston Scientific, Boehringer Ingelheim, and Medtronic and received speaker honoraria and/or travel expenses from Abbott, Abiomed, Astra Zeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Edwards Lifesciences, Medtronic, Novartis, Novo Nordisk, Pfizer, Shockwave Medical, and Zoll. Tanja Rudolph received speaker's fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and JenaValve, medical advisory fees from JenaValve and Medtronic, proctor fees from Edwards Lifesciences and Medtronic, and institutional research grants from Boston Scientific and Edwards Lifesciences. Sabine Bleiziffer received speaker fees from Abbott, Edwards Lifesciences, Medtronic, and Boston Scientific. EDAT- 2024/03/04 12:44 MHDA- 2025/03/17 18:30 PMCR- 2024/03/04 CRDT- 2024/03/04 11:06 PHST- 2023/10/20 00:00 [received] PHST- 2024/02/13 00:00 [accepted] PHST- 2025/03/17 18:30 [medline] PHST- 2024/03/04 12:44 [pubmed] PHST- 2024/03/04 11:06 [entrez] PHST- 2024/03/04 00:00 [pmc-release] AID - 10.1007/s00392-024-02402-9 [pii] AID - 2402 [pii] AID - 10.1007/s00392-024-02402-9 [doi] PST - ppublish SO - Clin Res Cardiol. 2025 Mar;114(3):323-331. doi: 10.1007/s00392-024-02402-9. Epub 2024 Mar 4. PMID- 38426701 OWN - NLM STAT- MEDLINE DCOM- 20240304 LR - 20250630 IS - 1678-9741 (Electronic) IS - 0102-7638 (Print) IS - 0102-7638 (Linking) VI - 39 IP - 2 DP - 2024 Mar 1 TI - The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement. PG - e20220436 LID - 10.21470/1678-9741-2022-0436 [doi] LID - e20220436 AB - INTRODUCTION: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in-hospital complications as well as mortality of patients undergoing Evolut R valve implantation. METHODS: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium-3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in-hospital mortality. Patients were divided into two groups, AA 48 degrees , based on the mean AA measurement (48.3+/-8.8) on multislice computer tomography. RESULTS: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. CONCLUSION: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted. FAU - Aktan, Adem AU - Aktan A AUID- ORCID: 0000-0003-0505-9784 AD - Department of Cardiology, Mardin Training and Research Hospital, Mardin, Turkey. FAU - Demir, Muhammed AU - Demir M AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Guzel, Tuncay AU - Guzel T AD - Department of Cardiology, Health Science University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey. FAU - Karahan, Mehmet Zulkuf AU - Karahan MZ AD - Department of Cardiology, Faculty of Medicine, Artuklu University, Mardin, Turkey. FAU - Aslan, Burhan AU - Aslan B AD - Department of Cardiology, Health Science University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey. FAU - Kilic, Raif AU - Kilic R AD - Department of Cardiology, Diyarlife Hospital, Diyarbakir, Turkey. FAU - Gunlu, Serhat AU - Gunlu S AD - Department of Cardiology, Dagkapi State Hospital, Diyarbakir, Turkey. FAU - Arslan, Bayram AU - Arslan B AD - Department of Cardiology, Ergani State Hospital, Diyarbakir, Turkey. FAU - Ozbek, Mehmet AU - Ozbek M AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Ertas, Faruk AU - Ertas F AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. LA - eng PT - Journal Article DEP - 20240301 PL - Brazil TA - Braz J Cardiovasc Surg JT - Brazilian journal of cardiovascular surgery JID - 101677045 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Prosthesis Design MH - *Kidney Failure, Chronic/etiology/surgery MH - *Heart Failure/surgery MH - *Hypertension/etiology PMC - PMC10903524 OTO - NOTNLM OT - Aortic Angulation OT - Aortic Stenosis OT - Logistic Models OT - Transcatheter Aortic Valve Replacement COIS- No conflict of interest. EDAT- 2024/03/01 12:43 MHDA- 2024/03/04 06:46 PMCR- 2024/02/21 CRDT- 2024/03/01 08:34 PHST- 2024/03/04 06:46 [medline] PHST- 2024/03/01 12:43 [pubmed] PHST- 2024/03/01 08:34 [entrez] PHST- 2024/02/21 00:00 [pmc-release] AID - 10.21470/1678-9741-2022-0436 [doi] PST - epublish SO - Braz J Cardiovasc Surg. 2024 Mar 1;39(2):e20220436. doi: 10.21470/1678-9741-2022-0436. PMID- 38425812 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240302 IS - 2491-0929 (Electronic) IS - 2426-3958 (Print) IS - 2426-3958 (Linking) VI - 10 IP - 1 DP - 2024 Feb TI - Efficacy and safety of a minimalistic balloon aortic valvuloplasty strategy in a centre without heart surgery. PG - 40-50 LID - 10.4244/AIJ-D-23-00041 [doi] AB - BACKGROUND: Balloon aortic valvuloplasty (BAV) is a palliative tool for patients with symptomatic severe aortic stenosis (AS) at prohibitive risk for surgery or as a bridge to surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). BAV is traditionally performed in hospitals with onsite cardiac surgery due to its potential complications. AIMS: The aim of this study was to evaluate the safety of BAV procedures performed by trained high-volume operators in a centre without onsite surgery and to assess the effect of a minimalistic approach to reduce periprocedural complications. METHODS: From 2016 to 2021, 187 BAV procedures were performed in 174 patients. Patients were elderly (mean age: 85.0+/-5.4 years) and had high-risk (mean European System for Cardiac Operative Risk Evaluation score [EuroSCORE] II: 10.1+/-9.9) features. According to the indications, 4 cohorts were identified: 1) bridge to TAVR (n=98; 56%); 2) bridge to SAVR (n=8; 5%); 3) cardiogenic shock (n=11; 6%); and 4) palliation (n=57; 33%). BAV procedures were performed using the standard retrograde technique via femoral access in 165 patients (95%), although radial access was used in 9 patients (5%). Ultrasound-guided vascular puncture was performed in 118 patients (72%) and left ventricular pacing was administered through a stiff guidewire in 105 cases (60%). RESULTS: BAV safety was confirmed by 1 periprocedural death (0.6%), 1 intraprocedural stroke (0.6%), 2 major vascular complications (1%) and 9 minor vascular complications (5%). Nine cases of in-hospital mortality occurred (5%), predominantly in patients with cardiogenic shock. CONCLUSIONS: BAV is a safe procedure that can be performed in centres without onsite cardiac surgery using a minimalistic approach that can reduce periprocedural complications. FAU - Bruno, Matteo AU - Bruno M AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Iannopollo, Gianmarco AU - Iannopollo G AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Cardelli, Laura Sofia AU - Cardelli LS AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Capecchi, Alessandro AU - Capecchi A AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Lanzilotti, Valerio AU - Lanzilotti V AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Verardi, Roberto AU - Verardi R AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Pedone, Chiara AU - Pedone C AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Nobile, Giampiero AU - Nobile G AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. FAU - Casella, Gianni AU - Casella G AD - Cardiology Department, Ospedale Maggiore, Bologna, Italy and Azienda USL di Bologna, Bologna, Italy. LA - eng PT - Journal Article DEP - 20240229 PL - France TA - AsiaIntervention JT - AsiaIntervention JID - 101697313 PMC - PMC10900243 COIS- The authors have no conflicts of interest to declare. EDAT- 2024/03/01 06:44 MHDA- 2024/03/01 06:45 PMCR- 2024/02/29 CRDT- 2024/03/01 03:53 PHST- 2023/07/18 00:00 [received] PHST- 2023/10/06 00:00 [accepted] PHST- 2024/03/01 06:45 [medline] PHST- 2024/03/01 06:44 [pubmed] PHST- 2024/03/01 03:53 [entrez] PHST- 2024/02/29 00:00 [pmc-release] AID - 10.4244/AIJ-D-23-00041 [doi] PST - epublish SO - AsiaIntervention. 2024 Feb 29;10(1):40-50. doi: 10.4244/AIJ-D-23-00041. eCollection 2024 Feb. PMID- 38417474 OWN - NLM STAT- MEDLINE DCOM- 20240807 LR - 20250711 IS - 1535-6280 (Electronic) IS - 0146-2806 (Linking) VI - 49 IP - 5 DP - 2024 May TI - Transcarotid versus trans-axillary/subclavian transcatheter aortic valve replacement (TAVR): A systematic review and meta-analysis. PG - 102488 LID - S0146-2806(24)00127-0 [pii] LID - 10.1016/j.cpcardiol.2024.102488 [doi] AB - BACKGROUND: Transcatheter Aortic Valve Replacement (TAVR) is the treatment of choice in patients with severe aortic stenosis. Transcarotid (TCa) or Trans-axillary/subclavian (TAx/Sc) are safer and less invasive non-femoral approaches, where transfemoral access is difficult or impossible to obtain. METHODS: This meta-analysis was performed based on PRISMA guidelines after registering in PROSPERO (CRD42023482842). This meta-analysis was performed to compare the safety of the transcarotid and trans-axillary/subclavian approach for TAVR including studies from inception to October 2023. RESULTS: Seven studies with a total of 6227 patients were included in the analysis (TCa: 2566; TAx/Sc: 3661). Transcarotid TAVR approach had a favorable trend for composite of stroke and all-cause mortality (OR 0.79, CI 0.60-1.04), all-cause mortality, stroke, major vascular complication, and new requirement of permanent pacemaker though those were statistically insignificant. On sub-analysis of the results of the studies based on the territory (USA vs French), composite outcome of all cause mortality, stroke and major bleeding (OR 0.54, CI 0.54-0.81), composite of stroke and all cause mortality (OR 0.64, CI 0.50-0.81), and stroke/TIA (OR 0.53, CI 0.39-0.73) showed lower odds of occurrence among patient managed with TCa approach in the American cohort. CONCLUSION: Overall, transcarotid approach had favorable though statistically insignificant odds for composite (stroke and all-cause mortality) and individual outcomes (stroke, all-cause mortality, etc.). There are significant variations in observed outcomes based on study's geographic location. Large prospective randomized clinical trials comparing the two approaches with representative samples are necessary to guide the clinicians in choosing among these approaches. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Dawadi, Sagun AU - Dawadi S AD - Department of Internal Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, 44600, Nepal. FAU - Oli, Prakash Raj AU - Oli PR AD - Department of Internal Medicine, Province Hospital, Birendranagar, Surkhet, Karnali Province 21700, Nepal. FAU - Shrestha, Dhan Bahadur AU - Shrestha DB AD - Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL 60608, USA. FAU - Shtembari, Jurgen AU - Shtembari J AD - Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL 60608, USA. FAU - Pant, Kailash AU - Pant K AD - Department of Internal Medicine, Division of Cardiovascular Medicine, University of Illinois College of Medicine, OSF Healthcare, Peoria, IL 61614, USA. FAU - Shrestha, Bishesh AU - Shrestha B AD - Division of Cardiology, Department of Internal Medicine, Bassett Medical Center, 1 Atwell Rd, Cooperstown, NY 13326, USA. FAU - Mattumpuram, Jishanth AU - Mattumpuram J AD - Division of Cardiology, Department of Internal Medicine, University of Louisville School of Medicine, 550 S Jackson St, Louisville, KY 40202, USA. Electronic address: jishanth.mattumpuram@louisville.edu. FAU - Katz, Daniel H AU - Katz DH AD - Division of Cardiology, Department of Internal Medicine, Bassett Medical Center, 1 Atwell Rd, Cooperstown, NY 13326, USA. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20240228 PL - Netherlands TA - Curr Probl Cardiol JT - Current problems in cardiology JID - 7701802 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Aortic Valve Stenosis/surgery MH - *Axillary Artery MH - *Subclavian Artery/surgery MH - Carotid Arteries/surgery MH - Treatment Outcome MH - Aortic Valve/surgery MH - Postoperative Complications/epidemiology OTO - NOTNLM OT - Trans-axillary/subclavian TAVR OT - Transcarotid TAVR OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest The authors report no conflicts of interest. EDAT- 2024/02/29 00:43 MHDA- 2024/04/02 06:46 CRDT- 2024/02/28 19:13 PHST- 2024/02/23 00:00 [received] PHST- 2024/02/24 00:00 [accepted] PHST- 2024/04/02 06:46 [medline] PHST- 2024/02/29 00:43 [pubmed] PHST- 2024/02/28 19:13 [entrez] AID - S0146-2806(24)00127-0 [pii] AID - 10.1016/j.cpcardiol.2024.102488 [doi] PST - ppublish SO - Curr Probl Cardiol. 2024 May;49(5):102488. doi: 10.1016/j.cpcardiol.2024.102488. Epub 2024 Feb 28. PMID- 38412895 OWN - NLM STAT- MEDLINE DCOM- 20240424 LR - 20241231 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 271 DP - 2024 May TI - Transfemoral transcatheter aortic valve replacement with VitaFlow(TM) valve for pure native aortic regurgitation in patients with high surgical risk: Rationale and design of a prospective, multicenter, and randomized SEASON-AR trial. PG - 76-83 LID - S0002-8703(24)00049-8 [pii] LID - 10.1016/j.ahj.2024.02.022 [doi] AB - BACKGROUND: Previous studies primarily demonstrated that transfemoral transcatheter aortic valve replacement (TAVR) with self-expanding valve appeared to be a safe and feasible treatment for patients with pure native aortic regurgitation (AR). However, the routine application of transfemoral TAVR for pure AR patients lacks support from randomized trials. TRIAL DESIGN: SEASON-AR trial is a prospective, multicenter, randomized, controlled, parallel-group, open-label trial, involving at least 20 sites in China, aiming to enroll 210 patients with pure native severe AR and high surgical risk. All enrolled patients are randomly assigned in a 1:1 fashion to undergo transfemoral TAVR with VitaFlow(TM) valve and receive guideline-directed medical therapy (GDMT) or to receive GDMT alone. The primary endpoint is the rate of major adverse cardiac events (MACE) at 12 months after the procedure, defined by the composite of all-cause mortality, disabling stroke, and rehospitalization for heart failure. The major secondary endpoints encompass various measures, including procedure-related complications, device success, 6-minute walk distance, and the occurrence of each individual component of the primary endpoint. After hospital discharge, follow-up was conducted through clinical visits or telephone contact at 1, 6, and 12 months. The follow-up will continue annually until 5 years after the index procedure to assess the long-term outcomes. CONCLUSION: SEASON-AR trial is the first study designed to investigate the clinical efficacy and safety of transfemoral TAVR with a self-expanding valve in patients with pure native severe AR with inoperable or high-risk, as compared to medical treatment only. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Zhang, Juan AU - Zhang J AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Kong, Xiang-Quan AU - Kong XQ AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Gao, Xiao-Fei AU - Gao XF AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Chen, Jing AU - Chen J AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China. FAU - Chen, Xiang AU - Chen X AD - Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China. FAU - Li, Bo AU - Li B AD - Department of Cardiology, Zibo Central Hospital, Zibo, China. FAU - Shao, Yi-Bing AU - Shao YB AD - Department of Cardiology, Qingdao Municipal Hospital, Qingdao, China. FAU - Wang, Yan AU - Wang Y AD - Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China. FAU - Jiang, Hong AU - Jiang H AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China. FAU - Zhu, Jian-Cheng AU - Zhu JC AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Zhang, Jun-Jie AU - Zhang JJ AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Electronic address: jameszll@163.com. FAU - Chen, Shao-Liang AU - Chen SL AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. CN - SEASON-AR investigators LA - eng PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240225 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery MH - *Aortic Valve Insufficiency/surgery/epidemiology MH - China/epidemiology MH - Femoral Artery MH - *Heart Valve Prosthesis MH - Postoperative Complications/epidemiology/prevention & control MH - Prospective Studies MH - Prosthesis Design MH - Stroke/prevention & control/etiology/epidemiology MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - Randomized Controlled Trials as Topic MH - Multicenter Studies as Topic COIS- Conflict of interest There is nothing to disclose. EDAT- 2024/02/28 00:43 MHDA- 2024/04/25 00:54 CRDT- 2024/02/27 19:10 PHST- 2024/01/09 00:00 [received] PHST- 2024/02/17 00:00 [revised] PHST- 2024/02/22 00:00 [accepted] PHST- 2024/04/25 00:54 [medline] PHST- 2024/02/28 00:43 [pubmed] PHST- 2024/02/27 19:10 [entrez] AID - S0002-8703(24)00049-8 [pii] AID - 10.1016/j.ahj.2024.02.022 [doi] PST - ppublish SO - Am Heart J. 2024 May;271:76-83. doi: 10.1016/j.ahj.2024.02.022. Epub 2024 Feb 25. PMID- 38410558 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240229 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 16 IP - 1 DP - 2024 Jan 30 TI - Transcatheter aortic valve replacement in the treatment of bicuspid aortic stenosis with "down-size" interventional valves: procedural and mid-term follow-up. PG - 593-603 LID - 10.21037/jtd-23-1885 [doi] AB - BACKGROUND: Due to the influence of anatomical structure, replacing the bicuspid valve using transcatheter aortic valve replacement (TAVR) would increase the risk of perivalvular leakage and conduction block, affecting the hemodynamic effect of the interventional valve. In this study, for bicuspid and tricuspid valves, we implemented different valve selection strategies to explore the safety and effectiveness of TAVR in the treatment of bicuspid aortic stenosis with "down-size" interventional valves using the VenusA-valve system. METHODS: The operation was performed with the VenusA-valve via transfemoral approach. The selected valves were appropriately sized based on the results of transthoracic echocardiography (TTE), contrast-enhanced computed tomography (CT), and the morphology of intraoperative pre-dilation balloons. For tricuspid valve cases, the VenusA valve is usually larger than the annulus diameter, whereas the "down-size" approach was adopted for bicuspid aortic valve (BAV) cases. The shape of the pre-dilation balloon allowed further sizing of the annulus diameter by the degree of lumbar constriction of the balloon, aiding in intervention valve size selection, particularly in cases of BAVs. RESULTS: A total of 65 patients underwent TAVR for aortic stenosis with VenusA-valve systems. Of these, 29 cases had a BAV and 36 cases had a tricuspid aortic valve (TAV). The distribution of VenusA-valve sizes differed between TAV and BAV cases (P=0.007). Furthermore, there was a significant decrease in the average mean gradient in TAV patients from 54.7 to 12.2 mmHg (P<0.001), and in BAV patients from 61.6 to 14.3 mmHg (P<0.001). The percentage of paravalvular leakage greater than mild was 6.90% in the BAVs and 5.56% in the TAVs at procedural outcomes (P=0.955). The mean follow-up period was 22.23 months (range, 12 to 39 months). The proportion of New York Heart Association (NYHA) class III/IV decreased from 78.5% preoperatively to 11.3% at the last follow-up (P<0.001). A total of 27 patients with TAV and 19 patients with BAV underwent TTE at 1-year follow-up after operation. There was no significant contrast in the average pressure difference between TAVs and BAVs at 1-year follow-up (11.9 vs. 14.3 mmHg, P=0.18). CONCLUSIONS: The VenusA-valve for TAVR produced positive clinical outcomes and valve functionality in both BAVs and TAVs. In the case of BAVs, selecting a smaller interventional valve size was deemed viable. CI - 2024 Journal of Thoracic Disease. All rights reserved. FAU - Liu, Kun AU - Liu K AD - Department of Cardiac Surgery, Cardiovascular Medical Center, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China. FAU - Wu, Kaisheng AU - Wu K AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Shen, Jinglun AU - Shen J AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Meng, Fei AU - Meng F AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Nappi, Francesco AU - Nappi F AD - Department of Cardiac Surgery, Centre Cardiologique du Nord, Saint-Denis, France. FAU - Alfonso, Fernando AU - Alfonso F AD - Department of Cardiology, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, CIBERCV, IIS-IP, Madrid, Spain. FAU - Wang, Shengxun AU - Wang S AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Zheng, Shuai AU - Zheng S AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Zhang, Haibo AU - Zhang H AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. LA - eng PT - Journal Article DEP - 20240122 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC10894397 OTO - NOTNLM OT - Transcatheter aortic valve replacement (TAVR) OT - bicuspid aortic valve (BAV) OT - tricuspid aortic valve (TAV) OT - valve size selection COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1885/coif). The authors have no conflicts of interest to declare. EDAT- 2024/02/27 06:45 MHDA- 2024/02/27 06:46 PMCR- 2024/01/30 CRDT- 2024/02/27 03:41 PHST- 2023/12/12 00:00 [received] PHST- 2024/01/16 00:00 [accepted] PHST- 2024/02/27 06:46 [medline] PHST- 2024/02/27 06:45 [pubmed] PHST- 2024/02/27 03:41 [entrez] PHST- 2024/01/30 00:00 [pmc-release] AID - jtd-16-01-593 [pii] AID - 10.21037/jtd-23-1885 [doi] PST - ppublish SO - J Thorac Dis. 2024 Jan 30;16(1):593-603. doi: 10.21037/jtd-23-1885. Epub 2024 Jan 22. PMID- 38407552 OWN - NLM STAT- MEDLINE DCOM- 20240319 LR - 20240321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 103 IP - 4 DP - 2024 Mar TI - Assessment of the MANTA closure device in real-life transfemoral transcatheter aortic valve replacement: A single-centre observational study. PG - 650-659 LID - 10.1002/ccd.30969 [doi] AB - BACKGROUND: Vascular complications increase morbidity and mortality in transcatheter aortic valve replacement (TAVR). Data involving suture-based percutaneous vascular closure devices (VCDs) have been extensive. Although promising, data regarding the efficacy and safety of the MANTA VCD (Teleflex) are scarce. We sought to assess the safety and effectiveness of the MANTA device in a real-life unselected cohort of patients undergoing transfemoral-TAVR (TF-TAVR). METHODS: This single-center retrospective observational study included a cohort of consecutive patients with severe aortic stenosis (AS) treated by our team using TAVR between January 2020 to December 2022. The primary outcome measure was access-related major and minor vascular complications according to the Valve Academic Research Consortium (VARC-3) definition criteria. RESULTS: From January 2020 to December 2022, a total of 347 patients underwent TF-TAVR were treated using the MANTA 18 Fr VCD system for vascular closure. Mean age was 82.4 +/- 6.1 years (56-98 years). There were no significant differences in preoperative and procedural characteristics between patients with and without VCD-related major vascular complications. Access site-related major and minor vascular complications occurred in 20 of 347 patients (5.7%). Overall, major vascular complications occurred in 5 patients (1.4%) and device failure was seen in 17 patients (4.9%). CONCLUSION: This French real world evaluation of large-bore arteriotomy closure in TF-TAVR indicated that MANTA VCD is a feasible alternative with an acceptable low rate of access-site-related complications. CI - (c) 2024 Wiley Periodicals LLC. FAU - Boussofara, Amine AU - Boussofara A AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. FAU - Godin, Matthieu AU - Godin M AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. FAU - Canville, Alexandre AU - Canville A AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. FAU - Baala, Brahim AU - Baala B AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. FAU - Berland, Jacques AU - Berland J AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. FAU - Koning, Rene AU - Koning R AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. FAU - Landolff, Quentin AU - Landolff Q AUID- ORCID: 0000-0003-4022-2065 AD - Department of Cardiology, Clinique Saint Hilaire, Rouen, France. LA - eng PT - Journal Article PT - Observational Study DEP - 20240226 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Vascular Closure Devices MH - *Catheterization, Peripheral/adverse effects MH - Punctures OTO - NOTNLM OT - TAVR OT - vascular closure device OT - vascular complications EDAT- 2024/02/26 12:42 MHDA- 2024/03/19 06:44 CRDT- 2024/02/26 11:34 PHST- 2023/11/30 00:00 [revised] PHST- 2023/09/15 00:00 [received] PHST- 2024/01/31 00:00 [accepted] PHST- 2024/03/19 06:44 [medline] PHST- 2024/02/26 12:42 [pubmed] PHST- 2024/02/26 11:34 [entrez] AID - 10.1002/ccd.30969 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Mar;103(4):650-659. doi: 10.1002/ccd.30969. Epub 2024 Feb 26. PMID- 38401656 OWN - NLM STAT- MEDLINE DCOM- 20240501 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 219 DP - 2024 May 15 TI - Sex-Related Outcomes of Transcatheter Aortic Valve Implantation With Self-Expanding or Balloon-Expandable Valves: Insights from the OPERA-TAVI Registry. PG - 60-70 LID - S0002-9149(24)00095-X [pii] LID - 10.1016/j.amjcard.2024.01.028 [doi] AB - Evidence regarding gender-related differences in response to transcatheter aortic valve implantation according to the valve type is lacking. This study aimed to evaluate the impact of gender on the treatment effect of Evolut PRO/PRO+ (PRO) or SAPIEN 3 Ultra (ULTRA) devices on clinical outcomes. The Comparative Analysis of Evolut PRO vs SAPIEN 3 Ultra Valves for Transfemoral Transcatheter Aortic Valve Implantation (OPERA-TAVI) is a multicenter, multinational registry including patients who underwent the latest-iteration PRO or ULTRA implantation. Overall, 1,174 of 1,897 patients were matched based on valve type and compared according to gender, whereas 470 men and 630 women were matched and compared according to valve type. The 30-day and 1-year outcomes were evaluated. In the PRO and ULTRA groups, men had a higher co-morbidity burden, whereas women had smaller aortic root. The 30-day (device success [DS], early safety outcome, permanent pacemaker implantation, patient-prosthesis mismatch, paravalvular regurgitation, bleedings, vascular complications, and all-cause death) and 1-year outcomes (all-cause death, stroke, and heart failure hospitalization) did not differ according to gender in both valve groups. However, the male gender decreased the likelihood of 30-day DS with ULTRA versus PRO (p for interaction = 0.047). A higher risk of 30-day permanent pacemaker implantation and 1-year stroke and a lower risk of patient-prosthesis mismatch was observed in PRO versus ULTRA, regardless of gender. In conclusion, gender did not modify the treatment effect of PRO versus ULTRA on clinical outcomes, except for 30-day DS, which was decreased in men (vs women) who received ULTRA (vs PRO). CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Adamo, Marianna AU - Adamo M AD - Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. Electronic address: mariannaadamo@hotmail.com. FAU - Branca, Luca AU - Branca L AD - Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Pezzola, Elisa AU - Pezzola E AD - Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiovascular Department, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Science, Leipzig, Germany. FAU - Garot, Philippe AU - Garot P AD - Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta specializzazione (ISMETT), Palermo, Italy. FAU - Fiorina, Claudia AU - Fiorina C AD - Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Sammartino, Sofia AU - Sammartino S AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Santos, Ignacio Amat AU - Santos IA AD - Division of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospital, University of Galway, Ireland. FAU - De Marco, Federico AU - De Marco F AD - Interventional Cardiology Department, IRCSS Centro Cardiologico Monzino, Milan, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Franco, Luis Nombela AU - Franco LN AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Akodad, Mariama AU - Akodad M AD - Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France; Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Ribichini, Flavio Luciano AU - Ribichini FL AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese (MI), Italy. FAU - Laterra, Giulia AU - Laterra G AD - Universita degli Studi di Enna "Kore," Enna, Italy. FAU - Mazzapicchi, Alessandro AU - Mazzapicchi A AD - Cardiovascular Department, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Tomii, Daijiro AU - Tomii D AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Laforgia, Pietro AU - Laforgia P AD - Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Cannata, Stefano AU - Cannata S AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta specializzazione (ISMETT), Palermo, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Fezzi, Simone AU - Fezzi S AD - Department of Cardiology, University Hospital, University of Galway, Ireland. FAU - Criscione, Enrico AU - Criscione E AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese (MI), Italy. FAU - Poletti, Enrico AU - Poletti E AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese (MI), Italy. FAU - Mazzucca, Mattia AU - Mazzucca M AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese (MI), Italy. FAU - Valvo, Roberto AU - Valvo R AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese (MI), Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Mainardi, Andrea AU - Mainardi A AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Andreaggi, Stefano AU - Andreaggi S AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Quagliana, Angelo AU - Quagliana A AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Montarello, Nicholas AU - Montarello N AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Hennessey, Breda AU - Hennessey B AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Mon-Noboa, Matias AU - Mon-Noboa M AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Meier, David AU - Meier D AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Sgroi, Carmelo AU - Sgroi C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Reddavid, Claudia Maria AU - Reddavid CM AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Strazzieri, Orazio AU - Strazzieri O AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Motta, Silvia Crescenzia AU - Motta SC AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Melfa, Chiara AU - Melfa C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Cal, Mariachiara AU - Cal M AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Science, Leipzig, Germany. FAU - Webb, John G AU - Webb JG AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Metra, Marco AU - Metra M AD - Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore," Enna, Italy. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20240223 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Male MH - Female MH - *Registries MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Sex Factors MH - Aged, 80 and over MH - *Prosthesis Design MH - Aged MH - Treatment Outcome MH - Postoperative Complications/epidemiology MH - Aortic Valve/surgery OTO - NOTNLM OT - TAVI OT - gender OT - valve type COIS- Declaration of competing interest Dr. Adamo has received speaker fees form Abbott. Dr. Pilgrim Thomas Pilgrim reports research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr. Abdel-Wahab's institution has received speaker honoraria and/or consultancy fees on his behalf from Boston Scientific and Medtronic. Dr. Garot has served as medical director and being a shareholder of CERC, a CRO dedicated to cardiovascular diseases; and has received speaker/consultancy fees from Abbott, Biosensors, Boston Scientific, Edwards Lifesciences (Abbott), and General Electric HealthCare. Dr. Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, and Abbott. Dr. Mylotte is a consultant for Medtronic, Boston Scientific, and MicroPort. Dr. De Backer has received institutional research grants and/or consulting fees from Abbott and Boston Scientific. Dr. Akodad has received research funding from Medtronic, Biotronik, MUSE-Explore, Villa M, and Federation Francaise de Cardiologie. Dr. Meier is supported by the Swiss National Science Foundation (grant P2LAP3_199561). Dr. Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic, and SMT. Dr. Tamburino is consultant for Medtronic. Dr. Metra has received consulting fees from Abbott Vascular, Actelion, Amgen, AstraZeneca, Bayer, Edwards Therapeutics, Livanova, Servier, Vifor Pharma, and WindTree Therapeutics. Dr. Barbanti is a consultant for Boston Scientific, Edwards Lifesciences, and Medtronic. The remaining authors have no competing interest to declare. EDAT- 2024/02/25 00:42 MHDA- 2024/05/02 00:49 CRDT- 2024/02/24 19:13 PHST- 2023/10/11 00:00 [received] PHST- 2023/12/30 00:00 [revised] PHST- 2024/01/22 00:00 [accepted] PHST- 2024/05/02 00:49 [medline] PHST- 2024/02/25 00:42 [pubmed] PHST- 2024/02/24 19:13 [entrez] AID - S0002-9149(24)00095-X [pii] AID - 10.1016/j.amjcard.2024.01.028 [doi] PST - ppublish SO - Am J Cardiol. 2024 May 15;219:60-70. doi: 10.1016/j.amjcard.2024.01.028. Epub 2024 Feb 23. PMID- 38398401 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240227 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 4 DP - 2024 Feb 14 TI - Learning Curve for Starting a Successful Single-Centre TAVR Programme with Multiple Devices: Early and Mid-Term Follow-Up. LID - 10.3390/jcm13041088 [doi] LID - 1088 AB - Aims: We report 30-day, 1-year, and 3-year outcomes for a new TAVR programme that used five different transcatheter heart valve (THV) systems. Methods: From 2014 to 2020, 122 consecutive patients with severe aortic stenosis (AS) received TAVR based on the Heart Team decision. Outcomes were analysed for the whole study population and in addition the first 63 patients (Cohort A, 2014 to 2019) were compared to the last 59 patients (Cohort B, 2019 to 2020). Outcomes included VARC-2 definitions and device performance assessed via transthoracic echocardiography by independent high-volume investigators. Results: The mean patient age was 77.9 +/- 6.1 years old, and 48 (39.3%) were male. The mean logistic Euroscore II was 4.2 +/- 4.5, and the mean STS score was 6.9 +/- 4.68. The systems used were as follows: Medtronic Corevalve Evolute R/PRO (82 patients-67.2%); Abbott Portico (13-10.6%); Boston Scientific Lotus (10-8.2%); Meril Myval (11-9%); and Boston Scientific Neo Accurate (6-5%). Access was transfemoral (95.9% of patients); surgical cut down (18% vs. percutaneous 77.8%); subclavian (n = 2); trans-axillary (n = 2); and direct aorta (n = 1). VARC-2 outcomes were as follows: device success rate 97.5%; stroke rate 1.6%; major vascular complication 3.3%; permanent pacemaker implantation 12.4%. At discharge, the incidences of grade I and II aortic regurgitation were 39.95 and 55.5%, respectively. At one year, all-cause mortality was 7.4% without admissions for valve-related dysfunction. The 3-year all-cause mortality and all-stroke rates were 22.9% and 4.1%, respectively. Between the 1-year and 3-year follow-ups, valve-related dysfunction was detected in three patients; one had THV system endocarditis that led to death. There was a remarkable but statistically non-significant decrease in mortality from Cohort A to Cohort B [four (6.3%) vs. one patient (1.7%), p = 0.195] and major vascular complications occurred at a significantly higher rate in the Cohort B [zero (0%) vs. four (6.8% patient, p = 0.036)]. Overall, we found that using multiple devices was safe and allowed for a learning team to achieve a high device success rate from the beginning (97.5%). Conclusions: TAVR with different THV systems showed acceptable early and mid-term outcomes for survival, technical success, and valve-related adverse events in high-risk patients with significant AS, even in the learning curve phase. FAU - Magyari, Balazs AU - Magyari B AUID- ORCID: 0000-0002-8851-9637 AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. FAU - Kittka, Balint AU - Kittka B AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. FAU - Gojak, Ilona AU - Gojak I AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. FAU - Schonfeld, Kristof AU - Schonfeld K AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. FAU - Szapary, Laszlo Botond AU - Szapary LB AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. FAU - Simon, Mihaly AU - Simon M AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. FAU - Kiss, Rudolf AU - Kiss R AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. FAU - Bertalan, Andrea AU - Bertalan A AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. FAU - Varady, Edit AU - Varady E AD - Department of Medical Imaging, Medical School, University of Pecs, 7624 Pecs, Hungary. FAU - Gyimesi, Andras AU - Gyimesi A AD - EconNet Research Group, Faculty of Business and Economics, University of Pecs, 7624 Pecs, Hungary. FAU - Szokodi, Istvan AU - Szokodi I AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. FAU - Horvath, Ivan Gabor AU - Horvath IG AD - Heart Institute, Medical School, University of Pecs, 7624 Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary. LA - eng GR - NKFIH K120536/National Research, Development and Innovation Office/ PT - Journal Article DEP - 20240214 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10889517 OTO - NOTNLM OT - TAVR OT - balloon-expandable transcatheter heart valve OT - bicuspid aortic valve and radial paradox OT - learning curve OT - paravalvular leak OT - self-expandable transcatheter heart valve COIS- The authors have no conflict of interest associated with this publication. There was no financial support for this work that would have influenced its outcome. EDAT- 2024/02/24 11:45 MHDA- 2024/02/24 11:46 PMCR- 2024/02/14 CRDT- 2024/02/24 01:13 PHST- 2024/01/19 00:00 [received] PHST- 2024/02/02 00:00 [revised] PHST- 2024/02/10 00:00 [accepted] PHST- 2024/02/24 11:46 [medline] PHST- 2024/02/24 11:45 [pubmed] PHST- 2024/02/24 01:13 [entrez] PHST- 2024/02/14 00:00 [pmc-release] AID - jcm13041088 [pii] AID - jcm-13-01088 [pii] AID - 10.3390/jcm13041088 [doi] PST - epublish SO - J Clin Med. 2024 Feb 14;13(4):1088. doi: 10.3390/jcm13041088. PMID- 38395540 OWN - NLM STAT- MEDLINE DCOM- 20240226 LR - 20250528 IS - 2589-7500 (Electronic) IS - 2589-7500 (Linking) VI - 6 IP - 3 DP - 2024 Mar TI - Automated cardiac arrest detection using a photoplethysmography wristband: algorithm development and validation in patients with induced circulatory arrest in the DETECT-1 study. PG - e201-e210 LID - S2589-7500(23)00249-2 [pii] LID - 10.1016/S2589-7500(23)00249-2 [doi] AB - BACKGROUND: Unwitnessed out-of-hospital cardiac arrest is associated with low survival chances because of the delayed activation of the emergency medical system in most cases. Automated cardiac arrest detection and alarming using biosensor technology would offer a potential solution to provide early help. We developed and validated an algorithm for automated circulatory arrest detection using wrist-derived photoplethysmography from patients with induced circulatory arrests. METHODS: In this prospective multicentre study in three university medical centres in the Netherlands, adult patients (aged 18 years or older) in whom short-lasting circulatory arrest was induced as part of routine practice (transcatheter aortic valve implantation, defibrillation testing, or ventricular tachycardia induction) were eligible for inclusion. Exclusion criteria were a known bilateral significant subclavian artery stenosis or medical issues interfering with the wearing of the wristband. After providing informed consent, patients were equipped with a photoplethysmography wristband during the procedure. Invasive arterial blood pressure and electrocardiography were continuously monitored as the reference standard. Development of the photoplethysmography algorithm was based on three consecutive training cohorts. For each cohort, patients were consecutively enrolled. When a total of 50 patients with at least one event of circulatory arrest were enrolled, that cohort was closed. Validation was performed on the fourth set of included patients. The primary outcome was sensitivity for the detection of circulatory arrest. FINDINGS: Of 306 patients enrolled between March 14, 2022, and April 21, 2023, 291 patients were included in the data analysis. In the development phase (n=205), the first training set yielded a sensitivity for circulatory arrest detection of 100% (95% CI 94-100) and four false positive alarms; the second training set yielded a sensitivity of 100% (94-100), with six false positive alarms; and the third training set yielded a sensitivity of 100% (94-100), with two false positive alarms. In the validation phase (n=86), the sensitivity for circulatory arrest detection was 98% (92-100) and 11 false positive circulatory arrest alarms. The positive predictive value was 90% (95% CI 82-94). INTERPRETATION: The automated detection of induced circulatory arrests using wrist-derived photoplethysmography is feasible with good sensitivity and low false positives. These promising findings warrant further development of this wearable technology to enable automated cardiac arrest detection and alarming in a home setting. FUNDING: Dutch Heart Foundation (Hartstichting). CI - Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. FAU - Edgar, Roos AU - Edgar R AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Scholte, Niels T B AU - Scholte NTB AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Ebrahimkheil, Kambiz AU - Ebrahimkheil K AD - Corsano Health, The Hague, Netherlands. FAU - Brouwer, Marc A AU - Brouwer MA AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Beukema, Rypko J AU - Beukema RJ AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Mafi-Rad, Masih AU - Mafi-Rad M AD - Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands. FAU - Vernooy, Kevin AU - Vernooy K AD - Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands. FAU - Yap, Sing-Chien AU - Yap SC AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Ronner, Eelko AU - Ronner E AD - Department of Cardiology, Reinier de Graaf hospital, Delft, Netherlands. FAU - van Mieghem, Nicolas AU - van Mieghem N AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Boersma, Eric AU - Boersma E AD - Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Stas, Peter C AU - Stas PC AD - Corsano Health, The Hague, Netherlands. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Bonnes, Judith L AU - Bonnes JL AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. Electronic address: judith.bonnes@radboudumc.nl. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - England TA - Lancet Digit Health JT - The Lancet. Digital health JID - 101751302 SB - IM CIN - Lancet Digit Health. 2024 Mar;6(3):e148-e149. doi: 10.1016/S2589-7500(24)00020-7. PMID: 38395532 MH - Adult MH - Humans MH - Prospective Studies MH - *Photoplethysmography MH - *Heart Arrest/diagnosis MH - Arrhythmias, Cardiac MH - Algorithms COIS- Declaration of interests KE is a data scientist at Corsano Health. RJB received a research grant from Biosense Webster, and payment for a lecture from The Cardiovascular Education Institute. KV received a research grant from Medtronic; consulting fees from Medtronic, Abbott, and Biosense Webster; a speakers fee from Philips; participates in the advisory board of Medtronic; and received educational grants from Medtronic, Abbott, and Biosense Webster. S-CY is a consultant of Boston Scientific; has received research grants from Biotronik, Medtronic, and Boston Scientific; received personal payments for presentations from Boston Scientific, Biotronik, and Medtronic; and his institution received payment for his participation on a Data Safety Monitoring Board from Boston Scientific. ER received consulting fees from Corsano Health. NvM received grants from Abbott Vascular, Boston Scientific, Medtronic, Edwards Lifesciences, Daiichi Sankyo, and AstraZeneca; received personal consulting fees from Abbott Vascular, Boston Scientific, Medtronic, Anteris, JenaValve, Daiichi Sankyo, AstraZeneca, Amgen, Siemens, and Pie Medical; and received payment for presentations from Abbott Vascular, Biotronik, Amgen, Daiichi Sankyo, Medtronic, and Boston Scientifc. PCS is the CEO of Corsano Health. NvR received a research grant from the Dutch Heart Foundation related to this manuscript; received research grants from Biotronik, Abbott, Medtronic, and Philips, not related to this manuscript; and speaker fees were received from Abbott, Bayer, RainMed, and Microport, not related to this manuscript. All other authors declare no competing interests. EDAT- 2024/02/24 11:42 MHDA- 2024/02/26 06:42 CRDT- 2024/02/23 21:01 PHST- 2023/08/25 00:00 [received] PHST- 2023/11/22 00:00 [revised] PHST- 2023/11/30 00:00 [accepted] PHST- 2024/02/26 06:42 [medline] PHST- 2024/02/24 11:42 [pubmed] PHST- 2024/02/23 21:01 [entrez] AID - S2589-7500(23)00249-2 [pii] AID - 10.1016/S2589-7500(23)00249-2 [doi] PST - ppublish SO - Lancet Digit Health. 2024 Mar;6(3):e201-e210. doi: 10.1016/S2589-7500(23)00249-2. PMID- 38355269 OWN - NLM STAT- MEDLINE DCOM- 20240216 LR - 20250818 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 3 DP - 2024 Feb 12 TI - Non-Vitamin K Antagonist Versus Vitamin K Antagonist Oral Anticoagulant Agents After Transcatheter Aortic Valve Replacement. PG - 405-418 LID - S1936-8798(23)01578-9 [pii] LID - 10.1016/j.jcin.2023.11.038 [doi] AB - BACKGROUND: Studies comparing long-term outcomes between non-vitamin K antagonist (VKA) oral anticoagulant agents (direct oral anticoagulant agents [DOACs]) and VKA anticoagulant agents after transcatheter aortic valve replacement (TAVR) are scarce, with conflicting results. OBJECTIVES: The aim of this study was to examine the periprocedural, short-term, and long-term safety and effectiveness of DOACs vs VKAs in patients undergoing TAVR via femoral access with concomitant indications for oral anticoagulation. METHODS: Consecutive patients undergoing transfemoral TAVR in the prospective national SwissTAVI Registry between February 2011 and June 2021 were analyzed. Net clinical benefit (a composite of all-cause mortality, myocardial infarction, stroke, and life-threatening or major bleeding) and the primary safety endpoint (a composite of life-threatening and major bleeding) were compared between the VKA and DOAC groups at 30 days, 1 year, and 5 years after TAVR. RESULTS: After 1:1 propensity score matching, 1,454 patients were available for analysis in each group. There was no significant difference in the rate of the net clinical benefit and the safety endpoints between the groups as assessed at 30 days and 1 and 5 years post-TAVR between VKAs and DOACs. VKAs were associated with significantly higher rates of 1- year (HR: 1.28; 95% CI: 1.01-1.62) and 5-year (HR: 1.25; 95% CI: 1.11-1.40) all-cause mortality. Long-term risk for disabling stroke was significantly lower in the VKA group after excluding periprocedural events (HR: 0.64; 95% CI: 0.46-0.90). CONCLUSIONS: At 5 years after TAVR, VKAs are associated with a higher risk for all-cause mortality, a lower risk for disabling stroke, and a similar rate of life-threatening or major bleeding compared with DOACs. (SwissTAVI Registry; NCT01368250). CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Alaour, Bashir AU - Alaour B AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Ferrari, Enrico AU - Ferrari E AD - Department of Cardiovascular Surgery, Cardiocentro Ticino Institute-EOC, Lugano, Switzerland. FAU - Heg, Dik AU - Heg D AD - CTU Bern, University of Bern, Bern, Switzerland. FAU - Tueller, David AU - Tueller D AD - Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Department of Cardiology, Lausanne University Hospital-CHUV, Lausanne, Switzerland. FAU - Noble, Stephane AU - Noble S AD - Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland. FAU - Jeger, Raban AU - Jeger R AD - Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland; University of Basel, Basel, Switzerland. FAU - Reuthebuch, Oliver AU - Reuthebuch O AD - University of Basel, Basel, Switzerland; Department of Cardiovascular Surgery, Basel University Hospital, University of Basel, Basel, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Cantonal Hospital Lucerne, Lucerne, Switzerland. FAU - Templin, Christian AU - Templin C AD - Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland. FAU - Wenaweser, Peter AU - Wenaweser P AD - Heart Clinic Hirslanden, Hirslanden Clinic Zurich, Zurich, Switzerland. FAU - Nietlispach, Fabian AU - Nietlispach F AD - HeartCenter Im Park, Hirslanden Clinic Im Park, Zurich. FAU - Taramasso, Maurizio AU - Taramasso M AD - Heart Center Hirslanden, Hirslanden Clinic Zurich, Zurich, Switzerland. FAU - Huber, Christoph AU - Huber C AD - Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland. FAU - Roffi, Marco AU - Roffi M AD - Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: stefan.stortecky@insel.ch. LA - eng SI - ClinicalTrials.gov/NCT01368250 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Anticoagulants) RN - 0 (Fibrinolytic Agents) RN - 12001-79-5 (Vitamin K) SB - IM CIN - JACC Cardiovasc Interv. 2024 Feb 12;17(3):419-421. doi: 10.1016/j.jcin.2023.12.024. PMID: 38355270 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Prospective Studies MH - Treatment Outcome MH - Anticoagulants/adverse effects MH - Hemorrhage/chemically induced MH - *Stroke/etiology/prevention & control MH - Fibrinolytic Agents MH - Vitamin K MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - aortic valve stenosis OT - non-vitamin K antagonist oral anticoagulant OT - oral anticoagulation OT - transcatheter aortic valve replacement OT - vitamin K antagonist COIS- Funding Support and Author Disclosures Dr Heg is affiliated with CTU Bern, University of Bern, which has a staff policy of not accepting honoraria or consultancy fees. However, CTU Bern is involved in the design, conduct, or analysis of clinical studies funded by not-for-profit and for-profit organizations. In particular, pharmaceutical and medical device companies provide direct funding to some of these studies. For an up-to-date list of CTU Bern's conflicts of interest, see http://www.ctu.unibe.ch/research/declaration_of_interest/index_eng.html. Dr Stortecky has received research grants to the institution from Edwards Lifesciences, Medtronic, Abbott Vascular, and Boston Scientific; and has received speaker fees from Boston Scientific. Dr Ferrari is a consultant for Edwards Lifesciences; has received research grants to the institution from Edwards Lifesciences and Medtronic; and has received speaker fees from Edwards Lifesciences. Dr Templin has received institutional grants from Abbott Vascular, Medtronic, and SMT; and has received consulting grants from Biotronik, MicroPort, and Innova. Dr Muller has received institutional research grants from Edwards Lifesciences; and has received honoraria from Edwards Lifesciences and Abbott Vascular. Dr Noble has received institutional research grants from Edwards Lifesciences, Medtronic, Abbott Vascular, and Boston Scientific; and is a consultant for Medtronic. Dr Roffi has received institutional research grants from Cordis, Medtronic, Biotronik, Terumo, and Boston Scientific. Dr Jeger has received grants to the institution from Abbott, Amgen, AstraZeneca, Bayer, B. Braun Melsungen, Biosense Webster, Biotronik, Boston Scientific, Bristol Myers Squibb, Cardionovum, Cordis, Daiichi Sankyo, Edwards Lifesciences, GE Medical Systems, MCM Medsys, Medtronic, Novartis, Pfizer, Terumo, and Vascular Medical. Dr Toggweiler serves as a consultant and proctor for Medtronic, Boston Scientific, Edwards Lifesciences, and Biosensors; serves as a proctor for Edwards Lifesciences and Abbott Vascular; serves as a consultant for Medira, Shockwave Medical, Teleflex, atHeart Medical, Cardiac Dimensions, and Polares Medical; has received institutional research grants from Boston Scientific, Fumedica, and Novartis; has received speaker honoraria from Sanofi, AstraZeneca, ReCor Medical, and Daiichi Sankyo; and holds equity in Hi-D Imaging. Dr Pilgrim has received research, travel, or educational grants to the institution without personal remuneration from Biotronik, Boston Scientific, Edwards Lifesciences, and ATSens; and has received speaker fees and consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and Highlife. Dr Wenaweser is a proctor for Edwards Lifesciences and Medtronic. Dr Nietlispach is a consultant for Edwards Lifesciences and Abbott. Dr Taramasso is a consultant for or has received consultancy fees from Abbott, Edwards Lifesciences, Medtronic, Boston Scientific, Shenqi Medical, MEDIRA, CoreMedic, Pi-Cardia, VentriMend, CardioValve, CoreQuest, and Hi-D Imaging. Dr Windecker has received research, travel, or educational grants to the institution without personal remuneration from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, CorFlow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Farapulse, Fumedica, Guerbet, Idorsia, Inari Medical, Infraredx, Janssen-Cilag, Johnson & Johnson, MedAlliance, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech, Pfizer, Polares, Regeneron, Sanofi, Servier, Sinomed, Terumo, Vifor, and V-Wave; has served as an advisory board member and/or member of the steering or executive groups of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave with payments to the institution but no personal payments; and is a member of the steering or executive committee groups of several investigator-initiated trials that receive funding from industry without impact on his personal remuneration. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/02/15 00:42 MHDA- 2024/02/16 06:43 CRDT- 2024/02/14 20:57 PHST- 2023/08/30 00:00 [received] PHST- 2023/11/13 00:00 [revised] PHST- 2023/11/17 00:00 [accepted] PHST- 2024/02/16 06:43 [medline] PHST- 2024/02/15 00:42 [pubmed] PHST- 2024/02/14 20:57 [entrez] AID - S1936-8798(23)01578-9 [pii] AID - 10.1016/j.jcin.2023.11.038 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Feb 12;17(3):405-418. doi: 10.1016/j.jcin.2023.11.038. PMID- 38347233 OWN - NLM STAT- MEDLINE DCOM- 20240515 LR - 20261016 IS - 1438-8359 (Electronic) IS - 0913-8668 (Linking) VI - 38 IP - 3 DP - 2024 Jun TI - Comparison of remimazolam-based and propofol-based total intravenous anesthesia on hemodynamics during anesthesia induction in patients undergoing transcatheter aortic valve replacement: a randomized controlled trial. PG - 330-338 LID - 10.1007/s00540-024-03311-x [doi] AB - PURPOSE: This study aimed to compare the hemodynamic effects of remimazolam- and propofol-based total intravenous anesthesia in patients who underwent transcatheter aortic valve replacement. METHODS: This was a single-center, single-blind, randomized controlled trial set at Nara Medical University, Kashihara, Japan. We included 36 patients aged >/= 20 years scheduled to undergo elective transfemoral transcatheter aortic valve replacement (TAVR) under general anesthesia. The participants were randomly assigned to the remimazolam and propofol groups (n = 18 each). Remimazolam- or propofol-based total intravenous anesthesia was initiated at 12 mg/kg/min or 2.5 mcg/mL via target-controlled infusion, respectively, along with remifentanil. After confirming the loss of consciousness, the administration rate was adjusted using electroencephalographic monitoring. The primary outcome was the rate of arterial hypotension, defined as a mean arterial pressure < 60 mmHg, from anesthesia induction until the beginning of the surgical incision. The total doses of ephedrine and phenylephrine were also assessed. RESULTS: During anesthesia induction, the arterial hypotension rates were 11.9% and 21.6% in the remimazolam and propofol groups, respectively (P = 0.01). The total dose of ephedrine was higher in the propofol group (14.4 mg) than in the remimazolam group (1.6 mg) (P < 0.001); however, the total dose of phenylephrine was not significantly different between the two groups (propofol 0.31 mg vs. remimazolam: 0.17 mg, P = 0.10). CONCLUSION: Remimazolam-based total intravenous anesthesia resulted in a lower hypotension rate than propofol-based total intravenous anesthesia during induction in patients undergoing TAVR. Remimazolam-based total intravenous anesthesia can be used safely during anesthetic induction in patients with severe aortic stenosis. CI - (c) 2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists. FAU - Kotani, Taichi AU - Kotani T AD - Department of Anesthesiology, Nara Medical University Kashihara, Shijo 840, Nara, 634-8522, Japan. FAU - Ida, Mitsuru AU - Ida M AUID- ORCID: 0000-0001-5285-257X AD - Department of Anesthesiology, Nara Medical University Kashihara, Shijo 840, Nara, 634-8522, Japan. nwnh0131@yahoo.co.jp. FAU - Naito, Yusuke AU - Naito Y AD - Department of Anesthesiology, Nara Medical University Kashihara, Shijo 840, Nara, 634-8522, Japan. FAU - Kawaguchi, Masahiko AU - Kawaguchi M AD - Department of Anesthesiology, Nara Medical University Kashihara, Shijo 840, Nara, 634-8522, Japan. LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20240212 PL - Japan TA - J Anesth JT - Journal of anesthesia JID - 8905667 RN - YI7VU623SF (Propofol) RN - 0 (Anesthetics, Intravenous) RN - 12794-10-4 (Benzodiazepines) RN - P10582JYYK (Remifentanil) SB - IM CIN - J Anesth. 2024 Oct;38(5):721-722. doi: 10.1007/s00540-024-03356-y. PMID: 38822139 CIN - J Anesth. 2024 Oct;38(5):723-724. doi: 10.1007/s00540-024-03361-1. PMID: 38914765 MH - Humans MH - *Propofol/administration & dosage MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/methods MH - *Hemodynamics/drug effects MH - *Anesthetics, Intravenous/administration & dosage MH - *Anesthesia, Intravenous/methods MH - Aged MH - Single-Blind Method MH - Aged, 80 and over MH - *Benzodiazepines/administration & dosage MH - Hypotension MH - Anesthesia, General/methods MH - Remifentanil/administration & dosage OTO - NOTNLM OT - Aortic valve stenosis OT - Hemodynamics OT - Propofol OT - Randomized controlled trial OT - Remimazolam EDAT- 2024/02/13 00:42 MHDA- 2024/05/15 12:45 CRDT- 2024/02/12 23:30 PHST- 2023/10/31 00:00 [received] PHST- 2024/01/10 00:00 [accepted] PHST- 2024/05/15 12:45 [medline] PHST- 2024/02/13 00:42 [pubmed] PHST- 2024/02/12 23:30 [entrez] AID - 10.1007/s00540-024-03311-x [pii] AID - 10.1007/s00540-024-03311-x [doi] PST - ppublish SO - J Anesth. 2024 Jun;38(3):330-338. doi: 10.1007/s00540-024-03311-x. Epub 2024 Feb 12. PMID- 38337345 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240212 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 3 DP - 2024 Jan 23 TI - Using Upper Arm Vein as Temporary Pacemaker Access Site: A Next Step in Minimizing the Invasiveness of Transcatheter Aortic Valve Replacement. LID - 10.3390/jcm13030651 [doi] LID - 651 AB - Background The femoral vein is commonly used as a pacemaker access site during transcatheter aortic valve replacement (TAVR). Using an upper arm vein as an alternative access site potentially causes fewer bleeding complications and shorter time to mobilization. We aimed to assess the safety and efficacy of an upper arm vein as a temporary pacemaker access site during TAVR. Methods We evaluated all patients undergoing TAVR in our center between January 2020 and January 2023. Upper arm, femoral, and jugular vein pacemaker access was used in 255 (45.8%), 191 (34.3%), and 111 (19.9%) patients, respectively. Clinical outcomes were analyzed according to pacemaker access in the overall population and in a propensity-matched population involving 165 upper arm and 165 femoral vein patients. Primary endpoint was Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 pacemaker access site-related bleeding. Results In the overall population, primary endpoint was lowest for upper arm, followed by femoral and jugular vein access (2.4% vs. 5.8% vs. 10.8%, p = 0.003). Time to mobilization was significantly longer (p < 0.001) in the jugular cohort compared with the other cohorts. In the propensity-matched cohort, primary endpoint showed a trend toward lower occurrence in the upper arm compared with the femoral cohort (2.4% vs. 6.1%, p = 0.10). Time to mobilization was significantly shorter (480 vs. 1140 min, p < 0.001) in the upper arm cohort, with a comparable skin-to-skin time (83 vs. 85 min, p = 0.75). Cross-over from upper arm pacemaker access was required in 17 patients (6.3% of attempted cases via an upper arm vein). Conclusions Using an upper arm vein as a temporary pacemaker access site is safe and feasible. Its use might be associated with fewer bleeding complications and shorter time to mobilization compared with the femoral vein. FAU - Rooijakkers, Maxim J P AU - Rooijakkers MJP AUID- ORCID: 0000-0002-6815-7667 AD - Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - Versteeg, Geert A A AU - Versteeg GAA AUID- ORCID: 0009-0002-1583-2953 AD - Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - van Wely, Marleen H AU - van Wely MH AUID- ORCID: 0000-0003-4579-111X AD - Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - Rodwell, Laura AU - Rodwell L AD - Section Biostatistics, Department of Health Sciences, Radboud Institute for Health Sciences, 6525 EZ Nijmegen, The Netherlands. FAU - van Nunen, Lokien X AU - van Nunen LX AD - Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - van Geuns, Robert Jan AU - van Geuns RJ AUID- ORCID: 0000-0003-2943-5932 AD - Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - van Garsse, Leen A F M AU - van Garsse LAFM AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - Geuzebroek, Guillaume S C AU - Geuzebroek GSC AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - Verkroost, Michel W A AU - Verkroost MWA AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - Heijmen, Robin H AU - Heijmen RH AUID- ORCID: 0000-0003-1503-2374 AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands. LA - eng PT - Journal Article DEP - 20240123 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10855945 OTO - NOTNLM OT - aortic stenosis OT - bleeding complications OT - pacemaker OT - transcatheter aortic valve replacement COIS- Maxim J. P. Rooijakkers, Geert A. A. Versteeg, Laura Rodwell, Lokien X. van Nunen, Robert Jan van Geuns, Leen A. F. M. van Garsse, Guillaume S. C. Geuzebroek, Michel W. A. Verkroost, and Robin H. Heijmen do not have potential conflicts of interest or disclosures to report. Marleen H. van Wely was a proctor and consultant for Abbott Vascular. Niels van Royen has received research funding from Abbott, Philips, Medtronic, and Biotronik, has served as a consultant for RainMed, Castor, and Medtronic, and received speaker fees from Abbott and Bayer. EDAT- 2024/02/10 10:45 MHDA- 2024/02/10 10:46 PMCR- 2024/01/23 CRDT- 2024/02/10 01:02 PHST- 2023/11/09 00:00 [received] PHST- 2024/01/15 00:00 [revised] PHST- 2024/01/19 00:00 [accepted] PHST- 2024/02/10 10:46 [medline] PHST- 2024/02/10 10:45 [pubmed] PHST- 2024/02/10 01:02 [entrez] PHST- 2024/01/23 00:00 [pmc-release] AID - jcm13030651 [pii] AID - jcm-13-00651 [pii] AID - 10.3390/jcm13030651 [doi] PST - epublish SO - J Clin Med. 2024 Jan 23;13(3):651. doi: 10.3390/jcm13030651. PMID- 38335504 OWN - NLM STAT- MEDLINE DCOM- 20240223 LR - 20260527 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 36 IP - 2 DP - 2024 Feb TI - Sensor-guided transcatheter aortic valve replacement. LID - 10.25270/jic/23.00242 [doi] AB - OBJECTIVES: The SavvyWire(OpSens Medical) is a support wire for transcatheter aortic valve replacement (TAVR) procedures that, in addition to its dedicated left ventricle (LV) pacing capabilities, has a distal pressure sensor that measures live transvalvular hemodynamics during the procedure. We aimed to determine the safety, efficacy, and functionality of the SavvyWire during TAVR procedures in an all-comer population. METHODS: We performed a multicentric, prospective, observational, single-arm, all-comers registry of patients with symptomatic, severe aortic stenosis undergoing TAVR in 3 Canadian centers. Data were collected in a dedicated database, and pre-specified questionnaires were fulfilled by the heart team implanters after each procedure. RESULTS: A total of 60 patients were included (mean age: 78.6 +/- 7.2 years; 51% women; mean Society of Thoracic Surgeons score: 2.2 +/- 1.6%). TAVR was performed through a transfemoral approach in 90% of cases, and balloon- and self-expandable valves were used in 73% and 27% of patients, respectively. There were no cases of LV perforation, guidewire deformation, significant loss of capture, or major software malfunction. The rate of successful delivery of the TAVR system was 100%, and effective LV pacing was achieved in 98% of patients. The pre-TAVR mean gradient was 39 +/- 14 mm Hg while the final post-TAVR gradient was 8 +/- 5 mm Hg; the mean aortic systolic pressure during rapid pacing was 54 +/- 12 mm Hg. In 97% of the TAVR procedures, SavvyWire's functionality was reported to be better or similar to other TAVR workhorse support wires. CONCLUSIONS: SavvyWire was safe, effective, and functional for live transvalvular hemodynamic evaluation and rapid pacing during TAVR procedures. More studies with larger sample sizes and comparison against different wires and gradient measurement methods are warranted. FAU - Farjat-Pasos, Julio AU - Farjat-Pasos J AD - Quebec Heart and Lung Institute, Quebec, Canada. FAU - Ibrahim, Reda AU - Ibrahim R AD - Montreal Heart Institute, Montreal, Canada. FAU - Sathananthan, Janarthanan AU - Sathananthan J AD - Vancouver General Hospital, Vancouver, Canada. FAU - Paradis, Jean-Michel AU - Paradis JM AD - Quebec Heart and Lung Institute, Quebec, Canada. FAU - Poulin, Anthony AU - Poulin A AD - Quebec Heart and Lung Institute, Quebec, Canada. FAU - Asgar, Anita W AU - Asgar AW AD - Montreal Heart Institute, Montreal, Canada. FAU - Dorval, Jean-Francois AU - Dorval JF AD - Montreal Heart Institute, Montreal, Canada. FAU - Cook, Richard AU - Cook R AD - Vancouver General Hospital, Vancouver, Canada. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Quebec Heart and Lung Institute, Quebec, Canada. Email: josep.rodes@criucpq.ulaval.ca. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Canada MH - *Heart Valve Prosthesis MH - Hemodynamics MH - Prospective Studies MH - Prosthesis Design MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - TAVR OT - hemodynamics OT - left ventricle pacing OT - transcatheter aortic valve replacement EDAT- 2024/02/09 18:42 MHDA- 2024/02/10 14:42 CRDT- 2024/02/09 16:43 PHST- 2024/02/10 14:42 [medline] PHST- 2024/02/09 18:42 [pubmed] PHST- 2024/02/09 16:43 [entrez] AID - 10.25270/jic/23.00242 [doi] PST - ppublish SO - J Invasive Cardiol. 2024 Feb;36(2). doi: 10.25270/jic/23.00242. PMID- 38320876 OWN - NLM STAT- MEDLINE DCOM- 20240524 LR - 20260510 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 63 DP - 2024 Jun TI - Transcarotid versus transthoracic transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 8-13 LID - S1553-8389(24)00016-2 [pii] LID - 10.1016/j.carrev.2024.01.015 [doi] AB - BACKGROUND: Transthoracic approaches may be contraindicated in some patients and may be associated with poorer outcomes. Therefore other alternative access routes are increasingly being performed. We conducted a systematic review of the literature on Transcarotid transcatheter aortic valve replacement (TC-TAVR) and meta-analysis comparing outcomes of TC-TAVR and other access routes. METHODS: We comprehensively searched for controlled randomized and non-randomized studies from 4 online databases. We presented data using risk ratios (95 % confidence intervals) and measured heterogeneity using Higgins' I(2). RESULTS: Sixteen observational studies on Transcarotid TAVR were included in the analysis; 4 studies compared 180 TC-TAVR patients vs 524 TT-TAVR patients. The mean age and STS score for patients undergoing TC-TAVR were 80 years and 7.6 respectively. For TT-TAVR patients, the mean age and STS score were 79.7 years and 8.7 respectively. TC-TAVR patients had lower 30-day MACE [7.8 % vs 13.7 %; OR 0.54 (95 % CI 0.29-0.99, P = 0.05)] and major or life-threatening bleeding [4.0 % vs 14.2 %; OR 0.25 (95 % CI 0.09-0.67, P = 0.006)]. There was no significant difference in 30-day: mortality [5.0 % vs 8.6 %; OR 0.61 (95 % CI 0.29-1.30, P = 0.20)], stroke or transient ischemic attack [2.8 % vs 4.0 %; OR 0.65 (95 % CI 0.25-1.73, P = 0.39)] and moderate or severe aortic valve regurgitation [5.0 % vs 4.6 %; OR 1.14. (95 % CI 0.52-2.52, P = 0.75)]. There was a trend towards fewer major vascular complications in TC-TAVR [3.0 % vs 7.8 %; OR 0.42 (95 % CI 0.16-1.12, P = 0.08)]. CONCLUSION: Compared with transthoracic TAVR, TC-TAVR patients had lower odds of 30-day MACE and life-threatening bleeding and no differences in 30-day mortality, stroke or TIA, aortic valve regurgitation. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Munguti, Cyrus AU - Munguti C AD - Internal Medicine, University of Kansas School of Medicine - Wichita, KS, United States of America. FAU - Ndunda, Paul AU - Ndunda P AD - Internal Medicine, University of Kansas School of Medicine - Wichita, KS, United States of America. FAU - Vindhyal, Mohinder R AU - Vindhyal MR AD - Internal Medicine, University of Kansas School of Medicine - Wichita, KS, United States of America. FAU - Abukar, Abdullah AU - Abukar A AD - Internal Medicine, University of California San Francisco, San Francisco, CA, United States of America. FAU - Abdel-Jawad, Mohammed AU - Abdel-Jawad M AD - Internal Medicine, University of Kansas School of Medicine - Wichita, KS, United States of America; Internal Medicine, Ascension Via Christi St Francis Hospital, Wichita, KS, United States of America. FAU - Fanari, Zaher AU - Fanari Z AD - Internal Medicine/Cardiology, University of California San Francisco, Fresno, CA, United States of America. LA - eng PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20240126 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - *Aortic Valve Stenosis/surgery/diagnostic imaging/mortality/physiopathology MH - Catheterization, Peripheral/adverse effects/methods MH - Postoperative Complications/epidemiology/etiology MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - Transaortic OT - Transcarotid OT - Transthoracic Transcatheter aortic valve replacement COIS- Declaration of competing interest All the authors have no declarations to make. EDAT- 2024/02/07 00:42 MHDA- 2024/05/25 05:44 CRDT- 2024/02/06 21:56 PHST- 2023/06/27 00:00 [received] PHST- 2023/12/27 00:00 [revised] PHST- 2024/01/23 00:00 [accepted] PHST- 2024/05/25 05:44 [medline] PHST- 2024/02/07 00:42 [pubmed] PHST- 2024/02/06 21:56 [entrez] AID - S1553-8389(24)00016-2 [pii] AID - 10.1016/j.carrev.2024.01.015 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 Jun;63:8-13. doi: 10.1016/j.carrev.2024.01.015. Epub 2024 Jan 26. PMID- 38310595 OWN - NLM STAT- MEDLINE DCOM- 20240803 LR - 20261010 IS - 1573-2614 (Electronic) IS - 1387-1307 (Linking) VI - 38 IP - 4 DP - 2024 Aug TI - Cerebral regional oxygen saturation as a predictive parameter for preoperative heart failure and delayed hemodynamic recovery in transcutaneous aortic valve implantation: a retrospective cohort study. PG - 763-772 LID - 10.1007/s10877-024-01129-2 [doi] AB - This study aimed to investigate the relationship of perioperative cerebral regional oxygen saturation (rSO(2)) with various preoperative clinical variables and hemodynamic changes during transfemoral transcatheter aortic valve implantation (TAVI) under general anesthesia. We retrospectively analyzed cerebral rSO(2) values from left-hemisphere measurements obtained using near-infrared spectroscopy (O3 regional oximetry) at five time points: pre-induction, the start of the procedure, the start of valve deployment, time of lowest cerebral rSO(2) value during valve deployment, and the end of the procedure. This study included 91 patients (60 with balloon-expandable valves and 31 with self-expandable valves). The baseline cerebral rSO(2) values were correlated with B-type natriuretic peptide, hemoglobin, fractional shortening, ejection fraction, left ventricular mass index, left ventricular end-systolic diameter, STS risk of mortality, and STS morbidity or mortality. The patients who took longer to recover their systolic blood pressure to 90 mmHg after valve deployment with a balloon-expandable valve (group B) had lower cerebral rSO(2) values during deployment compared to patients with faster recovery with balloon-expandable valve (group A) and with self-expandable valve (group C). Baseline cerebral rSO(2) is associated with preoperative variables related to cardiac failure and function, and a significant decline during valve deployment may indicate a risk of prolonged hypotension during TAVI. CI - (c) 2024. The Author(s), under exclusive licence to Springer Nature B.V. FAU - Iwata, Shihoko AU - Iwata S AUID- ORCID: 0000-0002-4834-0405 AD - Department of Anesthesiology and Pain Medicine, Juntedo University Hospital, 3-1-3, Hongo, Bunkyo-ku, Tokyo, Japan. shk_wt_0204@ybb.ne.jp. FAU - Ozaki, Makoto AU - Ozaki M AUID- ORCID: 0000-0001-7841-6661 AD - Nishiarai Nursing School, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20240204 PL - Netherlands TA - J Clin Monit Comput JT - Journal of clinical monitoring and computing JID - 9806357 RN - S88TT14065 (Oxygen) SB - IM MH - Humans MH - Male MH - Retrospective Studies MH - Female MH - Aged MH - *Transcatheter Aortic Valve Replacement/methods MH - *Hemodynamics MH - Aged, 80 and over MH - *Heart Failure/physiopathology/surgery MH - *Oximetry/methods MH - *Spectroscopy, Near-Infrared/methods MH - *Oxygen/metabolism MH - *Oxygen Saturation MH - Brain/metabolism MH - Aortic Valve/surgery MH - Anesthesia, General MH - Aortic Valve Stenosis/surgery MH - Cerebrovascular Circulation MH - Treatment Outcome OTO - NOTNLM OT - Aortic stenosis OT - B-type natriuretic peptide OT - Cerebral regional oxygen saturation OT - Near-infrared spectroscopy OT - Transcatheter aortic valve implantation OT - Valve deployment EDAT- 2024/02/04 18:42 MHDA- 2024/08/04 13:43 CRDT- 2024/02/04 15:53 PHST- 2023/09/24 00:00 [received] PHST- 2024/01/18 00:00 [accepted] PHST- 2024/08/04 13:43 [medline] PHST- 2024/02/04 18:42 [pubmed] PHST- 2024/02/04 15:53 [entrez] AID - 10.1007/s10877-024-01129-2 [pii] AID - 10.1007/s10877-024-01129-2 [doi] PST - ppublish SO - J Clin Monit Comput. 2024 Aug;38(4):763-772. doi: 10.1007/s10877-024-01129-2. Epub 2024 Feb 4. PMID- 38307247 OWN - NLM STAT- MEDLINE DCOM- 20240616 LR - 20260811 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 84 IP - 2 DP - 2024 Aug TI - Transcatheter aortic valve replacement in Germany with need for a surgical bailout. PG - 99-104 LID - S0914-5087(24)00009-1 [pii] LID - 10.1016/j.jjcc.2024.01.003 [doi] AB - BACKGROUND: In transcatheter aortic valve replacement (TAVR), complications may force the need for a surgical bailout, but knowledge is rare about outcomes in Germany. METHODS: Using national health records, we investigated all TAVR in German hospitals between 2007 and 2020, focusing on 2018-2020. We extracted data on those interventions with need for a surgical bailout. RESULTS: A total of 159,643 TAVR were analyzed, with an overall rate of surgical bailout of 2.30 %, an overall in-hospital mortality of 3.85 %, and in-hospital mortality in case of bailout of 16.51 %. The number of all annual TAVR procedures increased substantially (202 to 22,972), with the rate of surgical bailout declining from 27.23 to 0.61 % and overall mortality from 11.39 to 2.29 %. However, in-hospital mortality after bailout was still high (28.37 % in 2020). The standardized rates of overall mortality and surgical bailout between 2018 and 2020 were significantly lower for balloon-expandable and self-expanding transfemoral TAVR than for transapical TAVR after risk adjustment [transapical/transfemoral balloon-expandable/transfemoral self-expanding TAVR: in-hospital mortality: 5.66 % (95 % CI 4.81 %; 6.52 %)/2.30 % (2.03 %; 2.57 %)/2.32 % (2.07 %; 2.57 %); surgical bailout: 2.33 % (1.68 %; 2.97 %)/0.79 % (0.60 %; 0.98 %)/0.42 % (0.31 %; 0.53 %)]. Coronary artery disease [risk-adjusted OR = 1.50 (1.21; 1.85), p < 0.001] and atrial fibrillation [OR = 1.29 (1.07; 1.57), p = 0.009] were found to be the main risk factors for bailout. CONCLUSIONS: Rates of TAVR with need for a surgical bailout and overall in-hospital mortality have declined noticeably over the years in Germany. However, the outcomes are still unfavorable after surgical bailout, as in-hospital mortality is continuously high. We present risk factors for surgical bailout to improve preparation of subsequent measures. It must be a major goal to further reduce the rate of surgical bailouts in the future. CI - Copyright (c) 2024 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Oettinger, Vera AU - Oettinger V AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Electronic address: vera.oettinger@uniklinik-freiburg.de. FAU - Hilgendorf, Ingo AU - Hilgendorf I AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Wolf, Dennis AU - Wolf D AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Stachon, Peter AU - Stachon P AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Heidenreich, Adrian AU - Heidenreich A AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240201 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/mortality MH - Germany/epidemiology MH - *Hospital Mortality MH - Male MH - Female MH - Aged, 80 and over MH - Aged MH - *Aortic Valve Stenosis/surgery/mortality MH - Postoperative Complications/epidemiology MH - Risk Factors MH - Aortic Valve/surgery OTO - NOTNLM OT - In-hospital mortality OT - National electronic health records OT - Surgical bailout OT - Transcatheter aortic valve implantation OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest The authors declare that there is no conflict of interest. EDAT- 2024/02/03 00:41 MHDA- 2024/06/17 00:42 CRDT- 2024/02/02 19:30 PHST- 2023/04/30 00:00 [received] PHST- 2024/01/20 00:00 [revised] PHST- 2024/01/25 00:00 [accepted] PHST- 2024/06/17 00:42 [medline] PHST- 2024/02/03 00:41 [pubmed] PHST- 2024/02/02 19:30 [entrez] AID - S0914-5087(24)00009-1 [pii] AID - 10.1016/j.jjcc.2024.01.003 [doi] PST - ppublish SO - J Cardiol. 2024 Aug;84(2):99-104. doi: 10.1016/j.jjcc.2024.01.003. Epub 2024 Feb 1. PMID- 38283568 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241023 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 8 IP - 1 DP - 2024 Jan TI - FAcilitating Safe Trans-femoral ACCESS for Transcatheter Aortic Valve Replacement in High Body Mass Index Patients-The FAST-ACCESS Cohort Study. PG - 100232 LID - 10.1016/j.shj.2023.100232 [doi] LID - 100232 FAU - Khan, Sarosh AU - Khan S AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. AD - Anglia Ruskin University, Chelmsford, Essex, UK. FAU - Jagathesan, Rohan AU - Jagathesan R AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Frost, Olivia M T AU - Frost OMT AD - St. George's University of London, London, UK. FAU - Crawford, Iveta AU - Crawford I AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Smith, Sheila AU - Smith S AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Gedela, Swamy AU - Gedela S AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Fawaz, Samer AU - Fawaz S AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. AD - Anglia Ruskin University, Chelmsford, Essex, UK. FAU - Simpson, Rupert AU - Simpson R AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. AD - Anglia Ruskin University, Chelmsford, Essex, UK. FAU - Singh, Arvind AU - Singh A AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Karamasis, Grigoris V AU - Karamasis GV AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. AD - Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. FAU - Keeble, Thomas R AU - Keeble TR AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. AD - Anglia Ruskin University, Chelmsford, Essex, UK. FAU - Davies, John R AU - Davies JR AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Kabir, Alamgir AU - Kabir A AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Aggarwal, Rajesh AU - Aggarwal R AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. FAU - Cook, Christopher M AU - Cook CM AD - Essex Cardiothoracic Centre, Basildon, Essex, UK. AD - Anglia Ruskin University, Chelmsford, Essex, UK. LA - eng PT - Journal Article DEP - 20231117 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC10818142 OTO - NOTNLM OT - Adhesive panniculus retractor OT - BMI OT - TAVR OT - Transfemoral OT - Vascular access OT - Vascular complications EDAT- 2024/01/29 06:43 MHDA- 2024/01/29 06:44 PMCR- 2023/11/17 CRDT- 2024/01/29 04:32 PHST- 2023/04/13 00:00 [received] PHST- 2023/09/11 00:00 [revised] PHST- 2023/09/27 00:00 [accepted] PHST- 2024/01/29 06:44 [medline] PHST- 2024/01/29 06:43 [pubmed] PHST- 2024/01/29 04:32 [entrez] PHST- 2023/11/17 00:00 [pmc-release] AID - S2474-8706(23)00126-4 [pii] AID - 100232 [pii] AID - 10.1016/j.shj.2023.100232 [doi] PST - epublish SO - Struct Heart. 2023 Nov 17;8(1):100232. doi: 10.1016/j.shj.2023.100232. eCollection 2024 Jan. PMID- 38256589 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241023 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 2 DP - 2024 Jan 14 TI - Transcaval versus Supra-Aortic Vascular Accesses for Transcatheter Aortic Valve Replacement: A Systematic Review with Meta-Analysis. LID - 10.3390/jcm13020455 [doi] LID - 455 AB - A growing body of evidence suggests that extrathoracic vascular accesses for transcatheter aortic valve replacement (TAVR) yield favorable outcomes and can be considered as primary alternatives when the gold-standard transfemoral access is contraindicated. Data comparing the transcaval (TCv) to supra-aortic (SAo) approaches (transcarotid, transsubclavian, and transaxillary) for TAVR are lacking. We aimed to compare the outcomes and safety of TCv and SAo accesses for TAVR as alternatives to transfemoral TAVR. A systematic review with meta-analysis was performed by searching PubMed/MEDLINE and EMBASE databases for all articles comparing TCv-TAVR against SAo-TAVR published until September 2023. Outcomes included in-hospital or 30-day all-cause mortality (ACM) and postoperative complications. A total of three studies with 318 TCv-TAVR and 179 SAo-TAVR patients were included. No statistically significant difference was found regarding in-hospital or 30-day ACM (relative risk [RR] 1.04, 95% confidence interval [CI] 0.47-2.34, p = 0.91), major bleeding, the need for blood transfusions, major vascular complications, and acute kidney injury. TCv-TAVR was associated with a non-statistically significant lower rate of neurovascular complications (RR 0.39, 95%CI 0.14-1.09, p = 0.07). These results suggest that both approaches may be considered as first-line alternatives to transfemoral TAVR, depending on local expertise and patients' anatomy. Additional data from long-term cohort studies are needed. FAU - Antiochos, Panagiotis AU - Antiochos P AUID- ORCID: 0000-0001-8466-7360 AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Kirsch, Matthias AU - Kirsch M AD - Division of Cardiovascular Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Monney, Pierre AU - Monney P AUID- ORCID: 0000-0002-3083-7333 AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Tzimas, Georgios AU - Tzimas G AUID- ORCID: 0000-0002-2810-8887 AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Meier, David AU - Meier D AUID- ORCID: 0000-0002-5524-5844 AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Fournier, Stephane AU - Fournier S AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Ferlay, Clemence AU - Ferlay C AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. AD - Division of Cardiovascular Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. AD - Adult Intensive Care Unit, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Nowacka, Anna AU - Nowacka A AD - Division of Cardiovascular Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Rancati, Valentina AU - Rancati V AD - Division of Anesthesiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Abellan, Christophe AU - Abellan C AD - Division of Internal Medicine, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Skalidis, Ioannis AU - Skalidis I AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. FAU - Lu, Henri AU - Lu H AUID- ORCID: 0000-0002-9074-6505 AD - Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland. LA - eng PT - Journal Article PT - Review DEP - 20240114 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10816274 OTO - NOTNLM OT - TAVI OT - TAVR OT - meta-analysis OT - supra-aortic OT - transcatheter aortic valve replacement OT - transcaval COIS- Olivier Muller reports grants from Edwards Lifesciences and Abbott Cardiovascular. The other authors do not have any conflict of interest in relation to this manuscript. EDAT- 2024/01/23 06:43 MHDA- 2024/01/23 06:44 PMCR- 2024/01/14 CRDT- 2024/01/23 01:15 PHST- 2023/12/13 00:00 [received] PHST- 2024/01/08 00:00 [revised] PHST- 2024/01/12 00:00 [accepted] PHST- 2024/01/23 06:44 [medline] PHST- 2024/01/23 06:43 [pubmed] PHST- 2024/01/23 01:15 [entrez] PHST- 2024/01/14 00:00 [pmc-release] AID - jcm13020455 [pii] AID - jcm-13-00455 [pii] AID - 10.3390/jcm13020455 [doi] PST - epublish SO - J Clin Med. 2024 Jan 14;13(2):455. doi: 10.3390/jcm13020455. PMID- 38254339 OWN - NLM STAT- MEDLINE DCOM- 20240308 LR - 20260618 IS - 1540-8167 (Electronic) IS - 1045-3873 (Linking) VI - 35 IP - 3 DP - 2024 Mar TI - Post-TAVR conduction abnormalities leading to permanent pacemaker implantation: Risk factors, prevention, and management. PG - 488-497 LID - 10.1111/jce.16185 [doi] AB - Transcatheter aortic valve replacement (TAVR) often leads to conduction abnormalities, necessitating pacemaker implantation. This review of 38 meta-analyses identified preexisting right bundle branch block (RBBB), LAHB, and new-onset left bundle branch block as key risk factors, with a higher PPM risk in male and older patients. Procedural factors like transfemoral access and self-expandable valves also increase this risk. Prevention focuses on tailoring TAVR to individual electrophysiological and anatomical profiles. However, there's a lack of consensus in managing these conduction disturbances post-TAVR, highlighting the need for further research and standardized treatment strategies. CI - (c) 2024 Wiley Periodicals LLC. FAU - Ghazal, Rachad AU - Ghazal R AUID- ORCID: 0009-0001-4790-5283 AD - Faculty of Medicine, American University of Beirut, Beirut, Lebanon. FAU - Garabedian, Haroutioun AU - Garabedian H AUID- ORCID: 0009-0002-6919-0562 AD - Faculty of Medicine, American University of Beirut, Beirut, Lebanon. FAU - Sawaya, Fadi AU - Sawaya F AUID- ORCID: 0000-0002-6623-4243 AD - Structural Heart and Valve Division, American University of Beirut Medical Center, Beirut, Lebanon. AD - Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon. FAU - Refaat, Marwan M AU - Refaat MM AUID- ORCID: 0000-0002-3210-1987 AD - Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon. AD - Cardiac Electrophysiology Division, American University of Beirut Medical Center, Beirut, Lebanon. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20240122 PL - United States TA - J Cardiovasc Electrophysiol JT - Journal of cardiovascular electrophysiology JID - 9010756 SB - IM MH - Humans MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery MH - Risk Factors MH - *Pacemaker, Artificial/adverse effects MH - Bundle-Branch Block/diagnosis/etiology/prevention & control MH - Aortic Valve/surgery OTO - NOTNLM OT - aortic stenosis (AS) OT - conduction abnormalities OT - pacemaker implantation OT - transcatheter aortic valve replacement EDAT- 2024/01/23 06:44 MHDA- 2024/03/08 06:43 CRDT- 2024/01/23 00:53 PHST- 2023/12/26 00:00 [revised] PHST- 2023/08/22 00:00 [received] PHST- 2024/01/04 00:00 [accepted] PHST- 2024/03/08 06:43 [medline] PHST- 2024/01/23 06:44 [pubmed] PHST- 2024/01/23 00:53 [entrez] AID - 10.1111/jce.16185 [doi] PST - ppublish SO - J Cardiovasc Electrophysiol. 2024 Mar;35(3):488-497. doi: 10.1111/jce.16185. Epub 2024 Jan 22. PMID- 38248874 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240128 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 11 IP - 1 DP - 2023 Dec 22 TI - Transcatheter Aortic Valve Implantation Access Sites: Same Goals, Distinct Aspects, Various Merits and Demerits. LID - 10.3390/jcdd11010004 [doi] LID - 4 AB - Transcatheter aortic valve implantation (TAVI) has been established as a safe and efficacious treatment for patients with severe symptomatic aortic stenosis (AS). Despite being initially developed and indicated for high-surgical-risk patients, it is now offered to low-risk populations based on the results of large randomized controlled trials. The most common access sites in the vast majority of patients undergoing TAVI are the common femoral arteries; however, 10-20% of the patients treated with TAVI require an alternative access route, mainly due to peripheral atherosclerotic disease or complex anatomy. Hence, to achieve successful delivery and implantation of the valve, several arterial approaches have been studied, including transcarotid (TCr), axillary/subclavian (A/Sc), transapical (TAp), transaortic (TAo), suprasternal-brachiocephalic (S-B), and transcaval (TCv). This review aims to concisely summarize the most recent literature data and current guidelines as well as evaluate the various access routes for TAVI, focusing on the indications, the various special patient groups, and the advantages and disadvantages of each technique, as well as their adverse events. FAU - Katsaros, Odysseas AU - Katsaros O AUID- ORCID: 0000-0002-7684-3245 AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Apostolos, Anastasios AU - Apostolos A AUID- ORCID: 0000-0003-2616-7952 AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Ktenopoulos, Nikolaos AU - Ktenopoulos N AUID- ORCID: 0000-0002-0995-7015 AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Koliastasis, Leonidas AU - Koliastasis L AUID- ORCID: 0000-0002-7966-9174 AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. AD - Department of Cardiology, University of Brussels, CHU Saint-Pierre, 1000 Brussels, Belgium. FAU - Kachrimanidis, Ioannis AU - Kachrimanidis I AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Drakopoulou, Maria AU - Drakopoulou M AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Korovesis, Theofanis AU - Korovesis T AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Karanasos, Antonios AU - Karanasos A AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Tsalamandris, Sotirios AU - Tsalamandris S AUID- ORCID: 0000-0002-9945-930X AD - Department of Cardiology, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Latsios, George AU - Latsios G AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Synetos, Andreas AU - Synetos A AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Tsioufis, Konstantinos AU - Tsioufis K AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. FAU - Toutouzas, Konstantinos AU - Toutouzas K AD - First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece. LA - eng PT - Journal Article PT - Review DEP - 20231222 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC10817029 OTO - NOTNLM OT - TAVI OT - TAVR OT - access site OT - aortic stenosis OT - axillary/subclavian OT - suprasternal-brachiocephalic OT - transaortic OT - transapical OT - transcarotid OT - transcaval COIS- The authors declare no conflicts of interest. EDAT- 2024/01/22 06:42 MHDA- 2024/01/22 06:43 PMCR- 2023/12/22 CRDT- 2024/01/22 04:44 PHST- 2023/11/14 00:00 [received] PHST- 2023/12/03 00:00 [revised] PHST- 2023/12/20 00:00 [accepted] PHST- 2024/01/22 06:43 [medline] PHST- 2024/01/22 06:42 [pubmed] PHST- 2024/01/22 04:44 [entrez] PHST- 2023/12/22 00:00 [pmc-release] AID - jcdd11010004 [pii] AID - jcdd-11-00004 [pii] AID - 10.3390/jcdd11010004 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2023 Dec 22;11(1):4. doi: 10.3390/jcdd11010004. PMID- 38245395 OWN - NLM STAT- MEDLINE DCOM- 20240408 LR - 20240408 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 33 IP - 3 DP - 2024 Mar TI - Acute Kidney Injury Following Transcatheter Aortic Valve Implantation-A Contemporary Perspective of Incidence, Predictors, and Outcomes. PG - 316-323 LID - S1443-9506(23)04456-6 [pii] LID - 10.1016/j.hlc.2023.11.018 [doi] AB - BACKGROUND: Acute kidney injury (AKI) is a known complication following transcatheter aortic valve implantation (TAVI), associated with increased morbidity and mortality. Most of this data relates to higher-risk patients with early-generation TAVI valves. With TAVI now established as a safe and cost-effective procedure for low-risk patients, there is a distinct need for updated analysis. We aimed to assess the incidence, predictors, and outcomes of AKI in a contemporary cohort of TAVI patients, concurrently examining the role of temporal evolution on AKI. METHOD: A total of 2,564 patients undergoing TAVI from 2008-2023 included in the Alfred-Cabrini-Epworth (ACE) TAVI Registry were analysed. Patients were divided into AKI and no AKI groups. Outcomes were reported according to the Valve Academic Research Consortium-3 (VARC-3) criteria. RESULTS: Of 2,564 patients, median age 83 (78-87) years, 57.4% men and a median Society of Thoracic Surgeons score of 3.6 (2.4-5.5), 163 (6.4%) patients developed AKI with incidence falling from 9.7% between 2008-2014 to 6% between 2015-2023 (p=0.022). On multivariable analysis, independent predictors of AKI were male sex (adjusted odds ratio [aOR] 1.89, p=0.005), congestive cardiac failure (aOR 1.52, p=0.048), estimated glomerular filtration rate 30-59 (aOR: 2.79, p<0.001), estimated glomerular filtration rate <30 (aOR 8.65, p<0.001), non-femoral access (aOR 5.35, p<0.001), contrast volume (aOR 1.01, p<0.001), self-expanding valve (aOR 1.60, p=0.045), and bleeding (aOR 2.88, p=0.005). Acute kidney injury was an independent predictor of 30-day (aOR: 6.07, p<0.001) and 12-month (aOR: 3.01, p=0.002) mortality, an association that remained consistent when excluding TAVIs performed prior to 2015. CONCLUSIONS: Acute kidney injury remains a relatively common complication of TAVI, associated with significant morbidity and mortality even in less comorbid, contemporary practice patients. CI - Copyright (c) 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Butala, Anant D AU - Butala AD AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. Electronic address: https://twitter.com/anant_butala. FAU - Nanayakkara, Shane AU - Nanayakkara S AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Cardiology, Cabrini Hospital, Melbourne, Vic, Australia; Department of Cardiology, Epworth Hospital, Melbourne, Vic, Australia. Electronic address: https://twitter.com/DrNanayakkara. FAU - Navani, Rohan V AU - Navani RV AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. FAU - Palmer, Sonny AU - Palmer S AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Medicine, University of Melbourne, Melbourne, Vic, Australia. FAU - Noaman, Samer AU - Noaman S AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. Electronic address: https://twitter.com/SamerNoaman. FAU - Haji, Kawa AU - Haji K AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia. FAU - Htun, Nay M AU - Htun NM AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Cardiology, Cabrini Hospital, Melbourne, Vic, Australia. FAU - Walton, Antony S AU - Walton AS AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Cardiology, Epworth Hospital, Melbourne, Vic, Australia. FAU - Stub, Dion AU - Stub D AD - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Department of Cardiology, Cabrini Hospital, Melbourne, Vic, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, Vic, Australia. Electronic address: d.stub@alfred.org.au. LA - eng PT - Journal Article DEP - 20240119 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Humans MH - Male MH - Aged, 80 and over MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Incidence MH - Risk Factors MH - Comorbidity MH - *Acute Kidney Injury/epidemiology/etiology MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/surgery MH - Treatment Outcome OTO - NOTNLM OT - Aortic stenosis OT - Contrast induced nephropathy OT - Incidence OT - Kidney injury OT - TAVI COIS- Conflicts of Interest There are no conflicts of interest to disclose. EDAT- 2024/01/21 00:42 MHDA- 2024/04/08 06:43 CRDT- 2024/01/20 21:53 PHST- 2023/07/26 00:00 [received] PHST- 2023/10/08 00:00 [revised] PHST- 2023/11/08 00:00 [accepted] PHST- 2024/04/08 06:43 [medline] PHST- 2024/01/21 00:42 [pubmed] PHST- 2024/01/20 21:53 [entrez] AID - S1443-9506(23)04456-6 [pii] AID - 10.1016/j.hlc.2023.11.018 [doi] PST - ppublish SO - Heart Lung Circ. 2024 Mar;33(3):316-323. doi: 10.1016/j.hlc.2023.11.018. Epub 2024 Jan 19. PMID- 38242742 OWN - NLM STAT- MEDLINE DCOM- 20240219 LR - 20240404 IS - 1879-291X (Electronic) IS - 0301-5629 (Linking) VI - 50 IP - 4 DP - 2024 Apr TI - Is the Corrected Carotid Flow Time a Clinically Acceptable Surrogate Hemodynamic Parameter for the Left Ventricular Ejection Time? PG - 528-535 LID - S0301-5629(23)00407-6 [pii] LID - 10.1016/j.ultrasmedbio.2023.12.013 [doi] AB - OBJECTIVE: The corrected left ventricular ejection time (cLVET) comprises the phase from aortic valve opening to aortic valve closure corrected for heart rate. As a surrogate measure for cLVET, the corrected carotid flow time (ccFT) has been proposed in previous research. The aim of this study was to assess the clinical agreement between cLVET and ccFT in a dynamic clinical setting. METHODS: Twenty-five patients with severe aortic valve stenosis (AS) were selected for transcatheter aortic valve replacement (TAVR). The cLVET and ccFT were derived from the left ventricular outflow tract (LVOT) and the common carotid artery (CCA), respectively, using pulsed wave Doppler ultrasound. Bazett's (B) and Wodey's (W) equations were used to calculate cLVET and ccFT. Measurements were performed directly before (T1) and after (T2) TAVR. Correlation, Bland-Altman and concordance analyses were performed. RESULTS: Corrected LVET decreased from T1 to T2 (p < 0.001), with relative reductions of 11% (B) and 9% (W). Corrected carotid flow time decreased (p < 0.001), with relative reductions of 12% (B) and 10% (W). The correlation between cLVET and ccFT was strong for B (rho = 0.74, p < 0.001) and W (rho = 0.81, p < 0.001). The bias was -39 ms (B) and -37 ms (W), and the upper and lower levels of agreement were 19 and -98 ms (B) and 5 and -78 ms (W), respectively. Trending ability between cLVET and ccFT was good (concordance 96%) for both B and W. CONCLUSION: In TAVR patients, the clinical agreement between cLVET and ccFT was acceptable, indicating that ccFT could serve as a surrogate measure for cLVET. CI - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved. FAU - van Houte, Joris AU - van Houte J AD - Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands. Electronic address: joris.v.houte@catharinaziekenhuis.nl. FAU - Eerdekens, Rob AU - Eerdekens R AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Manning, Fokko AU - Manning F AD - Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Te Pas, Mariska AU - Te Pas M AD - Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Houterman, Saskia AU - Houterman S AD - Department of Research, Catharina Hospital, Eindhoven, The Netherlands. FAU - Wijnbergen, Inge AU - Wijnbergen I AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Montenij, Leon AU - Montenij L AD - Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. FAU - Tonino, Pim AU - Tonino P AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. FAU - Bouwman, Arthur AU - Bouwman A AD - Department of Anesthesiology, Catharina Hospital, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. LA - eng PT - Journal Article DEP - 20240119 PL - England TA - Ultrasound Med Biol JT - Ultrasound in medicine & biology JID - 0410553 SB - IM MH - Humans MH - Retrospective Studies MH - Aortic Valve MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Hemodynamics MH - Treatment Outcome OTO - NOTNLM OT - Acceleration time OT - Carotid Doppler ultrasound OT - Common carotid artery OT - Corrected carotid flow time OT - Left ventricular ejection time OT - Transcatheter aortic valve replacement OT - Transthoracic echocardiography COIS- Conflict of interest J.v.H., R.E., F.M., M.t.P., S.H., I.W. and P.T. declare they have no conflicts of interests. L.M. and A.B. act as clinical consultants for Philips Research in Eindhoven, The Netherlands, for which they receive consultant honoraria. EDAT- 2024/01/20 05:42 MHDA- 2024/02/19 06:43 CRDT- 2024/01/19 21:54 PHST- 2023/08/23 00:00 [received] PHST- 2023/12/06 00:00 [revised] PHST- 2023/12/07 00:00 [accepted] PHST- 2024/02/19 06:43 [medline] PHST- 2024/01/20 05:42 [pubmed] PHST- 2024/01/19 21:54 [entrez] AID - S0301-5629(23)00407-6 [pii] AID - 10.1016/j.ultrasmedbio.2023.12.013 [doi] PST - ppublish SO - Ultrasound Med Biol. 2024 Apr;50(4):528-535. doi: 10.1016/j.ultrasmedbio.2023.12.013. Epub 2024 Jan 19. PMID- 38215966 OWN - NLM STAT- MEDLINE DCOM- 20240616 LR - 20260811 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 84 IP - 2 DP - 2024 Aug TI - Minimum-incision transsubclavian transcatheter aortic valve replacement with balloon-expandable valve for dialysis patients. PG - 93-98 LID - S0914-5087(24)00001-7 [pii] LID - 10.1016/j.jjcc.2024.01.001 [doi] AB - BACKGROUND: Dialysis patients undergoing transcatheter aortic valve replacement (TAVR) face increased risk and have poorer outcomes than non-dialysis patients. Moreover, TAVR in dialysis patients using an alternative approach is considered extremely risky and little is known about the outcomes. We routinely perform minimum-incision transsubclavian TAVR (MITS-TAVR), which is contraindicated for transfemoral (TF) TAVR. This study aimed to evaluate the outcomes of MITS-TAVR compared with those of TF-TAVR in dialysis patients. METHODS: This single-center, observational study included 79 consecutive dialysis patients who underwent MITS-TAVR (MITS group, n = 22) or TF-TAVR (TF group, n = 57) under regional anesthesia. RESULTS: The rates of peripheral artery disease (MITS vs. TF, 72.7 % vs. 26.3 %; p < 0.01), shaggy aortas (MITS vs. TF, 63.6 % vs. 5.26 %; p < 0.01), and tortuous aortas (MITS vs. TF, 13.6 % vs. 1.75 %; p = 0.031) were significantly higher in the MITS group. The 30-day mortality was 2.53 % and comparable between the two groups (MITS vs. TF, 4.54 % vs. 1.75 %; p = 0.479). In the MITS group, 14 patients had ipsilateral dialysis fistulas, and three patients had patent in situ ipsilateral internal thoracic artery grafts; however, no vascular complications were observed. Kaplan-Meier survival curves for the two groups showed no significant difference in the survival rate (at 2 years; MITS vs. TF, 77.3 % vs. 68.8 %; p = 0.840) and freedom from cardiovascular mortality (at 2 years; MITS vs. TF, 90.9 % vs. 96.5 %; p = 0.898). The multivariable Cox proportional hazard model also indicated that survival in the MITS group was not significantly different from that in the TF group (hazard ratio 1.48; 95 % confidence interval, 0.77-2.85, p = 0.244). The patency rate of ipsilateral dialysis fistula was 100 % during follow-up. CONCLUSION: The outcome of MITS-TAVR was comparable to that of TF-TAVR in dialysis patients, despite the higher risk of patient characteristics. CI - Copyright (c) 2024 Elsevier Ltd. All rights reserved. FAU - Domoto, Satoru AU - Domoto S AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: domoto.satoru@twmu.ac.jp. FAU - Yamaguchi, Junichi AU - Yamaguchi J AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Tsuchiya, Ken AU - Tsuchiya K AD - Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan. FAU - Inagaki, Yusuke AU - Inagaki Y AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Nakamae, Kosuke AU - Nakamae K AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. FAU - Hirota, Masataka AU - Hirota M AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. FAU - Arashi, Hiroyuki AU - Arashi H AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Hanafusa, Norio AU - Hanafusa N AD - Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan. FAU - Hoshino, Junichi AU - Hoshino J AD - Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Niinami, Hiroshi AU - Niinami H AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. LA - eng PT - Journal Article PT - Observational Study DEP - 20240110 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/methods/adverse effects MH - *Renal Dialysis MH - Aged MH - Aged, 80 and over MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Aortic Valve/surgery MH - Heart Valve Prosthesis OTO - NOTNLM OT - Balloon-expandable valve OT - Dialysis patient OT - Transcathether aortic valve replacement OT - Transsubclavian approach COIS- Declaration of competing interest Satoru Domoto is a proctor of Edwards Lifesciences, Medtronic, and Abbott. EDAT- 2024/01/13 00:42 MHDA- 2024/06/17 00:42 CRDT- 2024/01/12 19:30 PHST- 2023/10/01 00:00 [received] PHST- 2023/11/21 00:00 [revised] PHST- 2024/01/05 00:00 [accepted] PHST- 2024/06/17 00:42 [medline] PHST- 2024/01/13 00:42 [pubmed] PHST- 2024/01/12 19:30 [entrez] AID - S0914-5087(24)00001-7 [pii] AID - 10.1016/j.jjcc.2024.01.001 [doi] PST - ppublish SO - J Cardiol. 2024 Aug;84(2):93-98. doi: 10.1016/j.jjcc.2024.01.001. Epub 2024 Jan 10. PMID- 38204548 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240111 IS - 2666-0849 (Electronic) IS - 2666-0849 (Linking) VI - 28 DP - 2023 Dec 20 TI - 3-Dimensional CT Planning for TAVR With a Novel Self-Expandable Valve in a Calcified Anatomy. PG - 102116 LID - 10.1016/j.jaccas.2023.102116 [doi] LID - 102116 AB - Recently, a novel transfemoral self-expandable valve (JenaValve Trilogy) was granted a CE mark as a dedicated device for transfemoral treatment of both aortic valve stenosis and regurgitation. Here, we highlight the importance of 3-dimensional preprocedural planning for the optimal choice of a prosthesis in challenging anatomies by reporting an unusual case of a heavily calcified aortic sinus. CI - (c) 2023 Published by Elsevier on behalf of the American College of Cardiology Foundation. FAU - Geyer, Martin AU - Geyer M AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Tamm, Alexander R AU - Tamm AR AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Munzel, Thomas AU - Munzel T AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Treede, Hendrik AU - Treede H AD - Department for Cardiac and Vascular Surgery, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - von Bardeleben, Ralph Stephan AU - von Bardeleben RS AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. LA - eng PT - Journal Article DEP - 20231109 PL - Netherlands TA - JACC Case Rep JT - JACC. Case reports JID - 101757292 PMC - PMC10774813 OTO - NOTNLM OT - JenaValve OT - aortic stenosis OT - multidisciplinary heart team OT - noninvasive imaging OT - transcatheter aortic valve replacement COIS- Dr Tamm has received lecture honoraria from Edwards Lifesciences and Medtronic, and has been a proctor for JenaValve Technology. Dr Teede has been a proctor and consultant for JenaValve Technology. Dr von Bardeleben has been a consultant and the recipient of lecture honoraria from Abbott Structural Heart, Boehringer Ingelheim, Cardiac Dimensions, Edwards Lifesciences, GE Health Systems, and Philips Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/01/11 07:42 MHDA- 2024/01/11 07:43 PMCR- 2023/11/09 CRDT- 2024/01/11 04:00 PHST- 2023/08/20 00:00 [received] PHST- 2023/10/10 00:00 [revised] PHST- 2023/10/12 00:00 [accepted] PHST- 2024/01/11 07:43 [medline] PHST- 2024/01/11 07:42 [pubmed] PHST- 2024/01/11 04:00 [entrez] PHST- 2023/11/09 00:00 [pmc-release] AID - S2666-0849(23)00452-7 [pii] AID - 102116 [pii] AID - 10.1016/j.jaccas.2023.102116 [doi] PST - epublish SO - JACC Case Rep. 2023 Nov 9;28:102116. doi: 10.1016/j.jaccas.2023.102116. eCollection 2023 Dec 20. PMID- 38202229 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240112 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 13 IP - 1 DP - 2023 Dec 30 TI - Short-Term Changes in Arterial Stiffness Measured by 2D Speckle Tracking in Patients Undergoing Transcatheter Aortic Valve Implantation. LID - 10.3390/jcm13010222 [doi] LID - 222 AB - Arterial stiffness has received increasing interest as a cardiovascular marker in patients with aortic valve stenosis (AS). So far, studies on the impact of aortic valve replacement (AVR) on arterial stiffness have been equivocal. Two-dimensional speckle tracking (2DST) is a novel, non-invasive method to measure the motion of the vessel wall. In this prospective observational study, we aimed to assess the change in arterial stiffness of the common carotid artery (CCA) measured by 2DST in patients undergoing transcatheter aortic valve implantation (TAVI). A total of 47 patients were included in the study (age 80.04 +/- 6.065 years). Peak circumferential strain (CS) was significantly improved after TAVI (4.50 +/- 2.292 vs. 5.12 +/- 2.958, p = 0.012), as was the peak strain rate (CSR) (0.85 +/- 0.567 vs. 1.35 +/- 0.710, p = 0.002). Body mass index (BMI), mean arterial pressure (MAP) and hemodynamic parameters were associated with this change. 2DST results did not correlate with aortic pulse wave velocity (aPWV) or augmentation index normalized to heart rate (AIx@75), suggesting a distinct difference between arterial stiffness of the CCA and other stiffness parameters. 2DST seems to be a promising new tool to assess arterial stiffness in TAVI patients. FAU - Arnold, Leonie AU - Arnold L AD - Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany. FAU - Haas, Nikolaus Alexander AU - Haas NA AD - Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany. FAU - Jakob, Andre AU - Jakob A AUID- ORCID: 0000-0003-3580-2268 AD - Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany. FAU - Fischer, Julius AU - Fischer J AD - Department of Medicine I, University Hospital, LMU Munich, 81377 Munich, Germany. FAU - Massberg, Steffen AU - Massberg S AD - Department of Medicine I, University Hospital, LMU Munich, 81377 Munich, Germany. FAU - Deseive, Simon AU - Deseive S AD - Department of Medicine I, University Hospital, LMU Munich, 81377 Munich, Germany. FAU - Oberhoffer, Felix Sebastian AU - Oberhoffer FS AD - Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany. LA - eng PT - Journal Article DEP - 20231230 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10779940 OTO - NOTNLM OT - 2D speckle tracking OT - transcatheter aortic valve replacement OT - vascular stiffness COIS- The authors declare no conflict of interest. EDAT- 2024/01/11 07:43 MHDA- 2024/01/11 07:44 PMCR- 2023/12/30 CRDT- 2024/01/11 01:10 PHST- 2023/11/04 00:00 [received] PHST- 2023/12/07 00:00 [revised] PHST- 2023/12/22 00:00 [accepted] PHST- 2024/01/11 07:44 [medline] PHST- 2024/01/11 07:43 [pubmed] PHST- 2024/01/11 01:10 [entrez] PHST- 2023/12/30 00:00 [pmc-release] AID - jcm13010222 [pii] AID - jcm-13-00222 [pii] AID - 10.3390/jcm13010222 [doi] PST - epublish SO - J Clin Med. 2023 Dec 30;13(1):222. doi: 10.3390/jcm13010222. PMID- 38200136 OWN - NLM STAT- MEDLINE DCOM- 20240112 LR - 20241019 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 14 IP - 1 DP - 2024 Jan 10 TI - Percutaneous transaxillary approach through the first segment of the axillary artery for the Impella-supported PCI Versus TAVR. PG - 1016 LID - 10.1038/s41598-024-51552-3 [doi] LID - 1016 AB - Percutaneous transaxillary approach (PTAX) through the first segment of the axillary artery is not widely recognized as a safe method. Furthermore, PTAX has never been directly compared between Impella-supported percutaneous coronary interventions (Impella-PCI) and transcatheter aortic valve replacement (TAVR). This study evaluated the feasibility and safety of PTAX through the first axillary segment in Impella-PCI versus TAVR. In cases where standard imaging guidance was insufficient, a technique involving puncturing the axillary artery "on-the-balloon" was employed. The endpoints were bleeding and vascular complications, as defined by BARC and VARC-3 criteria. PTAX was successfully performed in all 46 attempted cases: 23 for Impella-PCI and 23 for TAVR. Strict adherence to BARC and VARC-3 criteria led to the frequent identification of major bleeding (57%) and a moderately frequent diagnosis of vascular complications (17%). These incidences were primarily based on post-procedural hemoglobin reduction (> 3 g/dl) but not overt bleeding. The Impella group exhibited a higher rate of BARC 3b bleeding due to a greater hemoglobin decline resulting from the prolonged implant duration and PCI itself. Left axillary access was linked to smaller blood loss. Bleeding and vascular complications, as per BARC and VARC-3 definitions, did not affect short-term prognosis, with only 3 Impella patients succumbing to heart failure unrelated to the procedures during one-month follow-up period. CI - (c) 2024. The Author(s). FAU - Sacha, Jerzy AU - Sacha J AD - Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. sacha@op.pl. AD - Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland. sacha@op.pl. FAU - Krawczyk, Krzysztof AU - Krawczyk K AD - Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. FAU - Gwozdz, Witold AU - Gwozdz W AD - Department of Cardiac Surgery, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. FAU - Lipski, Przemyslaw AU - Lipski P AD - Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. FAU - Milejski, Wojciech AU - Milejski W AD - Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. FAU - Feusette, Piotr AU - Feusette P AD - Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. FAU - Cisowski, Marek AU - Cisowski M AD - Department of Cardiac Surgery, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. FAU - Gierlotka, Marek AU - Gierlotka M AD - Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland. LA - eng PT - Journal Article DEP - 20240110 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 RN - 0 (Hemoglobins) SB - IM MH - Humans MH - Axillary Artery/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Percutaneous Coronary Intervention/adverse effects MH - Axilla MH - Hemoglobins PMC - PMC10781673 COIS- J.S. is an Impella proctor. EDAT- 2024/01/11 00:42 MHDA- 2024/01/12 06:42 PMCR- 2024/01/10 CRDT- 2024/01/10 23:22 PHST- 2023/09/15 00:00 [received] PHST- 2024/01/06 00:00 [accepted] PHST- 2024/01/12 06:42 [medline] PHST- 2024/01/11 00:42 [pubmed] PHST- 2024/01/10 23:22 [entrez] PHST- 2024/01/10 00:00 [pmc-release] AID - 10.1038/s41598-024-51552-3 [pii] AID - 51552 [pii] AID - 10.1038/s41598-024-51552-3 [doi] PST - epublish SO - Sci Rep. 2024 Jan 10;14(1):1016. doi: 10.1038/s41598-024-51552-3. PMID- 38190006 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240111 IS - 2090-911X (Electronic) IS - 1110-2608 (Print) IS - 1110-2608 (Linking) VI - 76 IP - 1 DP - 2024 Jan 8 TI - Transcatheter aortic valve replacement in patients with a pre-existing prosthetic mitral valve: a single center experience with two cases. PG - 3 LID - 10.1186/s43044-023-00433-7 [doi] LID - 3 AB - BACKGROUND: The performance of transcatheter aortic valve replacement (TAVR) in patients with pre-existing prosthetic mitral valves is technically challenging due to the potential interference between both prosthetic devices. At present, there are no clear recommendations for this patient subset due to their exclusion from clinical trials. We report our experience of two cases with pre-existing prosthetic mechanical mitral valves who underwent TAVR. CASE PRESENTATION: The first case was a 57 year old man with severe aortic stenosis and type 2 diabetes mellitus who had a mitral valve replacement 32 years ago. Operative mortality risk assessed by the Society for Thoracic Surgery (STS) Score was 1.7%, but he was considered high risk in view of previous cardiac surgery. Pre-procedure CT evaluation revealed favorable aortic root and femoral access anatomy with the mechanical mitral valve located 6.3 mm below the aortic annular plane. He underwent TAVR with a Medtronic Evolut R 29 mm self-expanding transcatheter heart valve via the femoral approach. The second case was a 66 year old lady who presented with severe aortic stenosis, atrial fibrillation and a history of mitral valve replacement 17 years ago for rheumatic mitral stenosis. Her STS score was 3.5%. Pre-procedure CT showed favorable aortic root and femoral access parameters with a mitral-aortic distance of 3.6 mm. TAVR was performed with a balloon expandable Myval 21.5 mm transcatheter heart valve via a transfemoral access. Both procedures were done successfully. CONCLUSION: This report highlights the feasibility of TAVR in post-mitral valve replacement patients provided careful pre-procedural evaluation, and planning is done. CI - (c) 2024. The Author(s). FAU - Kushimo, Oyewole A AU - Kushimo OA AUID- ORCID: 0000-0002-0760-8014 AD - Max Institute of Heart and Vascular Sciences, Max Super-Specialty Hospital, Saket, New Delhi, 110017, India. wolekushimo@gmail.com. AD - Cardiology Unit, Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria. wolekushimo@gmail.com. FAU - Yadav, Mitendra S AU - Yadav MS AD - Max Institute of Heart and Vascular Sciences, Max Super-Specialty Hospital, Saket, New Delhi, 110017, India. FAU - Pandey, Purneshwar AU - Pandey P AD - Max Institute of Heart and Vascular Sciences, Max Super-Specialty Hospital, Saket, New Delhi, 110017, India. FAU - Singh, Santosh AU - Singh S AD - Max Institute of Heart and Vascular Sciences, Max Super-Specialty Hospital, Saket, New Delhi, 110017, India. FAU - Kumar, Viveka AU - Kumar V AD - Max Institute of Heart and Vascular Sciences, Max Super-Specialty Hospital, Saket, New Delhi, 110017, India. LA - eng PT - Journal Article DEP - 20240108 PL - Germany TA - Egypt Heart J JT - The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology JID - 9106952 PMC - PMC10774252 OTO - NOTNLM OT - Case report OT - Prosthetic mitral valve OT - Transcatheter aortic valve replacement OT - Transfemoral COIS- We have no conflicts of interest to declare. EDAT- 2024/01/08 12:43 MHDA- 2024/01/08 12:44 PMCR- 2024/01/08 CRDT- 2024/01/08 11:21 PHST- 2023/09/01 00:00 [received] PHST- 2023/12/24 00:00 [accepted] PHST- 2024/01/08 12:44 [medline] PHST- 2024/01/08 12:43 [pubmed] PHST- 2024/01/08 11:21 [entrez] PHST- 2024/01/08 00:00 [pmc-release] AID - 10.1186/s43044-023-00433-7 [pii] AID - 433 [pii] AID - 10.1186/s43044-023-00433-7 [doi] PST - epublish SO - Egypt Heart J. 2024 Jan 8;76(1):3. doi: 10.1186/s43044-023-00433-7. PMID- 38176131 OWN - NLM STAT- MEDLINE DCOM- 20240115 LR - 20240820 IS - 1532-2831 (Electronic) IS - 1078-8174 (Linking) VI - 30 IP - 1 DP - 2024 Jan TI - Iodine contrast volume reduction in preoperative transcatheter aortic valve implantation computed tomography: Comparison with 64- and 256-multidetector row computed tomography. PG - 408-415 LID - S1078-8174(23)00257-2 [pii] LID - 10.1016/j.radi.2023.12.017 [doi] AB - INTRODUCTION: This study aimed to compare the vascular enhancement and radiation dose in preoperative transcatheter aortic valve implantation (TAVI) computed tomography (CT) with a reduced contrast medium (CM) using volume scans in 256-multidetector row CT (MDCT) with a standard CM using 64-MDCT. METHODS: This study included 78 patients with preoperative TAVI CT with either 64- or 256-MDCT. The CM was injected at 1.5 mL/kg in the 64-MDCT group and 1.0 mL/kg in the 256-MDCT group. We compared vascular enhancement of the aortic root and access routes, image quality (IQ) scores, and radiation dose in both groups. RESULTS: Despite the reduced CM (by 33 %) in the 256-MDCT group, the mean vascular enhancement of the right and left subclavian arteries was significantly higher than that in the 64-MDCT group [284 and 267 Hounsfield units (HU) vs. 376 and 359 HU; p < 0.05]; however, no significant differences in the mean vascular enhancement in the ascending aorta, abdominal aorta at the celiac level, and bilateral common femoral arteries were observed between the two groups (p > 0.05 for all). The median IQ scores at the aortic root were higher in the 256-MDCT group than in the 64-MDCT group (3 vs. 4; p < 0.05), and those at the femoral access routes were comparable (4 vs. 4; p = 0.33). The mean effective dose was significantly reduced by 30 % in the 256-MDCT group (23.6 vs. 16.3 mSv; p < 0.05). CONCLUSION: In preoperative TAVI CT, volume scans using 256-MDCT provide comparable or better vascular enhancement and IQ with a 30 % reduction in CM and radiation dose than those using 64-MDCT. IMPLICATIONS FOR PRACTICE: Volume scan using 256-MDCT for preoperative TAVI CT may reduce CM and radiation dose in TAVI patients with renal dysfunction. CI - Copyright (c) 2023 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. FAU - Yoshiura, T AU - Yoshiura T AD - Graduate School of Health Sciences, Kumamoto University, Kuhonji 4-24-1, Chuo-ku, Kumamoto, 860-0976, Japan; Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: momotaro137koko@yahoo.co.jp. FAU - Masuda, T AU - Masuda T AD - Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Okayama, 701-0193, Japan. Electronic address: takanorimasuda@yahoo.co.jp. FAU - Kobayashi, Y AU - Kobayashi Y AD - Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: kobalislin5@kih.biglobe.ne.jp. FAU - Kikuhara, Y AU - Kikuhara Y AD - Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: yamayuka0321@gmail.com. FAU - Ishibashi, T AU - Ishibashi T AD - Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: i_toru_1221@yahoo.co.jp. FAU - Nonaka, H AU - Nonaka H AD - Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: swing_by_byp@yahoo.co.jp. FAU - Oku, T AU - Oku T AD - Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: pixy241724@yahoo.co.jp. FAU - Sato, T AU - Sato T AD - Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan. Electronic address: tomoyasu_satou@yahoo.co.jp. FAU - Funama, Y AU - Funama Y AD - Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. Electronic address: funama@kumamoto-u.ac.jp. LA - eng PT - Journal Article DEP - 20240103 PL - Netherlands TA - Radiography (Lond) JT - Radiography (London, England : 1995) JID - 9604102 RN - 9679TC07X4 (Iodine) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Multidetector Computed Tomography MH - *Iodine MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Radiation Dosage MH - Aorta, Abdominal OTO - NOTNLM OT - Computed tomography angiography OT - Contrast enhancement OT - Contrast medium OT - Radiation dose OT - Transcatheter aortic valve implantation EDAT- 2024/01/05 00:42 MHDA- 2024/01/15 12:43 CRDT- 2024/01/04 18:06 PHST- 2023/10/12 00:00 [received] PHST- 2023/12/24 00:00 [revised] PHST- 2023/12/25 00:00 [accepted] PHST- 2024/01/15 12:43 [medline] PHST- 2024/01/05 00:42 [pubmed] PHST- 2024/01/04 18:06 [entrez] AID - S1078-8174(23)00257-2 [pii] AID - 10.1016/j.radi.2023.12.017 [doi] PST - ppublish SO - Radiography (Lond). 2024 Jan;30(1):408-415. doi: 10.1016/j.radi.2023.12.017. Epub 2024 Jan 3. PMID- 38162114 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240103 IS - 2223-3652 (Print) IS - 2223-3660 (Electronic) IS - 2223-3652 (Linking) VI - 13 IP - 6 DP - 2023 Dec 15 TI - Transcatheter aortic valve replacement in patients with preoperative ascending aortic diameter >/=45 mm. PG - 939-947 LID - 10.21037/cdt-23-324 [doi] AB - BACKGROUND: Current indication for concomitant replacement of ascending aorta (AA) in patients undergoing surgical aortic valve replacement is that AA diameter exceeds 45 mm. However, the impact of AA dilation (>/=45 mm) in patients undergoing transcatheter aortic valve replacement (TAVR) remains unclear. METHODS: We retrospectively evaluated 467 consecutive patients who underwent transfemoral TAVR from January 2016 to April 2021. Cox proportional hazards regression was performed to identify risk factors for all-cause mortality. The primary endpoint was the all-cause mortality, and the secondary endpoints were the occurrence of the aortic dissection and/or rupture. RESULTS: One hundred patients (21.4%) presented preoperative AA >/=45 mm. The median age was 73 years for patients with AA >/=45 mm and 75 years for patients with AA <45 mm (P=0.021). The in-hospital mortality rate was 1.1%. There was no iatrogenic injury to the AA. Only one patient (0.2%) in AA <45 mm group experienced retrograde type B aortic dissection in the descending aorta. The median follow-up was 19 [16-34] months in patients with AA >/=45 mm and 27 [15-37] months in patients with AA <45 mm (P=0.152). No statistical difference was found between the two groups regarding the overall survival (92.5%+/-3.5% vs. 78.3%+/-6.8%, P=0.198). Only one patient in AA <45 mm group experienced type A aortic dissection 10 months after the procedure. In both univariable and multivariable analysis, AA >/=45 mm was not an independent predictor for all-cause mortality. CONCLUSIONS: Transfemoral TAVR can be performed safely in patients with preoperative AA >/=45 mm with a low intraprocedural risk. The mid-term survival appears not to be affected by the presence of AA >/=45 mm, and adverse aortic events are rare. CI - 2023 Cardiovascular Diagnosis and Therapy. All rights reserved. FAU - An, Kang AU - An K AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Zhang, Fengwen AU - Zhang F AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Ouyang, Wenbin AU - Ouyang W AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Pan, Xiangbin AU - Pan X AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. LA - eng PT - Journal Article DEP - 20231208 PL - China TA - Cardiovasc Diagn Ther JT - Cardiovascular diagnosis and therapy JID - 101601613 PMC - PMC10753242 OTO - NOTNLM OT - Transcatheter aortic valve replacement (TAVR) OT - adverse aortic event OT - ascending aorta (AA) OT - transfemoral route COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-23-324/coif). The authors have no conflicts of interest to declare. EDAT- 2024/01/02 11:41 MHDA- 2024/01/02 11:42 PMCR- 2023/12/15 CRDT- 2024/01/01 04:14 PHST- 2023/07/29 00:00 [received] PHST- 2023/10/08 00:00 [accepted] PHST- 2024/01/02 11:42 [medline] PHST- 2024/01/02 11:41 [pubmed] PHST- 2024/01/01 04:14 [entrez] PHST- 2023/12/15 00:00 [pmc-release] AID - cdt-13-06-939 [pii] AID - 10.21037/cdt-23-324 [doi] PST - ppublish SO - Cardiovasc Diagn Ther. 2023 Dec 15;13(6):939-947. doi: 10.21037/cdt-23-324. Epub 2023 Dec 8. PMID- 38152173 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231229 IS - 2666-2507 (Electronic) IS - 2666-2507 (Linking) VI - 22 DP - 2023 Dec TI - Clinical and structural outcomes of neocommissural alignment in transaxillary and transcarotid transcatheter aortic valve implantation with a self-expandable transcatheter heart valve. PG - 150-158 LID - 10.1016/j.xjtc.2023.06.017 [doi] AB - OBJECTIVES: This study analyzes neocommissural alignment and the clinical and hemodynamic outcomes after transaxillary and transcarotid implantation of the Acurate neo2 transcatheter heart valve. METHODS: We performed a retrospective, single-center analysis of early outcomes after transaxillary and transcarotid implantation of the Acurate neo2 transcatheter heart valve. Primary outcomes were neocommisural alignment, in-hospital mortality, and valve hemodynamic performance. Commissural alignment between native and transcatheter heart valves was assessed by transesophageal echocardiogram before and after the procedure. RESULTS: Between October 2021 and November 2022, 40 consecutive patients were treated with the Acurate neo2 through a transaxillary or transcarotid approach. Access was achieved via the left subclavian artery in 30 cases and the left common carotid artery in 10 cases, with a mean vessel diameter of 6.7 mm. Implants most commonly used were size M (37.5%), L (35%), and S (27.5%). On the basis of transesophageal echocardiogram analysis, there was no significant difference in mean commissural orientation between native (mean, 65.1 degrees ; SD, 41.3 degrees ) and neocommissures (mean, 64 degrees ; SD, 44.1 degrees ) (P = .661). Mean commissural orientation did not significantly differ between native and neocommissures (P = .661). Optimal alignment or mild commissural misalignment was achieved in 99.5% of cases. There were no cases of severe commissural misalignment. Postprocedural mean values for peak and mean gradients were 12.7 mm Hg and 5.2 mm Hg, respectively. There were 2 cases of moderate paravalvular leak and 4 cases of mild paravalvular leak. CONCLUSIONS: This patient-specific technique for transaxillary and transcarotid insertion of the Acurate neo2 delivery system prevents implantations with more than mild commissural misalignment and with a high device success rate. CI - (c) 2023 The Author(s). FAU - Mosquera, Victor X AU - Mosquera VX AD - Department of Cardiac Surgery, Complejo Hospitalario Universitario de A Coruna, A Coruna, Spain. AD - Instituto de Investigacion Biomedica de A Coruna (INIBIC), University of A Coruna, A Coruna, Spain. AD - University of Santiago de Compostela, Santiago de Compostela, Spain. FAU - Muinelo-Paul, Adrian AU - Muinelo-Paul A AD - Department of Cardiac Surgery, Complejo Hospitalario Universitario de A Coruna, A Coruna, Spain. FAU - Pato-Lopez, Oscar AU - Pato-Lopez O AD - Department of Anesthesiology, Complejo Hospitalario Universitario de A Coruna, A Coruna, Spain. FAU - Bouzas-Mosquera, Alberto AU - Bouzas-Mosquera A AD - Instituto de Investigacion Biomedica de A Coruna (INIBIC), University of A Coruna, A Coruna, Spain. AD - Department of Cardiology, Complejo Hospitalario Universitario de A Coruna, A Coruna, Spain. FAU - Cuenca-Castillo, Jose J AU - Cuenca-Castillo JJ AD - Department of Cardiac Surgery, Complejo Hospitalario Universitario de A Coruna, A Coruna, Spain. AD - Instituto de Investigacion Biomedica de A Coruna (INIBIC), University of A Coruna, A Coruna, Spain. AD - University of Santiago de Compostela, Santiago de Compostela, Spain. LA - eng PT - Journal Article DEP - 20230721 PL - United States TA - JTCVS Tech JT - JTCVS techniques JID - 101768546 PMC - PMC10750428 OTO - NOTNLM OT - computed tomography OT - self-expandable OT - transaxillary/transcarotid OT - transcatheter aortic valve implantation OT - transcatheter heart valve OT - transesophageal echocardiography EDAT- 2023/12/28 06:42 MHDA- 2023/12/28 06:43 PMCR- 2023/07/21 CRDT- 2023/12/28 04:00 PHST- 2023/05/03 00:00 [received] PHST- 2023/06/09 00:00 [revised] PHST- 2023/06/29 00:00 [accepted] PHST- 2023/12/28 06:43 [medline] PHST- 2023/12/28 06:42 [pubmed] PHST- 2023/12/28 04:00 [entrez] PHST- 2023/07/21 00:00 [pmc-release] AID - S2666-2507(23)00220-1 [pii] AID - 10.1016/j.xjtc.2023.06.017 [doi] PST - epublish SO - JTCVS Tech. 2023 Jul 21;22:150-158. doi: 10.1016/j.xjtc.2023.06.017. eCollection 2023 Dec. PMID- 38151309 OWN - NLM STAT- MEDLINE DCOM- 20231229 LR - 20250502 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 24 DP - 2023 Dec 25 TI - Bleeding in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Incidence, Trends, Clinical Outcomes, and Predictors. PG - 2951-2962 LID - S1936-8798(23)01372-9 [pii] LID - 10.1016/j.jcin.2023.10.011 [doi] AB - BACKGROUND: Bleeding is one of the most frequent complications in patients undergoing transcatheter aortic valve replacement (TAVR). Importantly, major bleeding is associated with poor clinical outcomes after TAVR. However, large studies on bleeding complications in the contemporary TAVR population are limited. OBJECTIVES: The aim of this study was to assess the incidence, temporal trends, clinical outcomes, and predictors of bleeding in patients undergoing transfemoral TAVR. METHODS: The CENTER2 study is a pooled patient-level database from 10 clinical studies including patients who underwent TAVR between 2007 and 2022. RESULTS: A total of 23,562 patients underwent transfemoral TAVR. The mean age was 81.5 +/- 6.7 years, and 56% were women. Major bleeding within the first 30 days was observed in 1,545 patients (6.6%). Minor bleeding was reported in 1,143 patients (4.7%). Rates of major bleeding decreased from 11.5% in 2007-2010 to 5.5% in 2019-2022 (P(trend) < 0.001). Dual antiplatelet therapy was associated with higher major bleeding rates compared with single antiplatelet therapy (12.2% vs 9.1%; OR: 1.40; 95% CI: 1.13-1.72; P = 0.002). Patients with major bleeding had increased mortality risk during the first 30 days (14.1% vs 4.3%; OR: 3.66; 95% CI: 3.11-4.31; P < 0.001) and during 1-year follow-up (27.8% vs 14.5%; HR: 1.50; 95% CI: 1.41-1.59; P < 0.001). Minor bleeding did not affect 1-year mortality risk (16.7% vs 14.5%; HR: 1.11; 95% CI: 0.93-1.32; P = 0.27). Predictors of major bleeding were female sex and peripheral vascular disease. CONCLUSIONS: Bleeding complications remain frequent and important in patients undergoing transfemoral TAVR. Increased mortality risk in major bleeding persists after the initial 30 days. (Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation With Balloon-Expandable Valves Versus Self-Expandable Valves [CENTER]; NCT03588247). CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - van Nieuwkerk, Astrid C AU - van Nieuwkerk AC AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Aarts, Hugo M AU - Aarts HM AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Hemelrijk, Kimberley I AU - Hemelrijk KI AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Canton, Tomas AU - Canton T AD - Interventional Cardiology, Hospital Virgen de la Salud, Toledo, Spain. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. FAU - de Brito, Fabio S Jr AU - de Brito FS Jr AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Barbanti, Marco AU - Barbanti M AD - Universita Degli Studi di Enna "Kore," Enna, Italy. FAU - Kornowski, Ran AU - Kornowski R AD - Cardiology Department, Rabin Medical Center, Petach Tikva, Israel. FAU - Latib, Azeem AU - Latib A AD - Department of Cardiology, Montefiore Medical Center, New York, New York, USA; Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa. FAU - D'Onofrio, Augusto AU - D'Onofrio A AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. FAU - Ribichini, Flavio AU - Ribichini F AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Maneiro Melon, Nicolas AU - Maneiro Melon N AD - Hospital 12 de Octubre, Madrid, Spain. FAU - Dumonteil, Nicolas AU - Dumonteil N AD - Clinique Pasteur, Toulouse, France. FAU - Abizaid, Alexandre AU - Abizaid A AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Sartori, Samantha AU - Sartori S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - D'Errigo, Paola AU - D'Errigo P AD - National Centre for Global Health - Istituto Superiore di Sanita, Rome, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. FAU - Fabroni, Margherita AU - Fabroni M AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Orvin, Katia AU - Orvin K AD - Cardiology Department, Rabin Medical Center, Petach Tikva, Israel. FAU - Pagnesi, Matteo AU - Pagnesi M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Vicaino Arellano, Manuel AU - Vicaino Arellano M AD - Hospital Virgen de a Macarena, Sevilla, Spain. FAU - Dangas, George AU - Dangas G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Voskuil, Michiel AU - Voskuil M AD - Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Delewi, Ronak AU - Delewi R AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. Electronic address: r.delewi@amsterdamumc.nl. LA - eng SI - ClinicalTrials.gov/NCT03588247 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Dec 25;16(24):2963-2966. doi: 10.1016/j.jcin.2023.10.060. PMID: 38151310 MH - Humans MH - Female MH - Aged MH - Aged, 80 and over MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/diagnostic imaging/surgery MH - Incidence MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome MH - Hemorrhage/epidemiology/etiology MH - Risk Factors OTO - NOTNLM OT - aortic valve stenosis OT - bleeding OT - mortality OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures This study was supported by the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation (CVON 2018-28 and 2012-06 Heart Brain Connection), the Dutch Federation of University Medical Centres, the Netherlands Organisation for Health Research and Development, and the Royal Netherlands Academy of Sciences. Dr de Brito is a proctor for Edwards Lifesciences and Medtronic. Dr Barbanti is consultant for Edwards Lifesciences; and has received speaker honoraria from Medtronic and Biotronik. Dr Latib is a consultant for Medtronic; and has received honoraria from Abbott Vascular. Dr Pagnesi has received personal fees from Abbott Vascular. Dr Delewi has received educational grants from Boston Scientific and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/12/28 00:42 MHDA- 2023/12/29 06:42 CRDT- 2023/12/27 20:54 PHST- 2023/06/08 00:00 [received] PHST- 2023/10/05 00:00 [revised] PHST- 2023/10/10 00:00 [accepted] PHST- 2023/12/29 06:42 [medline] PHST- 2023/12/28 00:42 [pubmed] PHST- 2023/12/27 20:54 [entrez] AID - S1936-8798(23)01372-9 [pii] AID - 10.1016/j.jcin.2023.10.011 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Dec 25;16(24):2951-2962. doi: 10.1016/j.jcin.2023.10.011. PMID- 38141726 OWN - NLM STAT- MEDLINE DCOM- 20240807 LR - 20260511 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 399 DP - 2024 Mar 15 TI - Impact of carotid artery stenosis on outcomes of transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 131670 LID - S0167-5273(23)01805-3 [pii] LID - 10.1016/j.ijcard.2023.131670 [doi] AB - INTRODUCTION: Carotid Artery Stenosis (CAS) is common in elderly patients undergoing Transcatheter Aortic Valve Replacement (TAVR). However, the impact of CAS on the outcomes of TAVR is unclear. PURPOSE: This systematic review and meta-analysis aimed to compare the clinical and periprocedural outcomes in patients with and without CAS undergoing TAVR. METHODS: PubMed, Embase, and Cochrane databases were searched until February 2023. We included studies that performed a direct comparison of outcomes of TAVR in CAS versus non-CAS patients. Data was extracted from published reports and the ROBINS-I tool was utilized for quality assessment. The R studio software (version 4.2.2) was adopted for statistical analysis. RESULTS: Five observational studies and 111.915 patients were included. The mean age was 80.7 +/- 8.2 years and 46.3% were female. The risk of stroke or transient ischemic attack was elevated in the group of patients with CAS (OR 1.44; 95% CI 1.07-1.95; p = 0.016). In contrast, myocardial infarction (OR 1.24; 95% CI 1.05-1.47; p = 0.074) and all-cause mortality (OR 0.99; 95% CI 0.73-1.35; p = 0.95) were not significantly different between CAS and non-CAS groups. Acute kidney injury and new pacemaker implantation did not differ between patients with and without CAS. CONCLUSIONS: Our findings suggest that CAS is significantly associated with cerebrovascular events in patients undergoing TAVR, without significantly impacting all-cause mortality. Further prospective studies are needed for a more granular assessment of additional determinants of this association, such as unilateral vs. bilateral involvement and whether there is a threshold of CAS severity for increased risk. CI - Copyright (c) 2023 Elsevier B.V. All rights reserved. FAU - Caetano, Lucas da Silva AU - Caetano L da Silva AD - Department of Medicine, Federal University of Paraiba, Joao Pessoa, Brazil. Electronic address: lucascaetanocrf@gmail.com. FAU - Gibicoski, Tathiane Brum AU - Gibicoski TB AD - Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil. FAU - Rodriguez, Francisco AU - Rodriguez F AD - Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil. FAU - Scabello, Isabela AU - Scabello I AD - Joao Pessoa University Center, Joao Pessoa, Brazil. FAU - da Silva Neto, Edgar Paulo AU - da Silva Neto EP AD - Santo Amaro Hospital, Recife, Brazil. FAU - Iplinski, Betina AU - Iplinski B AD - Santa Casa de Misericordia Hospital, Porto Alegre, Brazil. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20231222 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Carotid Stenosis/surgery/complications/mortality MH - *Aortic Valve Stenosis/surgery/mortality MH - Treatment Outcome MH - Postoperative Complications/epidemiology/etiology OTO - NOTNLM OT - Carotid stenosis OT - Stroke OT - Transcatheter aortic valve replacement COIS- Declaration of Competing Interest None to declare. EDAT- 2023/12/24 09:41 MHDA- 2024/02/12 05:43 CRDT- 2023/12/23 19:24 PHST- 2023/06/26 00:00 [received] PHST- 2023/12/03 00:00 [revised] PHST- 2023/12/18 00:00 [accepted] PHST- 2024/02/12 05:43 [medline] PHST- 2023/12/24 09:41 [pubmed] PHST- 2023/12/23 19:24 [entrez] AID - S0167-5273(23)01805-3 [pii] AID - 10.1016/j.ijcard.2023.131670 [doi] PST - ppublish SO - Int J Cardiol. 2024 Mar 15;399:131670. doi: 10.1016/j.ijcard.2023.131670. Epub 2023 Dec 22. PMID- 38141461 OWN - NLM STAT- MEDLINE DCOM- 20240108 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 211 DP - 2024 Jan 15 TI - A Novel System for Transcatheter Aortic Valve Implantation: First-in-Man Study. PG - 343-349 LID - S0002-9149(23)00992-X [pii] LID - 10.1016/j.amjcard.2023.09.021 [doi] AB - Transcatheter aortic valve implantation (TAVI) has become a therapeutic treatment for severe symptomatic patients with aortic stenosis. This study aimed to test a novel transcatheter aortic self-expandable bioprosthesis-the ScienCrown system (Lepu Medtech Inc., Beijing, China)-and evaluate the safety of the new device during TAVI. ScienCrown aortic valve implantation was performed on 10 patients. Clinical assessment was performed at baseline, post procedure, and after 1 year. Clinical outcomes and adverse events were assessed according to Valvular Academic Research Consortium-3 criteria. The mean age was 75.30 +/- 4.78 years with a mean Society of Thoracic Surgeons score of 4.64 +/- 3.23%. Device success was achieved in all patients (80% transfemoral, 20% transapical). After 1 year, there were no deaths, disabling strokes, myocardial infarctions, conversions to surgery, or major procedure-related complications. New pacemaker implantation was required in one patient (10%). ScienCrown implantation resulted in a reduction in mean valve gradient (63.00 +/- 18.84 to 9.67 +/- 4.97 mm Hg, p <0.001) and an increase in effective orifice area (0.57 +/- 0.20 to 2.57 +/- 0.59 cm(2), p <0.001) at 1 year. Paravalvular leak was absent in 9 patients (90%), and there was a trace in one patient (10%). All patients were in New York Heart Association class I to II at a mean follow-up of 1 year. The experience showed that ScienCrown transcatheter aortic valve system was safely and successfully implanted for treatment of severe symptomatic aortic stenosis. The newer-generation device affords a stable implantation while providing optimal hemodynamic performance. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Liu, Qingrong AU - Liu Q AD - Department of Cardiology, Beijing Aerospace General Hospital, Beijing, China; Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Mei, Ju AU - Mei J AD - Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Zhang, Hongliang AU - Zhang H AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Zhou, Wenbing AU - Zhou W AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Qiu, Kejin AU - Qiu K AD - Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China. FAU - Zhou, Qing AU - Zhou Q AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Chen, Yang AU - Chen Y AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Duan, Wei AU - Duan W AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Zhou, Changping AU - Zhou C AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Tang, Min AU - Tang M AD - Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Huang, Jianbing AU - Huang J AD - Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Liu, Haixia AU - Liu H AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Liu, Qingqing AU - Liu Q AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Chang, Rencao AU - Chang R AD - Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China. FAU - Niu, Guannan AU - Niu G AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. FAU - Zhang, Yuxin AU - Zhang Y AD - Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China. FAU - Wu, Tao AU - Wu T AD - Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China. FAU - Zhang, Ting AU - Zhang T AD - Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China. FAU - Fang, Weiyi AU - Fang W AD - Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. FAU - Wu, Yongjian AU - Wu Y AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China. Electronic address: yongjianwu_nccd@163.com. FAU - Gao, Runlin AU - Gao R AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. LA - eng PT - Journal Article DEP - 20231222 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/methods MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery/etiology MH - Prosthesis Design OTO - NOTNLM OT - ScienCrown OT - aortic stenosis OT - transapical OT - transcatheter aortic valve implantation (TAVI) OT - transfemoral system COIS- Declaration of Competing Interest The authors have no competing interests to declare. EDAT- 2023/12/24 09:42 MHDA- 2024/01/08 06:42 CRDT- 2023/12/23 18:09 PHST- 2023/04/22 00:00 [received] PHST- 2023/09/05 00:00 [revised] PHST- 2023/09/06 00:00 [accepted] PHST- 2024/01/08 06:42 [medline] PHST- 2023/12/24 09:42 [pubmed] PHST- 2023/12/23 18:09 [entrez] AID - S0002-9149(23)00992-X [pii] AID - 10.1016/j.amjcard.2023.09.021 [doi] PST - ppublish SO - Am J Cardiol. 2024 Jan 15;211:343-349. doi: 10.1016/j.amjcard.2023.09.021. Epub 2023 Dec 22. PMID- 38135568 OWN - NLM STAT- MEDLINE DCOM- 20240512 LR - 20260510 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 62 DP - 2024 May TI - Comparison of ultrasound- versus fluoroscopy-guidEd femorAl access In tranS-catheter aortic valve replacement In the Era of contempoRary devices: The EASIER registry. PG - 40-47 LID - S1553-8389(23)00938-7 [pii] LID - 10.1016/j.carrev.2023.12.007 [doi] AB - BACKGROUND: Vascular complications (VCs) still represent one of the principal concerns of trans-femoral trans-catheter aortic valve replacement (TF-TAVR). New-generation devices can minimize such complications but the arterial access management is left to the operator's choice. This study aims to describe the rate of VCs in a contemporary cohort of patients undergoing TAVR with new-generation devices and to determine whether an ultrasound-guided (USG) vs. a fluoroscopy-guided (FG) femoral access management has an impact on their prevention. METHODS: This is a prospective, observational, multicenter study. Consecutive patients undergoing TAVR with new-generation devices were analyzed from January 2022 to October 2022 in five tertiary care centers. Femoral accesses were managed according to the operator's preferences. All the patients underwent a pre-discharge peripheral ultrasound control. VCs and bleedings were the main endpoints of interest. RESULTS: A total of 458 consecutive patients were enrolled (274 in the USG group and 184 in the FG group). VCs occurred in 6.5 % of the patients (5.2 % minor and 1.3 % major). There was no difference between the USG and the FG groups in terms of any VCs (7.3 % vs. 5.4 %; p = 0.4), or any VARC-3 bleedings (6.9 % vs 6 %, p = 0.9). At logistic regression analysis, the two guidance strategies did not result as predictors of VCs (odds Ratio 0.8, 95 % Confidence Interval 0.46-1.4; P = 0.4). CONCLUSIONS: In a contemporary cohort of patients undergoing TAVR with new-generation devices, the occurrence of VCs is low and mostly represented by minor VCs. USG and FG modalities did not affect the rate of VCs. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Bianchini, Emiliano AU - Bianchini E AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy; Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Morello, Alberto AU - Morello A AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Bellamoli, Michele AU - Bellamoli M AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy; Clinique Pasteur, Toulouse, France. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Aurigemma, Cristina AU - Aurigemma C AD - Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Tagliaferri, Marco AU - Tagliaferri M AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Montonati, Carolina AU - Montonati C AD - Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, 20161 Milan, Italy. FAU - Dumonteil, Nicolas AU - Dumonteil N AD - Clinique Pasteur, Toulouse, France. FAU - Cimmino, Michele AU - Cimmino M AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Villa, Emmanuel AU - Villa E AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Corcione, Nicola AU - Corcione N AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Bettari, Luca AU - Bettari L AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Messina, Antonio AU - Messina A AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Stanzione, Alessio AU - Stanzione A AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Troise, Giovanni AU - Troise G AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Mor, Donata AU - Mor D AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Maggi, Antonio AU - Maggi A AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Bellosta, Raffaello AU - Bellosta R AD - Vascular Surgery, Department Cardiovascular Surgery, Fondazione Poliambulanza, Brescia, Italy. FAU - Pegorer, Matteo Alberto AU - Pegorer MA AD - Vascular Surgery, Department Cardiovascular Surgery, Fondazione Poliambulanza, Brescia, Italy. FAU - Zoccai, Giuseppe Biondi AU - Zoccai GB AD - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, 20161 Milan, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Trani, Carlo AU - Trani C AD - Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. FAU - Buono, Andrea AU - Buono A AD - Valve Center, Fondazione Poliambulanza Institute, Brescia, Italy. Electronic address: andrebuo@hotmail.com. FAU - Giordano, Arturo AU - Giordano A AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20231216 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - *Femoral Artery/diagnostic imaging MH - Male MH - Female MH - Prospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Aged, 80 and over MH - Aged MH - *Registries MH - Fluoroscopy MH - *Ultrasonography, Interventional MH - Treatment Outcome MH - *Catheterization, Peripheral/adverse effects/instrumentation MH - *Punctures MH - *Aortic Valve/surgery/diagnostic imaging/physiopathology MH - Risk Factors MH - *Radiography, Interventional/adverse effects MH - Heart Valve Prosthesis MH - Time Factors MH - Aortic Valve Stenosis/surgery/diagnostic imaging MH - Prosthesis Design OTO - NOTNLM OT - Femoral access management OT - Fluoroscopy OT - Puncture guidance OT - TAVR OT - Ultrasound OT - Vascular complication COIS- Declaration of competing interest Giuseppe Biondi-Zoccai has consulted for Amarin, Balmed, Cardionovum, Crannmedical, Endocore Lab, Eukon, Guidotti, Innovheart, Meditrial, Microport, Opsens Medical, Terumo, and Translumina, outside the present work. All other authors report no conflict of interest. Cristina Aurigemma has been involved in advisory board activities by Abbott, Abiomed, Medtronic, and Biotronic. Enrico Romagnoli received speaker fees from St. Jude. Carlo Trani and Francesco Burzotta received speakers' fees from Abbott Vascular, Abiomed, Medtronic and Terumo. The other authors have no conflicts of interest to declare. EDAT- 2023/12/23 12:42 MHDA- 2024/05/13 00:42 CRDT- 2023/12/22 21:59 PHST- 2023/11/15 00:00 [received] PHST- 2023/12/02 00:00 [revised] PHST- 2023/12/15 00:00 [accepted] PHST- 2024/05/13 00:42 [medline] PHST- 2023/12/23 12:42 [pubmed] PHST- 2023/12/22 21:59 [entrez] AID - S1553-8389(23)00938-7 [pii] AID - 10.1016/j.carrev.2023.12.007 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 May;62:40-47. doi: 10.1016/j.carrev.2023.12.007. Epub 2023 Dec 16. PMID- 38116334 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231221 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 15 IP - 11 DP - 2023 Nov TI - Infective Endocarditis Following Aortic Valve Replacement: A Systematic Review. PG - e49048 LID - 10.7759/cureus.49048 [doi] LID - e49048 AB - Aortic valve replacement (AVR) successfully treats aortic valve stenosis and aortic regurgitation from aging or bicuspid aortic valves. The procedure intends to restore the obstructed left ventricular outflow tract (LVOT). AVR can be performed surgically (surgical aortic valve replacement (SAVR); open heart) or via transcatheter (transcatheter aortic valve replacement (TAVR)), typically done through a femoral approach as a minimally invasive procedure, allowing for quicker recovery and reduced hospital stays. AVR has many complications, including life-threatening ones, such as infective endocarditis (IE), retarding the recovery process and increasing mortality following surgery. IE is an uncommon and deadly condition that involves multiple organ systems and is caused by bacteremia stemming from a microorganism that enters the bloodstream. Many manifestations are involved in the development of IE, such as fevers, flu-like symptoms, splinter hemorrhages, Osler nodes, abscesses, and vegetations found on the valves at the leaflets. Vegetations and abscesses tend to create further complications, such as stroke and acute kidney injury, as emboli block blood flow, leading to ischemia and damage. This paper aims to evaluate the difference in SAVR- and TAVR-associated IE, as the goal is to elucidate a danger that diminishes the positive effects of either procedure despite its rarity. Studies have been inconclusive in determining whether or not there is a trend, let alone a difference in incident rates. Both procedures share similar risk factors, but SAVR-associated IE is usually caused by Staphylococcus aureus, and studies indicate possibly Enterococcus spp. in TAVR-associated IE. Incident rates of IE are much higher than they should be, whether or not they differ between procedures, and future research needs to consider the pathways and risk factors that can be used to reduce the occurrence of AVR-associated IE. CI - Copyright (c) 2023, Slouha et al. FAU - Slouha, Ethan AU - Slouha E AD - Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD. FAU - Rood, Catherine AU - Rood C AD - Pharmacology, St. George's University School of Medicine, St. George's, GRD. FAU - Burle, Venkata Sathya AU - Burle VS AD - Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD. FAU - Al-Geizi, Hanin AU - Al-Geizi H AD - Pharmacology, St. George's University School of Medicine, St. George's, GRD. FAU - Clunes, Lucy A AU - Clunes LA AD - Pharmacology, St George's University, St. George's, GRD. FAU - Kollias, Theofanis F AU - Kollias TF AD - Microbiology, Immunology and Pharmacology, St. George's University School of Medicine, St. George's, GRD. LA - eng PT - Journal Article PT - Review DEP - 20231119 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC10728577 OTO - NOTNLM OT - aortic valve replacement OT - infective endocarditis OT - percutaneous aortic valve replacement OT - surgical aortic vavle replacement OT - transcatheter aortic valve replacement COIS- The authors have declared that no competing interests exist. EDAT- 2023/12/20 06:42 MHDA- 2023/12/20 06:43 PMCR- 2023/11/19 CRDT- 2023/12/20 03:59 PHST- 2023/11/18 00:00 [accepted] PHST- 2023/12/20 06:43 [medline] PHST- 2023/12/20 06:42 [pubmed] PHST- 2023/12/20 03:59 [entrez] PHST- 2023/11/19 00:00 [pmc-release] AID - 10.7759/cureus.49048 [doi] PST - epublish SO - Cureus. 2023 Nov 19;15(11):e49048. doi: 10.7759/cureus.49048. eCollection 2023 Nov. PMID- 38116127 OWN - NLM STAT- MEDLINE DCOM- 20231221 LR - 20241016 IS - 1540-8183 (Electronic) IS - 0896-4327 (Print) IS - 0896-4327 (Linking) VI - 2023 DP - 2023 TI - Neo-Commissural Alignment by Withdrawing and Readvancing the Delivery System during Transcatheter Aortic Valve Replacement with Self-Expanding Prosthesis. PG - 1060481 LID - 10.1155/2023/1060481 [doi] LID - 1060481 AB - OBJECTIVE: To investigate the feasibility of obtaining neo-commissural alignment by withdrawing and readvancing the delivery system during transcatheter aortic valve replacement (TAVR) with self-expanding prosthesis. METHODS: TAVR was performed in five patients with severe aortic valve stenosis by the femoral approach. The delivery catheter was withdrawn and readvanced with the opposite orientation when the Venus-A plus transcatheter heart valve (THV) centre marker was found to be overlapped with or close to the left marker at the aortic annulus level on the fluoroscopic image at the projection of the right and left coronary cusps superimposing. Neo-commissural alignment was evaluated by comparing the aortic computed tomography before TAVR with it after TAVR. RESULTS: The THV centre marker was overlapped with or close to the right marker at the aortic annulus level on the fluoroscopic image at the projection of the right and left coronary cusps superimposed in all the present five patients after withdrawing and readvancing the delivery system. The commissural angle deviation before vs. post TAVR was 12.3 degrees +/- 7.0 degrees . Three of five patients had neo-commissural alignment. Two of the five patients had mild neo-commissural misalignment. CONCLUSIONS: It is possible to obtain the neo-commissural alignment by controlling delivery catheter insertion orientation using the markers on the inflow of the Venus-A plus valve. CI - Copyright (c) 2023 Xian Liu et al. FAU - Liu, Xian AU - Liu X AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Wang, Yingdong AU - Wang Y AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Sheng, Yuhe AU - Sheng Y AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Han, Yaling AU - Han Y AUID- ORCID: 0000-0003-2453-6443 AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Jing, Quanmin AU - Jing Q AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Wang, Geng AU - Wang G AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Liang, Zhenyang AU - Liang Z AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Li, Yang AU - Li Y AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Wang, Bin AU - Wang B AUID- ORCID: 0000-0003-4761-0642 AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Xu, Kai AU - Xu K AUID- ORCID: 0009-0003-2694-7892 AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China. FAU - Yang, Li AU - Yang L AD - National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu 610064, China. FAU - Mintz, Gary S AU - Mintz GS AD - Cardiovascular Research Foundation, New York, NY, USA. LA - eng PT - Journal Article DEP - 20231211 PL - United States TA - J Interv Cardiol JT - Journal of interventional cardiology JID - 8907826 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome PMC - PMC10728361 COIS- All authors declare that there are no conflicts of interest. EDAT- 2023/12/20 06:42 MHDA- 2023/12/21 06:43 PMCR- 2023/12/11 CRDT- 2023/12/20 03:54 PHST- 2023/05/12 00:00 [received] PHST- 2023/09/20 00:00 [revised] PHST- 2023/11/30 00:00 [accepted] PHST- 2023/12/21 06:43 [medline] PHST- 2023/12/20 06:42 [pubmed] PHST- 2023/12/20 03:54 [entrez] PHST- 2023/12/11 00:00 [pmc-release] AID - 10.1155/2023/1060481 [doi] PST - epublish SO - J Interv Cardiol. 2023 Dec 11;2023:1060481. doi: 10.1155/2023/1060481. eCollection 2023. PMID- 38110017 OWN - NLM STAT- MEDLINE DCOM- 20240202 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 213 DP - 2024 Feb 15 TI - Balloon-Expandable Versus Self-Expandable Valve in Transcatheter Aortic Valve Replacement: A Nation-Wide Study. PG - 119-125 LID - S0002-9149(23)01388-7 [pii] LID - 10.1016/j.amjcard.2023.12.007 [doi] AB - A few studies have reported comparative analysis of clinical outcomes between balloon-expandable valve (BEV) and self-expandable valve (SEV) after transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis using newer-generation devices. However, those reports were mostly limited to short-term outcomes and Western populations. In the present study, data of patients with severe aortic stenosis who underwent TAVR between March 2016 and December 2018 were obtained from the National Health Insurance Service in Korea. The primary end point, defined as all-cause mortality, was compared in BEV (SAPIEN 3, Edwards Lifesciences, Irvine, California) and SEV (Evolut R, Medtronic, Minneapolis, MN) groups using a propensity-score matching analysis. Cumulative event rates of ischemic stroke, repeat procedures, and permanent pacemaker insertion (PPI) were evaluated as secondary outcomes. All events were followed up to a maximum of 3 years. A total of 1,172 patients underwent transfemoral TAVR, of whom 707 (60.3%) were treated with BEV and 452 (38.6%) with SEV. After 1:1 propensity-score matching, the BEV group showed lower all-cause mortality after a median follow-up of 12.0 months (mean: 13.1 +/- 9.3 months) based on Cox proportional hazard model analysis (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.45 to 0.99, p = 0.04). Cumulative incidence of ischemic stroke was not statistically different between the 2 groups (HR 0.68, 95% CI 0.29 to 1.59, p = 0.37). PPI occurred less frequently in the BEV group (HR 0.4, 95% CI 0.25 to 0.64, p < 0.01). Repeat procedures were rare (1 patient in BEV and 2 patients in SEV group). In conclusion, Korean nation-wide data analysis showed that BEV was associated with less all-cause death and incidence of PPI after TAVR than was SEV using a newer-generation device. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Sa, Young Kyoung AU - Sa YK AD - Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Choi, Ik Jun AU - Choi IJ AD - Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. Electronic address: mrfasthand@catholic.ac.kr. FAU - Chang, Kiyuk AU - Chang K AD - Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Hwang, Byung-Hee AU - Hwang BH AD - Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Chung, Woo-Baek AU - Chung WB AD - Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Lee, Kwan Yong AU - Lee KY AD - Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Choo, Eun-Ho AU - Choo EH AD - Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Kim, Chan Joon AU - Kim CJ AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Park, Mahn Won AU - Park MW AD - Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Choi, Yoon Seok AU - Choi YS AD - Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Park, Chul Soo AU - Park CS AD - Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Yoo, Ki Dong AU - Yoo KD AD - Division of Cardiology, Department of Internal Medicine, St. Vincent Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Jeon, Doo Soo AU - Jeon DS AD - Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. FAU - Oak, Min-Ho AU - Oak MH AD - College of Pharmacy, Mokpo National University, Muan, Jeonnam, Korea. FAU - Lee, Jungkuk AU - Lee J AD - Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea. FAU - Kang, Dongwoo AU - Kang D AD - Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20231216 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/epidemiology/surgery/etiology MH - *Heart Valve Prosthesis MH - Incidence MH - Treatment Outcome MH - Aortic Valve/surgery MH - Prosthesis Design OTO - NOTNLM OT - balloon-expandable valve OT - mortality OT - self-expandable valve OT - transcatheter aortic valve replacement COIS- Declaration of competing interest The authors have no competing interests to declare. EDAT- 2023/12/19 00:41 MHDA- 2024/02/02 06:42 CRDT- 2023/12/18 19:25 PHST- 2023/08/30 00:00 [received] PHST- 2023/11/27 00:00 [revised] PHST- 2023/12/09 00:00 [accepted] PHST- 2024/02/02 06:42 [medline] PHST- 2023/12/19 00:41 [pubmed] PHST- 2023/12/18 19:25 [entrez] AID - S0002-9149(23)01388-7 [pii] AID - 10.1016/j.amjcard.2023.12.007 [doi] PST - ppublish SO - Am J Cardiol. 2024 Feb 15;213:119-125. doi: 10.1016/j.amjcard.2023.12.007. Epub 2023 Dec 16. PMID- 38108869 OWN - NLM STAT- MEDLINE DCOM- 20231219 LR - 20250819 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 35 IP - 12 DP - 2023 Dec TI - The Allegra transcatheter heart valve: Long-term clinical and echocardiographic outcomes. LID - 10.25270/jic/23.00163 [doi] AB - OBJECTIVES: The Allegra-THV is a novel, self-expanding THV with supra-annular bovine leaflets. The valve is available in 3 different sizes and is delivered through an 18 French sheath. To determine the safety and efficacy of the Allegra transcatheter heart valve (THV; Biosensors) for the treatment of severe aortic valve stenosis under real-world conditions. METHODS: Consecutive patients undergoing transcatheter aortic valve replacement (TAVR) at the Heart-Centre Lucerne with the Allegra-THV were included. Echocardiographic data were collected at baseline, before discharge, and at 1-year follow-up; clinical outcomes were recorded for up to 3 years. Clinical endpoints were defined according to the definitions of the Valve-Academic-Research-Consortium. RESULTS: One hundred-three patients (age 81 +/- 7 years, 63% women) were enrolled. Median European System for Cardiac Operative Risk Evaluation II score was 4.1% (IQR 1.8%-4.2%). Mean aortic valve gradient was 6.9 +/- 3.3 mm Hg and 7.7 +/- 3.3 mm Hg, and an effective orifice area was 2.1 +/- 0.5 cm2 and 2.0 +/- 0.5 cm2 at 30 days and 1-year follow-up, respectively. More than mild paravalvular leak was observed in 2.0% of patients at 30 days and 3.3% at 1 year. At 1-year follow-up, 14.7% of patients required implantation of a new permanent pacemaker, 1 patient had endocarditis with an uneventful clinical course and good THV-function after antibiotic therapy, and no thrombosis, structural-valve-detoriation (SVD), or non-SVD had occurred. At 3-year follow-up, rates of all-cause and cardiovascular mortality were 31.4% and 18.8%, respectively. CONCLUSIONS: Transfemoral implantation of the Allegra-THV resulted in favorable clinical and echocardiographic outcomes at up to 3-year follow-up. Head-to-head randomized clinical trials are necessary to determine if the Allegra-THV valve performs as well as current generation valves. FAU - Wolfrum, Mathias AU - Wolfrum M AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Moccetti, Federico AU - Moccetti F AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Conrad, Nina AU - Conrad N AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Loretz, Lucca AU - Loretz L AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Bossard, Matthias AU - Bossard M AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Attiger-Toller, Adrian AU - Attiger-Toller A AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Cuculi, Florim AU - Cuculi F AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. LA - eng PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Aged MH - Aged, 80 and over MH - Animals MH - Cattle MH - Female MH - Humans MH - Male MH - Catheters MH - *Echocardiography MH - *Heart Valves MH - *Transcatheter Aortic Valve Replacement/instrumentation OTO - NOTNLM OT - Allegra OT - TAVR OT - aortic stenosis OT - outcomes OT - transcatheter aortic valve OT - transcatheter aortic valve replacement EDAT- 2023/12/18 12:42 MHDA- 2023/12/19 06:41 CRDT- 2023/12/18 11:06 PHST- 2023/12/19 06:41 [medline] PHST- 2023/12/18 12:42 [pubmed] PHST- 2023/12/18 11:06 [entrez] AID - 10.25270/jic/23.00163 [doi] PST - ppublish SO - J Invasive Cardiol. 2023 Dec;35(12). doi: 10.25270/jic/23.00163. PMID- 38094169 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231214 IS - 2666-0849 (Electronic) IS - 2666-0849 (Linking) VI - 26 DP - 2023 Nov 15 TI - Percutaneous Management of Aortic Root Rupture After Balloon-Expandable TAVR. PG - 102080 LID - 10.1016/j.jaccas.2023.102080 [doi] LID - 102080 AB - This article presents a case of aortic root rupture after transfemoral aortic valve replacement, successfully treated by a percutaneous approach, with a good evolution of the patient both during hospitalization and in the long term, being asymptomatic at the cardiovascular level after 18 months of follow-up. (Level of Difficulty: Advanced.). CI - (c) 2023 The Authors. FAU - Lopez Vazquez, Domingo AU - Lopez Vazquez D AD - Cardiology, Complexo Hospitalario Universitario A Coruna (CHUAC), SERGAS, A Coruna, Spain. FAU - Flores Rios, Xacobe AU - Flores Rios X AD - Cardiology, Complexo Hospitalario Universitario A Coruna (CHUAC), SERGAS, A Coruna, Spain. FAU - Salgado Fernandez, Jorge AU - Salgado Fernandez J AD - Cardiology, Complexo Hospitalario Universitario A Coruna (CHUAC), SERGAS, A Coruna, Spain. FAU - Rebollal Leal, Fernando AU - Rebollal Leal F AD - Cardiology, Complexo Hospitalario Universitario A Coruna (CHUAC), SERGAS, A Coruna, Spain. FAU - Vazquez Rodriguez, Jose Manuel AU - Vazquez Rodriguez JM AD - Cardiology, Complexo Hospitalario Universitario A Coruna (CHUAC), SERGAS, A Coruna, Spain. LA - eng PT - Journal Article DEP - 20231019 PL - Netherlands TA - JACC Case Rep JT - JACC. Case reports JID - 101757292 PMC - PMC10715956 OTO - NOTNLM OT - aortic valve OT - percutaneous coronary intervention OT - pericardial effusion COIS- The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/12/14 06:42 MHDA- 2023/12/14 06:43 PMCR- 2023/10/19 CRDT- 2023/12/14 04:11 PHST- 2023/07/04 00:00 [received] PHST- 2023/09/11 00:00 [revised] PHST- 2023/09/19 00:00 [accepted] PHST- 2023/12/14 06:43 [medline] PHST- 2023/12/14 06:42 [pubmed] PHST- 2023/12/14 04:11 [entrez] PHST- 2023/10/19 00:00 [pmc-release] AID - S2666-0849(23)00416-3 [pii] AID - 102080 [pii] AID - 10.1016/j.jaccas.2023.102080 [doi] PST - epublish SO - JACC Case Rep. 2023 Oct 19;26:102080. doi: 10.1016/j.jaccas.2023.102080. eCollection 2023 Nov 15. PMID- 38090283 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231213 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 15 IP - 11 DP - 2023 Nov 30 TI - Vascular access site complications after transfemoral transcatheter aortic valve implantation: a comparison of open and percutaneous puncture approaches. PG - 5901-5912 LID - 10.21037/jtd-23-999 [doi] AB - BACKGROUND: In transfemoral transcatheter aortic valve implantation (TF-TAVI), which approach has lower vascular access site complications between the open puncture (OP) and percutaneous puncture (PP) approaches is still controversial. Moreover, few studies have analyzed risk factors for vascular access site complications in TF-TAVI. This study aimed to compare vascular access site complications between the OP and PP approaches in patients undergoing TF-TAVI and access risk factors for vascular access site complications. METHODS: Three hundred fifty-one patients who underwent TF-TAVI via the PP (n=251) and OP (n=100) were retrospectively examined. RESULTS: Incidence of vascular access site complications was 7.0% in the OP group and 8.4% in the PP group (P=0.828). Two deaths from vascular access site complications occurred in the PP group. After performing inverse probability weighting (IPW), regression analysis showed that PP was associated with a significantly higher odds of vascular access site complications [odds ratio =2.033; 95% confidence interval (CI): 1.397-2.958; P<0.001]. Common femoral artery (CFA) depth (hazard ratio =1.04; 95% CI: 1.000-1.070; P=0.045) and sheath/CFA diameter ratio (hazard ratio =971; 95% CI: 22.6-41,700; P<0.001) were independent complication risk factors. In patients with CFA depth >/=35 mm, the incidence of vascular access site complications was higher with PP than OP. Sheath/CFA diameter ratio >/=0.9 was associated with increased risk of vascular injury with both approaches. CONCLUSIONS: The incidence of vascular access site complications in patients undergoing TF-TAVI was significantly lower with OP than PP after IPW. OP may be preferable when CFA depth is >/=35 mm. When the sheath/CFA diameter ratio is >/=0.9, approaches other than the TF approach should be considered. CI - 2023 Journal of Thoracic Disease. All rights reserved. FAU - Sumii, Yosuke AU - Sumii Y AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Morisaki, Akimasa AU - Morisaki A AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Okai, Tsukasa AU - Okai T AD - Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Taniuchi, Satsuki AU - Taniuchi S AD - Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Shintani, Ayumi AU - Shintani A AD - Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Kawase, Takumi AU - Kawase T AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Nishiya, Kenta AU - Nishiya K AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Sakon, Yoshito AU - Sakon Y AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Fujii, Hiromichi AU - Fujii H AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Shibata, Toshihiko AU - Shibata T AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. FAU - Takahashi, Yosuke AU - Takahashi Y AD - Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. LA - eng PT - Journal Article DEP - 20231030 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC10713323 OTO - NOTNLM OT - Open puncture (OP) OT - percutaneous puncture (PP) OT - transcatheter aortic valve implantation (TAVI) OT - transfemoral approach (TF approach) OT - vascular complications COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-999/coif). The authors have no conflicts of interest to declare. EDAT- 2023/12/13 18:42 MHDA- 2023/12/13 18:43 PMCR- 2023/11/30 CRDT- 2023/12/13 13:07 PHST- 2023/06/25 00:00 [received] PHST- 2023/09/14 00:00 [accepted] PHST- 2023/12/13 18:43 [medline] PHST- 2023/12/13 18:42 [pubmed] PHST- 2023/12/13 13:07 [entrez] PHST- 2023/11/30 00:00 [pmc-release] AID - jtd-15-11-5901 [pii] AID - 10.21037/jtd-23-999 [doi] PST - ppublish SO - J Thorac Dis. 2023 Nov 30;15(11):5901-5912. doi: 10.21037/jtd-23-999. Epub 2023 Oct 30. PMID- 38088154 OWN - NLM STAT- MEDLINE DCOM- 20240117 LR - 20240329 IS - 1941-7705 (Electronic) IS - 1941-7713 (Linking) VI - 17 IP - 1 DP - 2024 Jan TI - Daily Physical Activity Measured by Wearable Smartwatch for Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the SMART TAVR Study. PG - e010066 LID - 10.1161/CIRCOUTCOMES.123.010066 [doi] AB - BACKGROUND: This study aims to evaluate limited data about daily physical activity patterns, influential factors, and their association with 1-year mortality or rehospitalization after transcatheter aortic valve replacement (TAVR) through smartwatches. METHODS: Consecutive severe aortic stenosis patients undergoing elective transfemoral TAVR in a Chinese tertiary hospital were enrolled from July 2021 to May 2022 and received a Huawei smartwatch at least 1 day before TAVR. The primary outcome was a composite of all-cause mortality or hospital readmission within 1 year. Linear mixed-effects models were applied to determine influential factors of daily step counts, and Cox proportional hazard regression models were to estimate the association between baseline step counts within 1 month since discharge and composite outcome from months 2 to 12. The dose-response association was assessed using restricted cubic spline curves. RESULTS: A total of 222 participants and 59 469 valid monitoring person-day records were included (mean age, 72.7 years; 61% women). Step counts increased rapidly within the first 2 months (P<0.001), followed by a slower increase for those without composite outcomes (P=0.029) and a gradual decrease for those who developed composite outcomes (P<0.001). In multivariate linear mixed models, a 1-m increase in baseline 6-minute walk test and a 1-month delay after discharge were associated with 4 (95% CI, 1-7) and 170 (95% CI, 145-194) additional step counts, respectively. In restricted cubic spline analysis, the hazard ratio declined progressively until approximately 5000 steps per day, after which they leveled. Below 5000 steps, the adjusted hazard ratio of composite outcome associated with each 1000-step count increase was 0.67 (0.50-0.89; P=0.007). However, above 5000 steps, step counts were not significantly associated with the composite outcome (P=0.645), with a hazard ratio of 1.12 (0.70-1.79). CONCLUSIONS: Daily step counts rapidly increased within the first 2 months post-TAVR. Increased physical activity was associated with a lower risk of 1-year mortality or rehospitalization after TAVR for patients with daily step counts below 5000. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04454177. FAU - Fan, Jiaqi AU - Fan J AUID- ORCID: 0000-0002-1909-9026 AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. AD - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (J.F.). AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.). FAU - Liu, Qiong AU - Liu Q AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.). AD - Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China (Q.L., J.W.). FAU - Dai, Hanyi AU - Dai H AUID- ORCID: 0000-0002-7782-891X AD - Zhejiang University School of Medicine, Hangzhou, China (H.D., D.Z.). FAU - Zhou, Dao AU - Zhou D AUID- ORCID: 0000-0001-7815-9490 AD - Zhejiang University School of Medicine, Hangzhou, China (H.D., D.Z.). FAU - Guo, Yuchao AU - Guo Y AUID- ORCID: 0000-0002-8206-6323 AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Xu, Jianguo AU - Xu J AD - Department of Electrocardiogram (J.X.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Wang, Lihan AU - Wang L AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Hu, Po AU - Hu P AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Jiang, Jubo AU - Jiang J AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Lin, Xinping AU - Lin X AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.). FAU - Li, Cheng AU - Li C AD - Department of Nursing (C.L.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Liu, Xianbao AU - Liu X AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology (J.F., Q.L., Y.G., L.W., P.H., J.J., X. Lin, X. Liu, J.W.), Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. AD - State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (J.F., Q.L., X.L., J.W.). AD - Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, China (Q.L., J.W.). AD - Research Center for Life Science and Human Health, Binjiang Institute of Zhejiang University, Hangzhou, China (J.W.). LA - eng SI - ClinicalTrials.gov/NCT04454177 PT - Journal Article DEP - 20231213 PL - United States TA - Circ Cardiovasc Qual Outcomes JT - Circulation. Cardiovascular quality and outcomes JID - 101489148 SB - IM MH - Humans MH - Female MH - Aged MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Treatment Outcome MH - Exercise MH - *Wearable Electronic Devices MH - Aortic Valve/surgery MH - Risk Factors MH - Severity of Illness Index OTO - NOTNLM OT - aortic valve OT - humans OT - prognosis OT - quality of life OT - transcatheter aortic valve replacement COIS- Disclosures None. EDAT- 2023/12/13 06:42 MHDA- 2024/01/17 06:43 CRDT- 2023/12/13 05:26 PHST- 2024/01/17 06:43 [medline] PHST- 2023/12/13 06:42 [pubmed] PHST- 2023/12/13 05:26 [entrez] AID - 10.1161/CIRCOUTCOMES.123.010066 [doi] PST - ppublish SO - Circ Cardiovasc Qual Outcomes. 2024 Jan;17(1):e010066. doi: 10.1161/CIRCOUTCOMES.123.010066. Epub 2023 Dec 13. PMID- 38073100 OWN - NLM STAT- MEDLINE DCOM- 20240613 LR - 20240614 IS - 1875-6212 (Electronic) IS - 1570-1611 (Linking) VI - 22 IP - 2 DP - 2024 TI - Strategies to Minimize Access Site-related Complications in Patients Undergoing Transfemoral Artery Procedures with Large-bore Devices. PG - 79-87 LID - 10.2174/0115701611233184231206100222 [doi] AB - Large bore accesses refer to accesses with a diameter of 10 French or greater and are necessary for various medical devices, including those used in transcatheter aortic valve replacement, endovascular aneurysm repair stent-grafts, and percutaneous mechanical support devices. Notably, the utilization of these devices via femoral access is steadily increasing due to advancements in technology and implantation techniques, which are expanding the pool of patients suitable for percutaneous procedures. However, procedures involving large bore devices carry a high risk of bleeding and vascular complications (VCs), impacting both morbidity and long-term mortality. In this review article, we will first discuss the incidence, determinants, and prognostic impact of VCs in patients undergoing large bore access procedures. Subsequently, we will explore the strategies developed in recent years to minimize VCs, including techniques for optimizing vascular puncture through femoral cannulation, such as the use of echo-guided access cannulation and fluoroscopic guidance. Additionally, we will evaluate existing vascular closure devices designed for large bore devices. Finally, we will consider new pharmacological strategies aimed at reducing the risk of periprocedural access-related bleeding. CI - Copyright(c) Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. FAU - Sorrentino, Sabato AU - Sorrentino S AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Di Costanzo, Assunta AU - Di Costanzo A AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Salerno, Nadia AU - Salerno N AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Caracciolo, Alessandro AU - Caracciolo A AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Bruno, Federica AU - Bruno F AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Panarello, Alessandra AU - Panarello A AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Bellantoni, Antonio AU - Bellantoni A AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Mongiardo, Annalisa AU - Mongiardo A AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. FAU - Indolfi, Ciro AU - Indolfi C AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, 8810, Italy. LA - eng PT - Journal Article PT - Review PL - United Arab Emirates TA - Curr Vasc Pharmacol JT - Current vascular pharmacology JID - 101157208 SB - IM MH - Humans MH - *Femoral Artery MH - *Hemorrhage/prevention & control/etiology MH - *Catheterization, Peripheral/adverse effects/instrumentation MH - *Punctures MH - Risk Factors MH - Vascular Closure Devices MH - Endovascular Procedures/adverse effects/instrumentation MH - Treatment Outcome MH - Hemostatic Techniques/instrumentation/adverse effects MH - Vascular Access Devices/adverse effects MH - Equipment Design MH - Risk Assessment OTO - NOTNLM OT - Large bore access procedures OT - artery procedures OT - femoral access OT - long-term mortality. OT - morbidity OT - vascular complications EDAT- 2023/12/11 06:45 MHDA- 2024/06/13 12:42 CRDT- 2023/12/11 00:54 PHST- 2023/08/30 00:00 [received] PHST- 2023/11/21 00:00 [revised] PHST- 2023/11/22 00:00 [accepted] PHST- 2024/06/13 12:42 [medline] PHST- 2023/12/11 06:45 [pubmed] PHST- 2023/12/11 00:54 [entrez] AID - CVP-EPUB-136595 [pii] AID - 10.2174/0115701611233184231206100222 [doi] PST - ppublish SO - Curr Vasc Pharmacol. 2024;22(2):79-87. doi: 10.2174/0115701611233184231206100222. PMID- 38069663 OWN - NLM STAT- MEDLINE DCOM- 20240226 LR - 20241023 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 47 IP - 2 DP - 2024 Feb TI - Femoral vessel complications after transfemoral TAVR-A contemporary sonography-based assessment of 480 patients with third-generation transcatheter valves. PG - e24197 LID - 10.1002/clc.24197 [doi] LID - e24197 AB - BACKGROUND: Postinterventional sonographic assessment of the femoral artery after transfemoral transcatheter aortic valve replacement (TF-TAVR) has the potential to identify several pathologies. We investigated the incidence and risk factors of femoral vessel complications in a modern TAVR collective using postinterventional sonography. METHODS: Between September 2017 and March 2022, 480 patients underwent TF-TAVR with postinterventional femoral sonography at a single center. Clinical outcomes and adverse events were analyzed after the Valve Academic Research Consortium 3 (VARC-3) criteria. RESULTS: In this cohort (51.2% male; age 80 +/- 7.5 years, median EuroSCORE II 3.7) 74.8% (n = 359) were implanted with a self-expandable and 25.2% (n = 121) with a balloon-expandable valve. The main access (valve-delivery) was located right in 91.4% (n = 438), and the primary closure system was Proglide in 95% (n = 456). Vascular complications (VC) were observed in 29.16% (n = 140) of patients; 23.3% (n = 112) presented with minor- and 5.8% (n = 28) with major VC. Postinterventional femoral artery stenosis on the main access was observed in 9.8% (n = 47). Multivariable logistic regression analysis revealed female sex (p = .03, odds ratio [OR] 2.32, 95% confidence interval [CI] 1.09-4.89) and the number of used endovascular closure devices (p = .014, OR 0.11, 95%CI 0.02-0.64) as predictive factors for femoral artery stenosis. CONCLUSIONS: The incidence of postinterventional femoral artery stenosis following TF-TAVR was higher than expected with a number of used closure devices and female sex being independent risk factors. Considering the continuous advance of TAVR in low-risk patients with preserved physical activity, emphasis should be directed at the correct diagnosis and follow-up of these complications. CI - (c) 2023 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC. FAU - Werner, Paul AU - Werner P AUID- ORCID: 0000-0003-0925-6160 AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Winter, Martin AU - Winter M AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Muller, Markus AU - Muller M AD - Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Zierfuss, Bernhard AU - Zierfuss B AD - Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Coti, Luliana AU - Coti L AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Mach, Markus AU - Mach M AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Scherzer, Sabine AU - Scherzer S AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Simon, Paul AU - Simon P AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Laufer, Gunther AU - Laufer G AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Willfort-Ehringer, Andrea AU - Willfort-Ehringer A FAU - Andreas, Martin AU - Andreas M AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. LA - eng PT - Journal Article DEP - 20231209 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis/adverse effects MH - Constriction, Pathologic/complications/surgery MH - Treatment Outcome MH - Risk Factors MH - *Vascular Diseases MH - Femoral Artery/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnosis MH - Retrospective Studies PMC - PMC10823444 OTO - NOTNLM OT - femoral artery stenosis OT - postinterventional sonography OT - transfemoral aortic valve replacement OT - vascular complications COIS- Martin Andreas is proctor/speaker/consultant (Abbott, Edwards, Medtronic, Boston, Zoll) and received institutional funding (Abbott, Edwards, Medtronic, LSI). Guenther Laufer is an advisory-board member (Edwards). The other authors have no conflict of interest to declare. EDAT- 2023/12/10 06:42 MHDA- 2024/02/26 06:43 PMCR- 2023/12/09 CRDT- 2023/12/09 07:54 PHST- 2023/10/24 00:00 [revised] PHST- 2023/06/01 00:00 [received] PHST- 2023/11/15 00:00 [accepted] PHST- 2024/02/26 06:43 [medline] PHST- 2023/12/10 06:42 [pubmed] PHST- 2023/12/09 07:54 [entrez] PHST- 2023/12/09 00:00 [pmc-release] AID - CLC24197 [pii] AID - 10.1002/clc.24197 [doi] PST - ppublish SO - Clin Cardiol. 2024 Feb;47(2):e24197. doi: 10.1002/clc.24197. Epub 2023 Dec 9. PMID- 38059295 OWN - NLM STAT- MEDLINE DCOM- 20240104 LR - 20240321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 103 IP - 1 DP - 2024 Jan TI - Comparison of MANTA versus Perclose Prostyle large-bore vascular closure devices during transcatheter aortic valve implantation. PG - 160-168 LID - 10.1002/ccd.30921 [doi] AB - BACKGROUND: New vascular closure devices (VCD) are being introduced for achieving hemostasis after transcatheter aortic valve implantation (TAVI). However, no safety or efficacy data have been published compared to other contemporary VCD. AIM: To compare the safety and efficacy of suture-based Perclose Prostyle as compared to plug-based MANTA device. METHODS: A total of 408 consecutive TAVI patients from two high volume TAVI centers were included in the present study. Patients were grouped according to VCD: Prostyle versus MANTA. Propensity score matching (PSM) and multivariable analysis were utilized to compare clinical endpoints between the two groups. The primary endpoint was any vascular complication (VC) according to VARC-3 criteria. RESULTS: After PSM, a total of 264 patients were analyzed, of them 132 in each group. Overall baseline characteristics of the two groups were comparable. Primary end-point was similar between MANTA as compared to Prostyle (16.7% vs. 15.3% respectively, p = 0.888). The main driver for VC among MANTA group were minor vascular complications (15.2%). Conversely, minor and major VC contributed equally to the primary endpoint among Prostyle group (7.6%) (p = 0.013). No outcome predictors were identified in multivariate analysis. CONCLUSIONS: VCD for transfemoral TAVI using the new-generation Prostyle device or the MANTA device achieved comparable VARC-3 VC rates. CI - (c) 2023 Wiley Periodicals LLC. FAU - Barbash, Israel M AU - Barbash IM AD - Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Wasserstrum, Yishay AU - Wasserstrum Y AD - Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Erlebach, Magdalena AU - Erlebach M AUID- ORCID: 0000-0001-7560-9257 AD - Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universitat Munchen, Munich, Germany. FAU - Guetta, Victor AU - Guetta V AD - Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Ziegelmuller, Johannes AU - Ziegelmuller J AD - Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universitat Munchen, Munich, Germany. FAU - Segev, Amit AU - Segev A AD - Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Fefer, Paul AU - Fefer P AD - Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Maor, Elad AU - Maor E AUID- ORCID: 0000-0002-5087-0464 AD - Interventional Cardiology Unit, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Lange, Rudiger AU - Lange R AD - Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universitat Munchen, Munich, Germany. FAU - Ruge, Hendrik AU - Ruge H AD - Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universitat Munchen, Munich, Germany. LA - eng PT - Journal Article DEP - 20231207 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Vascular Closure Devices MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - Femoral Artery/diagnostic imaging/surgery MH - *Catheterization, Peripheral/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Aortic Valve/diagnostic imaging/surgery MH - Hemostatic Techniques/adverse effects OTO - NOTNLM OT - transcatheter aortic valve replacement OT - vascular closure device OT - vascular complication EDAT- 2023/12/07 06:42 MHDA- 2024/01/04 11:43 CRDT- 2023/12/07 04:19 PHST- 2023/09/28 00:00 [revised] PHST- 2023/04/14 00:00 [received] PHST- 2023/11/12 00:00 [accepted] PHST- 2024/01/04 11:43 [medline] PHST- 2023/12/07 06:42 [pubmed] PHST- 2023/12/07 04:19 [entrez] AID - 10.1002/ccd.30921 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Jan;103(1):160-168. doi: 10.1002/ccd.30921. Epub 2023 Dec 7. PMID- 38028496 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231201 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Single femoral artery access is safe and feasible during transcatheter aortic valve replacement: a propensity score matched analysis. PG - 1228258 LID - 10.3389/fcvm.2023.1228258 [doi] LID - 1228258 AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) potentially may be significantly simplified by using the single artery access (SA) technique, which does not require a secondary artery access. Nevertheless, the safety and efficacy of this technique remains unclear. Our goal was to determine if single artery access TAVR (without upgrading the sheath size) is a feasible, minimally invasive procedure. METHODS: Patients with symptomatic severe aortic stenosis who underwent TAVR via the femoral artery were consecutively enrolled in this study. Eligible individuals were divided into 2 groups: the SA group and the dual artery access (DA) group. The primary end point was device success (defined by the valve academic research consortium 3, VARC 3). A 6-month follow-up and propensity score matching analyses were performed. RESULTS: After propensity score matching analysis, a total of 130 patients were included: 65 in the SA group and 65 in the DA group. The SA procedure achieved similar device success (95.4% vs. 87.7%; P = 0.115) compared with the DA procedure. The SA procedure shortened the operating time (102 min vs. 125 min; P = 0.001) but did not increase the x-ray time or dose. Both a 20 Fr and a 22 Fr sheath (without upgrading the sheath size) could be used for the SA procedure. There was no major vascular complication occurred in both groups. The incidence of minor main vascular and access complications in the SA group was comparable to those of the DA procedure (0.0% vs. 3.1%; P = 0.156). CONCLUSIONS: The SA access procedure is a promising minimally invasive TAVR technique with a low incidence of vascular complications and a high incidence of device success. It is safe and possibly applicable in all TAVR procedures. CI - (c) 2023 Yan, Yao, Yuan, Liu, Luo, Lu, Chang, Zhang, Liu, Yin and Song. FAU - Yan, Yunfeng AU - Yan Y AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Yao, Jing AU - Yao J AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Yuan, Fei AU - Yuan F AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Liu, Xinmin AU - Liu X AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Luo, Taiyang AU - Luo T AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Lu, Zhinan AU - Lu Z AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Chang, Sanshuai AU - Chang S AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Zhang, Qian AU - Zhang Q AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Liu, Ran AU - Liu R AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Yin, Chengqian AU - Yin C AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Song, Guangyuan AU - Song G AD - Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. LA - eng PT - Journal Article DEP - 20231103 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10655139 OTO - NOTNLM OT - propensity matched analysis OT - simplification OT - single artery access procedure OT - transcatheter aortic valve replacement OT - transfemoral COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/11/29 18:43 MHDA- 2023/11/29 18:44 PMCR- 2023/01/01 CRDT- 2023/11/29 17:14 PHST- 2023/05/24 00:00 [received] PHST- 2023/10/05 00:00 [accepted] PHST- 2023/11/29 18:44 [medline] PHST- 2023/11/29 18:43 [pubmed] PHST- 2023/11/29 17:14 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1228258 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Nov 3;10:1228258. doi: 10.3389/fcvm.2023.1228258. eCollection 2023. PMID- 38028449 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231201 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Impact of route of access and stenosis subtype on outcome after transcatheter aortic valve replacement. PG - 1256112 LID - 10.3389/fcvm.2023.1256112 [doi] LID - 1256112 AB - INTRODUCTION: Previous analyses have reported the outcomes of transcatheter aortic valve replacement (TAVR) for patients with low-flow, low-gradient (LFLG) aortic stenosis (AS), without stratifying according to the route of access. Differences in mortality rates among access routes have been established for high-gradient (HG) patients and hypothesized to be even more pronounced in LFLG AS patients. This study aims to compare the outcomes of patients with LFLG or HG AS following transfemoral (TF) or transapical (TA) TAVR. METHODS: A total of 910 patients, who underwent either TF or TA TAVR with a median follow-up of 2.22 (IQR: 1.22-4.03) years, were included in this multicenter cohort study. In total, 146 patients (16.04%) suffered from LFLG AS. The patients with HG and LFLG AS were stratified according to the route of access and compared statistically. RESULTS: The operative mortality rates of patients with HG and LFLG were found to be comparable following TF access. The operative mortality rate was significantly increased for patients who underwent TA access [odds ratio (OR): 2.91 (1.54-5.48), p = 0.001] and patients with LFLG AS [OR: 2.27 (1.13-4.56), p = 0.02], which could be corroborated in a propensity score-matched subanalysis. The observed increase in the risk of operative mortality demonstrated an additive effect [OR for TA LFLG: 5.45 (2.35-12.62), p < 0.001]. LFLG patients who underwent TA access had significantly higher operative mortality rates (17.78%) compared with TF LFLG (3.96%, p = 0.016) and TA HG patients (6.36%, p = 0.024). CONCLUSIONS: HG patients experienced a twofold increase in operative mortality rates following TA compared with TF access, while LFLG patients had a fivefold increase in operative mortality rates. TA TAVR appears suboptimal for patients with LFLG AS. Prospective studies should be conducted to evaluate alternative options in cases where TF is not possible. CI - (c) 2023 Maier, Lambert, Senoner, Dobner, Hoppe, Fellner, Pfeifer, Feuchtner, Friedrich, Semsroth, Bonaros, Holfeld, Muller, Reinthaler, Steinwender and Barbieri. FAU - Maier, Julian AU - Maier J AD - Department of Cardiology, Kepler University Hospital, Linz, Austria. AD - Johannes Kepler University Linz, Medical Faculty, Linz, Austria. AD - Institute for Cardiovascular and Metabolic Research (ICMR), Johannes Kepler University Linz, Linz, Austria. AD - Institute of Pharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria. FAU - Lambert, Thomas AU - Lambert T AD - Department of Cardiology, Kepler University Hospital, Linz, Austria. AD - Johannes Kepler University Linz, Medical Faculty, Linz, Austria. FAU - Senoner, Thomas AU - Senoner T AD - University Clinic of Internal Medicine III, Medical University Innsbruck, Innsbruck, Austria. FAU - Dobner, Stephan AU - Dobner S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. AD - 3rd Medical Department of Cardiology and Intensive Care Medicine, Clinic Ottakring (former Wilhelminenhospital), Vienna, Austria. FAU - Hoppe, Uta Caroline AU - Hoppe UC AD - University Clinic of Internal Medicine II, Paracelsus Medical University, Salzburg, Austria. FAU - Fellner, Alexander AU - Fellner A AD - Department of Cardiology, Kepler University Hospital, Linz, Austria. AD - Johannes Kepler University Linz, Medical Faculty, Linz, Austria. FAU - Pfeifer, Bernhard Erich AU - Pfeifer BE AD - Institute of Clinical Epidemiology, Tirol Kliniken, Innsbruck, Austria. AD - Division of Digital Medicine and Telehealth, University for Health Sciences, Medical Informatics and Technology (UMIT), Hall in Tirol, Austria. FAU - Feuchtner, Gudrun Maria AU - Feuchtner GM AD - Department of Radiology, Medical University Innsbruck, Innsbruck, Austria. FAU - Friedrich, Guy AU - Friedrich G AD - University Clinic of Internal Medicine III, Medical University Innsbruck, Innsbruck, Austria. FAU - Semsroth, Severin AU - Semsroth S AD - Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria. FAU - Bonaros, Nikolaos AU - Bonaros N AD - Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria. FAU - Holfeld, Johannes AU - Holfeld J AD - Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria. FAU - Muller, Silvana AU - Muller S AD - University Clinic of Internal Medicine III, Medical University Innsbruck, Innsbruck, Austria. FAU - Reinthaler, Markus AU - Reinthaler M AD - Department of Cardiology, Campus Benjamin Franklin, Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health, Berlin, Germany. AD - Institute of Active Polymers and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Hereon, Teltow, Germany. FAU - Steinwender, Clemens AU - Steinwender C AD - Department of Cardiology, Kepler University Hospital, Linz, Austria. AD - Johannes Kepler University Linz, Medical Faculty, Linz, Austria. AD - Institute for Cardiovascular and Metabolic Research (ICMR), Johannes Kepler University Linz, Linz, Austria. FAU - Barbieri, Fabian AU - Barbieri F AD - University Clinic of Internal Medicine III, Medical University Innsbruck, Innsbruck, Austria. AD - Department of Cardiology, Campus Benjamin Franklin, Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health, Berlin, Germany. LA - eng PT - Journal Article DEP - 20231109 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10665844 OTO - NOTNLM OT - access route OT - high gradient aortic stenosis OT - low-flow low-gradient aortic stenosis OT - transapical access OT - transcatheter aortic valve implantation OT - transcatheter aortic valve replacement OT - transfemoral access COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/11/29 18:42 MHDA- 2023/11/29 18:43 PMCR- 2023/01/01 CRDT- 2023/11/29 17:14 PHST- 2023/07/10 00:00 [received] PHST- 2023/10/16 00:00 [accepted] PHST- 2023/11/29 18:43 [medline] PHST- 2023/11/29 18:42 [pubmed] PHST- 2023/11/29 17:14 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1256112 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Nov 9;10:1256112. doi: 10.3389/fcvm.2023.1256112. eCollection 2023. PMID- 37999706 OWN - NLM STAT- MEDLINE DCOM- 20231229 LR - 20250502 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 24 DP - 2023 Dec 25 TI - Transaxillary Access for JenaValve to Treat Pure Native Aortic Regurgitation. PG - 3039-3040 LID - S1936-8798(23)01310-9 [pii] LID - 10.1016/j.jcin.2023.09.016 [doi] FAU - Geyer, Martin AU - Geyer M AD - Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Tamm, Alexander R AU - Tamm AR AD - Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Ahoopai, Majid AU - Ahoopai M AD - Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Munzel, Thomas AU - Munzel T AD - Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Treede, Hendrik AU - Treede H AD - Department of Cardiothoracic and Vascular Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - von Bardeleben, Ralph Stephan AU - von Bardeleben RS AD - Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. Electronic address: stephan.von_bardeleben@unimedizin-mainz.de. LA - eng PT - Journal Article DEP - 20231122 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Aortic Valve Insufficiency/diagnostic imaging/etiology/surgery MH - Treatment Outcome MH - Aortic Valve/diagnostic imaging/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Heart Valve Prosthesis MH - *Aortic Valve Stenosis/surgery MH - Risk Factors OTO - NOTNLM OT - JenaValve OT - TAVR OT - aortic valve regurgitation OT - interdisciplinary heart team OT - transaxillary access COIS- Funding Support and Author Disclosures Dr Tamm is a proctor for JenaValve Technology. Dr Treede is a proctor and consultant for JenaValve Technology. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/11/24 12:41 MHDA- 2023/12/29 06:42 CRDT- 2023/11/24 10:35 PHST- 2023/08/13 00:00 [received] PHST- 2023/09/04 00:00 [revised] PHST- 2023/09/12 00:00 [accepted] PHST- 2023/12/29 06:42 [medline] PHST- 2023/11/24 12:41 [pubmed] PHST- 2023/11/24 10:35 [entrez] AID - S1936-8798(23)01310-9 [pii] AID - 10.1016/j.jcin.2023.09.016 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Dec 25;16(24):3039-3040. doi: 10.1016/j.jcin.2023.09.016. Epub 2023 Nov 22. PMID- 37998499 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231127 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 10 IP - 11 DP - 2023 Oct 25 TI - Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement. LID - 10.3390/jcdd10110441 [doi] LID - 441 AB - INTRODUCTION: Although transfemoral aortic valve replacement (TAVR) is a safe treatment for elderly patients with severe aortic valve stenosis, postoperative microembolism has been described. In this secondary endpoint analysis of the POST-TAVR trial, we aimed to investigate whether changes in neuron-specific enolase (NSE)-a biomarker of neuronal damage-are associated with changes in memory function or postoperative delirium (POD). MATERIALS AND METHODS: This was a prospective single-center study enrolling patients undergoing elective TAVR. Serum NSE was measured before and 24 h after TAVR. POD was diagnosed using CAM-ICU testing. Memory function was assessed before TAVR and before hospital discharge using the "Consortium to Establish a Registry for Alzheimer's Disease" (CERAD) word list and the digit span task (DST) implemented in "∆elta-App". RESULTS: Subjects' median age was 82 years (25th to 75th percentile: 77.5-85.0), 42.6% of subjects were women. CERAD scores significantly increased from pre- to post-TAVR, with p < 0.001. POD occurred in 4.4% (6/135) of subjects at median 2 days after TAVR. After TAVR, NSE increased from a median of 1.85 ng/mL (1.30-2.53) to 2.37 ng/mL (1.69-3.07), p < 0.001. The median increase in NSE was 40.4% (13.1-138.0) in patients with POD versus 17.3% (3.3-43.4) in those without POD (p = 0.17). CONCLUSIONS: Memory function improved after TAVR, likely due to learning effects, with no association to change in NSE. Patients with POD appear to have significantly higher postoperative levels of NSE compared to patients without POD after TAVR. This finding suggests that neuronal damage, as indicated by NSE elevation, may not significantly impair assessed memory function after TAVR. FAU - Nubel, Jonathan AU - Nubel J AUID- ORCID: 0000-0002-6051-8931 AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School Theodor Fontane, 16321 Bernau, Germany. AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, 16816 Cottbus, Germany. FAU - Buhre, Charlotte AU - Buhre C AUID- ORCID: 0000-0002-6582-9763 AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School Theodor Fontane, 16321 Bernau, Germany. AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, 16816 Cottbus, Germany. FAU - Hoffmeister, Meike AU - Hoffmeister M AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, 16816 Cottbus, Germany. AD - Institute of Biochemistry, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany. FAU - Oess, Stefanie AU - Oess S AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, 16816 Cottbus, Germany. AD - Institute of Biochemistry, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany. FAU - Labrenz, Oliver AU - Labrenz O AD - Department of Psychology, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany. FAU - Jost, Kerstin AU - Jost K AD - Department of Psychology, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany. FAU - Hauptmann, Michael AU - Hauptmann M AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, 16816 Cottbus, Germany. AD - Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany. FAU - Schon, Julika AU - Schon J AD - Anesthesia and Intensive Care, University Hospital Ruppin Brandenburg (UKRB), Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany. FAU - Fritz, Georg AU - Fritz G AD - Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Heart Centre Brandenburg, Brandenburg Medical School Theodor Fontane, 16321 Bernau, Germany. FAU - Butter, Christian AU - Butter C AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School Theodor Fontane, 16321 Bernau, Germany. FAU - Haase-Fielitz, Anja AU - Haase-Fielitz A AUID- ORCID: 0000-0001-6881-2249 AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School Theodor Fontane, 16321 Bernau, Germany. AD - Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, 39120 Magdeburg, Germany. LA - eng PT - Journal Article DEP - 20231025 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC10672434 OTO - NOTNLM OT - TAVR OT - cognitive assessment OT - memory function OT - neuron-specific enolase OT - postoperative delirium COIS- The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. EDAT- 2023/11/24 12:42 MHDA- 2023/11/24 12:43 PMCR- 2023/10/25 CRDT- 2023/11/24 09:36 PHST- 2023/09/21 00:00 [received] PHST- 2023/10/16 00:00 [revised] PHST- 2023/10/23 00:00 [accepted] PHST- 2023/11/24 12:43 [medline] PHST- 2023/11/24 12:42 [pubmed] PHST- 2023/11/24 09:36 [entrez] PHST- 2023/10/25 00:00 [pmc-release] AID - jcdd10110441 [pii] AID - jcdd-10-00441 [pii] AID - 10.3390/jcdd10110441 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2023 Oct 25;10(11):441. doi: 10.3390/jcdd10110441. PMID- 37995156 OWN - NLM STAT- MEDLINE DCOM- 20240702 LR - 20250429 IS - 1531-7013 (Electronic) IS - 1087-2418 (Linking) VI - 29 IP - 4 DP - 2024 Aug 1 TI - Cardiac evaluation of the liver transplant candidate. PG - 299-304 LID - 10.1097/MOT.0000000000001122 [doi] AB - PURPOSE OF REVIEW: This review aims to summarize recent changes in the cardiac evaluation of adult liver transplant candidates. Over the last several years, there have been significant advances in the use of coronary computed tomography angiography (CCTA) with and without fractional flow reserve (FFR) and increasingly widespread availability of coronary calcium scoring for risk stratification for obstructive coronary artery disease. This has led to novel strategies for risk stratification in cirrhotic patients being considered for liver transplant and an updated American Heart Association (AHA) position paper on the evaluation of liver and kidney transplant candidates. The diagnosis of cirrhotic cardiomyopathy has been refined. These new diagnostic criteria require that specific echocardiographic parameters are evaluated in all patients. The definition of pulmonary hypertension on echocardiography has been altered and no longer utilizes right atrium (RA) pressure estimates based on inferior vena cava (IVC) size and collapse. This provides more volume neutral estimates of pulmonary pressure. RECENT FINDINGS: Although CCTA has outstanding negative predictive value, false positive results are not uncommon and often lead to further testing. Revised diagnostic criteria for cirrhotic cardiomyopathy improve risk stratification for peri-operative volume overload and outcomes. Refined pulmonary hypertension criteria provide improved guidance for right heart catheterization (RHC) and referral to subspecialists. There are emerging data regarding the safety and efficacy of TAVR for severe aortic stenosis in cirrhotic patients. SUMMARY: Increased utilization of noninvasive testing, including CCTA and/or coronary calcium scoring, can improve the negative predictive value of testing for obstructive coronary artery disease and potentially reduce reliance on coronary angiography. Application of the 2020 criteria for cirrhotic cardiomyopathy will improve systolic and diastolic function assessment and subsequent perioperative risk stratification. The use of global strain scores is emphasized, as it provides important information beyond ejection fraction and diastolic parameters. A standardized one-parameter echo cut-off for elevated pulmonary pressures simplifies both evaluation and follow-up. Innovative transcutaneous techniques for valvular stenosis and regurgitation offer new options for patients at prohibitive surgical risk. CI - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved. FAU - Possick, Stephen AU - Possick S AD - Yale University School of Medicine, Cardiovascular Medicine. FAU - Khungar, Vandana AU - Khungar V AD - Yale University School of Medicine, Transplant Hepatology, Hepatology, Gastroenterology. FAU - Deshpande, Ranjit AU - Deshpande R AD - Department of Anesthesia, Yale University School of Medicine, New Haven, Connecticut, USA. LA - eng PT - Journal Article PT - Review DEP - 20231123 PL - United States TA - Curr Opin Organ Transplant JT - Current opinion in organ transplantation JID - 9717388 SB - IM MH - Humans MH - *Liver Transplantation/adverse effects MH - *Predictive Value of Tests MH - Risk Assessment MH - Patient Selection MH - Risk Factors MH - Liver Cirrhosis/surgery MH - Cardiomyopathies/etiology/physiopathology MH - Coronary Angiography MH - Treatment Outcome MH - Echocardiography EDAT- 2023/11/23 18:41 MHDA- 2024/07/02 14:42 CRDT- 2023/11/23 12:33 PHST- 2024/07/02 14:42 [medline] PHST- 2023/11/23 18:41 [pubmed] PHST- 2023/11/23 12:33 [entrez] AID - 00075200-202408000-00012 [pii] AID - 10.1097/MOT.0000000000001122 [doi] PST - ppublish SO - Curr Opin Organ Transplant. 2024 Aug 1;29(4):299-304. doi: 10.1097/MOT.0000000000001122. Epub 2023 Nov 23. PMID- 37994240 OWN - NLM STAT- MEDLINE DCOM- 20240104 LR - 20250626 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 103 IP - 1 DP - 2024 Jan TI - Computed tomography derived anatomical predictors of vascular access complications following transfemoral transcatheter aortic valve implantation: A systematic review. PG - 169-185 LID - 10.1002/ccd.30918 [doi] AB - BACKGROUND: Vascular complications after percutaneous transfemoral transcatheter aortic valve implantation (TAVI) are associated with adverse clinical outcomes and remain a significant challenge. AIMS: The purpose of this review is to synthesize the existing evidence regarding the iliofemoral artery features predictive of vascular complications after TAVI on pre-procedural contrast-enhanced multidetector computed tomography (MDCT). METHODS: A systematic search was performed in Embase and Medline (Pubmed) databases. Studies of patients undergoing transfemoral TAVI with MDCT were included. Studies with only valve-in-valve TAVI, planned surgical intervention and those using fluoroscopic assessment were excluded. Data on study cohort, procedural characteristics and significant predictors of vascular complications were extracted. RESULTS: We identified 23 original studies involving 8697 patients who underwent TAVI between 2006 and 2020. Of all patients, 8514 (97.9%) underwent percutaneous transfemoral-TAVI, of which 8068 (94.8%) had contrast-enhanced MDCT. The incidence of major vascular complications was 6.7 +/- 4.1% and minor vascular complications 26.1 +/- 7.8%. Significant independent predictors of major and minor complications related to vessel dimensions were common femoral artery depth (>54 mm), sheath-to-iliofemoral artery diameter ratio (>0.91-1.19), sheath-to-femoral artery diameter ratio (>1.03-1.45) and sheath-to-femoral artery area ratio (>1.35). Substantial iliofemoral vessel tortuosity predicted 2-5-fold higher vascular risk. Significant iliofemoral calcification predicted 2-5-fold higher risk. The iliac morphology score was the only hybrid scoring system with predictive value. CONCLUSIONS: Independent iliofemoral predictors of access-site complications in TAVI were related to vessel size, depth, calcification and tortuosity. These should be considered when planning transfemoral TAVI and in the design of future risk prediction models. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Androshchuk, Vitaliy AU - Androshchuk V AUID- ORCID: 0000-0002-1464-3109 AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. AD - Department of Cardiology, St Thomas' Hospital, King's College London, London, UK. FAU - Chehab, Omar AU - Chehab O AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. AD - Department of Cardiology, St Thomas' Hospital, King's College London, London, UK. FAU - Prendergast, Bernard AU - Prendergast B AD - Department of Cardiology, St Thomas' Hospital, King's College London, London, UK. FAU - Rajani, Ronak AU - Rajani R AD - Department of Cardiology, St Thomas' Hospital, King's College London, London, UK. AD - School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. FAU - Patterson, Tiffany AU - Patterson T AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. AD - Department of Cardiology, St Thomas' Hospital, King's College London, London, UK. FAU - Redwood, Simon AU - Redwood S AD - School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. AD - Department of Cardiology, St Thomas' Hospital, King's College London, London, UK. LA - eng GR - FS/14/11/30526/BHF_/British Heart Foundation/United Kingdom GR - FS/CRTF/22/24328/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Systematic Review DEP - 20231122 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Femoral Artery/diagnostic imaging/surgery MH - Tomography, X-Ray Computed/methods MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome MH - *Vascular Diseases/complications PMC - PMC10915898 OTO - NOTNLM OT - AVDP - aortic valve disease OT - ICT - imaging OT - VCOM - vascular complications OT - electron beam CT/multidetector CT OT - percutaneous intervention COIS- The authors declare no conflicts of interest. EDAT- 2023/11/23 06:42 MHDA- 2024/01/04 11:44 PMCR- 2024/03/06 CRDT- 2023/11/23 04:03 PHST- 2023/10/17 00:00 [revised] PHST- 2023/08/15 00:00 [received] PHST- 2023/11/12 00:00 [accepted] PHST- 2024/01/04 11:44 [medline] PHST- 2023/11/23 06:42 [pubmed] PHST- 2023/11/23 04:03 [entrez] PHST- 2024/03/06 00:00 [pmc-release] AID - CCD30918 [pii] AID - 10.1002/ccd.30918 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Jan;103(1):169-185. doi: 10.1002/ccd.30918. Epub 2023 Nov 22. PMID- 37989704 OWN - NLM STAT- MEDLINE DCOM- 20231219 LR - 20231219 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 32 IP - 12 DP - 2023 Dec TI - Recurrent Valve Frame Infolding in the 34mm Self-Expanding Medtronic Evolut Pro+ Transcatheter Valve System: A Single Centre Experience. PG - 1482-1488 LID - S1443-9506(23)04356-1 [pii] LID - 10.1016/j.hlc.2023.08.015 [doi] AB - BACKGROUND: Valve frame infolding (VFI) is a rare complication (1-3%) of transcatheter aortic valve implantation (TAVI), which primarily occurs in large sized self-expanding valves. We report the incidence of VFI in a small group of patients with highly calcified and extra-large aortic annuli, who underwent implantation of the newer generation 34mm Medtronic Evolut Pro+ (EP+) valve system. METHODS: A retrospective review was conducted on all patients presenting to a single centre experienced with TAVI in Sydney, NSW, Australia, between June and October 2022, for transfemoral TAVI using the Medtronic 34mm EP+ valve system. VFI was diagnosed using fluoroscopy, and pre-procedure computed tomography (CT) was analysed offline. RESULTS: VFI occurred in four of 10 patients who underwent TAVI using the 34mm EP+ system. Between VFI and non-VFI patients, the annular size, aortic angulation and total calcium volume was similar. Calcium distribution between the coronary cusps was symmetrical in non-VFI patients (37%, 33% and 30%), compared to 52% in the non-coronary cusp (NCC) in VFI patients. The mean ellipticity index was higher in VFI versus non-VFI patients (22% vs 14%). CONCLUSION: The 34mm Medtronic EP+ valve system is vital for safe and effective treatment of a niche subgroup of patients with extra-large annuli and extensive calcification, however operators should be aware of the increased incidence of VFI. Heavy eccentric calcification at the NCC, as well as using the cusp-overlap implant technique may exacerbate VFI, while multiplanar fluoroscopic screening may improve recognition. CI - Copyright (c) 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved. FAU - Rao, Karan AU - Rao K AD - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Cardiology, North Shore Private Hospital, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. FAU - Baer, Alexandra AU - Baer A AD - Department of Cardiology, North Shore Private Hospital, Sydney, NSW, Australia. FAU - Hansen, Peter AU - Hansen P AD - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Cardiology, North Shore Private Hospital, Sydney, NSW, Australia. FAU - Bhindi, Ravinay AU - Bhindi R AD - Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Cardiology, North Shore Private Hospital, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: ravinay.bhindi@sydney.edu.au. LA - eng PT - Journal Article DEP - 20231121 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - SY7Q814VUP (Calcium) SB - IM MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - Calcium MH - *Heart Valve Prosthesis MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome MH - Prosthesis Design OTO - NOTNLM OT - Aortic stenosis OT - TAVI EDAT- 2023/11/22 00:42 MHDA- 2023/12/19 06:42 CRDT- 2023/11/21 22:02 PHST- 2023/06/07 00:00 [received] PHST- 2023/08/15 00:00 [revised] PHST- 2023/08/21 00:00 [accepted] PHST- 2023/12/19 06:42 [medline] PHST- 2023/11/22 00:42 [pubmed] PHST- 2023/11/21 22:02 [entrez] AID - S1443-9506(23)04356-1 [pii] AID - 10.1016/j.hlc.2023.08.015 [doi] PST - ppublish SO - Heart Lung Circ. 2023 Dec;32(12):1482-1488. doi: 10.1016/j.hlc.2023.08.015. Epub 2023 Nov 21. PMID- 37982864 OWN - NLM STAT- MEDLINE DCOM- 20240125 LR - 20241023 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 113 IP - 1 DP - 2024 Jan TI - Comparing balloon-expandable and self-expanding transfemoral transcatheter aortic valve replacement based on subgroups in Germany 2019/2020. PG - 168-176 LID - 10.1007/s00392-023-02326-w [doi] AB - BACKGROUND: Previously, overall comparable outcomes were seen for balloon-expandable (BE) or self-expanding (SE) transfemoral transcatheter aortic valve replacement (TAVR). However, subgroup analyses based on large case numbers are still needed. METHODS: German national data of all BE and SE transfemoral TAVR treating aortic valve stenosis in 2019 and 2020 were analysed. We then compared different outcomes and performed a subgroup analysis for the endpoint in-hospital mortality. RESULTS: Overall, 46,243 TAVR were analysed, 19,910 BE, and 26,333 SE. Patients in the SE group had a significantly higher logistic EuroSCORE (13.61 vs 12.66%, p < 0.001), age (81.55 vs 79.99a, p < 0.001), and proportion of women (54.82 vs 40.06%, p < 0.001). Both groups showed a similar in-hospital mortality with 2.37% in BE and 2.35% in SE (p = 0.916). In-hospital mortality also did not differ significantly after risk adjustment (OR = 0.98 [0.86, 1.13], p = 0.799). Patients in the SE group had a significantly lower risk of major bleeding (OR = 0.83 [0.73, 0.95], p = 0.006), but a significantly higher risk of stroke (OR = 1.38 [1.19, 1.59], p < 0.001), delirium (OR = 1.15 [1.06, 1.24], p = 0.001), and permanent pacemaker implantation (OR = 1.29 [1.21, 1.37], p < 0.001). In the subgroup analysis of in-hospital mortality, there were no significant differences in any of the observed subgroups (age < 75/75-79/80-84/ >/= 85a, logistic EuroSCORE < 4/4- < 9/ >/= 9, gender, NYHA III/IV, previous CABG, peripheral vascular disease, COPD, pulmonary hypertension, renal disease GFR < 30 ml/min, and diabetes mellitus). CONCLUSION: In the direct comparison of balloon-expandable and self-expanding TAVR, there are no differences for in-hospital mortality in subgroups. CI - (c) 2023. The Author(s). FAU - Oettinger, Vera AU - Oettinger V AUID- ORCID: 0000-0003-4460-2102 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. vera.oettinger@uniklinik-freiburg.de. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. vera.oettinger@uniklinik-freiburg.de. FAU - Hilgendorf, Ingo AU - Hilgendorf I AUID- ORCID: 0000-0002-0024-1643 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Wolf, Dennis AU - Wolf D AUID- ORCID: 0000-0003-1525-4348 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Rilinger, Jonathan AU - Rilinger J AUID- ORCID: 0000-0001-9333-3629 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Maier, Alexander AU - Maier A AUID- ORCID: 0000-0003-0200-7495 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AUID- ORCID: 0000-0002-7542-1956 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AUID- ORCID: 0000-0003-0837-6945 AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AUID- ORCID: 0000-0003-2767-8009 AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. LA - eng PT - Journal Article DEP - 20231120 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Postoperative Complications/etiology MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery MH - Germany MH - Aortic Valve/surgery MH - *Heart Valve Prosthesis/adverse effects MH - Risk Factors MH - Prosthesis Design PMC - PMC10808194 OTO - NOTNLM OT - Aortic valve stenosis OT - In-hospital mortality OT - National electronic health records OT - Subgroup analysis OT - Transcatheter aortic valve implantation OT - Transcatheter aortic valve replacement COIS- The authors declare that they have no conflict of interest. EDAT- 2023/11/20 13:42 MHDA- 2024/01/25 06:44 PMCR- 2023/11/20 CRDT- 2023/11/20 11:05 PHST- 2023/07/17 00:00 [received] PHST- 2023/10/16 00:00 [accepted] PHST- 2024/01/25 06:44 [medline] PHST- 2023/11/20 13:42 [pubmed] PHST- 2023/11/20 11:05 [entrez] PHST- 2023/11/20 00:00 [pmc-release] AID - 10.1007/s00392-023-02326-w [pii] AID - 2326 [pii] AID - 10.1007/s00392-023-02326-w [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Jan;113(1):168-176. doi: 10.1007/s00392-023-02326-w. Epub 2023 Nov 20. PMID- 37982161 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20250104 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 20 IP - 1 DP - 2024 Jan 1 TI - One-year clinical outcomes of transcatheter aortic valve implantation with the latest iteration of self-expanding or balloonexpandable devices: insights from the OPERA-TAVI registry. PG - 95-103 LID - EIJ-D-23-00720 [pii] LID - 10.4244/EIJ-D-23-00720 [doi] AB - BACKGROUND: Midterm comparative analyses of the latest iterations of the most used Evolut and SAPIEN platforms for transcatheter aortic valve implantation (TAVI) are lacking. AIMS: We aimed to compare 1-year clinical outcomes of TAVI patients receiving Evolut PRO/PRO+ (PRO) or SAPIEN 3 Ultra (ULTRA) devices in current real-world practice. METHODS: Among patients enrolled in the OPERA-TAVI registry, patients with complete 1-year follow-up were considered for the purpose of this analysis. One-to-one propensity score matching was used to compare TAVI patients receiving PRO or ULTRA devices. The primary endpoint was a composite of 1-year all-cause death, disabling stroke and rehospitalisation for heart failure. Five prespecified subgroups of patients were considered according to leaflet and left ventricular outflow tract calcifications, annulus dimensions and angulation, and leaflet morphology. RESULTS: Among a total of 1,897 patients, 587 matched pairs of patients with similar clinical and anatomical characteristics were compared. The primary composite endpoint did not differ between patients receiving PRO or ULTRA devices (Kaplan-Meier [KM] estimates 14.0% vs 11.9%; log-rank p=0.27). Patients receiving PRO devices had higher rates of 1-year disabling stroke (KM estimates 2.6% vs 0.4%; log-rank p=0.001), predominantly occurring within 30 days after TAVI (1.4% vs 0.0%; p=0.004). Outcomes were consistent across all the prespecified subsets of anatomical scenarios (all p(interaction)>0.10). CONCLUSIONS: One-year clinical outcomes of patients undergoing transfemoral TAVI and receiving PRO or ULTRA devices in the current clinical practice were similar, but PRO patients had higher rates of disabling stroke. Outcomes did not differ across the different anatomical subsets of the aortic root. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiovascular Department, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Garot, Philippe AU - Garot P AD - Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Sammartino, Sofia AU - Sammartino S AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), Palermo, Italy. FAU - Branca, Luca AU - Branca L AD - Spedali Civili, Brescia, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Amat-Santos, Ignacio AU - Amat-Santos I AD - Division of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospital, University of Galway, Ireland. FAU - De Marco, Federico AU - De Marco F AD - Interventional Cardiology Department, IRCSS Centro Cardiologico Monzino, Milan, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Nombela Franco, Luis AU - Nombela Franco L AD - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. FAU - Akodad, Mariama AU - Akodad M AD - Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. FAU - Ribichini, Flavio Luciano AU - Ribichini FL AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Mazzapicchi, Alessandro AU - Mazzapicchi A AD - Cardiovascular Department, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Tomii, Daijiro AU - Tomii D AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Laforgia, Pietro AU - Laforgia P AD - Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Cannata, Stefano AU - Cannata S AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), Palermo, Italy. FAU - Fiorina, Claudia AU - Fiorina C AD - Spedali Civili, Brescia, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Fezzi, Simone AU - Fezzi S AD - Department of Cardiology, University Hospital, University of Galway, Ireland. FAU - Criscione, Enrico AU - Criscione E AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Poletti, Enrico AU - Poletti E AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Mazzucca, Mattia AU - Mazzucca M AD - Division of Cardiology, IRCSS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Mainardi, Andrea AU - Mainardi A AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Andreaggi, Stefano AU - Andreaggi S AD - Division of Cardiology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. FAU - Quagliana, Angelo AU - Quagliana A AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Montarello, Nicholas J AU - Montarello NJ AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Hennessey, Breda AU - Hennessey B AD - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. FAU - Mon-Noboa, Matias AU - Mon-Noboa M AD - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. FAU - Meier, David AU - Meier D AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. FAU - Adamo, Marianna AU - Adamo M AD - Spedali Civili, Brescia, Italy. FAU - Sgroi, Carmelo AU - Sgroi C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Reddavid, Claudia Maria AU - Reddavid CM AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Strazzieri, Orazio AU - Strazzieri O AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Crescenzia Motta, Silvia AU - Crescenzia Motta S AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Melfa, Chiara AU - Melfa C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Cali, Mariachiara AU - Cali M AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Laterra, Giulia AU - Laterra G AD - Ospedale Umberto I, ASP 4 di Enna, Enna, Italy. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Webb, John G AU - Webb JG AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. AD - Abbott Vascular, Santa Clara, CA, USA. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore", Enna, Italy. LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis/adverse effects MH - Treatment Outcome MH - Registries MH - *Stroke/etiology MH - Prosthesis Design PMC - PMC10758986 COIS- T. Pilgrim reports research, travel or educational grants to the institution, without personal remuneration, from Biotronik, Boston Scientific, Edwards Lifesciences, and ATsens; speaker fees and/or consultancy fees to the institution from Biotronik, Boston Scientific, Edwards Lifesciences, Abbott, Medtronic, Biosensors, and HighLife. M. Abdel-Wahab has reported that his institution received speaker honoraria and/or consultancy fees on his behalf from Boston Scientific and Medtronic. P. Garot has reported serving as medical director and being a shareholder of CERC, a CRO dedicated to cardiovascular diseases; and has received speaker/consultancy fees from Abbott, Biosensors, Boston Scientific, Edwards Lifesciences, and GE HealthCare. A. Latib has reported serving on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, and Abbott. D. Mylotte is a consultant for Medtronic, Boston Scientific, and MicroPort. O. De Backer has received institutional research grants and/or consulting fees from Abbott and Boston Scientific. M. Akodad has reported receiving research funding from Medtronic, Biotronik, MUSE-Explore, Villa M, and La Federation Francaise de Cardiologie. D. Meier is supported by the Swiss National Science Foundation (grant P2LAP3_199561). L. Sondergaard has received consultancy fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic, and SMT. C. Tamburino is a consultant for Medtronic. M. Barbanti has reported that he is a consultant for Boston Scientific, Edwards Lifesciences, and Medtronic. The other authors have no conflicts of interest to declare. The Guest Editor reports lecture fees paid to his institution from Amgen, Bayer Healthcare, Biotronik, Boehringer Ingelheim, Boston Scientific, Daiichi Sankyo, Edwards Lifesciences, Ferrer, Pfizer, and Novartis; consultancy fees paid to his institution from Boehringer Ingelheim; and grant support from Bayer Healthcare, Boston Scientific, Biotronik, Edwards Lifesciences, GlaxoSmithKline, Medtronic, and Pfizer. EDAT- 2023/11/20 06:54 MHDA- 2024/01/03 09:42 PMCR- 2025/01/01 CRDT- 2023/11/20 04:16 PHST- 2024/01/03 09:42 [medline] PHST- 2023/11/20 06:54 [pubmed] PHST- 2023/11/20 04:16 [entrez] PHST- 2025/01/01 00:00 [pmc-release] AID - EIJ-D-23-00720 [pii] AID - 10.4244/EIJ-D-23-00720 [doi] PST - ppublish SO - EuroIntervention. 2024 Jan 1;20(1):95-103. doi: 10.4244/EIJ-D-23-00720. PMID- 37982158 OWN - NLM STAT- MEDLINE DCOM- 20240321 LR - 20250319 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 20 IP - 6 DP - 2024 Mar 18 TI - A systematic algorithm for large-bore arterial access closure after TAVI: the TAVI-MultiCLOSE study. PG - e354-e362 LID - EIJ-D-23-00725 [pii] LID - 10.4244/EIJ-D-23-00725 [doi] AB - BACKGROUND: Despite transcatheter aortic valve implantation (TAVI) having become a routine procedure, access site bleeding and vascular complications are still a concern which contribute to procedure-related morbidity and mortality. AIMS: The TAVI-MultiCLOSE study aimed to assess the safety and efficacy of a new vascular closure algorithm for percutaneous large-bore arterial access closure following transfemoral (TF)-TAVI. METHODS: All consecutive TF-TAVI cases in which the MultiCLOSE vascular closure algorithm was used were prospectively included in a multicentre, observational study. This stepwise algorithm entails the reinsertion of a 6-8 Fr sheath (primary access) following the initial preclosure with one or two suture-based vascular closure devices (VCDs). This provides the operator with the opportunity to perform a quick and easy angiographic control and tailor the final vascular closure with either an additional suture- or plug-based VCD, or neither of these. RESULTS: Among 630 patients who underwent TF-TAVI utilising the MultiCLOSE algorithm, complete arterial haemostasis was achieved in 616 patients (98%). VCD failure occurred in 14 patients (2%), treated with either balloon inflation (N=1), covered stent (N=12) or surgical repair (N=1). Overall, this vascular closure approach resulted in a minor and major vascular complication rate of 2.2% and 0.6%, respectively. At 30 days, only one new minor vascular complication (0.2%) was noted. In-hospital and 30-day all-cause mortality rates were 0.2% and 1.0%, respectively. CONCLUSIONS: Use of the MultiCLOSE vascular closure algorithm was demonstrated to contribute to an easy, safe, efficacious and durable vascular closure after TF-TAVI, resulting in a major vascular complication rate of less than 1%. FAU - Rosseel, Liesbeth AU - Rosseel L AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. AD - Cardiology Department, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium. FAU - Montarello, Nicholas J AU - Montarello NJ AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Nuyens, Philippe AU - Nuyens P AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tirado-Conte, Gabriella AU - Tirado-Conte G AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Quagliana, Angelo AU - Quagliana A AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Cornelis, Kristoff AU - Cornelis K AD - Cardiology Department, Algemeen Ziekenhuis Maria Middelares, Ghent, Belgium. FAU - Flore, Vincent AU - Flore V AD - Cardiology Department, Algemeen Ziekenhuis Maria Middelares, Ghent, Belgium. FAU - Rosseel, Michael AU - Rosseel M AD - Cardiology Department, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium. FAU - Bieliauskas, Gintautas AU - Bieliauskas G AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Sondergaard, Lars AU - Sondergaard L AD - Consultant Cardiologist, Abbott, Santa Clara, CA, USA. FAU - De Backer, Ole AU - De Backer O AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20240318 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis MH - Femoral Artery/surgery MH - Hemorrhage/etiology/prevention & control MH - Hemostatic Techniques/adverse effects MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - *Vascular Closure Devices/adverse effects PMC - PMC10949328 COIS- G. Bieliauskas, L. Sondergaard, and O. De Backer received institutional research grants and consulting fees from Abbott. G. Tirado-Conte holds a research-training contract with 'Rio Hortega' (CM21/00091) from the Spanish Ministry of Science and Innovation (Instituto de Salud Carlos III). The other authors have no conflicts of interest to declare. EDAT- 2023/11/20 06:56 MHDA- 2024/03/21 12:46 PMCR- 2025/03/18 CRDT- 2023/11/20 04:15 PHST- 2024/03/21 12:46 [medline] PHST- 2023/11/20 06:56 [pubmed] PHST- 2023/11/20 04:15 [entrez] PHST- 2025/03/18 00:00 [pmc-release] AID - EIJ-D-23-00725 [pii] AID - 10.4244/EIJ-D-23-00725 [doi] PST - epublish SO - EuroIntervention. 2024 Mar 18;20(6):e354-e362. doi: 10.4244/EIJ-D-23-00725. PMID- 37959289 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231117 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 21 DP - 2023 Oct 29 TI - Pre-Procedural Assessment of the Femoral Access Route for Transcatheter Aortic Valve Implantation: Comparison of a Non-Contrast Time-of-Flight Magnetic Resonance Angiography Protocol with Contrast-Enhanced Dual-Source Computed Tomography Angiography. LID - 10.3390/jcm12216824 [doi] LID - 6824 AB - Background: We aimed to evaluate the feasibility of a non-contrast time-of-flight magnetic resonance angiography (TOF-MRA) protocol for the pre-procedural access route assessment of transcatheter aortic valve implantation (TAVI) in comparison with contrast-enhanced cardiac dual-source computed tomography angiography (CTA). Methods and Results: In total, 51 consecutive patients (mean age: 82.69 +/- 5.69 years) who had undergone a pre-TAVI cardiac CTA received TOF-MRA for a pre-procedural access route assessment. The MRA image quality was rated as very good (median of 5 [IQR 4-5] on a five-point Likert scale), with only four examinations rated as non-diagnostic. The TOF-MRA systematically underestimated the minimal effective vessel diameter in comparison with CTA (for the effective vessel diameter in mm, the right common iliac artery (CIA)/external iliac artery (EIA)/common femoral artery (CFA) MRA vs. CTA was 8.04 +/- 1.46 vs. 8.37 +/- 1.54 (p < 0.0001) and the left CIA/EIA/CFA MRA vs. CTA was 8.07 +/- 1.32 vs. 8.28 +/- 1.34 (p < 0.0001)). The absolute difference between the MRA and CTA was small (for the Bland-Altman analyses in mm, the right CIA/EIA/CFA was -0.36 +/- 0.77 and the left CIA/EIA/CFA was -0.25 +/- 0.61). The overall correlation between the MRA and CTA measurements was very good (with a Pearson correlation coefficient of 0.87 (p < 0.0001) for the right CIA/EIA/CFA and a Pearson correlation coefficient of 0.9 (p < 0.0001) for the left CIA/EIA/CFA). The feasibility agreement between the MRA and CTA for transfemoral access was good (the right CIA/EIA/CFA agreement was 97.9% and the left CIA/EIA/CFA agreement was 95.7%, Kohen's kappa: 0.477 (p = 0.001)). Conclusions: The TOF-MRA protocol was feasible for the assessment of the access route in an all-comer pre-TAVI population. This protocol might be a reliable technique for patients at an increased risk of contrast-induced nephropathy. FAU - Brado, Johannes AU - Brado J AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Breitbart, Philipp AU - Breitbart P AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Hein, Manuel AU - Hein M AUID- ORCID: 0000-0003-0430-7184 AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Pache, Gregor AU - Pache G AD - Radiology Hegau Bodensee, Practice for Diagnostic Radiology, Kreuzensteinstrasse 7, 78224 Singen, Germany. FAU - Schmitt, Ramona AU - Schmitt R AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Hein, Jonas AU - Hein J AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Apweiler, Matthias AU - Apweiler M AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Soschynski, Martin AU - Soschynski M AD - Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany. FAU - Schlett, Christopher AU - Schlett C AD - Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany. FAU - Bamberg, Fabian AU - Bamberg F AD - Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany. FAU - Neumann, Franz-Josef AU - Neumann FJ AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. FAU - Krauss, Tobias AU - Krauss T AD - Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany. FAU - Ruile, Philipp AU - Ruile P AD - Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Sudring 15, 79189 Bad Krozingen, Germany. LA - eng PT - Journal Article DEP - 20231029 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10647847 OTO - NOTNLM OT - CT angiography OT - MR angiography OT - renal insufficiency OT - transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2023/11/14 06:43 MHDA- 2023/11/14 06:44 PMCR- 2023/10/29 CRDT- 2023/11/14 02:13 PHST- 2023/09/14 00:00 [received] PHST- 2023/10/10 00:00 [revised] PHST- 2023/10/13 00:00 [accepted] PHST- 2023/11/14 06:44 [medline] PHST- 2023/11/14 06:43 [pubmed] PHST- 2023/11/14 02:13 [entrez] PHST- 2023/10/29 00:00 [pmc-release] AID - jcm12216824 [pii] AID - jcm-12-06824 [pii] AID - 10.3390/jcm12216824 [doi] PST - epublish SO - J Clin Med. 2023 Oct 29;12(21):6824. doi: 10.3390/jcm12216824. PMID- 37942071 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231110 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Cardiac decompensation of patients before transcatheter aortic valve implantation-clinical presentation, responsiveness to associated medication, and prognosis. PG - 1232054 LID - 10.3389/fcvm.2023.1232054 [doi] LID - 1232054 AB - AIMS: Cardiac decompensation (CD) in patients with aortic stenosis is a "red flag" for future adverse events. We classified patients undergoing transcatheter aortic valve implantation (TAVI) into those with acute, prior, or no prior CD at the timepoint of TAVI and compared their clinical presentation, prognosis, and effects of the prescribed medication during follow-up. METHODS: Retrospective analysis of patients of one center fulfilling the criteria of 30-day device success after transfemoral TAVI. RESULTS: From those patients with no CD (n = 1,985) ranging to those with prior CD (n = 497) and to those with acute CD (n = 87), we observed a stepwise increase in the proportion of patients in poor clinical condition, NYHA class III/IV, low psoas muscle area, fluid overload (rales, oedema, pleural effusion), reduced ejection fraction, renal insufficiency, and anemia. More diuretics but less renin-angiotensin system inhibitors (ACEI/ARB) were prescribed for patients with acute CD compared to other groups. Prior CD (hazard ratio and 95% CI 1.40; 1.02-1.91) and acute CD (1.72; 1.01-2.91), a reduced general condition (1.53; 1.06-2.20), fluid overload (1.54;1.14-2.08), atrial fibrillation (1.76; 1.32-2.33), and anemia (1.43;1.08-1.89) emerged as strong independent predictors of one-year mortality. In all three classes of CD, prescribing of ACEI/ARB was associated with a substantial improvement of survival. CONCLUSIONS: The clinical presentation of (acute or prior) cardiac decompensation in patients with AS overlapped substantially with that of patients with classical signs of heart failure. Our results may support an early treatment strategy in patients with left ventricular dysfuntion before clinical signs of congestion are manifest. Moreover, these patients require intensive medical attention after TAVI. CI - (c) 2023 Fischer-Rasokat, Renker, Charitos, Strunk, Treiber, Rolf, Weferling, Choi, Hamm and Kim. FAU - Fischer-Rasokat, Ulrich AU - Fischer-Rasokat U AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Renker, Matthias AU - Renker M AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Charitos, Efstratios I AU - Charitos EI AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Strunk, Christopher AU - Strunk C AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Treiber, Julia AU - Treiber J AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Rolf, Andreas AU - Rolf A AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Weferling, Maren AU - Weferling M AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Choi, Yeong-Hoon AU - Choi YH AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany. AD - Medical Clinic I (Cardiology and Angiology), University Hospital of Giessen, Giessen, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany. AD - German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Bad Nauheim, Germany. AD - Medical Clinic I (Cardiology and Angiology), University Hospital of Giessen, Giessen, Germany. LA - eng PT - Journal Article DEP - 20231023 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10627789 OTO - NOTNLM OT - angiotensin receptor blockers OT - angiotensin-converting enzyme inhibitors OT - aortic stenosis OT - cardiac decompensation OT - heart failure OT - prognosis OT - transcatheter aortic valve implantation (TAVI) COIS- UF-R: none. EC: proctor fees from Boston Scientific. MR: speaker fees from St. Jude Medical/Abbott. CS: none. JT: none. AR: none. MW: speaker fees from Boston Scientific. Y-HC: proctor/speaker/scientific advisor fees from Getinge, Jotec/CryoLife, Cytosorbents. CH: advisory board Medtronic. W-KK: proctor/speaker fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Meril Life Sciences, Shockwave Medical. EDAT- 2023/11/09 06:42 MHDA- 2023/11/09 06:43 PMCR- 2023/01/01 CRDT- 2023/11/09 04:20 PHST- 2023/05/31 00:00 [received] PHST- 2023/10/10 00:00 [accepted] PHST- 2023/11/09 06:43 [medline] PHST- 2023/11/09 06:42 [pubmed] PHST- 2023/11/09 04:20 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1232054 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Oct 23;10:1232054. doi: 10.3389/fcvm.2023.1232054. eCollection 2023. PMID- 37940389 OWN - NLM STAT- MEDLINE DCOM- 20231204 LR - 20231204 IS - 1875-2128 (Electronic) IS - 1875-2128 (Linking) VI - 116 IP - 12 DP - 2023 Dec TI - Transfemoral versus trans-subclavian access in transcatheter aortic valve implantation using self-expandable valve: A propensity-matched comparison. PG - 555-562 LID - S1875-2136(23)00196-1 [pii] LID - 10.1016/j.acvd.2023.09.006 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation is unfeasible for 10-15% of patients using the conventional transfemoral approach. Other alternative approaches, such as the subclavian approach, have emerged, with no clear recommendation indicating the superiority of one technique over another. AIM: To compare the 1-month mortality and postprocedural outcomes of patients undergoing transcatheter aortic valve implantation using a self-expandable valve via transfemoral and subclavian access. METHODS: This was a retrospective single-centre study including 1496 patients who underwent transcatheter aortic valve implantation between January 2016 and December 2020 at Clermont-Ferrand University Hospital, France. Propensity score matching was used to compare transfemoral and subclavian access. RESULTS: After building two propensity score-matched groups of 221 patients each with either access route (total n=442), baseline characteristics were similar. The procedure duration was significantly longer in the subclavian access group (53 [45-64] versus 60 [51-72] minutes; P<0.001), but with a lower amount of contrast agent (138 [118-165] versus 123 [105-150] mL; P<0.001), fluoroscopy time (11.2 [9-14] versus 9.9 [7-12] minutes; P<0.001) and radiation dose (397 [264-620] versus 321 [217-485] mGy; P<0.001). No significant difference was observed concerning 1-month mortality (odds ratio 1.62, 95% confidence interval 0.52-5.03; P=0.39) or periprocedural complications. Follow-up at 1 year confirmed no difference in longer-term mortality (hazard ratio 0.78, 95% confidence interval 0.52-5.03; P=0.43). CONCLUSIONS: The subclavian approach provides similar results to the transfemoral approach in terms of mortality, efficacy and safety; it is a reasonable and effective alternative when the reference transfemoral approach is impossible or seems complex. CI - Copyright (c) 2023 Elsevier Masson SAS. All rights reserved. FAU - Bennes, Olivier AU - Bennes O AD - Cardiology Department, CHU Clermont-Ferrand, Clermont-Auvergne University, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France. Electronic address: obennes@chu-clermontferrand.fr. FAU - Souteyrand, Geraud AU - Souteyrand G AD - Cardiology Department, CHU Clermont-Ferrand, Clermont-Auvergne University, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France. FAU - Cambier, Sebastien AU - Cambier S AD - Delegation to Clinical Research and Innovation, Biostatistics Unit, CHU Clermont-Ferrand, Clermont-Auvergne University, 63000 Clermont-Ferrand, France. FAU - Motreff, Pascal AU - Motreff P AD - Cardiology Department, CHU Clermont-Ferrand, Clermont-Auvergne University, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France. FAU - Riocreux, Clement AU - Riocreux C AD - Cardiology Department, CHU Clermont-Ferrand, Clermont-Auvergne University, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France. FAU - Eljezi, Vedat AU - Eljezi V AD - Department of Perioperative Medicine, CHU Clermont-Ferrand, CNRS, Clermont-Auvergne University, 63000 Clermont-Ferrand, France. FAU - Lahaye, Clement AU - Lahaye C AD - Department of Geriatrics, CHU Clermont-Ferrand, CNRS, Clermont-Auvergne University, 63000 Clermont-Ferrand, France. FAU - Eschalier, Romain AU - Eschalier R AD - Cardiology Department, CHU Clermont-Ferrand, Clermont-Auvergne University, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France. FAU - Innorta, Andrea AU - Innorta A AD - Department of Cardiovascular Surgery, CHU Clermont-Ferrand, CNRS, Clermont-Auvergne University, 63000 Clermont-Ferrand, France. FAU - Combaret, Nicolas AU - Combaret N AD - Cardiology Department, CHU Clermont-Ferrand, Clermont-Auvergne University, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France. LA - eng PT - Journal Article DEP - 20231020 PL - Netherlands TA - Arch Cardiovasc Dis JT - Archives of cardiovascular diseases JID - 101465655 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Retrospective Studies MH - *Heart Valve Prosthesis MH - Proportional Hazards Models MH - Treatment Outcome MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - Propensity score OT - Subclavian OT - TAVI EDAT- 2023/11/09 00:42 MHDA- 2023/12/04 12:41 CRDT- 2023/11/08 21:52 PHST- 2023/06/16 00:00 [received] PHST- 2023/09/22 00:00 [revised] PHST- 2023/09/25 00:00 [accepted] PHST- 2023/12/04 12:41 [medline] PHST- 2023/11/09 00:42 [pubmed] PHST- 2023/11/08 21:52 [entrez] AID - S1875-2136(23)00196-1 [pii] AID - 10.1016/j.acvd.2023.09.006 [doi] PST - ppublish SO - Arch Cardiovasc Dis. 2023 Dec;116(12):555-562. doi: 10.1016/j.acvd.2023.09.006. Epub 2023 Oct 20. PMID- 37933787 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20231216 IS - 1559-0879 (Electronic) IS - 1556-9845 (Print) IS - 1556-9845 (Linking) VI - 18 IP - 6 DP - 2023 Nov-Dec TI - Minimally Invasive Surgical Versus Transcatheter Aortic Valve Replacement: A Retrospective Observational Single-Center Study in Japan. PG - 547-556 LID - 10.1177/15569845231205587 [doi] AB - OBJECTIVE: This study aimed to compare the outcomes of minimally invasive aortic valve replacement (MICS-AVR) versus transfemoral transcatheter aortic valve replacement (TF-TAVR) in Asian patients. METHODS: We conducted a retrospective, observational, single-center study in Japan, including cases of MICS-AVR (n = 202) and TF-TAVR (n = 248) between 2014 and 2021. In a total of 450 cases, propensity score matching was performed at a ratio of 1:1, resulting in 96 pairs. Furthermore, we performed competing-risk regression and mediation analyses to determine the treatment effect on outcomes of interests, considering death as a competing risk, and to evaluate the mediation effect of paravalvular leak (PVL) severity. RESULTS: There were similar incidences of all-cause death, cardiac death, stroke and cerebral hemorrhage, and aortic valve reintervention between the 2 groups. However, the TF-TAVR cohort had a longer hospital length of stay and higher rates of significant PVL compared with the MICS-AVR cohort. Multivariable-adjusted Cox regression analyses revealed that heart failure hospitalization (hazard ratio [HR] = 0.129, 95% confidence interval [CI]: 0.038 to 0.445, p = 0.001) and permanent pacemaker implantation (HR = 0.050, 95% CI: 0.006 to 0.409, p = 0.005) favored MICS-AVR. Competing-risk regression analyses confirmed similar findings. All outcomes were unrelated to PVL severity. CONCLUSIONS: To our knowledge, this is the first comparative study of clinical outcomes in Asian patients undergoing MICS-AVR versus TF-TAVR, revealing that MICS-AVR could be a feasible and efficient alternative to TF-TAVR. Future larger-scale randomized controlled trials are needed to validate the present results. FAU - Yamamoto, Hiroyuki AU - Yamamoto H AUID- ORCID: 0000-0003-4742-7653 AD - Department of Cardiovascular Medicine, Narita-Tomisato Tokushukai Hospital, Japan. FAU - Nakayama, Taisuke AU - Nakayama T AD - Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, Matsudo, Japan. FAU - Ishii, Naoki AU - Ishii N AD - Department of Gastroenterology, Tokyo Shinagawa Hospital, Japan. FAU - Nakamura, Yoshitsugu AU - Nakamura Y AD - Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, Matsudo, Japan. LA - eng PT - Journal Article PT - Observational Study DEP - 20231107 PL - United States TA - Innovations (Phila) JT - Innovations (Philadelphia, Pa.) JID - 101257528 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Heart Valve Prosthesis Implantation/methods MH - Retrospective Studies MH - Japan/epidemiology MH - *Aortic Valve Stenosis/surgery/etiology MH - Treatment Outcome MH - Risk Factors MH - Aortic Valve/surgery PMC - PMC10714700 OTO - NOTNLM OT - Japan OT - heart failure hospitalization OT - minimally invasive aortic valve replacement OT - permanent pacemaker implantation OT - transfemoral transcatheter aortic valve replacement COIS- Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2023/11/07 12:43 MHDA- 2023/12/17 09:46 PMCR- 2023/12/12 CRDT- 2023/11/07 07:23 PHST- 2023/12/17 09:46 [medline] PHST- 2023/11/07 12:43 [pubmed] PHST- 2023/11/07 07:23 [entrez] PHST- 2023/12/12 00:00 [pmc-release] AID - 10.1177_15569845231205587 [pii] AID - 10.1177/15569845231205587 [doi] PST - ppublish SO - Innovations (Phila). 2023 Nov-Dec;18(6):547-556. doi: 10.1177/15569845231205587. Epub 2023 Nov 7. PMID- 37932574 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231109 IS - 2363-9024 (Electronic) IS - 2363-9024 (Linking) VI - 9 IP - 1 DP - 2023 Nov 7 TI - Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report. PG - 76 LID - 10.1186/s40981-023-00669-x [doi] LID - 76 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgery. However, there is a risk of surgical manipulation causing detachment of a lesion of the aortic valve, which can result in various embolisms. CASE PRESENTATION: An 87-year-old woman with symptomatic severe aortic valve stenosis was scheduled for transfemoral TAVI under monitored anesthesia. Preoperative examination revealed severe calcification of the aortic valve, but there was no calcification in the ascending aorta. After a delivery catheter system passed the aortic valve, left radial arterial pressure dropped significantly, and complete atrioventricular block (CAVB) occurred. Catecholamine administration and ventricular pacing improved hemodynamics, and a self-expandable valve was implanted. CAVB resolved after surgery, but her state of consciousness was poor, and her left hand became ischemic. Imaging studies revealed multiple embolic infarcts in her bilateral cerebrum and cerebellum. CONCLUSIONS: It should be noted that there is a risk of detachment of a calcified lesion of the aortic valve during TAVI, which can cause embolisms not only in the brain but also in the extremities and coronary arteries. CI - (c) 2023. The Author(s). FAU - Mitsuta, Yuki AU - Mitsuta Y AD - Department of Anesthesiology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan. FAU - Nakamura, Shingo AU - Nakamura S AD - Department of Anesthesiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan. FAU - Uemura, Yumiko AU - Uemura Y AD - Department of Anesthesiology, Minamata City General Hospital & Medical Center, Minamata, Japan. FAU - Tashima, Koichiro AU - Tashima K AD - Department of Anesthesiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan. FAU - Oyoshi, Takafumi AU - Oyoshi T AD - Department of Anesthesiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan. FAU - Hirata, Naoyuki AU - Hirata N AUID- ORCID: 0000-0002-3776-8115 AD - Department of Anesthesiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan. naohirata@mac.com. LA - eng PT - Journal Article DEP - 20231107 PL - Germany TA - JA Clin Rep JT - JA clinical reports JID - 101682121 PMC - PMC10628090 OTO - NOTNLM OT - Embolism OT - Stroke OT - Transcatheter aortic valve implantation COIS- The authors declare that they have no competing interests. EDAT- 2023/11/07 00:42 MHDA- 2023/11/07 00:43 PMCR- 2023/11/07 CRDT- 2023/11/06 23:47 PHST- 2023/08/04 00:00 [received] PHST- 2023/10/29 00:00 [accepted] PHST- 2023/10/25 00:00 [revised] PHST- 2023/11/07 00:43 [medline] PHST- 2023/11/07 00:42 [pubmed] PHST- 2023/11/06 23:47 [entrez] PHST- 2023/11/07 00:00 [pmc-release] AID - 10.1186/s40981-023-00669-x [pii] AID - 669 [pii] AID - 10.1186/s40981-023-00669-x [doi] PST - epublish SO - JA Clin Rep. 2023 Nov 7;9(1):76. doi: 10.1186/s40981-023-00669-x. PMID- 37932391 OWN - NLM STAT- MEDLINE DCOM- 20231108 LR - 20231109 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 13 IP - 1 DP - 2023 Nov 6 TI - Results of streamlining TAVR procedure towards a minimalist approach: a single center experience in Taiwan. PG - 19134 LID - 10.1038/s41598-023-46475-4 [doi] LID - 19134 AB - Trans-femoral transcatheter aortic valve replacement (TF-TAVR) performed under conscious sedation (LACS) is not yet become routine practice in Taiwan. We aimed to compared the results between patients received general anesthesia (GA) versus LACS. Our cohort was divided into 3 groups: initial 48 patients received TF-TAVR under routine GA (GA group), subsequent 50 patients under routine LACS (LACS group 1), and recent 125 patients under LACS (LACS group 2). The baseline, procedural characteristics and all outcomes were prospectively collected and retrospectively compared. From Sep 2010 to July 2019, a total of 223 patients were included. The procedure time (157.6 +/- 39.4 min vs 131.6 +/- 30.3 vs 95.2 +/- 40.0, < 0.0001), contrast medium consumption (245.6 +/- 92.6 ml vs 207.8 +/- 77.9 vs 175.1 +/- 64.6, < 0.0001), length of intensive care unit (2 [1-5] days vs 2 [1-3] vs 1 [1-1], P = 0.0001) and hospital stay (9 [7-13] days vs 8 [6-11] vs 6 [5-9], P = 0.0001) decreased significantly with LACS, combined with a trend of less hospital acquired pneumonia (12.5% vs 6.0% vs 5.6%, P = 0.427). 1-year survival rate were also different among 3 groups (83.3% vs 90.0% vs 93.6%, P = 0.053). In our single center experience, a "minimalist" approach of TF-TAVR procedure resulted in less medical resources usage, along with more favorable clinical outcomes. CI - (c) 2023. The Author(s). FAU - Ko, Tsung-Yu AU - Ko TY AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. AD - Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. FAU - Kao, Hsien-Li AU - Kao HL AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chen, Yi-Chang AU - Chen YC AD - Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan. FAU - Yeh, Chih-Fan AU - Yeh CF AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. FAU - Huang, Ching-Chang AU - Huang CC AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chen, Ying-Hsien AU - Chen YH AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chan, Chih-Yang AU - Chan CY AD - Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. FAU - Lin, Lung-Chun AU - Lin LC AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. FAU - Wang, Ming-Jiuh AU - Wang MJ AD - Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan. FAU - Chen, Yih-Sharng AU - Chen YS AD - Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. FAU - Lin, Mao-Shin AU - Lin MS AD - Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. linmaoshin@gmail.com. LA - eng PT - Journal Article DEP - 20231106 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - Taiwan MH - Treatment Outcome MH - Risk Factors MH - Time Factors MH - Length of Stay PMC - PMC10628271 COIS- The authors declare no competing interests. EDAT- 2023/11/07 00:42 MHDA- 2023/11/08 06:45 PMCR- 2023/11/06 CRDT- 2023/11/06 23:33 PHST- 2021/08/09 00:00 [received] PHST- 2023/11/01 00:00 [accepted] PHST- 2023/11/08 06:45 [medline] PHST- 2023/11/07 00:42 [pubmed] PHST- 2023/11/06 23:33 [entrez] PHST- 2023/11/06 00:00 [pmc-release] AID - 10.1038/s41598-023-46475-4 [pii] AID - 46475 [pii] AID - 10.1038/s41598-023-46475-4 [doi] PST - epublish SO - Sci Rep. 2023 Nov 6;13(1):19134. doi: 10.1038/s41598-023-46475-4. PMID- 37923021 OWN - NLM STAT- MEDLINE DCOM- 20240226 LR - 20250617 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 79 IP - 3 DP - 2024 Mar TI - Clinical outcomes of MANTA closure device in percutaneous endovascular aortic aneurysm repair. PG - 569-576 LID - S0741-5214(23)02186-9 [pii] LID - 10.1016/j.jvs.2023.10.054 [doi] AB - OBJECTIVE: The MANTA device is a plug-based vascular closure device (VCD) designed for large bore femoral arterial access site closure. It showed promising results in transcatheter aortic valve replacement cases. In this study, we report our results and evaluate the MANTA VCD in percutaneous endovascular aortic aneurysm repair (pEVAR). METHODS: All data of consecutive patients who underwent an elective pEVAR between October 2018 and December 2022 were retrospectively reviewed. In all patients at least one common femoral artery was intended to close with the MANTA VCD. Depending on the sheath size, the 14Fr or 18Fr MANTA VCD was used. On the preoperative computed tomography scan, the diameter of the common femoral artery (CFA) was measured and the amount of calcification based on the Peripheral Arterial Calcium Scoring System (PACSS) was scored. Primary outcome was procedural technical success. Procedural technical success was defined as placement of the MANTA closure device resulting in vascular closure with patent CFA, without requiring immediate open or endovascular surgery. The secondary outcomes were access site complications requiring reintervention and all-cause mortality at 30-day follow-up. RESULTS: In total, 152 consecutive patients underwent pEVAR with 291 common femoral artery closure procedures with the Manta VCD. Mean age was 74.1 +/- 6.4 years, with a mean body mass index of 27.7 +/- 4.4 kg/m(2). The mean diameter of the CFA was 10.5 +/- 1.9 mm. In 52.6% of the cases, there were no calcification on the preoperative computed tomography scan. The 18Fr and 14Fr Manta VCD were used 169 and 122 times, respectively. The technical success rate was 96.6%. Major vascular complications were reported in 4.5% of the cases, without any death-related events. CONCLUSIONS: This single-center retrospective cohort study analyzed the procedural technical success, major vascular complications and all-cause mortality at 30-day follow-up of the MANTA vascular closure device in 152 pEVAR patients with 291 common femoral artery closure procedures. The technical success rate was 96,6%. Major vascular complications were reported in 4.5% of the cases, without any death related events. We concluded that the MANTA device is a safe and feasible option with a high rate of technical success in patients undergoing pEVAR. CI - Copyright (c) 2023 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Peeters, Maxim AU - Peeters M AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. Electronic address: peetersmaxim@hotmail.com. FAU - Oosterveld, Rens AU - Oosterveld R AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands; Faculty of Medicine, Maastricht University, Maastricht, The Netherlands. FAU - Decraemer, Gilles AU - Decraemer G AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. FAU - Wong, ChunYu AU - Wong C AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. FAU - Salemans, Pieter AU - Salemans P AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. FAU - Nouwens, Ruben AU - Nouwens R AD - Procurement Department, Zuyderland Medical Centre, Heerlen, The Netherlands. FAU - Bouwman, Lee AU - Bouwman L AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands; Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands. FAU - Yazar, Ozan AU - Yazar O AD - Department of Surgery, Division of Vascular Surgery, Zuyderland Medical Centre, Heerlen, The Netherlands. LA - eng PT - Journal Article DEP - 20231102 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - *Endovascular Procedures/adverse effects MH - Hemostatic Techniques MH - Retrospective Studies MH - Treatment Outcome MH - *Vascular Closure Devices MH - *Aortic Aneurysm/diagnostic imaging/surgery MH - Femoral Artery/diagnostic imaging/surgery OTO - NOTNLM OT - Access complications OT - Endovascular aneurysm repair OT - MANTA OT - Vascular closure device COIS- Disclosures O.Y. and L.B are consultants for Artivion. EDAT- 2023/11/06 03:54 MHDA- 2024/02/26 06:45 CRDT- 2023/11/03 20:15 PHST- 2023/06/26 00:00 [received] PHST- 2023/10/15 00:00 [revised] PHST- 2023/10/18 00:00 [accepted] PHST- 2024/02/26 06:45 [medline] PHST- 2023/11/06 03:54 [pubmed] PHST- 2023/11/03 20:15 [entrez] AID - S0741-5214(23)02186-9 [pii] AID - 10.1016/j.jvs.2023.10.054 [doi] PST - ppublish SO - J Vasc Surg. 2024 Mar;79(3):569-576. doi: 10.1016/j.jvs.2023.10.054. Epub 2023 Nov 2. PMID- 37892835 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240927 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 20 DP - 2023 Oct 23 TI - Vascular Complications Following Transcatheter Aortic Valve Implantation, Using MANTA (Collagen Plug-Based) versus PROSTAR (Suture-Based), from a French Single-Center Retrospective Registry. LID - 10.3390/jcm12206697 [doi] LID - 6697 AB - TAVI requires a large-bore arteriotomy. Closure is usually performed by the suture system. Some studies report a vascular complication rate of up to 21%. MANTA is a recently developed percutaneous closure system dedicated to large caliber vessels based on an anchoring system. Early studies report a lower rate of vascular complications with MANTA devices. This single-center retrospective study included all patients who underwent femoral TAVI at the Brest University Hospital from 20 November 2019 to 31 March 2021. The primary endpoint is the rate of vascular complications (major and minor) pre and post-TAVI procedure. In total, 264 patients were included. There were no significant differences in vascular complications (major and minor) between the two groups (13.6% in the MANTA group versus 21.2% in the PROSTAR group; p = 0.105), although there was a tendency to have fewer minor vascular complications in the Manta group (12.1% versus 20.5%; p = 0.067). Manta was associated with a lower rate of bleeding complications (3.8% versus 15.2%; p = 0.002), predominantly minor complications with fewer closure failures (4.5% versus 13.6%; p = 0.01), less use of covered stents (4.5% versus 12.9%; p = 0.016), and with no difference in the need for vascular surgery compared to the Prostar group (1.5% versus 2.3%; p = 0.652). On the other hand, Manta was associated with a higher rate of femoral stenosis (4.5% versus 0%; p = 0.013) without clinical significance (1.5% versus 0%; p = 0.156). The Manta and Prostar devices are equivalent in terms of vascular complications. The Manta, compared to the Prostar, is associated with fewer bleeding complications. FAU - Benic, Clement AU - Benic C AD - Department of Cardiology, University Hospital of Brest, 29200 Brest, France. FAU - Nicol, Pierre Philippe AU - Nicol PP AD - Department of Cardiology, University Hospital of Brest, 29200 Brest, France. FAU - Hannachi, Sinda AU - Hannachi S AD - Department of Cardiology, University Hospital of Brest, 29200 Brest, France. FAU - Gilard, Martine AU - Gilard M AUID- ORCID: 0000-0002-2794-7953 AD - Department of Cardiology, University Hospital of Brest, 29200 Brest, France. FAU - Didier, Romain AU - Didier R AD - Department of Cardiology, University Hospital of Brest, 29200 Brest, France. FAU - Nasr, Bahaa AU - Nasr B AUID- ORCID: 0000-0002-6672-9764 AD - Department of Vascular Surgery, University Hospital of Brest, 29200 Brest, France. LA - eng PT - Journal Article DEP - 20231023 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10607530 OTO - NOTNLM OT - MANTA OT - PROSTAR OT - TAVI OT - femoral access OT - vascular complications COIS- The authors declare no conflict of interest. EDAT- 2023/10/28 11:45 MHDA- 2023/10/28 11:46 PMCR- 2023/10/23 CRDT- 2023/10/28 01:06 PHST- 2023/08/30 00:00 [received] PHST- 2023/09/22 00:00 [revised] PHST- 2023/10/20 00:00 [accepted] PHST- 2023/10/28 11:46 [medline] PHST- 2023/10/28 11:45 [pubmed] PHST- 2023/10/28 01:06 [entrez] PHST- 2023/10/23 00:00 [pmc-release] AID - jcm12206697 [pii] AID - jcm-12-06697 [pii] AID - 10.3390/jcm12206697 [doi] PST - epublish SO - J Clin Med. 2023 Oct 23;12(20):6697. doi: 10.3390/jcm12206697. PMID- 37890001 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20240321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 7 DP - 2023 Dec TI - Routine postaccess-closure angiography to detect vascular complications following transfemoral TAVR. PG - 1311-1316 LID - 10.1002/ccd.30894 [doi] AB - BACKGROUND: Vascular complications following transfemoral TAVR are associated with increased morbidity and mortality. Measures that may mitigate this risk are important. AIM: To evaluate the utility of routine, access-vessel angiography post sheath-removal in the detection and management of complications in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: This was a retrospective study of 512 consecutive patients who underwent transfemoral TAVR with routine post access-closure angiography from the radial artery. Rates of mild angiographically evident bleeding, bleeding requiring surgery/interventional-radiology, ischemia, 90-day access-site-related events, and major and minor vascular complications using Valve Academic Research Consortium 3 definitions were recorded. RESULTS: Of 512 patients, digital subtraction angiography (DSA) was undertaken via the radial artery in 467 patients (91%). In the remaining patients (9%) DSA was either not attempted, due to concerns regarding kidney disease and contrast volume, or failed due to anatomical factors (aortic tortuosity/calcification). Significant chronic kidney disease was present at baseline in 72.4% of this cohort (stages III-IV or dialysis). Ninety-four percent of cases underwent TAVR using a balloon-expandable platform. Mild iliofemoral extravasation was observed in 7.7% of the DSA cases. These cases were managed by manual compression with none requiring any vascular intervention subsequently. Valve Academic Research Consortium 3 major and minor access-site-related complications were observed in 0.4% and 12.2%, respectively. Access-site-related bleeding and ischemic events requiring interventional-radiology or vascular-surgery were observed in 0.9% and 1.7% of the DSA cases, respectively. No new renal replacement therapy was needed in any of the DSA cases. Discharge to 90-day access-related complications was 0.8%. CONCLUSIONS: Routine post access-closure angiography is feasible via the radial artery in patients undergoing transfemoral TAVR and appears safe. It facilitates early identification of complications and mitigates risk by enabling prompt action to be taken. Larger studies are needed to confirm these findings. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Savvoulidis, Panagiotis AU - Savvoulidis P AUID- ORCID: 0000-0002-2266-8357 AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Nadir, Adnan M AU - Nadir AM AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK. FAU - Mechery, Anthony AU - Mechery A AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Lawton, Ewa AU - Lawton E AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Khan, Kumail AU - Khan K AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Maqableh, Ghaith M AU - Maqableh GM AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. AD - Cardiology Department, Faculty of Medicine, Al Balqa Applied University, Amman, Jordan. FAU - Raja, Waseem AU - Raja W AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Wong, Chun Wai AU - Wong CW AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Radhakrishnan, Ashwin AU - Radhakrishnan A AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. FAU - Doshi, Sagar N AU - Doshi SN AD - Department of Cardiology, Queen Elizabeth University Hospital, Birmingham, UK. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK. LA - eng PT - Journal Article DEP - 20231027 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Risk Factors MH - Femoral Artery MH - Treatment Outcome MH - Hemorrhage/etiology MH - Angiography, Digital Subtraction/adverse effects MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - TAVR OT - VARC-3 OT - access-site-related complications OT - vascular complications EDAT- 2023/10/27 18:42 MHDA- 2023/12/17 09:46 CRDT- 2023/10/27 14:22 PHST- 2023/07/03 00:00 [revised] PHST- 2023/03/06 00:00 [received] PHST- 2023/10/14 00:00 [accepted] PHST- 2023/12/17 09:46 [medline] PHST- 2023/10/27 18:42 [pubmed] PHST- 2023/10/27 14:22 [entrez] AID - 10.1002/ccd.30894 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Dec;102(7):1311-1316. doi: 10.1002/ccd.30894. Epub 2023 Oct 27. PMID- 37885936 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241102 IS - 0970-9134 (Print) IS - 0973-7723 (Electronic) IS - 0970-9134 (Linking) VI - 39 IP - 6 DP - 2023 Nov TI - Simultaneous hybrid off-pump coronary artery bypass grafting and transcatheter aortic valve implantation in elderly patients. PG - 570-576 LID - 10.1007/s12055-023-01577-6 [doi] AB - PURPOSE: Optimal strategy for transcatheter aortic valve implantation (TAVI) in patients with coronary artery disease (CAD) is unresolved. We evaluated the surgical outcomes of hybrid coronary artery bypass grafting (CABG) and TAVI in elderly patients. METHODS: We retrospectively evaluated patients who underwent simultaneous TAVI and CABG at Wakayama Medical University, Japan. All patients underwent off-pump CABG (OPCAB) including minimally invasive cardiac surgery (MICS-CABG). In an earlier period, OPCAB + transfemoral TAVI (TF-TAVI) was the only method used, while in a later period, we introduced MICS-CABG and alternative approaches for TAVI. RESULTS: Twenty-seven patients were enrolled, the average age was 83.6 +/- 5.1 years. In the MICS-CABG and TAVI group, average patient age was higher (87.0 +/- 3.1 years) than in the earlier group. Thirty-day and in-hospital mortalities were zero. Incomplete revascularization rate was 33.3% and one patient required percutaneous coronary intervention after the operation. Graft patency rate was 100%. In MICS-CABG group, the number of distal anastomoses was smaller (1.29, range 1-2), but the number of days required to re-starting walking and postoperative hospital stay were shorter, and the rate of discharge to home was higher (100%) than in the other groups. CONCLUSIONS: Although 33.3% of patients did not achieve complete revascularization, there was no 30-day or in-hospital mortality. TAVI and hybrid OPCAB, including MICS-CABG, were suggested to be feasible treatment in elderly patients. CI - (c) Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. FAU - Honda, Kentaro AU - Honda K AUID- ORCID: 0000-0002-7151-6480 AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Wada, Teruaki AU - Wada T AD - Department of Cardiovascular Medicine, Wakayama Medical University Hospital, Wakayama City, Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Kunimoto, Hideki AU - Kunimoto H AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Fujimoto, Takahiro AU - Fujimoto T AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Matsuda, Maiko AU - Matsuda M AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Ikuchi, Mizuho AU - Ikuchi M AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Furuta, Yoshiki AU - Furuta Y AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Agematsu, Kota AU - Agematsu K AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Shiono, Yasutsugu AU - Shiono Y AD - Department of Cardiovascular Medicine, Wakayama Medical University Hospital, Wakayama City, Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Kitabata, Hironori AU - Kitabata H AD - Department of Cardiovascular Medicine, Wakayama Medical University Hospital, Wakayama City, Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Tanaka, Atsushi AU - Tanaka A AD - Department of Cardiovascular Medicine, Wakayama Medical University Hospital, Wakayama City, Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 FAU - Nishimura, Yoshiharu AU - Nishimura Y AD - Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University Hospital, 811-1, Kimiidera, Wakayama City, 641-8509 Japan. ROR: https://ror.org/005qv5373. GRID: grid.412857.d. ISNI: 0000 0004 1763 1087 LA - eng PT - Journal Article DEP - 20230829 PL - India TA - Indian J Thorac Cardiovasc Surg JT - Indian journal of thoracic and cardiovascular surgery JID - 8700105 PMC - PMC10597934 OTO - NOTNLM OT - MICS-CABG OT - TAVI and CAD OT - TAVI and hybrid OPCAB COIS- Conflict of interestNone. EDAT- 2023/10/27 06:43 MHDA- 2023/10/27 06:44 PMCR- 2024/11/01 CRDT- 2023/10/27 04:27 PHST- 2022/12/05 00:00 [received] PHST- 2023/07/11 00:00 [revised] PHST- 2023/07/11 00:00 [accepted] PHST- 2023/10/27 06:44 [medline] PHST- 2023/10/27 06:43 [pubmed] PHST- 2023/10/27 04:27 [entrez] PHST- 2024/11/01 00:00 [pmc-release] AID - 1577 [pii] AID - 10.1007/s12055-023-01577-6 [doi] PST - ppublish SO - Indian J Thorac Cardiovasc Surg. 2023 Nov;39(6):570-576. doi: 10.1007/s12055-023-01577-6. Epub 2023 Aug 29. PMID- 37877190 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20240321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 7 DP - 2023 Dec TI - Implantation depth of balloon-expandable transcatheter heart valves and risks for permanent pacemaker implantation and midterm adverse events. PG - 1301-1310 LID - 10.1002/ccd.30870 [doi] AB - BACKGROUND: Permanent pacemaker implantation (PPI) remains a relevant complication after transcatheter aortic valve implantation (TAVI) and its impact on outcome remains controversial. AIMS: This study aimed to analyze the effects of implantation depth on PPI at 30 days and assess its impact on outcome with the balloon-expandable Sapien 3 (S3) prosthesis. METHODS: Between 2014 and 2018, 849 patients without previous pacemaker undergoing transfemoral TAVI with the S3 were included. Prosthesis implantation depth was measured and divided into Quintiles. An ordinal logistic regression was used to assess its association with PPI, while a multivariate logistic regression was performed to identify predictors of PPI. Survival analyses were performed with the Kaplan-Meier method and a multivariable Cox regression was performed to ascertain the impact of PPI on mortality. RESULTS: Overall, incidence of PPI at 30 days was 9.7%. Implantation depth decreased consistently from a median of 6.7 mm [5.55-8.00] in 2014 to 2.7 mm [2.30-3.50] in 2018 (p < 0.001). When considering Quintiles of implantation depth, incidence of PPI was significantly higher in upper Quintiles and risk for PPI was significantly lower for the 1. Quintile compared to the 5. Quintile (OR: 0.34, 95% CI: [0.16-0.73]; p = 0.003). In the adjusted multivariable logistic regression implantation depth persisted ad independent predictor of PPI at 30 days. Patients requiring PPI at 30 days displayed significantly higher mortality at 4 years compared to patients without PPI (49.5% vs. 40.0%; log-rank = 0.022). In a multivariate analysis, increased logistic EuroScore, diabetes mellitus, and history of atrial fibrillation, were independent predictors of all-cause mortality at 2 years. CONCLUSIONS: Higher prosthesis implantation relative to the virtual aortic annulus was significantly associated with reduced risk for PPI at 30 days. Patients with PPI at 30 days exhibited higher mortality during follow-up, however, only logistic EuroScore, diabetes mellitus, and history of atrial fibrillation were identified as independent predictors of mortality at 2 years. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Pellegrini, Costanza AU - Pellegrini C AUID- ORCID: 0000-0001-5143-8203 AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Freissmuth, Markus AU - Freissmuth M AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Rheude, Tobias AU - Rheude T AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Graas, David AU - Graas D AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Mayr, N Patrick AU - Mayr NP AUID- ORCID: 0000-0002-3549-3007 AD - Institut fur Anasthesiologie, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Syryca, Finn AU - Syryca F AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Alvarez-Covarrubias, Hector A AU - Alvarez-Covarrubias HA AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. AD - Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico. FAU - Fetcu, Andrei AU - Fetcu A AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Hubner, Judith AU - Hubner J AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Lennerz, Carsten AU - Lennerz C AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Schunkert, Heribert AU - Schunkert H AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. AD - Deutsches Zentrum fur Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AUID- ORCID: 0000-0003-4341-891X AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. AD - Deutsches Zentrum fur Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AUID- ORCID: 0000-0002-0728-2819 AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. FAU - Joner, Michael AU - Joner M AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technical University Munich, Munich, Germany. AD - Deutsches Zentrum fur Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. LA - eng PT - Journal Article DEP - 20231025 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Atrial Fibrillation/diagnosis/therapy/etiology MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis/adverse effects MH - *Transcatheter Aortic Valve Replacement MH - *Pacemaker, Artificial MH - Aortic Valve/diagnostic imaging/surgery MH - Risk Factors MH - *Diabetes Mellitus OTO - NOTNLM OT - TAVI OT - implantation depth OT - mortality OT - pacemaker implantation EDAT- 2023/10/25 06:42 MHDA- 2023/12/17 09:42 CRDT- 2023/10/25 04:16 PHST- 2023/09/05 00:00 [revised] PHST- 2023/06/09 00:00 [received] PHST- 2023/10/05 00:00 [accepted] PHST- 2023/12/17 09:42 [medline] PHST- 2023/10/25 06:42 [pubmed] PHST- 2023/10/25 04:16 [entrez] AID - 10.1002/ccd.30870 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Dec;102(7):1301-1310. doi: 10.1002/ccd.30870. Epub 2023 Oct 25. PMID- 37870123 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20240321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 7 DP - 2023 Dec TI - Single center experience with the balloon-expandable Myval transcatheter aortic valve system with the first 100 patients: 30-day and 1-year follow-up. PG - 1317-1330 LID - 10.1002/ccd.30868 [doi] AB - AIMS: To report our single-center data, regarding the first 100 patients who underwent TAVR procedure with the new balloon-expandable MYVAL system. We report 30-day and 1-year outcomes in low to high-risk TAVR patient population. METHODS: From November 2019 to July 2021, 100 consecutive patients underwent TAVR procedure. Patient outcome was classified according to the VARC-2 definitions. The device performance was assessed using transthoracic echocardiography. Data collection was allowed by the Local Ethical Committee. RESULTS: The mean age was 74.7 years, 63 (63%) were male. The mean Euroscore II and STS score were 4.8 +/- 4.9 and 5.6 +/- 3.9, respectively. Transfemoral access was the most frequent (surgical vs. percutaneous 2% vs. 97%) and in one patient surgical subclavian access was used. VARC-2 outcomes were as follows: device success 99%, STROKE 1%, major and minor vascular complication was 1% and 11%, respectively, the rate of new permanent pacemaker implantation was 30.7%. At discharge, the incidence of grade I, grade II aortic regurgitation was 39% and 1%, respectively, without relevant PVL. In-hospital mortality was only 1%. These results included a high proportion (17%) of patients with bicuspid aortic valves. At 1 year, the all-cause mortality rate was 7% (only two due to cardiac event) and only a single patient had valve-related dysfunction requiring surgical aortic replacement. CONCLUSIONS: TAVR procedure with MYVAL transcatheter heart valve system shows excellent 30-day and 1-year outcomes regarding patient survival, technical success, and valve-related adverse events. The limitations of our study comprise a single-center study with retrospective data collection. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Magyari, Balazs AU - Magyari B AUID- ORCID: 0000-0002-8851-9637 AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. FAU - Kittka, Balint AU - Kittka B AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. FAU - Gojak, Ilona AU - Gojak I AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. FAU - Kasza, Gabor AU - Kasza G AD - Department of Vascular Surgery, Medical School, University of Pecs, Pecs, Hungary. FAU - Schonfeld, Kristof AU - Schonfeld K AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. FAU - Szapary, Laszlo Botond AU - Szapary LB AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. FAU - Simon, Mihaly AU - Simon M AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. FAU - Kiss, Rudolf AU - Kiss R AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. FAU - Bertalan, Andrea AU - Bertalan A AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. FAU - Varady, Edit AU - Varady E AD - Department of Medical Imaging, Medical School, University of Pecs, Pecs, Hungary. FAU - Gyimesi, Andras AU - Gyimesi A AD - EconNet Research Group, Faculty of Business and Economics, University of Pecs, Pecs, Hungary. FAU - Szokodi, Istvan AU - Szokodi I AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. FAU - Horvath, Ivan AU - Horvath I AD - Heart Institute, Medical School, University of Pecs, Pecs, Hungary. AD - Szentagothai Research Centre, University of Pecs, Pecs, Hungary. LA - eng GR - NKFIH K120536/National Research, Development, and Innovation Office of Hungary/ PT - Journal Article DEP - 20231023 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - Aged MH - Female MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Transcatheter Aortic Valve Replacement MH - Follow-Up Studies MH - Retrospective Studies MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Prosthesis Design OTO - NOTNLM OT - TAVR OT - annular rupture OT - balloon expendable transcatheter heart valve OT - bicuspid aortic valve OT - paravalvular leak OT - permanent pacemaker implantation EDAT- 2023/10/23 12:43 MHDA- 2023/12/17 09:42 CRDT- 2023/10/23 07:03 PHST- 2023/09/07 00:00 [revised] PHST- 2023/03/29 00:00 [received] PHST- 2023/10/03 00:00 [accepted] PHST- 2023/12/17 09:42 [medline] PHST- 2023/10/23 12:43 [pubmed] PHST- 2023/10/23 07:03 [entrez] AID - 10.1002/ccd.30868 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Dec;102(7):1317-1330. doi: 10.1002/ccd.30868. Epub 2023 Oct 23. PMID- 37868895 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231031 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 15 IP - 9 DP - 2023 Sep 28 TI - Comparison of self- and balloon-expandable valves in patients with dilatated ascending aorta undergoing transcatheter aortic valve replacement. PG - 4826-4835 LID - 10.21037/jtd-23-364 [doi] AB - BACKGROUND: Limited studies have focused on the performance of self-expandable valves (SEVs) and balloon-expandable valves (BEVs) in patients with dilatated ascending aorta (AA) undergoing transcatheter aortic valve replacement (TAVR). The present study compared the performance of widely used Edwards BEVs and domestic SEVs in patients with dilatated AA among Chinese population. METHODS: We identified and reviewed 207 patients who had baseline AA diameter >/=40 mm and underwent transfemoral TAVR. Patients were divided into two groups: SEV and BEV. The SEVs were locally manufactured valves that have received Chinese regulatory approval (Venus-A, Taurus One, and VitaFlow), while the BEVs were Edwards Sapien XT and Sapien3. Procedural device success and post-procedural changes of AA diameters were compared. RESULTS: The sample size of SEV group was larger than that of BEV group because BEVs were not available in China in the early clinical practice. The overall device success was slightly lower in SEV group compared with BEV group (84.2% vs. 95.8%, P=0.213). However, in the univariable and multivariable logistic regression analyses, only bicuspid aortic valve (BAV) was found to be an independent risk factor for device failure (OR: 2.632, CI: 1.107-6.257, P=0.029). During the median follow-up of 21 months, no statistical difference was found between the two groups regarding the overall survival (83.1%+/-4.7% vs. 95.8%+/-4.1%, P=0.533), and no aortic dissection nor rupture was observed. In a subgroup of patients who had follow-up CTs >/=12-month intervals, the AA diameter appeared to remain stable in SEV group with an aortic expansion rate of 0 (-0.4 to 0.8) mm (P=0.102), while it slightly enlarged in BEV group with an aortic expansion rate of 0.4 (-0.4 to 0.6) mm/y (P=0.038). In addition, the AA diameter also slightly enlarged in patients with BAV [0.2 (0 to 1.0) mm/y, P=0.015], while it remained stable in patients with tricuspid aortic valve (TAV) [0 (-0.8 to 0.6) mm/y, P=0.640]. CONCLUSIONS: In patients with dilatated AA who underwent TAVR, the type of THVs did not affect the procedural device success. BAV appeared to be a risk factor for both device failure and higher aortic expansion rate in these patients. CI - 2023 Journal of Thoracic Disease. All rights reserved. FAU - An, Kang AU - An K AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, China & Fuwai Hospital, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Zhang, Fengwen AU - Zhang F AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, China & Fuwai Hospital, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Ouyang, Wenbin AU - Ouyang W AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, China & Fuwai Hospital, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. FAU - Pan, Xiangbin AU - Pan X AD - Department of Structural Heart Disease, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, China & Fuwai Hospital, Beijing, China. AD - National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China. AD - Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China. AD - National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China. LA - eng PT - Journal Article DEP - 20230830 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC10586953 OTO - NOTNLM OT - Transcatheter aortic valve replacement (TAVR) OT - aortic expansion rate OT - ascending aorta (AA) OT - device success COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-364/coif). The authors have no conflicts of interest to declare. EDAT- 2023/10/23 06:48 MHDA- 2023/10/23 06:49 PMCR- 2023/09/28 CRDT- 2023/10/23 04:44 PHST- 2023/03/09 00:00 [received] PHST- 2023/08/04 00:00 [accepted] PHST- 2023/10/23 06:49 [medline] PHST- 2023/10/23 06:48 [pubmed] PHST- 2023/10/23 04:44 [entrez] PHST- 2023/09/28 00:00 [pmc-release] AID - jtd-15-09-4826 [pii] AID - 10.21037/jtd-23-364 [doi] PST - ppublish SO - J Thorac Dis. 2023 Sep 28;15(9):4826-4835. doi: 10.21037/jtd-23-364. Epub 2023 Aug 30. PMID- 37858593 OWN - NLM STAT- MEDLINE DCOM- 20231113 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 209 DP - 2023 Dec 15 TI - Procedural Volume and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement: From a Japanese Nationwide Registry. PG - 36-41 LID - S0002-9149(23)01087-1 [pii] LID - 10.1016/j.amjcard.2023.09.094 [doi] AB - The impact of procedural volume on transcatheter aortic valve replacement (TAVR) outcomes in Japan remains uncertain. Japan has carefully introduced TAVR after the establishment of techniques in Western countries and therefore may not exhibit volume-outcome relations after TAVR. Data on transfemoral TAVR was collected from the Japan Transcatheter Valve Therapy (J-TVT) registry between 2018 and 2020. Hospitals were categorized into quartiles (lowest, lower, high, and highest) based on annual TAVR volume. The primary analysis compared 30-day mortality among different TAVR volume hospitals. A multivariable adjustment analysis was performed to calculate the adjusted odds ratio (aOR) and 95% confidence intervals (CIs) of 30-day all-cause mortality with highest-volume hospital as the reference. A total of 2,741 transfemoral TAVR cases from 172 hospitals were included in the analysis. Median hospital TAVR volume was 38 (interquartile range 27 to 60) per year. Unadjusted 30-day mortality was 0.46%, 0.69%, 1.17%, and 1.18% from the lowest to the highest quartile of hospitals, respectively. There was no significant difference in 30-day mortality rates for lowest-volume hospitals (aOR 0.51, 95% CI 0.24 to 1.05, p = 0.07), low-volume hospitals (aOR 0.76, 95% CI 0.46 to 1.26, p = 0.29), or high-volume hospitals (aOR 1.11, 95% CI 0.74 to 1.67, p = 0.60). An analysis from the contemporary national registry in Japan did not find an obvious inverse relation between annual hospital volume and 30-day mortality. Our results suggest that TAVR has now reached a level of procedural maturity, with standardized outcomes observed across hospitals regardless of their annual procedural volume. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Ando, Tomo AU - Ando T AD - Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan. Electronic address: andotomo@hotmail.co.jp. FAU - Kumamaru, Hiraku AU - Kumamaru H AD - Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. FAU - Kohsaka, Shun AU - Kohsaka S AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Fukutomi, Motoki AU - Fukutomi M AD - Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan. FAU - Onishi, Takayuki AU - Onishi T AD - Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan. FAU - Shimamura, Kazuo AU - Shimamura K AD - Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Tobaru, Tetsuya AU - Tobaru T AD - Center of Cardiovascular Disease, Saiwai Hospital, Kawasaki, Japan. LA - eng PT - Journal Article DEP - 20231016 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2024 Jan 1;210:290-292. doi: 10.1016/j.amjcard.2023.10.034. PMID: 37866449 MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - East Asian People MH - Registries MH - Hospitals, High-Volume MH - Treatment Outcome MH - Aortic Valve/surgery MH - Risk Factors OTO - NOTNLM OT - registry OT - transcatheter aortic valve replacement OT - volume COIS- Declaration of Competing Interest Dr. Kumamaru reports receiving consultation fee from EPS Corporation, and speaker fee from Chugai Pharmaceutical Co., Ltd. Dr. Kumamaru is affiliated with the Department of Health Quality Assessment at the University of Tokyo, a social collaboration department supported by the National Clinical Database, Johnson & Johnson K.K., Nipro corporation, and Intuitive Surgical Sarl. Dr. Kohsaka has received an unrestricted research grant from Daiichi Sankyo Co., Ltd., and Novartis Pharmaceutical Co., Ltd. Dr. Hayashida is a proctor for Edwards Lifesciences and Medtronic. The remaining authors have no competing interests to declare. EDAT- 2023/10/20 06:42 MHDA- 2023/11/13 06:42 CRDT- 2023/10/20 00:29 PHST- 2023/08/04 00:00 [received] PHST- 2023/09/16 00:00 [revised] PHST- 2023/09/25 00:00 [accepted] PHST- 2023/11/13 06:42 [medline] PHST- 2023/10/20 06:42 [pubmed] PHST- 2023/10/20 00:29 [entrez] AID - S0002-9149(23)01087-1 [pii] AID - 10.1016/j.amjcard.2023.09.094 [doi] PST - ppublish SO - Am J Cardiol. 2023 Dec 15;209:36-41. doi: 10.1016/j.amjcard.2023.09.094. Epub 2023 Oct 16. PMID- 37854958 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231020 IS - 1734-9338 (Print) IS - 1897-4295 (Electronic) IS - 1734-9338 (Linking) VI - 19 IP - 3 DP - 2023 Sep TI - A comparison of neurological event and mortality rates between transcatheter aortic valve implantation and surgical aortic valve replacement. PG - 202-208 LID - 10.5114/aic.2023.131472 [doi] AB - INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for patients with symptomatic severe aortic stenosis. AIM: To evaluate the neurological event and mortality rates of TAVI in comparison with those of surgical aortic valve replacement (SAVR). MATERIAL AND METHODS: A systematic literature search identified pertinent full-text journal articles published from 2000 to 2022 that were taken as the study materials. RESULTS: Patients were at the age of 79.3 +/-2.8 years and 79.9 +/-2.9 years at the time of intervention/open surgery in the TAVI and SAVR groups, respectively. Patients' age and preoperative comorbidity rates were similar in both groups. A self-expanding valve prosthesis and a percutaneous transfemoral route were the most commonly used in patients receiving TAVI. The duration of the procedure and the hospital stay were much shorter, and the number of transfused blood units was much lower in the TAVI group than in the SAVR group. No significant intergroup difference was found in the prevalence of postoperative stroke, 1-month all-cause mortality, and 1-month and 1-year cardiovascular mortality rates. However, 1-year all-cause mortality was much lower in the TAVI than the SAVR group. The subgroups of risk stratification showed better outcomes for non-high-risk patients compared with high-risk patients. CONCLUSIONS: Irrespective of other postoperative complications of TAVI, this study emphasizes the postoperative major neurological events and mortality. TAVI appears to be superior to SAVR with regard to 1-year all-cause mortality. TAVI is thus recommended for elderly patients with symptomatic severe aortic stenosis at very high surgical risk contraindicated for SAVR. CI - Copyright: (c) 2023 Termedia Sp. z o. o. FAU - Yuan, Shi-Min AU - Yuan SM AD - The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, China. FAU - Yuan, Ai-Hong AU - Yuan AH AD - Department of Anesthesiology, the First Clinical College, China Medical University, Shenyang, China. LA - eng PT - Journal Article PT - Review DEP - 20230927 PL - Poland TA - Postepy Kardiol Interwencyjnej JT - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology JID - 101272671 PMC - PMC10580854 OTO - NOTNLM OT - aortic valve stenosis OT - mortality OT - stroke OT - transcatheter aortic valve replacement COIS- The authors declare no conflict of interest. EDAT- 2023/10/19 06:43 MHDA- 2023/10/19 06:44 PMCR- 2023/09/01 CRDT- 2023/10/19 04:28 PHST- 2023/04/24 00:00 [received] PHST- 2023/06/11 00:00 [accepted] PHST- 2023/10/19 06:44 [medline] PHST- 2023/10/19 06:43 [pubmed] PHST- 2023/10/19 04:28 [entrez] PHST- 2023/09/01 00:00 [pmc-release] AID - 51474 [pii] AID - 10.5114/aic.2023.131472 [doi] PST - ppublish SO - Postepy Kardiol Interwencyjnej. 2023 Sep;19(3):202-208. doi: 10.5114/aic.2023.131472. Epub 2023 Sep 27. PMID- 37854822 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231020 IS - 2666-2507 (Electronic) IS - 2666-2507 (Linking) VI - 21 DP - 2023 Oct TI - Concomitant carotid-carotid-axillary bypass with zone 0 branched endograft and transcatheter aortic valve-in-valve replacement via retroperitoneal access. PG - 26-31 LID - 10.1016/j.xjtc.2023.07.025 [doi] FAU - Bedeir, Kareem AU - Bedeir K AD - Cardiothoracic and Vascular Surgery Associates, Infirmary Health System, Mobile, Ala. FAU - McRee, Chad AU - McRee C AD - Cardiology Associates, Mobile, Ala. FAU - Johnson, William E AU - Johnson WE AD - Cardiothoracic and Vascular Surgery Associates, Infirmary Health System, Mobile, Ala. LA - eng PT - Journal Article DEP - 20230811 PL - United States TA - JTCVS Tech JT - JTCVS techniques JID - 101768546 PMC - PMC10580169 EDAT- 2023/10/19 06:44 MHDA- 2023/10/19 06:45 PMCR- 2023/08/11 CRDT- 2023/10/19 04:25 PHST- 2023/07/12 00:00 [received] PHST- 2023/07/21 00:00 [revised] PHST- 2023/07/25 00:00 [accepted] PHST- 2023/10/19 06:45 [medline] PHST- 2023/10/19 06:44 [pubmed] PHST- 2023/10/19 04:25 [entrez] PHST- 2023/08/11 00:00 [pmc-release] AID - S2666-2507(23)00273-0 [pii] AID - 10.1016/j.xjtc.2023.07.025 [doi] PST - epublish SO - JTCVS Tech. 2023 Aug 11;21:26-31. doi: 10.1016/j.xjtc.2023.07.025. eCollection 2023 Oct. PMID- 37854813 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231020 IS - 2666-2507 (Electronic) IS - 2666-2507 (Linking) VI - 21 DP - 2023 Oct TI - Transcarotid versus transaxillary access for transcatheter aortic valve replacement with a self-expanding valve: A propensity-matched analysis. PG - 45-55 LID - 10.1016/j.xjtc.2023.07.019 [doi] AB - Transaxillary access has been the most frequently used nonfemoral access route for transcatheter aortic valve replacement (TAVR) with a self-expanding valve. Use of transcarotid TAVR is increasing; however, comparative data on these methods are limited. We compared outcomes following transcarotid or transaxillary TAVR with a self-expanding, supra-annular valve. METHODS: The Transcatheter Valve Therapy Registry was queried for TAVR procedures using transaxillary and transcarotid access between July 2015 and June 2021. Patients received a self-expanding Evolut R, PRO, or PRO + valve (Medtronic) and had 1-year follow-up. Thirty-day and 1-year outcomes were compared in transcarotid and transaxillary groups after 1:2 propensity score-matching. Multivariable regression models were fitted to identify predictors of key end points. RESULTS: The propensity score-matched cohort included 576 patients receiving transcarotid and 1142 receiving transaxillary access. Median procedure time (99 vs 118 minutes; P < .001) and hospital stay (2 vs 3 days; P < .001) were shorter with transcarotid versus transaxillary access. At 30 days, patients with transcarotid access had similar mortality (Kaplan-Meier estimates 3.7% vs 4.3%, P = .57) but significantly lower stroke (3.1% vs 5.9%; P = .017) and mortality or stroke (6.0% vs 8.9%; P = .033) compared with patients receiving transaxillary access. Similar differences were observed at 1 year. Transaxillary access was associated with increased risk of 30-day stroke (hazard ratio, 2.14; 95% confidence interval, 1.27-3.58) by multivariable regression analysis. CONCLUSIONS: Transcarotid versus transaxillary access for TAVR using a self-expanding valve is associated with procedural benefits and significantly lower stroke and mortality or stroke at 30 days. In patients with unsuitable femoral anatomy, transcarotid access may be the preferred delivery route for self-expanding valves. CI - (c) 2023 The Author(s). FAU - Allen, Keith B AU - Allen KB AD - Department of Cardiovascular/Thoracic Surgery, St Luke's Mid America Heart Institute, Kansas City, Mo. FAU - Watson, Daniel AU - Watson D AD - Department of Cardiovascular/Thoracic Surgery, Riverside Methodist Hospital, Columbus, Ohio. FAU - Vora, Amit N AU - Vora AN AD - Department of Cardiology, University of Pittsburgh Medical Center Pinnacle Heart and Vascular Institute, Wormleysburg, Pa. FAU - Mahoney, Paul AU - Mahoney P AD - Department of Cardiology, Sentara Heart Hospital, Norfolk, Va. FAU - Chhatriwalla, Adnan K AU - Chhatriwalla AK AD - Department of Cardiology, St Luke's Mid America Heart Institute, Kansas City, Mo. FAU - Schwartz, Jonathan G AU - Schwartz JG AD - Department of Cardiology, Sanger Heart & Vascular Institute, Atrium Health, Charlotte, NC. FAU - Keller, Antoine AU - Keller A AD - Department of Cardiovascular/Thoracic Surgery, Ochsner Lafayette General Hospital, Lafayette, La. FAU - Sodhi, Nishtha AU - Sodhi N AD - UVA Heart and Vascular Center, Charlottesville, Va. FAU - Haugan, Daniel AU - Haugan D AD - Medtronic, Mounds View, Minn. FAU - Caskey, Michael AU - Caskey M AD - Department of Cardiovascular/Thoracic Surgery, Abrazo Arizona Heart Hospital, Phoenix, Ariz. LA - eng PT - Journal Article DEP - 20230803 PL - United States TA - JTCVS Tech JT - JTCVS techniques JID - 101768546 PMC - PMC10580150 OTO - NOTNLM OT - TAVR OT - TVT registry OT - self-expanding OT - supra-annular OT - transaxillary OT - transcarotid EDAT- 2023/10/19 06:46 MHDA- 2023/10/19 06:47 PMCR- 2023/08/03 CRDT- 2023/10/19 04:25 PHST- 2023/04/13 00:00 [received] PHST- 2023/07/19 00:00 [revised] PHST- 2023/07/22 00:00 [accepted] PHST- 2023/10/19 06:47 [medline] PHST- 2023/10/19 06:46 [pubmed] PHST- 2023/10/19 04:25 [entrez] PHST- 2023/08/03 00:00 [pmc-release] AID - S2666-2507(23)00267-5 [pii] AID - 10.1016/j.xjtc.2023.07.019 [doi] PST - epublish SO - JTCVS Tech. 2023 Aug 3;21:45-55. doi: 10.1016/j.xjtc.2023.07.019. eCollection 2023 Oct. PMID- 37853703 OWN - NLM STAT- MEDLINE DCOM- 20250714 LR - 20250714 IS - 1545-1550 (Electronic) IS - 1526-6028 (Linking) VI - 32 IP - 4 DP - 2025 Aug TI - Surgical Versus Interventional Treatment of Major Access Site Complications During Transfemoral TAVI Procedures at a Large Volume Center. PG - 1146-1154 LID - 10.1177/15266028231204291 [doi] AB - PURPOSE: Access-related vascular complications in transfemoral transcatheter aortic valve implantation (TAVI) can be treated endovascularly or surgically. The aim of this study was to evaluate the short- and long-term outcomes of endovascular treatment compared with surgical repair for access-related vascular complications. METHODS: This retrospective study was performed from January 1, 2018, to December 31, 2020. All transfemorally treated TAVI patients in whom a surgical or endovascular treatment for an access site complication was needed were included. The primary outcome was the need for any related vascular re-operation. RESULTS: In total, 1219 transfemoral TAVI procedures were conducted during the study period. 19 patients suffered an access complication requiring endovascular treatment, while 54 patients required surgical repair. No differences were seen with regard to re-operations (endovascular 15.8% vs surgical 14.8%; p=0.919), wound infections (endovascular 0% vs surgical. 11.1%; p=0.129), and wound healing disorders (endovascular 15.8% vs surgical 29.6%; p=0.237). Patients undergoing endovascular treatment were discharged earlier (endovascular 11.2 vs surgical 14.9 days; p=0.028). After surgical repair, patients received significantly more blood transfusions than endovascularly treated patients (endovascular 1.00 vs surgical 3.1 red blood cell concentrate bags; p<0.001). No differences were found regarding the new onset of walking pain, rest pain, and ischemic ulcers during follow-up. CONCLUSION: In this retrospective cohort, endovascular treatment of access-related vascular complications of transfemoral TAVI procedures was safe and feasible. During the hospital stay, endovascularly treated patients received fewer blood transfusions and were discharged faster than surgically treated patients. No differences regarding clinical outcomes and re-intervention rates were seen during the follow-up.Clinical ImpactGiven the in this retrospective study demonstrated safety and feasibility of endovascular treatment for major access-related vascular complications, along with the in-hospital benefits and absence of follow-up disadvantages compared to surgical treatment, endovascular treatment should be considered in cases of major access-related vascular complications in transfemoral TAVI patients. FAU - Meertens, Max AU - Meertens M AUID- ORCID: 0000-0002-7746-8723 AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Wegner, Moritz AU - Wegner M AUID- ORCID: 0000-0003-0601-9223 AD - Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany. FAU - Fischnaler, Carlos AU - Fischnaler C AD - Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany. FAU - Wienemann, Hendrik AU - Wienemann H AUID- ORCID: 0000-0001-5810-2868 AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Macherey, Sascha AU - Macherey S AUID- ORCID: 0000-0002-7080-6611 AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Lee, Samuel AU - Lee S AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Kuhn, Elmar AU - Kuhn E AD - Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany. FAU - Mauri, Victor AU - Mauri V AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Dorweiler, Bernhard AU - Dorweiler B AD - Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Adam, Matti AU - Adam M AD - Department III of Internal Medicine, University Hospital of Cologne, Cologne, Germany. FAU - Ahmad, Wael AU - Ahmad W AD - Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Cologne, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20231018 PL - United States TA - J Endovasc Ther JT - Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists JID - 100896915 SB - IM MH - Humans MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Male MH - Female MH - *Femoral Artery/surgery/diagnostic imaging MH - Aged, 80 and over MH - Treatment Outcome MH - *Endovascular Procedures/adverse effects MH - *Catheterization, Peripheral/adverse effects MH - Time Factors MH - Aged MH - Risk Factors MH - Punctures MH - *Hospitals, High-Volume MH - Risk Assessment MH - Reoperation MH - Postoperative Complications/surgery OTO - NOTNLM OT - TAVI OT - access complication OT - bleeding OT - endovascular treatment/therapy OT - occlusion OT - transfemoral COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2023/10/19 06:45 MHDA- 2025/07/14 12:29 CRDT- 2023/10/19 03:40 PHST- 2025/07/14 12:29 [medline] PHST- 2023/10/19 06:45 [pubmed] PHST- 2023/10/19 03:40 [entrez] AID - 10.1177/15266028231204291 [doi] PST - ppublish SO - J Endovasc Ther. 2025 Aug;32(4):1146-1154. doi: 10.1177/15266028231204291. Epub 2023 Oct 18. PMID- 37852534 OWN - NLM STAT- MEDLINE DCOM- 20231127 LR - 20260109 IS - 1559-2030 (Electronic) IS - 1551-7144 (Linking) VI - 134 DP - 2023 Nov TI - Rationale and design of Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation (NAPT) Trial. PG - 107358 LID - S1551-7144(23)00281-1 [pii] LID - 10.1016/j.cct.2023.107358 [doi] AB - BACKGROUND: Despite the wide implementation of transcatheter aortic valve implantation (TAVI), the optimal antithrombotic therapy after TAVI has not been established yet. Owing to the accumulating evidence supporting the efficacy and safety of single antiplatelet therapy (SAPT) over dual antiplatelet therapy, the latest guideline recommends life-long SAPT. However, there is scarce evidence supporting SAPT compared with non-antithrombotic therapy. Given the vulnerability of patients undergoing TAVI in terms of high bleeding risk, the benefit of SAPT may be canceled out by its potential increased bleeding risk. STUDY DESIGN AND OBJECTIVES: Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation (NAPT) Trial is a prospective, randomized controlled, open-label blinded endpoint multicenter trial conducted in Japan, testing the non-inferiority of non-antithrombotic therapy compared with aspirin monotherapy in patients who underwent TAVI and had no indications for long-term oral anticoagulation therapy (OAC). Patients who successfully underwent trans-femoral TAVI for severe aortic stenosis with either balloon-expandable or self-expandable valves are eligible for inclusion. Key exclusion criteria are (i) occurrence of perioperative complications (ii) indications of taking antithrombotic drugs for other reasons; (iii) eGFR <30 ml/min/1.73 m2 or hemodialysis or peritoneal dialysis. A total of 360 patients will be randomized (1:1) to aspirin monotherapy vs. non-antithrombotic therapy. The primary outcome is a composite of all-cause mortality, myocardial infarction, stroke, and bleeding. All bleeding events based on the Valve Academic Research Consortium 3 are included as a component of the primary outcome. CONCLUSION: The NAPT trial will determine the non-inferiority of a non-antithrombotic therapy compared with aspirin monotherapy after TAVI. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Inohara, Taku AU - Inohara T AD - Department of Cardiology, Keio University of School of Medicine, Tokyo, Japan. FAU - Otsuka, Toshiaki AU - Otsuka T AD - Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan. FAU - Watanabe, Yusuke AU - Watanabe Y AD - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. FAU - Shirai, Shinichi AU - Shirai S AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Tada, Norio AU - Tada N AD - Department of Cardiology, Sendai Kosei Hospital, Miyagi, Japan. FAU - Yamanaka, Futoshi AU - Yamanaka F AD - Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan. FAU - Ueno, Hiroshi AU - Ueno H AD - Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University, Isehara, Japan. FAU - Tabata, Minoru AU - Tabata M AD - Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan. FAU - Suzuyama, Hiroto AU - Suzuyama H AD - Department of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan. FAU - Asami, Masahiko AU - Asami M AD - Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Yamawaki, Masahiro AU - Yamawaki M AD - Department of Cardiology, Saiseikai Yokohamashi City Eastern Hospital, Kanagawa, Japan. FAU - Izumo, Masaki AU - Izumo M AD - Department of Cardiology, St. Marianna University Hospital, Kanagawa, Japan. FAU - Yamasaki, Kazumasa AU - Yamasaki K AD - Department of Cardiology, Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan. FAU - Nishina, Hidetaka AU - Nishina H AD - Department of Cardiology, Tsukuba Medical Center, Ibaraki, Japan. FAU - Fuku, Yasushi AU - Fuku Y AD - Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan. FAU - Mizutani, Kazuki AU - Mizutani K AD - Department of Cardiology, Kindai University Hospital, Osaka, Japan. FAU - Yashima, Fumiaki AU - Yashima F AD - Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan. FAU - Yamamoto, Masanori AU - Yamamoto M AD - Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University of School of Medicine, Tokyo, Japan. Electronic address: khayashidamd@gmail.com. LA - eng PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20231016 PL - United States TA - Contemp Clin Trials JT - Contemporary clinical trials JID - 101242342 RN - 0 (Platelet Aggregation Inhibitors) RN - R16CO5Y76E (Aspirin) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Platelet Aggregation Inhibitors/adverse effects MH - Prospective Studies MH - *Aortic Valve Stenosis/surgery/drug therapy/etiology MH - Aspirin/therapeutic use MH - Treatment Outcome MH - Multicenter Studies as Topic MH - Randomized Controlled Trials as Topic MH - Equivalence Trials as Topic OTO - NOTNLM OT - Anticoagulation therapy OT - Antiplatelet therapy OT - Antithrombotic therapy OT - Transcatheter aortic valve implantation COIS- Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Drs. Shirai, Yamamoto, and Hayashida are clinical proctors for Edwards Lifesciences, Medtronics, and Abbott Medicals. Drs. Tada, Naganuma, Mizutani, Tabata, Ueno, and Watanabe are clinical proctors for Edwards Lifesciences and Medtronic. Dr. Izumo is a screening proctor for Edwards Lifesciences. Dr. Yashima is a clinical proctor for Medtronic. All other authors have no relationships relevant to the contents of this article to disclose. EDAT- 2023/10/19 00:45 MHDA- 2023/11/27 12:42 CRDT- 2023/10/18 19:28 PHST- 2023/06/20 00:00 [received] PHST- 2023/10/05 00:00 [revised] PHST- 2023/10/15 00:00 [accepted] PHST- 2023/11/27 12:42 [medline] PHST- 2023/10/19 00:45 [pubmed] PHST- 2023/10/18 19:28 [entrez] AID - S1551-7144(23)00281-1 [pii] AID - 10.1016/j.cct.2023.107358 [doi] PST - ppublish SO - Contemp Clin Trials. 2023 Nov;134:107358. doi: 10.1016/j.cct.2023.107358. Epub 2023 Oct 16. PMID- 37843551 OWN - NLM STAT- MEDLINE DCOM- 20240214 LR - 20240214 IS - 1615-2573 (Electronic) IS - 0910-8327 (Print) IS - 0910-8327 (Linking) VI - 39 IP - 3 DP - 2024 Mar TI - Clinical impact of non-lying time on hospital-associated functional decline in older patients undergoing transcatheter aortic valve implantation. PG - 266-272 LID - 10.1007/s00380-023-02326-w [doi] AB - The purposes of the present study were: (1) to investigate the relationship between hospital-associated functional decline (HAFD) and non-lying time and (2) to clarify the optimal cut-off value for non-lying time associated with HAFD in older patients undergoing transcatheter aortic valve implantation (TAVI). From January 2021 to December 2022, patients admitted to a university hospital who underwent trans-femoral TAVI were consecutively recruited. We measured short physical performance battery (SPPB) pre and post-TAVI, and non-lying time from post-operative days 3-5. HAFD was defined as at least 1 point decrease in SPPB during pre and post-TAVI. Among 75 patients (47 female, mean age of 84.5 years) enrolled, 14 patients were classified as having HAFD. Non-lying time was significantly shorter in the HAFD group than in the non-HAFD group (371 min vs. 539 min, P < 0.001). Receiver-operating characteristic analysis determined an optimal cut-off value of 477 min for differentiating the patients more likely to experience HAFD (sensitivity, 75%; specificity, 92%; area under the curve, 0.798). The non-lying time could be one of the associated factors of HAFD in older patients with TAVI. Non-lying time of about 480 min (8 h) during hospitalization may be an initial target for preventing HAFD. CI - (c) 2023. The Author(s). FAU - Kono, Yuji AU - Kono Y AD - Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan. AD - Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan. FAU - Mukaino, Masahiko AU - Mukaino M AD - Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan. FAU - Ozawa, Yushi AU - Ozawa Y AD - Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan. FAU - Mizutani, Koji AU - Mizutani K AD - Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan. FAU - Senju, Yuki AU - Senju Y AD - Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan. FAU - Ogasawara, Takayuki AU - Ogasawara T AD - NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan. FAU - Yamaguchi, Masumi AU - Yamaguchi M AD - NTT Basic Research Laboratories and Bio-Medical Informatics Research Center, NTT Corporation, Atsugi, Japan. FAU - Muramatsu, Takashi AU - Muramatsu T AD - Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Japan. FAU - Izawa, Hideo AU - Izawa H AD - Department of Cardiology, School of Medicine, Fujita Health University, Toyoake, Japan. FAU - Otaka, Yohei AU - Otaka Y AD - Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan. otaka119@mac.com. LA - eng PT - Journal Article DEP - 20231016 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 SB - IM MH - Humans MH - Female MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Hospitalization MH - ROC Curve MH - Hospitals MH - Aortic Valve/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis Implantation MH - Risk Factors PMC - PMC10858148 OTO - NOTNLM OT - Hospital-associated functional decline OT - Non-lying time OT - Older patients OT - Transcatheter aortic valve implantation COIS- This research received no financial disclosure. EDAT- 2023/10/16 12:42 MHDA- 2024/02/10 22:54 PMCR- 2023/10/16 CRDT- 2023/10/16 11:03 PHST- 2023/05/09 00:00 [received] PHST- 2023/09/28 00:00 [accepted] PHST- 2024/02/10 22:54 [medline] PHST- 2023/10/16 12:42 [pubmed] PHST- 2023/10/16 11:03 [entrez] PHST- 2023/10/16 00:00 [pmc-release] AID - 10.1007/s00380-023-02326-w [pii] AID - 2326 [pii] AID - 10.1007/s00380-023-02326-w [doi] PST - ppublish SO - Heart Vessels. 2024 Mar;39(3):266-272. doi: 10.1007/s00380-023-02326-w. Epub 2023 Oct 16. PMID- 37842473 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231020 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 15 IP - 9 DP - 2023 Sep TI - Factors Associated With Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis. PG - e45131 LID - 10.7759/cureus.45131 [doi] LID - e45131 AB - The aim of this meta-analysis is to assess the effect of different independent predictors on acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI). This meta-analysis adhered to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive database search was conducted using PubMed, Web of Science, and Scopus for the period from January 1, 2015, to August 15, 2023. The following key terms were employed: "transcatheter aortic valve implantation" OR "transcatheter aortic valve replacement" AND "acute kidney injury" OR "acute renal failure." Our search was limited to studies published exclusively in the English language. The statistical analysis was conducted using RevMan version 5.4.1 (The Cochrane Collaboration). Estimates were presented as odds ratio (OR) with 95% confidence interval (CI) for categorical variables, while continuous variables were reported as mean difference (MD) with 95% CI. A total of 19 studies met the selection criteria and were included in the meta-analysis. The pooled incidence of AKI was reported as 20% (95% CI: 18-20%). Factors significantly associated with post-TAVI AKI encompass hypertension, chronic kidney disease (CKD), low estimated glomerular filtration rate (eGFR), high baseline creatinine levels, peripheral vascular disease (PVD), Society of Thoracic Surgeons (STS) score, European System for Cardiac Operative Risk Evaluation (EUROscore) II, and the transfemoral surgical approach. CI - Copyright (c) 2023, Benaicha et al. FAU - Benaicha, Karima AU - Benaicha K AD - Internal Medicine, University Hospital Isaad Hassani Beni Messous, Algiers, DZA. FAU - Aldroubi, Basel AU - Aldroubi B AD - Medical College, Tishreen University, Latakia, SYR. FAU - Yousuf, Paras AU - Yousuf P AD - Emergency Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK. FAU - Nath, Rabinder AU - Nath R AD - Medical College, Ghulam Muhammad Mahar, Sukkur, PAK. FAU - Saveeta, Fnu AU - Saveeta F AD - Internal Medicine, People's University of Medical and Health Sciences, Nawabshah, PAK. FAU - Kanwal, Fnu AU - Kanwal F AD - Medical College, Chandka Medical College, Larkana, PAK. FAU - Fatima, Tehreem AU - Fatima T AD - Internal Medicine, United Medical and Dental College, Creek General Hospital, Karachi, PAK. FAU - Hirani, Shamsha AU - Hirani S AD - Cardiology, Baqai Hospital, Karachi, PAK. LA - eng PT - Journal Article PT - Review DEP - 20230912 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC10569799 OTO - NOTNLM OT - acute kidney injury OT - factors OT - post-operative OT - systematic review and meta-analysis OT - transcatheter aortic valve implantation (tavi) COIS- The authors have declared that no competing interests exist. EDAT- 2023/10/16 06:48 MHDA- 2023/10/16 06:49 PMCR- 2023/09/12 CRDT- 2023/10/16 04:53 PHST- 2023/09/12 00:00 [accepted] PHST- 2023/10/16 06:49 [medline] PHST- 2023/10/16 06:48 [pubmed] PHST- 2023/10/16 04:53 [entrez] PHST- 2023/09/12 00:00 [pmc-release] AID - 10.7759/cureus.45131 [doi] PST - epublish SO - Cureus. 2023 Sep 12;15(9):e45131. doi: 10.7759/cureus.45131. eCollection 2023 Sep. PMID- 37840630 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231020 IS - 1671-5411 (Print) IS - 1671-5411 (Linking) VI - 20 IP - 9 DP - 2023 Sep 28 TI - App-based assessment of memory functions in patients after transfemoral aortic valve replacement. PG - 664-672 LID - 10.26599/1671-5411.2023.09.004 [doi] AB - BACKGROUND: Transfemoral aortic valve replacement (TAVR) is the standard treatment for elderly patients with aortic valve stenosis. Although safe and well-established, there is a risk of intraprocedural hemodynamic instability and silent cerebral embolism, which can lead to a decline in neurocognitive function and dementia. In clinical practice, comprehensive cognitive testing is difficult to perform. AI-assisted digital applications may help to optimize diagnosis and monitoring. METHODS: Neurocognitive function was assessed by validated psychometric tests using "∆elta -App", which uses artificial intelligence and computational linguistic methods for extraction and analysis. Memory function was assessed using the 'Consortium to Establish a Registry for Alzheimer's Disease' (CERAD) word list and digit span task (DST) before TAVR and before hospital discharge. The study is registered in the German Register of Clinical Trials (https://drks.de/search/de/trial/DRKS00020813). RESULTS: From October 2020 until March 2022, 141 patients were enrolled at University Hospital Heart Centre Brandenburg. Mean age was 81 +/- 6 years, 42.6% were women. Time between the pre- and post-interventional test was on average 6 +/- 3 days. Memory function before TAVR was found to be below average in relation to age and educational level. The pre-post TAVR comparison showed significant improvements in the wordlist repeat, P < 0.001 and wordlist recall test of CERAD, P < 0.001. There were no changes in the digital span test. CONCLUSIONS: Despite impaired preoperative memory function before TAVR, no global negative effect on memory function after TVAR was detected. The improvements shown in the word list test should be interpreted as usual learning effects in this task. CI - (c) 2023 JGC All rights reserved; www.jgc301.com. FAU - Nubel, Jonathan AU - Nubel J AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau, Germany. FAU - Hauptmann, Michael AU - Hauptmann M AD - Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany. AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, Cottbus, Germany. FAU - Schon, Julika AU - Schon J AD - Anesthesia and Intensive Care, University Hospital Ruppin Brandenburg (ukrb), Brandenburg Medical School (MHB) Theodor Fontane, Neuruppin, Germany. FAU - Fritz, Georg AU - Fritz G AD - Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Heart Centre Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau, Germany. FAU - Butter, Christian AU - Butter C AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau, Germany. AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, Cottbus, Germany. FAU - Haase-Fielitz, Anja AU - Haase-Fielitz A AD - Department of Cardiology, University Hospital Heart Centre Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau, Germany. AD - Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, Cottbus, Germany. AD - Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, Germany. LA - eng PT - Journal Article PL - China TA - J Geriatr Cardiol JT - Journal of geriatric cardiology : JGC JID - 101237881 PMC - PMC10568551 COIS- The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. EDAT- 2023/10/16 06:48 MHDA- 2023/10/16 06:49 PMCR- 2023/09/28 CRDT- 2023/10/16 04:18 PHST- 2023/10/16 06:49 [medline] PHST- 2023/10/16 06:48 [pubmed] PHST- 2023/10/16 04:18 [entrez] PHST- 2023/09/28 00:00 [pmc-release] AID - jgc-20-9-664 [pii] AID - 10.26599/1671-5411.2023.09.004 [doi] PST - ppublish SO - J Geriatr Cardiol. 2023 Sep 28;20(9):664-672. doi: 10.26599/1671-5411.2023.09.004. PMID- 37834910 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231031 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 19 DP - 2023 Sep 28 TI - Transcatheter Aortic Valve Replacement in Degenerated Perceval Bioprosthesis: Clinical and Technical Aspects in 32 Cases. LID - 10.3390/jcm12196265 [doi] LID - 6265 AB - BACKGROUND: Sutureless aortic bioprostheses are increasingly being used to provide shorter cross-clamp time and facilitate minimally invasive aortic valve replacement. As the use of sutureless valves has increased over the past decade, we begin to encounter their degeneration. We describe clinical outcomes and technical aspects in patients with degenerated sutureless Perceval (CorCym, Italy) aortic bioprosthesis treated with valve-in-valve transcatheter aortic valve replacement (VIV-TAVR). METHODS: Between March 2011 and March 2023, 1310 patients underwent aortic valve replacement (AVR) with Perceval bioprosthesis implantation. Severe bioprosthesis degeneration treated with VIV-TAVR occurred in 32 patients with a mean of 6.4 +/- 1.9 years (range: 2-10 years) after first implantation. Mean EuroSCORE II was 9.5 +/- 6.4% (range: 1.9-35.1%). RESULTS: Thirty of thirty-two (94%) VIV-TAVR were performed via transfemoral and two (6%) via transapical approach. Vascular complications occurred in two patients (6%), and mean hospital stay was 4.6 +/- 2.4 days. At mean follow-up of 16.7 +/- 15.2 months (range: 1-50 months), survival was 100%, and mean transvalvular pressure gradient was 18.7 +/- 5.3 mmHg. CONCLUSION: VIV-TAVR is a useful option for degenerated Perceval and appears safe and effective. This procedure is associated with good clinical results and excellent hemodynamic performance in our largest single-center experience. FAU - Concistre, Giovanni AU - Concistre G AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Gasbarri, Tommaso AU - Gasbarri T AUID- ORCID: 0000-0002-5181-7198 AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Ravani, Marcello AU - Ravani M AD - Department of Cardiology, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Al Jabri, Anees AU - Al Jabri A AD - Department of Cardiology, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Trianni, Giuseppe AU - Trianni G AD - Department of Cardiology, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Bianchi, Giacomo AU - Bianchi G AUID- ORCID: 0000-0003-4240-0099 AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Margaryan, Rafik AU - Margaryan R AUID- ORCID: 0000-0001-6005-472X AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Chiaramonti, Francesca AU - Chiaramonti F AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Murzi, Michele AU - Murzi M AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Kallushi, Enkel AU - Kallushi E AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Varone, Egidio AU - Varone E AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Simeoni, Simone AU - Simeoni S AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Leone, Alessandro AU - Leone A AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Farneti, Andrea AU - Farneti A AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Berti, Sergio AU - Berti S AUID- ORCID: 0000-0002-5244-0556 AD - Department of Cardiology, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. FAU - Solinas, Marco AU - Solinas M AD - Department of Adult Cardiac Surgery, G. Pasquinucci Heart Hospital, Fondazione CNR-G. Monasterio, 54100 Massa, Italy. LA - eng PT - Journal Article DEP - 20230928 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10573422 OTO - NOTNLM OT - aortic bioprosthesis degeneration OT - aortic valve replacement OT - sutureless aortic valve OT - transcatheter aortic valve COIS- The authors declare no conflict of interest. EDAT- 2023/10/14 10:46 MHDA- 2023/10/14 10:47 PMCR- 2023/09/28 CRDT- 2023/10/14 01:08 PHST- 2023/08/31 00:00 [received] PHST- 2023/09/22 00:00 [revised] PHST- 2023/09/26 00:00 [accepted] PHST- 2023/10/14 10:47 [medline] PHST- 2023/10/14 10:46 [pubmed] PHST- 2023/10/14 01:08 [entrez] PHST- 2023/09/28 00:00 [pmc-release] AID - jcm12196265 [pii] AID - jcm-12-06265 [pii] AID - 10.3390/jcm12196265 [doi] PST - epublish SO - J Clin Med. 2023 Sep 28;12(19):6265. doi: 10.3390/jcm12196265. PMID- 37788169 OWN - NLM STAT- MEDLINE DCOM- 20240130 LR - 20260402 IS - 1540-8175 (Electronic) IS - 0742-2822 (Linking) VI - 41 IP - 1 DP - 2024 Jan TI - "Piggyback Pigtails": Simplifying secondary transradial access for TAVR. PG - e15700 LID - 10.1111/echo.15700 [doi] AB - Minimalist approaches have evolved for TAVR over the last years with impact on in-hospital stay and patient safety. As part of this concept, transradial secondary arterial access is capable of reducing vascular and bleeding complications. Yet, steering of the marker pigtail catheter in the descending aorta might by fluoroscopic imaging sometimes be challenging. In our manuscript, we present a very simple "piggyback" technique, simplifying management of transradial secondary access in transfemoral TAVR. CI - (c) 2023 The Authors. Echocardiography published by Wiley Periodicals LLC. FAU - Ahoopai, Majid AU - Ahoopai M AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Geyer, Martin AU - Geyer M AUID- ORCID: 0000-0002-9935-8293 AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Tamm, Alexander R AU - Tamm AR AUID- ORCID: 0000-0003-2017-094X AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Gossler, Theresa AU - Gossler T AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Oberhoffer, Martin AU - Oberhoffer M AD - Department for Cardiac and Vascular Surgery, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Masseli, Franz AU - Masseli F AD - Department for Cardiac and Vascular Surgery, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Munzel, Thomas AU - Munzel T AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - von Bardeleben, Ralph Stephan AU - von Bardeleben RS AUID- ORCID: 0000-0002-1356-0037 AD - Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany. LA - eng PT - Journal Article DEP - 20231003 PL - United States TA - Echocardiography JT - Echocardiography (Mount Kisco, N.Y.) JID - 8511187 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Retrospective Studies MH - Treatment Outcome MH - Femoral Artery/diagnostic imaging MH - Risk Factors MH - Aortic Valve/surgery OTO - NOTNLM OT - TAVI OT - access site complications OT - aortic stenosis OT - femoral access OT - multidisciplinary heart team EDAT- 2023/10/03 18:43 MHDA- 2024/01/30 12:43 CRDT- 2023/10/03 12:43 PHST- 2023/09/01 00:00 [received] PHST- 2023/09/20 00:00 [accepted] PHST- 2024/01/30 12:43 [medline] PHST- 2023/10/03 18:43 [pubmed] PHST- 2023/10/03 12:43 [entrez] AID - 10.1111/echo.15700 [doi] PST - ppublish SO - Echocardiography. 2024 Jan;41(1):e15700. doi: 10.1111/echo.15700. Epub 2023 Oct 3. PMID- 37786426 OWN - NLM STAT- MEDLINE DCOM- 20231004 LR - 20231004 IS - 1178-1998 (Electronic) IS - 1176-9092 (Print) IS - 1176-9092 (Linking) VI - 18 DP - 2023 TI - Prognostic Value of Myocardial Function Imaging Markers in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement. PG - 1597-1606 LID - 10.2147/CIA.S413426 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) became the leading therapeutic strategy for aortic valve replacement in older patients with severe symptomatic aortic stenosis. Echocardiographic parameters that mark the left ventricle and right ventricle reverse remodeling after the TAVR are not well established. The aim of the current study is to describe the dynamics of both left ventricle (LV) and right ventricle (RV) strain derived from speckle tracking echocardiography in elderly patients at 3-months after the TAVR procedure. METHODS: We enrolled 52 consecutive patients (77 +/- 4.9 years old, median STS score of 3.1) who underwent transfemoral TAVR at our tertiary care center. All patients were evaluated at baseline and 3 months following TAVR. RESULTS: The LV global longitudinal strain (GLS) 3-month following TAVR was significantly improved compared with baseline values (-16 +/-4.2% vs -16 +/-4.2%; p < 0.001) but no significant changes in the RV GLS 3 and 6 segments model following TAVR were registered. The LV ejection fraction was significantly improved 3-months after the TAVR procedure. LV-GLS at baseline demonstrated a strong positive correlation with LV-GLS at 3 months (r = 0.69) and a moderate correlation with RV strain parameters (r = 0.38 and r = 0.56), but also a negative correlation with LVEF at follow-up (r=-0.61). Interestingly, in contrast to LVEF, none of the strain parameters correlated with age. NT-proBNP values were correlated with both LV-GLS (r = 0.37) and LVEF (r=-0.5) at baseline. However, at follow-up, baseline NT-proBNP values remained correlated only to LV-GLS at 3-months (r = 0.24), but the correlation was weak. CI - (c) 2023 Dadarlat-Pop et al. FAU - Dadarlat-Pop, Alexandra AU - Dadarlat-Pop A AUID- ORCID: 0000-0003-3964-6995 AD - Cardiology Department, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. AD - Cardiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Molnar, Adrian AU - Molnar A AD - Cardiovascular Surgery Department, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. AD - Cardiovascular Surgery Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Serban, Adela AU - Serban A AUID- ORCID: 0000-0001-7457-5753 AD - Cardiology Department, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. AD - Cardiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Tomoaia, Raluca AU - Tomoaia R AD - Cardiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. AD - Cardiology Department, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania. FAU - Hagiu, Claudia AU - Hagiu C AD - Gastroenterology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. AD - "Prof. Dr. Octavian Fodor" Regional Gastroenterology-Hepatology Institute, Cluj-Napoca, Romania. FAU - Manole, Simona AU - Manole S AUID- ORCID: 0000-0002-8492-5777 AD - Radiology and Medical Imaging Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. AD - Department of Radiology and Medical Imaging, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. FAU - Oprea, Alexandru AU - Oprea A AUID- ORCID: 0000-0002-7686-7378 AD - Cardiovascular Surgery Department, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. AD - Cardiovascular Surgery Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Mocanu, Lorena AU - Mocanu L AD - Cardiology Department, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. FAU - Picos, Andrei AU - Picos A AUID- ORCID: 0009-0002-6829-2559 AD - Department of Prevention in Dental Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Mot, Stefan AU - Mot S AD - Cardiology Department, Heart Institute Niculae Stancioiu, Cluj-Napoca, Romania. AD - Cardiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. LA - eng PT - Journal Article DEP - 20230925 PL - New Zealand TA - Clin Interv Aging JT - Clinical interventions in aging JID - 101273480 SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/methods MH - Prognosis MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Retrospective Studies MH - Aortic Valve MH - Ventricular Function, Left MH - Stroke Volume MH - Treatment Outcome PMC - PMC10541530 OTO - NOTNLM OT - aortic stenosis OT - elderly population OT - global longitudinal strain OT - outcome OT - transcatheter aortic valve replacement COIS- The authors declare no conflicts of interest. EDAT- 2023/10/03 06:47 MHDA- 2023/10/04 06:44 PMCR- 2023/09/25 CRDT- 2023/10/03 03:37 PHST- 2023/04/04 00:00 [received] PHST- 2023/09/12 00:00 [accepted] PHST- 2023/10/04 06:44 [medline] PHST- 2023/10/03 06:47 [pubmed] PHST- 2023/10/03 03:37 [entrez] PHST- 2023/09/25 00:00 [pmc-release] AID - 413426 [pii] AID - 10.2147/CIA.S413426 [doi] PST - epublish SO - Clin Interv Aging. 2023 Sep 25;18:1597-1606. doi: 10.2147/CIA.S413426. eCollection 2023. PMID- 37769621 OWN - NLM STAT- MEDLINE DCOM- 20231002 LR - 20250811 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 35 IP - 7 DP - 2023 Jul TI - Novel adaptations in percutaneous right transaxillary access for transcatheter aortic valve implantation using the sapien ultra valve. PG - E355-E364 AB - BACKGROUND: Percutaneous transaxillary access is used as an alternative to the transfemoral approach for transcatheter aortic valve implantation in patients with severe peripheral vascular disease. The left transaxillary approach is usually preferred due to ease of valve alignment with the aortic annulus. Some patients have anatomical and physiological factors which preclude this approach. Moreover, most catheterization lab layouts make left-sided approaches to the heart awkward for imaging, visualization, procedural ease, and radiation protection. AIMS: The authors describe novel adaptations to allow successful right transaxillary access for implantation of the transcatheter heart valve using the Edwards Sapien 3 system (Edwards Lifesciences). METHODS: We searched our local structural heart database for all patients who underwent transcatheter aortic valve implantation via axillary access, from January 2021 to January 2022. Patients with left axillary access were excluded. RESULTS: We report 6 percutaneous right transaxillary cases performed in the last year using steps which allow smooth delivery of the SAPIEN 3 Ultra valve down the greater curvature of the aorta and providing co-axial alignment of the valve. Only one patient had a vascular complication with arterial dissection at the closure point managed with 8 mm x 37 mm Bentley uncovered stent at the access site. CONCLUSION: With the modifications described in our article, the right transaxillary approach has now become our preferred secondary access route for TAVI. FAU - Waleed, Mohammad AU - Waleed M AD - Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Royal Sussex County Hospital, Brighton, BN2 5BE, England, United Kingdom. waleed1280@yahoo.com; mohammed.waleed1@nhs.net. FAU - Arunothayaraj, Sandeep AU - Arunothayaraj S FAU - McGrath, Sam AU - McGrath S FAU - Michail, Michael AU - Michail M FAU - Cockburn, James AU - Cockburn J FAU - Hildick-Smith, David AU - Hildick-Smith D LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Catheters MH - Aortic Valve/diagnostic imaging/surgery MH - Cardiac Catheterization/methods MH - *Heart Valve Prosthesis Implantation/methods MH - Prosthesis Design OTO - NOTNLM OT - transcatheter aortic valve implantation OT - Sapien valve OT - alternative access OT - severe aortic stenosis OT - transaxillary OT - transfemoral access EDAT- 2023/09/29 00:42 MHDA- 2023/10/02 06:42 CRDT- 2023/09/28 19:24 PHST- 2023/10/02 06:42 [medline] PHST- 2023/09/29 00:42 [pubmed] PHST- 2023/09/28 19:24 [entrez] AID - 10.25270/jic/23.00075 [doi] PST - ppublish SO - J Invasive Cardiol. 2023 Jul;35(7):E355-E364. doi: 10.25270/jic/23.00075. PMID- 37769569 OWN - NLM STAT- MEDLINE DCOM- 20231106 LR - 20231112 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 207 DP - 2023 Nov 15 TI - Hemostatic Profiles of Patients Who Underwent Transcatheter Versus Surgical Aortic Valve Replacement Versus Percutaneous Coronary Intervention. PG - 260-270 LID - S0002-9149(23)00865-2 [pii] LID - 10.1016/j.amjcard.2023.08.100 [doi] AB - Guidelines for transcatheter aortic valve replacement (TAVR) antithrombotic prophylaxis are extrapolated predominantly from percutaneous coronary intervention (PCI) data. Here, we examined temporal coagulation changes occurring in the early perioperative period to determine the pathobiologic validity of this supposition. This was a prospective observational study of consecutive patients who underwent transfemoral TAVR (n = 27), PCI (n = 12), or surgical aortic valve replacement (SAVR) requiring cardiopulmonary bypass and cross-clamping (n = 12). Blood samples were taken at 4 time points: T1 (baseline), after general anesthesia or sedation; T2, after heparin administration; T3, at the end of the procedure; and T4, 6 hours after the procedure. The samples were assessed concurrently using standard laboratory coagulation tests and viscoelastic tests of whole blood clotting, including the latest generation thromboelastometry (ROTEM sigma) and thromboelastometry (TEG 6s). Patients in the TAVR cohort were older and a had lower baseline hemoglobin level than patients in the PCI and SAVR cohorts. The baseline platelet function was similar between the TAVR and PCI cohorts and impaired in the SAVR cohort Figure S1. The baseline hemostatic measures were comparable among cohorts. Regarding the per-patient change from baseline, the TAVR cohort showed an overall more prothrombotic state than the other cohorts, with the most marked differences from the SAVR cohort after intraoperative heparin administration and from the PCI cohorts 6 hours after the procedure. In addition, the ROTEM and TEG parameters were well correlated but not interchangeable. In conclusion, patients who underwent TAVR have a more prothrombotic hemostatic profile than PCI and SAVR patients. These findings question the current guidelines that extrapolate antithrombotic regimens from PCI to TAVR settings. CI - Crown Copyright (c) 2023. Published by Elsevier Inc. All rights reserved. FAU - Fanning, Jonathon Paul AU - Fanning JP AD - Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia. Electronic address: j.fanning@uq.edu.au. FAU - Roberts, Shaun AU - Roberts S AD - Faculty of Medicine, The University of Queensland, Queensland, Australia; Department of Anaesthesia and Perioperative Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia. FAU - Anstey, Chris AU - Anstey C AD - Faculty of Medicine, The University of Queensland, Queensland, Australia; School of Medicine, Griffith University, Queensland, Australia. FAU - Yerkovich, Stephanie AU - Yerkovich S AD - Faculty of Medicine, The University of Queensland, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia. FAU - Lu, Lawrence Yanxi AU - Lu LY AD - Faculty of Medicine, The University of Queensland, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; Department of Anaesthesia and Perioperative Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia. FAU - Poon, Karl AU - Poon K AD - Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia. FAU - Incani, Alexander AU - Incani A AD - Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia. FAU - Natani, Sarvesh AU - Natani S AD - Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia. FAU - McCullough, James AU - McCullough J AD - School of Medicine, Griffith University, Queensland, Australia; Department of Intensive Care, Gold Coast University Hospital, Gold Coast, Queensland, Australia. FAU - Winearls, James AU - Winearls J AD - Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia; Department of Intensive Care, Gold Coast University Hospital, Gold Coast, Queensland, Australia. FAU - Fraser, John Francis AU - Fraser JF AD - Intensive Care Services, St. Andrew's War Memorial Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Queensland, Australia; Critical Care Research Group, The Prince Charles Hospital, Queensland, Australia; School of Medicine, Griffith University, Queensland, Australia. LA - eng SI - ANZCTR/ACTRN12619000080123 PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20230926 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Hemostatics) RN - 0 (Fibrinolytic Agents) RN - 9005-49-6 (Heparin) SB - IM MH - Humans MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Hemostatics MH - *Percutaneous Coronary Intervention/methods MH - Fibrinolytic Agents/therapeutic use MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/methods MH - *Heart Valve Prosthesis Implantation/methods MH - Heparin/therapeutic use MH - Risk Factors OTO - NOTNLM OT - anticoagulation OT - aortic valve replacement OT - interventional cardiology COIS- Declaration of Competing Interest Drs. Poon and Incani have significant relations with Edwards LifeSciences and Abbott Vascular, including consulting/proctoring fees and an unrestricted institutional grant. Dr. Fanning received a Research Fellowship from the Health Investment, Innovation and Research Office, Department of Health, Queensland Government, Australia (reference JDRF-02). The remaining authors have no competing interests to declare. EDAT- 2023/09/29 00:42 MHDA- 2023/11/06 06:42 CRDT- 2023/09/28 19:22 PHST- 2023/07/18 00:00 [received] PHST- 2023/08/09 00:00 [revised] PHST- 2023/08/17 00:00 [accepted] PHST- 2023/11/06 06:42 [medline] PHST- 2023/09/29 00:42 [pubmed] PHST- 2023/09/28 19:22 [entrez] AID - S0002-9149(23)00865-2 [pii] AID - 10.1016/j.amjcard.2023.08.100 [doi] PST - ppublish SO - Am J Cardiol. 2023 Nov 15;207:260-270. doi: 10.1016/j.amjcard.2023.08.100. Epub 2023 Sep 26. PMID- 37747290 OWN - NLM STAT- MEDLINE DCOM- 20231225 LR - 20240102 IS - 1748-880X (Electronic) IS - 0007-1285 (Print) IS - 0007-1285 (Linking) VI - 96 IP - 1152 DP - 2023 Dec TI - Computed tomography defined femoral artery plaque composition predicts vascular complications during transcatheter aortic valve implantation. PG - 20230296 LID - 10.1259/bjr.20230296 [doi] LID - 20230296 AB - OBJECTIVE: Vascular and bleeding complications after transcatheter aortic valve implantation (TAVI) are common and lead to increased morbidity and mortality. Analysis of plaque at the arterial access site may improve prediction of complications. METHODS: We investigated the association between demographic and procedural risk factors for Valve Academic Research Consortium (VARC-3) vascular complications in patients undergoing transfemoral TAVI with use of a vascular closure device (ProGlide((R)) or MANTA((R))) in this retrospective cohort study. The ability of pre-procedure femoral CT angiography to predict complications was investigated including a novel method of quantifying plaque composition of the common femoral artery using plaque maps created with patient specific X-ray attenuation cut-offs. RESULTS: 23 vascular complications occurred in the 299 patients in the study group (7.7%). There were no demographic risk factors associated with vascular complications and no statistical difference between use of closure device (ProGlide((R)) vs MANTA((R))) and vascular complications. Vascular complications after TAVI were associated with sheath size (OR 1.36, 95% CI 1.08-1.76, P 0.01) and strongly associated with CT-derived necrotic core volume in the common femoral artery of the procedural side (OR 17.49, 95% CI 1.21-226.60, P 0.03). CONCLUSION: Plaque map analysis of the common femoral artery by CT angiography reveals patients with greater necrotic core are at increased risk of VARC-3 vascular complications. ADVANCES IN KNOWLEDGE: The novel measurement of necrotic core volume in the common femoral artery on the procedural side by CT analysis was associated with post-TAVI vascular complications, which can be used to highlight increased risk. FAU - Carande, Elliott J AU - Carande EJ AUID- ORCID: 0000-0003-3478-0407 AD - Cwm Taff Morgannwg University Health Board, Princess of Wales Hospital, Coity Road, Bridgend, United Kingdom. FAU - Salim, Tarik S AU - Salim TS AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Chase, Alexander AU - Chase A AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Sekar, Baskar AU - Sekar B AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Aldalati, Omar AU - Aldalati O AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Hailan, Ahmed AU - Hailan A AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Khurana, Ayush AU - Khurana A AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Smith, Dave AU - Smith D AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. FAU - Obaid, Daniel Rhys AU - Obaid DR AUID- ORCID: 0000-0002-3891-1403 AD - Swansea Bay University Health Board, Morriston Hospital, Swansea, United Kingdom. AD - Swansea University Medical School, Swansea, United Kingdom. LA - eng PT - Journal Article DEP - 20231024 PL - England TA - Br J Radiol JT - The British journal of radiology JID - 0373125 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Femoral Artery/diagnostic imaging/surgery MH - Retrospective Studies MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Tomography, X-Ray Computed MH - Treatment Outcome MH - Aortic Valve PMC - PMC10646661 EDAT- 2023/09/25 12:41 MHDA- 2023/12/25 06:41 PMCR- 2023/10/24 CRDT- 2023/09/25 09:34 PHST- 2023/12/25 06:41 [medline] PHST- 2023/09/25 12:41 [pubmed] PHST- 2023/09/25 09:34 [entrez] PHST- 2023/10/24 00:00 [pmc-release] AID - 10.1259/bjr.20230296 [doi] PST - ppublish SO - Br J Radiol. 2023 Dec;96(1152):20230296. doi: 10.1259/bjr.20230296. Epub 2023 Oct 24. PMID- 37738782 OWN - NLM STAT- MEDLINE DCOM- 20231106 LR - 20231112 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 207 DP - 2023 Nov 15 TI - Strategy for Totally Percutaneous Management of Vascular Injury in Combined Transfemoral Transcatheter Aortic Valve Replacement and Endovascular Aortic Aneurysm Repair Procedures. PG - 130-136 LID - S0002-9149(23)00928-1 [pii] LID - 10.1016/j.amjcard.2023.08.148 [doi] AB - Minimally invasive treatment of severe aortic stenosis by transcatheter aortic valve replacement (TAVR) and infrarenal abdominal aortic aneurysm by endovascular aortic aneurysm repair (EVAR) requires large-bore vascular access. These percutaneous transfemoral interventions may be performed as a combined procedure, however, vascular injury may necessitate surgical vascular repair. We implemented a strategy designed to enable percutaneous vascular repair, with stent-graft implantation, if necessary, after these combined procedures. We identified all combined percutaneous TAVR and EVAR procedures which were performed at our institution. Patient and procedural characteristics and clinical outcomes were analyzed. Six consecutive patients underwent total percutaneous combined TAVR and EVAR procedures. In all cases, TAVR was performed first and was followed by EVAR. Both common femoral arteries served as primary access sites for delivery of the implanted devices and hemostasis was achieved by deployment of vascular closure devices. Secondary access sites included the right brachial artery in all patients and superficial femoral arteries in 50% of the patients. In all cases an "0.014" 300-cm length "safety" wire was delivered to the common femoral artery or descending aorta by way of a secondary access site to facilitate stent graft delivery. Successful device implantation was achieved in all cases. Vascular closure device failure occurred in 2 patients and was treated by stent graft implantation by way of the brachial and superficial femoral arteries, without need for surgical vascular repair. A strategy designed to facilitate percutaneous vascular repair after combined EVAR and TAVR procedures may enable a truly minimally invasive procedure. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Naoum, Ibrahim AU - Naoum I AD - Department of Cardiology, Haifa, Israel. FAU - Eitan, Amnon AU - Eitan A AD - Department of Cardiology, Haifa, Israel. FAU - Galili, Offer AU - Galili O AD - Department of Vascular & Endovascular Surgery, Carmel Medical Center, Haifa, Israel. FAU - Hayeq, Hashem AU - Hayeq H AD - Department of Vascular & Endovascular Surgery, Carmel Medical Center, Haifa, Israel. FAU - Shiran, Avinoam AU - Shiran A AD - Department of Cardiology, Haifa, Israel. FAU - Zissman, Keren AU - Zissman K AD - Department of Cardiology, Haifa, Israel. FAU - Sliman, Hussein AU - Sliman H AD - Department of Cardiology, Haifa, Israel. FAU - Jaffe, Ronen AU - Jaffe R AD - Department of Cardiology, Haifa, Israel. Electronic address: jafferonen@gmail.com. LA - eng PT - Journal Article DEP - 20230920 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Vascular System Injuries/etiology MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Endovascular Procedures/methods MH - *Aortic Valve Stenosis/surgery/etiology MH - *Aortic Aneurysm, Abdominal/surgery MH - Femoral Artery/surgery OTO - NOTNLM OT - endovascular aortic aneurysm repair OT - stent graft OT - transcatheter aortic valve replacement OT - vascular closure device failure COIS- Declaration of Competing Interest The authors have no competing interests to declare. EDAT- 2023/09/23 11:42 MHDA- 2023/11/06 06:41 CRDT- 2023/09/22 18:04 PHST- 2023/07/25 00:00 [received] PHST- 2023/08/21 00:00 [revised] PHST- 2023/08/21 00:00 [accepted] PHST- 2023/11/06 06:41 [medline] PHST- 2023/09/23 11:42 [pubmed] PHST- 2023/09/22 18:04 [entrez] AID - S0002-9149(23)00928-1 [pii] AID - 10.1016/j.amjcard.2023.08.148 [doi] PST - ppublish SO - Am J Cardiol. 2023 Nov 15;207:130-136. doi: 10.1016/j.amjcard.2023.08.148. Epub 2023 Sep 20. PMID- 37736440 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230923 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 15 IP - 8 DP - 2023 Aug TI - Outcomes of Vascular Surgery Performed Jointly With Other Departments. PG - e43833 LID - 10.7759/cureus.43833 [doi] LID - e43833 AB - OBJECTIVE: The purpose of this study is to evaluate the results of vascular surgery performed at our hospital, a tertiary emergency general hospital, in patients undergoing surgery in other departments. The results of the study were reviewed. METHODS: The study included cases in which cardiovascular surgery was performed at the request of other departments over a 15-year period from January 2006 to October 2022. Patient backgrounds, departments that requested surgery, surgical procedures, use of extracorporeal circulation, and surgical techniques were reviewed. Patients with femoral artery exposure or ECMO removal during transcatheter aortic valve implantation (TAVI) requested by cardiology were excluded. RESULTS: There were 58 vascular surgery cases requested by other departments during the study period. The age was 63+/-14 years, 43 (74%) were male and 15 (26%) were female. The departments of the patients were urology in 29 (50%), gastroenterology in 18 (31%), orthopedics in seven (12%), emergency department in three (5%), and obstetrics and gynecology in one (2%). The following surgical procedures were performed: tumor resection and reconstruction due to tumor invasion of the inferior vena cava in 27 cases (47%), bypass to secure intraperitoneal arterial blood flow in 15 cases (26%), bypass during resection of the femoral tumor in four cases (7%), hemostasis due to trauma in three cases (5%), intraperitoneal hemostasis in three cases (5%), thrombectomy in two cases (3%), and others in four cases (7%). Extracorporeal circulation was used in six (10%) of the patients. CONCLUSION: A 15-year case study of vascular surgery supports operations requested by other departments at our hospital. All reconstructed sites were open at the time of discharge. CI - Copyright (c) 2023, Nakajima et al. FAU - Nakajima, Tomohiro AU - Nakajima T AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Shibata, Tsuyoshi AU - Shibata T AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Mukawa, Kei AU - Mukawa K AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Nakanishi, Keitaro AU - Nakanishi K AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Mizuno, Takakimi AU - Mizuno T AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Arihara, Ayaka AU - Arihara A AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Miura, Shuhei AU - Miura S AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Nakazawa, Junji AU - Nakazawa J AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Iba, Yutaka AU - Iba Y AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. FAU - Kawaharada, Nobuyoshi AU - Kawaharada N AD - Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN. LA - eng PT - Journal Article DEP - 20230821 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC10509632 OTO - NOTNLM OT - cardiopulmonary bypass OT - great saphenous vein OT - inferior vena cava (ivc) OT - other division OT - vascular surgery COIS- The authors have declared that no competing interests exist. EDAT- 2023/09/22 06:42 MHDA- 2023/09/22 06:43 PMCR- 2023/08/21 CRDT- 2023/09/22 03:46 PHST- 2023/08/20 00:00 [accepted] PHST- 2023/09/22 06:43 [medline] PHST- 2023/09/22 06:42 [pubmed] PHST- 2023/09/22 03:46 [entrez] PHST- 2023/08/21 00:00 [pmc-release] AID - 10.7759/cureus.43833 [doi] PST - epublish SO - Cureus. 2023 Aug 21;15(8):e43833. doi: 10.7759/cureus.43833. eCollection 2023 Aug. PMID- 37727306 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230921 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve. PG - 1209184 LID - 10.3389/fcvm.2023.1209184 [doi] LID - 1209184 AB - BACKGROUND: Valve-in-valve (ViV) transfemoral transcatheter aortic valve implantation (TAVI) for failing aortic surgical bioprostheses or transcatheter heart valves (THV) has demonstrated a reasonable clinical and hemodynamic efficacy. Traditionally, self-expanding (SE) supra-annular THV are considered to result in superior hemodynamics compared with balloon-expandable intra-annular THV after ViV. However, so far no data are found on latest-generation intra-annular SE THV for aortic ViV procedures which might be superior with regard to coronary access or subsequent valve reintervention. AIM: We herein aim to evaluate a latest-generation SE intra-annular THV for aortic ViV procedures. MATERIALS AND METHODS: Between May 2022 and November 2022, five consecutive patients (4/5 female with mean age of 76.2 years and mean Society of Thoracic Surgeons predicted risk of mortality score of 2.9%) received ViV TAVI using the Navitor system (Abbott, Chicago, IL, USA) for treatment of failing surgical bioprostheses or THV. Data were retrospectively analyzed according to updated Valve Academic Research Consortium 3 (VARC-3) definitions. RESULTS: At 30 days, absence of mortality and VARC-3 adjudicated clinical endpoints were documented. Echocardiography at 30 days revealed complete absence of paravalvular leakage and single-digit mean transvalvular gradients (mean of 6.0 mmHg) in all patients. CONCLUSION: The investigated intra-annular SE THV results in excellent 30-day outcomes for aortic ViV procedures for failing surgical bioprostheses or THV. Despite the intra-annular design, hemodynamic results were excellent, even in small bioprostheses. Ease of use of this valve platform is reflected by only two cycles of resheathing in five ViV procedures with hemodynamic stability during all steps of valve deployment. CI - (c) 2023 Schaefer, Demal, Bhadra, Grundmann, Voigtlaender, Waldschmidt, Schirmer, Pecha, Schneeberger, Schofer, Sorensen, Blankenberg, Reichenspurner, Seiffert and Conradi. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Demal, Till Joscha AU - Demal TJ AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Voigtlander, Lisa AU - Voigtlander L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Waldschmidt, Lara AU - Waldschmidt L AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Schirmer, Johannes AU - Schirmer J AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Pecha, Simon AU - Pecha S AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Schneeberger, Yvonne AU - Schneeberger Y AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Sorensen, Nils AU - Sorensen N AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany. LA - eng PT - Journal Article DEP - 20230901 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10505706 OTO - NOTNLM OT - aortic valve OT - bioprostheses OT - self-expandable aortic valve OT - transcatheter aortic valve implantation OT - valve-in-valve COIS- AS received speaker honoraria from Abbott. LC is an advisory board member for Abbott, Medtronic, JenaValve, and MicroPort and has received honoraria from Edwards Lifesciences, Boston Scientific, Neovasc, Highlife, PiCardia, and MicroInterventions. MS received speaker honoraria from Abbott Vascular, Abiomed, Amgen, AstraZeneca, Boston Scientific, BMS/Pfizer, Daiichi Sankyo, Edwards Lifesciences, Inari, Medtronic, Philips, Shockwave Medical, and Siemens. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/09/20 06:42 MHDA- 2023/09/20 06:43 PMCR- 2023/01/01 CRDT- 2023/09/20 03:48 PHST- 2023/04/20 00:00 [received] PHST- 2023/08/07 00:00 [accepted] PHST- 2023/09/20 06:43 [medline] PHST- 2023/09/20 06:42 [pubmed] PHST- 2023/09/20 03:48 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1209184 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Sep 1;10:1209184. doi: 10.3389/fcvm.2023.1209184. eCollection 2023. PMID- 37726606 OWN - NLM STAT- MEDLINE DCOM- 20230921 LR - 20230922 IS - 1875-8312 (Electronic) IS - 1569-5794 (Print) IS - 1569-5794 (Linking) VI - 38 IP - 9 DP - 2022 Sep TI - Interaction between sex and left ventricular reverse remodeling and its association with outcomes after transcatheter aortic valve implantation. PG - 1973-1985 LID - 10.1007/s10554-022-02596-x [doi] AB - Women with severe aortic stenosis (AS) have better long-term prognosis after transcatheter aortic valve implantation (TAVI) compared to men. Whether this is caused by sex-related differences in left ventricular (LV) reverse remodeling after TAVI is unknown. Patients with severe AS who underwent transfemoral TAVI between 2007 and 2018 were selected. LV dimensions, volumes, and ejection fraction (LVEF) were assessed by transthoracic echocardiography before TAVI and at 6 and 12 months follow-up after TAVI. LV reverse remodeling was defined as the percentual LV mass index (LVMi) reduction compared to baseline. The primary outcome was all-cause mortality. A total of 459 patients (80 +/- 8 years; 52% male) were included. At 6 and 12 months follow-up, both sexes showed significant reductions in LV volumes and LVMi accompanied by improvement in LVEF, without significant differences between the sexes over time. During a median follow-up of 2.8 [IQR 1.9-4.3] years, 181 (39%) patients died. Women showed better outcomes compared to men (log-rank p = 0.024). In addition, male sex was independently associated with all-cause mortality in multivariable Cox regression (HR 1.423, 95% CI 1.039-1.951, p = 0.028). No association was observed between the interaction of percentual LVMi reduction and sex with outcomes (p = 0.64). Men and women with severe AS had similar improvement in LVEF, and similar reductions in LV volumes and LVMi at 6 and 12 months after TAVI. Women showed better survival after TAVI as compared to men. The superior outcomes noted in women after TAVI are not associated with sex differences in LV reverse remodeling. CI - (c) 2022. The Author(s). FAU - Kuneman, Jurrien H AU - Kuneman JH AUID- ORCID: 0000-0003-2162-2768 AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - Butcher, Steele C AU - Butcher SC AUID- ORCID: 0000-0001-8258-8802 AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - Stassen, Jan AU - Stassen J AUID- ORCID: 0000-0001-9745-5498 AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - Singh, Gurpreet K AU - Singh GK AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - Pio, Stephan M AU - Pio SM AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - van der Kley, Frank AU - van der Kley F AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - Ajmone Marsan, Nina AU - Ajmone Marsan N AUID- ORCID: 0000-0001-7208-5769 AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. FAU - Knuuti, Juhani AU - Knuuti J AUID- ORCID: 0000-0003-3156-9593 AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. AD - Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland. FAU - Bax, Jeroen J AU - Bax JJ AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. AD - Turku Heart Centre, University of Turku and Turku University Hospital, Turku, Finland. FAU - Delgado, Victoria AU - Delgado V AUID- ORCID: 0000-0002-9841-2737 AD - Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. v.delgado@lumc.nl. LA - eng GR - App000064741/European Society of Cardiology/ GR - T-2018-17405/European Society of Cardiology/ PT - Journal Article DEP - 20220421 PL - United States TA - Int J Cardiovasc Imaging JT - The international journal of cardiovascular imaging JID - 100969716 SB - IM MH - Female MH - Humans MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Predictive Value of Tests MH - Sex Characteristics MH - Echocardiography MH - Ventricular Remodeling PMC - PMC10509071 OTO - NOTNLM OT - Aortic stenosis OT - Echocardiography OT - Left ventricular reverse remodeling OT - Sex differences OT - Transcatheter aortic valve implantation COIS- The department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands has received unrestricted research grants from Abbot Vascular, Bayer, Bioventrix, GE Healthcare, Ionis, Medtronic, Biotronik, Boston Scientific, and Edwards Lifesciences. Jeroen J. Bax and Nina Ajmone Marsan received speaker fees from Abbot Vascular. Victoria Delgado received speaker fees from Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD, Novartis and Medtronic. Juhani Knuuti received consultancy fees from GE Healthcare and AstraZeneca and speaker fees from GE Healthcare, Bayer, Lundbeck, Boehringer-Ingelheim, Pfizer and Merck, outside of the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/09/20 00:43 MHDA- 2023/09/21 06:42 PMCR- 2022/04/21 CRDT- 2023/09/19 23:40 PHST- 2022/01/27 00:00 [received] PHST- 2022/03/10 00:00 [accepted] PHST- 2023/09/21 06:42 [medline] PHST- 2023/09/20 00:43 [pubmed] PHST- 2023/09/19 23:40 [entrez] PHST- 2022/04/21 00:00 [pmc-release] AID - 10.1007/s10554-022-02596-x [pii] AID - 2596 [pii] AID - 10.1007/s10554-022-02596-x [doi] PST - ppublish SO - Int J Cardiovasc Imaging. 2022 Sep;38(9):1973-1985. doi: 10.1007/s10554-022-02596-x. Epub 2022 Apr 21. PMID- 37720969 OWN - NLM STAT- MEDLINE DCOM- 20230919 LR - 20240924 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 19 IP - 7 DP - 2023 Sep 18 TI - Cerebral embolic protection during transcatheter heart interventions. PG - 549-570 LID - EIJ-D-23-00166 [pii] LID - 10.4244/EIJ-D-23-00166 [doi] AB - Stroke remains a devastating complication of transcatheter aortic valve replacement (TAVR), with the incidence of clinically apparent stroke seemingly fixed at around 3% despite TAVR's significant evolution during the past decade. Embolic showers of debris (calcium, atheroma, valve material, foreign material) are captured in the majority of patients who have TAVR using a filter-based cerebral embolic protection device (CEPD). Additionally, in systematic brain imaging studies, the majority of patients receiving TAVR exhibit new cerebral lesions. Mechanistic studies have shown reductions in the volume of new cerebral lesions using CEPDs, yet the first randomised trial powered for periprocedural stroke within 72 hours of a transfemoral TAVR failed to meet its primary endpoint of showing superiority of the SENTINEL CEPD. The present review summarises the clinicopathological rationale for the development of CEPDs, the evidence behind these devices to date and the emerging recognition of cerebral embolisation in many non-TAVR transcatheter procedures. Given the uniqueness of each of the various CEPDs under development, specific trials tailored to their designs will need to be undertaken to broaden the CEPD field, in addition to evaluating the role of CEPD in non-TAVR transcatheter heart interventions. Importantly, the cost-effectiveness of these devices will require assessment to broaden the adoption of CEPDs globally. FAU - Jimenez Diaz, Victor Alfonso AU - Jimenez Diaz VA AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain. AD - Cardiovascular Research Group, Galicia Sur Health Research Institute (IISGS), SERGAS-UVIGO, Vigo, Spain. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Linke, Axel AU - Linke A AD - Department of Internal Medicine and Cardiology, Heart Center Dresden University Hospital, Dresden, Germany and Technische Universitat Dresden, Dresden, Germany. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospital Galway, Galway, Ireland and University of Galway, Galway, Ireland. FAU - Lansky, Alexandra J AU - Lansky AJ AD - Division of Cardiology, Yale School of Medicine, New Haven, CT, USA. FAU - Grube, Eberhard AU - Grube E AD - Department of Medicine II, Heart Center, University Hospital Bonn, Bonn, Germany. FAU - Settergren, Magnus AU - Settergren M AD - Heart and Vascular Unit, Karolinska University Hospital, Stockholm, Sweden and Karolinska Institutet, Stockholm, Sweden. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. LA - eng GR - UL1 TR001863/TR/NCATS NIH HHS/United States PT - Journal Article PT - Review PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - SY7Q814VUP (Calcium) SB - IM MH - Humans MH - *Cardiac Surgical Procedures MH - Heart MH - Brain MH - Calcium MH - Catheters MH - *Intracranial Embolism/etiology/prevention & control PMC - PMC10495748 COIS- V.A.J. Diaz is co-founder of Protembis GmbH and co-inventor of ProtEmbo. D. Mylotte is a consultant for Medtronic, Boston Scientific, and MicroPort. A. Lansky reports institutional research support from Emblok, Emboline, and AorticLabs. R. Puri is a consultant to Protembis GmbH. The other authors have no conflicts of interest to declare. EDAT- 2023/09/18 06:41 MHDA- 2023/09/19 12:42 PMCR- 2024/09/18 CRDT- 2023/09/18 04:50 PHST- 2023/09/19 12:42 [medline] PHST- 2023/09/18 06:41 [pubmed] PHST- 2023/09/18 04:50 [entrez] PHST- 2024/09/18 00:00 [pmc-release] AID - EIJ-D-23-00166 [pii] AID - 10.4244/EIJ-D-23-00166 [doi] PST - ppublish SO - EuroIntervention. 2023 Sep 18;19(7):549-570. doi: 10.4244/EIJ-D-23-00166. PMID- 37708748 OWN - NLM STAT- MEDLINE DCOM- 20260312 LR - 20260312 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 206 DP - 2023 Nov 1 TI - The Benefit of Percutaneous Coronary Intervention Before Transcatheter Aortic Valve Replacement: A Multicenter Retrospective Outcome-Based Study. PG - 175-184 LID - S0002-9149(23)00836-6 [pii] LID - 10.1016/j.amjcard.2023.08.064 [doi] AB - There is inadequate evidence regarding the role of percutaneous coronary intervention (PCI) in patients who underwent transcatheter aortic valve replacement (TAVR). The current American Heart Association/American College of Cardiology guidelines are limited to class 2A recommendations for pre-TAVR revascularization in the setting of hemodynamically significant left main (LM), proximal left anterior descending (pLAD), or extensive bifurcation disease regardless of angina status. We performed a multicenter, retrospective, observational study assessing the benefit of PCI in patients with coronary artery disease who underwent transfemoral TAVR for severe symptomatic aortic stenosis. Patients were divided into 2 cohorts: (1) patients who did not undergo pre-TAVR PCI within the preceding 12 months (no-PCI group) and (2) patients who received pre-TAVR PCI within the preceding 12 months (PCI group). The primary outcome was defined as the composite end point of in-hospital and 30-day adverse events, including all-cause mortality, cardiac arrest, and myocardial infarction. Subgroup analyses were performed on patients with LM and/or pLAD disease and other high-risk features, including angina and heart failure. Comparisons were made between 1,809 consecutive patients (1,364 in the no-PCI group and 445 in the PCI group). There were no differences between the 2 cohorts regarding the primary composite outcome (2.0% vs 2.8%, p = 0.918) or individual secondary outcomes. Although LM/pLAD disease, New York Heart Association classes III to IV, and Society of Thoracic Surgeons risk score >/=8 were all independent predictors of the primary outcome, none of the subgroups demonstrated a benefit favoring PCI. In conclusion, there is no observed benefit from PCI within 12 months pre-TAVR in patients with severe aortic stenosis and concomitant coronary artery disease, including patients with LM/pLAD disease. CI - Copyright (c) 2023. Published by Elsevier Inc. FAU - Mosleh, Wassim AU - Mosleh W AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - Mather, Jeffery F AU - Mather JF AD - Departments of Research Administration. FAU - Delago, Augustin J Jr AU - Delago AJ Jr AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - Eastman, Lauren AU - Eastman L AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - Crain, Nathan AU - Crain N AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - Swann, Emily L AU - Swann EL AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - Masih, Rohit AU - Masih R AD - Cardiology, Hartford Healthcare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - DeVries, James T AU - DeVries JT AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - McKay, Raymond G AU - McKay RG AD - Cardiology, Hartford Healthcare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Young, Michael N AU - Young MN AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address: michael.n.young@hitchcock.org. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20230912 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Retrospective Studies MH - Female MH - Male MH - *Percutaneous Coronary Intervention/methods MH - *Aortic Valve Stenosis/surgery/complications MH - *Coronary Artery Disease/surgery/complications MH - Aged, 80 and over MH - Aged MH - Treatment Outcome MH - Hospital Mortality/trends MH - Follow-Up Studies MH - Survival Rate/trends MH - Postoperative Complications/epidemiology OTO - NOTNLM OT - aortic stenosis OT - percutaneous coronary intervention OT - transcatheter aortic valve replacement COIS- Declaration of Competing Interest The authors have no competing interests to declare. EDAT- 2023/09/15 00:42 MHDA- 2026/03/12 07:03 CRDT- 2023/09/14 18:07 PHST- 2023/06/25 00:00 [received] PHST- 2023/08/03 00:00 [revised] PHST- 2023/08/11 00:00 [accepted] PHST- 2026/03/12 07:03 [medline] PHST- 2023/09/15 00:42 [pubmed] PHST- 2023/09/14 18:07 [entrez] AID - S0002-9149(23)00836-6 [pii] AID - 10.1016/j.amjcard.2023.08.064 [doi] PST - ppublish SO - Am J Cardiol. 2023 Nov 1;206:175-184. doi: 10.1016/j.amjcard.2023.08.064. Epub 2023 Sep 12. PMID- 37696359 OWN - NLM STAT- MEDLINE DCOM- 20231204 LR - 20250703 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 394 DP - 2024 Jan 1 TI - Transaxillary versus transfemoral access as default access in TAVI: A propensity matched analysis. PG - 131353 LID - S0167-5273(23)01312-8 [pii] LID - 10.1016/j.ijcard.2023.131353 [doi] AB - BACKGROUND: Transfemoral (TF) access is default in transcatheter aortic valve implantation (TAVI). Transaxillary (TAx) access has been shown to be a safe alternative in case of prohibitive iliofemoral anatomy, but whether TAx as preferred access has similar safety and efficacy as TF access is unknown. The aim of this study was to compare outcomes between patients treated with self-expanding devices using TF or TAx route as preferred access in TAVI. METHODS: A single center cohort of 354 patients treated using TAx as preferred access and a multi-center cohort of 5980 patients treated using TF access were compared. Propensity score matching was used to reduce selection bias and potential confounding. After propensity score matching, each group consisted of 322 patients. Clinical outcomes according to VARC-2 were compared using chi-square test. RESULTS: In 6334 patients undergoing TAVI, mean age was 81.4 +/- 7.0 years, 57% was female and median logistic EuroSCORE was 14.7% (IQR 9.5-22.6). In the matched population (age 79.3 +/- 7.0, 50% female, logistic EuroSCORE 13.4%, IQR 9.0-21.5), primary outcomes 30-day and one-year all-cause mortality were similar between Tax and TF groups (30 days: 5% versus 6%, p = 0.90; 1 year: 20% versus 16%, p = 0.17). Myocardial infarction was more frequent in patients undergoing Tax TAVI compared with TF (4% versus 1%, p = 0.05), but new permanent pacemakers were less frequently implanted (12% versus 21%, p = 0.001). CONCLUSION: TAx as preferred access is feasible and safe with outcomes that are comparable to TF access. CI - Copyright (c) 2023 The Author(s). Published by Elsevier B.V. All rights reserved. FAU - van Wely, Marleen AU - van Wely M AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: marleen.vanwely@radboudumc.nl. FAU - van Nieuwkerk, Astrid C AU - van Nieuwkerk AC AD - Amsterdam UMC, University of Amsterdam, Heart Center; Department of Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: a.vannieuwkerk@amsterdamumc.nl. FAU - Rooijakkers, Maxim AU - Rooijakkers M AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: max.rooijakkers@radboudumc.nl. FAU - van der Wulp, Kees AU - van der Wulp K AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Kees.vanderwulp@radboudumc.nl. FAU - Gehlmann, Helmut AU - Gehlmann H AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Helmut.Gehlmann@radboudumc.nl. FAU - Verkroost, Michel AU - Verkroost M AD - Department of Cardio-Thoracic surgery, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: michel.verkroost@radboudumc.nl. FAU - van Garsse, Leen AU - van Garsse L AD - Department of Cardio-Thoracic surgery, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: leen.vangarsse@radboudumc.nl. FAU - Geuzebroek, Guillaume AU - Geuzebroek G AD - Department of Cardio-Thoracic surgery, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Guillaume.geuzebroek@radboudumc.nl. FAU - Baz, Jose Antonio AU - Baz JA AD - Servicio de Cardiologia, Hospital Universitario Alvaro Cunqueiro, Vigo, Pontevedra, Spain. Electronic address: joseantoniobaz@gmail.com. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. Electronic address: dtchetche@clinique-pasteur.com. FAU - De Brito, Fabio S Jr AU - De Brito FS Jr AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. Electronic address: fabio.cardiol@gmail.com. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. Electronic address: mbarbanti83@gmail.com. FAU - Kornowski, Ran AU - Kornowski R AD - Rabin Medical Center, Cardiology Department, Petach Tikva, Israel. Electronic address: ran.kornowski@gmail.com. FAU - Latib, Azeem AU - Latib A AD - Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Montefiore Medical Center, Department of Interventional Cardiology, New York, USA. Electronic address: alatib@gmail.com. FAU - D'Onofrio, Augusto AU - D'Onofrio A AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. Electronic address: augusto.donofrio@unipd.it. FAU - Ribichini, Flavio AU - Ribichini F AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. Electronic address: flavio.ribichini@univr.it. FAU - Dangas, George AU - Dangas G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. Electronic address: george.dangas@mountsinai.org. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. Electronic address: roxana.mehran@mountsinai.org. FAU - Delewi, Ronak AU - Delewi R AD - Amsterdam UMC, University of Amsterdam, Heart Center; Department of Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: r.delewi@amsterdamumc.nl. FAU - van Royen, Niels AU - van Royen N AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Niels.vanRoyen@radboudumc.nl. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230909 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - Female MH - Aged MH - Aged, 80 and over MH - Male MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/diagnosis/surgery/etiology MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - *Pacemaker, Artificial MH - Propensity Score MH - Aortic Valve/surgery OTO - NOTNLM OT - Aortic valve stenosis OT - Transcatheter aortic valve implantation OT - Vascular access in transcatheter aortic valve implantation COIS- Conflict of interest statement Dr. van Wely is a proctor for Abbott Vascular. Dr. van Nieuwkerk has no relevant disclosures. Dr. Rooijakkers has no relevant disclosures. Dr. van der Wulp has no relevant disclosures. Dr. Gehlmann is a proctor for Abbott Vascular and Medtronic. Dr. van Garsse is a proctor for Edwards Lifesciences. Dr. de Brito Jr. is a proctor for Edwards Lifesciences and Medtronic. Dr. Geuzebroek has no relevant dislclosures. Dr. Baz has no relevant disclosures. Dr. Tchetche has no relevant disclosures. Dr. De Brito Jr. has no relevant disclosures. Dr. Barbanti is consultant for Edwards Lifesciences and received speaker honoraria from Medtronic and Biotronik. Dr. Kornowski has no relevant disclosures. Dr. Latib is a consultant for Medtronic and has received honoraria from Abbott Vascular. Dr. D'Onofrio is a proctor for Edwards Lifesciences and for Symetis. Dr. Ribichini has no relevant disclosures. Dr. Dangas has no relevant disclosures. Dr. Mehran has no relevant disclosures. Dr. Delewi has no relevant disclosures. Dr. van Royen received research grants from Abbott Vascular, Philips, and Biotronik, speaker honoraria from Abbott Vascular and is consultant for Medtronic, Rainmed and Castor. EDAT- 2023/09/12 00:42 MHDA- 2023/12/04 12:43 CRDT- 2023/09/11 19:18 PHST- 2023/06/20 00:00 [received] PHST- 2023/08/10 00:00 [revised] PHST- 2023/09/08 00:00 [accepted] PHST- 2023/12/04 12:43 [medline] PHST- 2023/09/12 00:42 [pubmed] PHST- 2023/09/11 19:18 [entrez] AID - S0167-5273(23)01312-8 [pii] AID - 10.1016/j.ijcard.2023.131353 [doi] PST - ppublish SO - Int J Cardiol. 2024 Jan 1;394:131353. doi: 10.1016/j.ijcard.2023.131353. Epub 2023 Sep 9. PMID- 37685547 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231102 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 17 DP - 2023 Aug 24 TI - A Machine Learning Model for the Accurate Prediction of 1-Year Survival in TAVI Patients: A Retrospective Observational Cohort Study. LID - 10.3390/jcm12175481 [doi] LID - 5481 AB - BACKGROUND: predicting the 1-year survival of patients undergoing transcatheter aortic valve implantation (TAVI) is indispensable for managing safe early discharge strategies and resource optimization. METHODS: Routinely acquired data (134 variables) were used from 629 patients, who underwent transfemoral TAVI from 2012 up to 2018. Support vector machines, neuronal networks, random forests, nearest neighbour and Bayes models were used with new, previously unseen patients to predict 1-year mortality in TAVI patients. A genetic variable selection algorithm identified a set of predictor variables with high predictive power. RESULTS: Univariate analyses revealed 19 variables (clinical, laboratory, echocardiographic, computed tomographic and ECG) that significantly influence 1-year survival. Before applying the reject option, the model performances in terms of negative predictive value (NPV) and positive predictive value (PPV) were similar between all models. After applying the reject option, the random forest model identified a subcohort showing a negative predictive value of 96% (positive predictive value = 92%, accuracy = 96%). CONCLUSIONS: Our model can predict the 1-year survival with very high negative and sufficiently high positive predictive value, with very high accuracy. The "reject option" allows a high performance and harmonic integration of machine learning in the clinical decision process. FAU - Pollari, Francesco AU - Pollari F AUID- ORCID: 0000-0003-1729-532X AD - Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90471 Nuremberg, Germany. FAU - Hitzl, Wolfgang AU - Hitzl W AUID- ORCID: 0000-0002-7696-1479 AD - Research and Innovation Management (RIM), Team Biostatistics and Publication of Clinical Trial Studies, Paracelsus Medical University, 5020 Salzburg, Austria. AD - Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria. AD - Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, 5020 Salzburg, Austria. FAU - Rottmann, Magnus AU - Rottmann M AD - Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90471 Nuremberg, Germany. FAU - Vogt, Ferdinand AU - Vogt F AD - Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90471 Nuremberg, Germany. FAU - Ledwon, Miroslaw AU - Ledwon M AD - Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90471 Nuremberg, Germany. FAU - Langhammer, Christian AU - Langhammer C AD - Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Paracelsus Medical University, 90471 Nuremberg, Germany. FAU - Eckner, Dennis AU - Eckner D AUID- ORCID: 0000-0003-4791-0098 AD - Cardiology, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90419 Nuremberg, Germany. FAU - Jessl, Jurgen AU - Jessl J AD - Cardiology, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90419 Nuremberg, Germany. FAU - Bertsch, Thomas AU - Bertsch T AD - Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Paracelsus Medical University, 90471 Nuremberg, Germany. FAU - Pauschinger, Matthias AU - Pauschinger M AD - Cardiology, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90419 Nuremberg, Germany. FAU - Fischlein, Theodor AU - Fischlein T AD - Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University-Klinikum Nuremberg, 90471 Nuremberg, Germany. LA - eng PT - Journal Article DEP - 20230824 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10488486 OTO - NOTNLM OT - TAVI OT - machine learning OT - outcome OT - personalized OT - prediction OT - survival COIS- D.E. declares speaker fees from Edwards Lifesciences. F.P. is the inventor of an arterial cannula for mechanical circulatory support (patent EP3860674). The other authors have declared no conflicts of interest. No funding was provided for this study. EDAT- 2023/09/09 11:43 MHDA- 2023/09/09 11:44 PMCR- 2023/08/24 CRDT- 2023/09/09 01:08 PHST- 2023/07/11 00:00 [received] PHST- 2023/08/17 00:00 [revised] PHST- 2023/08/22 00:00 [accepted] PHST- 2023/09/09 11:44 [medline] PHST- 2023/09/09 11:43 [pubmed] PHST- 2023/09/09 01:08 [entrez] PHST- 2023/08/24 00:00 [pmc-release] AID - jcm12175481 [pii] AID - jcm-12-05481 [pii] AID - 10.3390/jcm12175481 [doi] PST - epublish SO - J Clin Med. 2023 Aug 24;12(17):5481. doi: 10.3390/jcm12175481. PMID- 37675085 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230908 IS - 2223-3652 (Print) IS - 2223-3660 (Electronic) IS - 2223-3652 (Linking) VI - 13 IP - 4 DP - 2023 Aug 31 TI - Ventricular pacing dependency after transcatheter aortic valve replacement: a prospective cohort. PG - 628-637 LID - 10.21037/cdt-23-63 [doi] AB - BACKGROUND: Atrioventricular conduction disturbance occurs in a significant number of patients undergoing transcatheter aortic valve replacement (TAVR). However, not all cases are ventricular pacing-dependent. Thus, we aimed to study the incidence, predictors, and outcomes of new ventricular pacing dependency (VpDep) after TAVR. METHODS: We prospectively analyzed 130 consecutive transfemoral TAVR cases performed in Ramathibodi Hospital between 2015 and 2020. Three patients with prior ventricular pacing-dependent on cardiac implantable electronic devices (CIEDs) were excluded. The endpoints were VpDep at 1 month and all-cause mortality at the follow-up period end in 2021. The effects of variables on VpDep and all-cause mortality were evaluated using multivariate binary logistic regression and Cox regression analyses, respectively. First-degree atrioventricular block (AVB) was considered severe when the PR interval was >300 ms. RESULTS: Of the 127 patients [mean age, 81.8 years; 62.2% females; 67.7% balloon-expandable (BE) device], 7 patients (5.5%) had CIEDs implanted before TAVR that were not ventricular pacing-dependent. TAVR was successfully performed in 126 (99.2%) patients. Periprocedural stroke, cardiac tamponade, and major bleeding occurred in 2 (1.6%), 4 (3.1%), and 4 (3.1%) patients, respectively. The VpDep incidence at 1 month was 7.9% (n=10) among all patients and 34.5% among those with CIEDs (n=29). VpDep was more likely to occur in patients with pre-existing right bundle branch block (RBBB) [odds ratio (OR), 21.38; 95% confidence interval (CI): 3.28-139.33; P=0.001] and severe 1(st) degree or Mobitz I AVB (OR, 14.79; 95% CI: 1.65-132.74; P=0.016). After a mean follow-up of 25.8 months [standard deviation (SD), 21.2 months], death from any cause occurred in 18 patients (14.2%). However, VpDep was not associated with an increased mortality. CONCLUSIONS: In this real-world cohort, pre-existing conduction abnormalities were significantly associated with a higher risk of VpDep. Mortality was similar between patients with and without VpDep. CI - 2023 Cardiovascular Diagnosis and Therapy. All rights reserved. FAU - Apiyasawat, Sirin AU - Apiyasawat S AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. AD - Division of Cardiology, Ramathibodi Hospital, Bangkok, Thailand. FAU - Chandavimol, Mann AU - Chandavimol M AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. FAU - Soontornmanokati, Natcha AU - Soontornmanokati N AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. FAU - Sirikhamkorn, Chulaporn AU - Sirikhamkorn C AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. LA - eng PT - Journal Article DEP - 20230731 PL - China TA - Cardiovasc Diagn Ther JT - Cardiovascular diagnosis and therapy JID - 101601613 PMC - PMC10478017 OTO - NOTNLM OT - Pacemaker OT - aortic stenosis OT - atrioventricular block (AVB) OT - transcatheter aortic valve replacement (TAVR) COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-23-63/coif). The authors have no conflicts of interest to declare. EDAT- 2023/09/07 06:42 MHDA- 2023/09/07 06:43 PMCR- 2023/08/31 CRDT- 2023/09/07 04:14 PHST- 2023/02/16 00:00 [received] PHST- 2023/07/14 00:00 [accepted] PHST- 2023/09/07 06:43 [medline] PHST- 2023/09/07 06:42 [pubmed] PHST- 2023/09/07 04:14 [entrez] PHST- 2023/08/31 00:00 [pmc-release] AID - cdt-13-04-628 [pii] AID - 10.21037/cdt-23-63 [doi] PST - ppublish SO - Cardiovasc Diagn Ther. 2023 Aug 31;13(4):628-637. doi: 10.21037/cdt-23-63. Epub 2023 Jul 31. PMID- 37674237 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230922 IS - 2055-0464 (Print) IS - 2055-0464 (Electronic) IS - 2055-0464 (Linking) VI - 10 IP - 1 DP - 2023 Sep 7 TI - Intraprocedural versus next day transthoracic echocardiography following minimalist transfemoral TAVI. PG - 14 LID - 10.1186/s44156-023-00025-w [doi] LID - 14 AB - BACKGROUND: Routine pre-discharge echocardiography (ECHO) is recommended post transcatheter aortic valve implantation (TAVI) as a baseline for future comparison. However, there is no clear guidance on the optimal timing of this study. AIM: The purpose of this retrospective study was to investigate the safety and work-force efficiency of intraprocedural same-day ECHO versus next-day ECHO, following transfemoral TAVI. METHODS AND RESULTS: In this retrospective study 100 consecutive patients who underwent intraprocedural ECHO only were compared with 100 consecutive patients undergoing both intraprocedural and routine next-day ECHO following elective transfemoral TAVI. All patients received the Sapien 3/Ultra transcatheter heart valve and were treated with a minimalist procedure with conscious sedation. The composite of in-hospital mortality, urgent ECHO and new tamponade after leaving the cath lab and before discharge was not different between the two groups (4 vs. 4%, P = 1). There was no paravalvular leak more than mild in any of the cases. Length of stay was similar (1 day). CONCLUSIONS: Intraprocedural post-TAVI ECHO appears as safe as next day pre-discharge ECHO and obviates the need for a routine next day study, thereby reducing burden on echocardiography services and allows better utilisation of resources. CI - (c) 2023. British Society of Echocardiography. FAU - Savvoulidis, Panagiotis AU - Savvoulidis P AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Nadir, M Adnan AU - Nadir MA AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Moody, William E AU - Moody WE AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Steeds, Richard AU - Steeds R AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Ludman, Peter F AU - Ludman PF AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Bradley, Joseph R AU - Bradley JR AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Singh, Aldrin AU - Singh A AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Lawton, Ewa AU - Lawton E AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Doshi, Sagar N AU - Doshi SN AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. Sagar.Doshi@uhb.nhs.uk. AD - Institute for Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. Sagar.Doshi@uhb.nhs.uk. LA - eng PT - Journal Article DEP - 20230907 PL - England TA - Echo Res Pract JT - Echo research and practice JID - 101664713 PMC - PMC10483768 OTO - NOTNLM OT - Complications OT - Echocardiography guidance OT - Next day ECHO OT - Same day ECHO OT - Transcatheter aortic valve implantation COIS- Dr SN Doshi is a proctor for Edwards LifeSciences and has received speaker fees from Medtronic and Boston Scientific. The other authors have no disclosures. EDAT- 2023/09/07 00:41 MHDA- 2023/09/07 00:42 PMCR- 2023/09/07 CRDT- 2023/09/06 23:42 PHST- 2023/03/16 00:00 [received] PHST- 2023/07/30 00:00 [accepted] PHST- 2023/09/07 00:42 [medline] PHST- 2023/09/07 00:41 [pubmed] PHST- 2023/09/06 23:42 [entrez] PHST- 2023/09/07 00:00 [pmc-release] AID - 10.1186/s44156-023-00025-w [pii] AID - 25 [pii] AID - 10.1186/s44156-023-00025-w [doi] PST - epublish SO - Echo Res Pract. 2023 Sep 7;10(1):14. doi: 10.1186/s44156-023-00025-w. PMID- 37668736 OWN - NLM STAT- MEDLINE DCOM- 20240419 LR - 20240426 IS - 1436-2813 (Electronic) IS - 0941-1291 (Print) IS - 0941-1291 (Linking) VI - 54 IP - 5 DP - 2024 May TI - Simulation to determine the approach of transcatheter aortic valve implantation in patients undergoing hemodialysis. PG - 428-435 LID - 10.1007/s00595-023-02743-4 [doi] AB - PURPOSE: The present study investigated potential access vessels in patients receiving hemodialysis who underwent surgical aortic valve replacement and determined which approaches were most suitable for performing transcatheter aortic valve implantation. METHODS: Consecutive patients undergoing hemodialysis with aortic valve stenosis who underwent surgical aortic valve replacement were included. Preoperative computed tomography data were analyzed to assess the vessel diameter and calcification. Simulations were conducted to determine the feasibility of inserting the 14-F eSheath of Sapien 3 via transfemoral, trans-cervical, trans-subclavian, and direct aorta approaches. RESULTS: A total of 72 patients were included in this study. The access route was characterized by severe calcification of the common iliac artery. The transfemoral approach was feasible in 77.8% of the cases, but the rate decreased to 33% when the calculations were based on the maximum sheath extension diameter. The trans-cervical, trans-subclavian, and direct aortic approaches were suitable for many patients. Lower extremity artery disease was identified as a risk factor for the unsuitability of the transfemoral approach. CONCLUSIONS: Common iliac artery calcification in patients undergoing hemodialysis restricts the use of the transfemoral approach. Therefore, some patients require alternative approaches. CI - (c) 2023. The Author(s). FAU - Takei, Yusuke AU - Takei Y AUID- ORCID: 0000-0002-1307-2164 AD - Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, 880 Kitakobayashi, Mibu-Machi, Shimotuga-gun, Tochigi, 321-0293, Japan. y-takei@dokkyomed.ac.jp. FAU - Saito, Shunsuke AU - Saito S AD - Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, 880 Kitakobayashi, Mibu-Machi, Shimotuga-gun, Tochigi, 321-0293, Japan. FAU - Shibasaki, Ikuko AU - Shibasaki I AD - Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, 880 Kitakobayashi, Mibu-Machi, Shimotuga-gun, Tochigi, 321-0293, Japan. FAU - Kuwata, Toshiyuki AU - Kuwata T AD - Division of Cardiovascular Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan. FAU - Yamada, Yasuyuki AU - Yamada Y AD - Division of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Gunma, Japan. FAU - Fukuda, Hirotsugu AU - Fukuda H AD - Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, 880 Kitakobayashi, Mibu-Machi, Shimotuga-gun, Tochigi, 321-0293, Japan. LA - eng PT - Journal Article DEP - 20230905 PL - Japan TA - Surg Today JT - Surgery today JID - 9204360 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Renal Dialysis MH - Femoral Artery/surgery PMC - PMC11026236 OTO - NOTNLM OT - Approach simulation OT - Hemodialysis OT - Transcatheter aortic valve implantation OT - Vascular complication COIS- The authors declare that they have no conflicts of interest. The authors have full control over all primary data and agree to allow the journal to review the data if requested. EDAT- 2023/09/05 12:41 MHDA- 2024/04/19 06:43 PMCR- 2023/09/05 CRDT- 2023/09/05 11:12 PHST- 2023/04/19 00:00 [received] PHST- 2023/08/13 00:00 [accepted] PHST- 2024/04/19 06:43 [medline] PHST- 2023/09/05 12:41 [pubmed] PHST- 2023/09/05 11:12 [entrez] PHST- 2023/09/05 00:00 [pmc-release] AID - 10.1007/s00595-023-02743-4 [pii] AID - 2743 [pii] AID - 10.1007/s00595-023-02743-4 [doi] PST - ppublish SO - Surg Today. 2024 May;54(5):428-435. doi: 10.1007/s00595-023-02743-4. Epub 2023 Sep 5. PMID- 37668097 OWN - NLM STAT- MEDLINE DCOM- 20231115 LR - 20231121 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 5 DP - 2023 Nov TI - Prosthesis-patient mismatch after transcatheter implantation of contemporary balloon-expandable and self-expandable valves in small aortic annuli. PG - 931-943 LID - 10.1002/ccd.30818 [doi] AB - BACKGROUND: Evidence of clinical impact of PPM after TAVI is conflicting and might vary according to the type of valve implanted. AIMS: To assess the clinical impact of prosthesis-patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI) with balloon-expandable (BEV) and self-expandable valves (SEV) in patients with small annuli. METHODS: TAVI-SMALL 2 enrolled 628 patients in an international retrospective registry, which included patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm(2) ) treated with transfemoral TAVI at 16 high-volume centers between 2011 and 2020. Analyses were performed comparing patients with less than moderate (n = 452), moderate (n = 138), and severe PPM (n = 38). Primary endpoint was incidence of all-cause mortality. Predictors of all-cause mortality and PPM were investigated. RESULTS: At a median follow-up of 380 days (interquartile range: 210-709 days), patients with severe PPM, but not moderate PPM, had an increased risk of all-cause mortality when compared with less than moderate PPM (log-rank p = 0.046). Severe PPM predicted all-cause mortality in patients with BEV (hazard ratio [HR]: 5.20, 95% confidence interval [CI]: 1.27-21.2) and intra-annular valves (IAVs, HR: 4.23, 95% CI: 1.28-14.02), and it did so with borderline significance in the overall population (HR: 2.89, 95% CI: 0.95-8.79). Supra-annular valve (SAV) implantation was the only predictor of severe PPM (odds ratio: 0.33, 95% CI: 0.13-0.83). CONCLUSIONS: Patients with small aortic annuli and severe PPM after TAVI have an increased risk of all-cause mortality at early term follow-up, especially after IAV or BEV implantation. TAVI with SAV protected from severe PPM. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Leone, Pier Pasquale AU - Leone PP AUID- ORCID: 0000-0002-0561-4760 AD - Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Regazzoli, Damiano AU - Regazzoli D AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Pagnesi, Matteo AU - Pagnesi M AUID- ORCID: 0000-0002-9298-7871 AD - Department of Medical and Surgical specialties, Radiological Sciences and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy. FAU - Costa, Giuliano AU - Costa G AUID- ORCID: 0000-0003-3770-8988 AD - U.O.C. Cardiologia, Centro Alte Specialita e Trapianti, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Teles, Rui AU - Teles R AUID- ORCID: 0000-0002-7952-6878 AD - Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal. FAU - Adamo, Marianna AU - Adamo M AUID- ORCID: 0000-0002-3855-1815 AD - Department of Medical and Surgical specialties, Radiological Sciences and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy. FAU - Taramasso, Maurizio AU - Taramasso M AUID- ORCID: 0000-0001-7295-1153 AD - HerzZentrum Hirslanden Zurich, University of Zurich, Zurich, Switzerland. FAU - De Marco, Federico AU - De Marco F AD - Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AUID- ORCID: 0000-0002-3239-4046 AD - GVM Care and Research, Maria Cecilia Hospital, Ravenna, Italy. FAU - Kargoli, Faraj AU - Kargoli F AUID- ORCID: 0000-0002-3609-9976 AD - Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA. FAU - Ohno, Yohei AU - Ohno Y AUID- ORCID: 0000-0003-4203-7613 AD - Department of Cardiology, Tokai University Hospital, Kanagawa, Japan. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AUID- ORCID: 0000-0002-5982-1669 AD - Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy. FAU - Ribichini, Flavio AU - Ribichini F AD - Department of Medicine, Division of Cardiology, University of Verona, Verona, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Maisano, Francesco AU - Maisano F AD - Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. FAU - Colombo, Antonio AU - Colombo A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Latib, Azeem AU - Latib A AUID- ORCID: 0000-0001-9035-343X AD - Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA. CN - TAVI-SMALL Investigators LA - eng PT - Journal Article DEP - 20230905 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2023 Nov;102(5):944-945. doi: 10.1002/ccd.30837. PMID: 37681951 MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/etiology MH - Retrospective Studies MH - Prosthesis Design MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects OTO - NOTNLM OT - TAVI OT - balloon-expandable valve OT - intra-annular valve OT - prosthesis-patient mismatch OT - self-expandable valve OT - small annuli OT - supra-annular valve EDAT- 2023/09/05 12:42 MHDA- 2023/11/15 06:42 CRDT- 2023/09/05 06:42 PHST- 2023/07/29 00:00 [revised] PHST- 2023/04/04 00:00 [received] PHST- 2023/08/19 00:00 [accepted] PHST- 2023/11/15 06:42 [medline] PHST- 2023/09/05 12:42 [pubmed] PHST- 2023/09/05 06:42 [entrez] AID - 10.1002/ccd.30818 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Nov;102(5):931-943. doi: 10.1002/ccd.30818. Epub 2023 Sep 5. PMID- 37665351 OWN - NLM STAT- MEDLINE DCOM- 20240222 LR - 20240224 IS - 1869-1447 (Electronic) IS - 1869-1439 (Print) IS - 1869-1439 (Linking) VI - 34 IP - 1 DP - 2024 Mar TI - Iatrogenic Air Embolisms During Endovascular Interventions: Impact of Origin and Number of Air Bubbles on Cerebral Infarctions. PG - 135-145 LID - 10.1007/s00062-023-01347-2 [doi] AB - PURPOSE: Cerebral infarctions caused by air embolisms (AE) are a feared risk in endovascular procedures; however, the relevance and pathophysiology of these AEs is still largely unclear. The objective of this study was to investigate the impact of the origin (aorta, carotid artery or right atrium) and number of air bubbles on cerebral infarctions in an experimental in vivo model. METHODS: In 20 rats 1200 or 2000 highly calibrated micro air bubbles (MAB) with a size of 85 microm were injected at the aortic valve (group Ao), into the common carotid artery (group CA) or into the right atrium (group RA) using a microcatheter via a transfemoral access, resembling endovascular interventions in humans. Magnetic resonance imaging (MRI) using a 9.4T system was performed 1 h after MAB injection followed by finalization. RESULTS: The number (5.5 vs. 5.5 median) and embolic patterns of infarctions did not significantly differ between groups Ao and CA. The number of infarctions were significantly higher comparing 2000 and 1200 injected MABs (6 vs. 4.5; p < 0.001). The infarctions were significantly larger for group CA (median infarction volume: 0.41 mm(3) vs. 0.19 mm(3); p < 0.001). In group RA and in the control group no infarctions were detected. Histopathological analyses showed early signs of ischemic stroke. CONCLUSION: Iatrogenic AEs originating at the ascending aorta cause a similar number and pattern of cerebral infarctions compared to those with origin at the carotid artery. These findings underline the relevance and potential risk of AE occurring during endovascular interventions at the aortic valve and ascending aorta. CI - (c) 2023. The Author(s). FAU - Schaefer, Tabea C AU - Schaefer TC AD - Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. AD - Clinic for small animals, Justus-Liebig-University Giessen, Giessen, Germany. FAU - Greive, Svenja AU - Greive S AD - Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. FAU - Mencl, Stine AU - Mencl S AD - Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany. FAU - Heiland, Sabine AU - Heiland S AD - Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. FAU - Kramer, Martin AU - Kramer M AD - Clinic for small animals, Justus-Liebig-University Giessen, Giessen, Germany. FAU - Mohlenbruch, Markus A AU - Mohlenbruch MA AD - Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. FAU - Kleinschnitz, Christoph AU - Kleinschnitz C AD - Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany. FAU - Bendszus, Martin AU - Bendszus M AD - Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. FAU - Vollherbst, Dominik F AU - Vollherbst DF AUID- ORCID: 0000-0002-8992-4757 AD - Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. dominik.vollherbst@med.uni-heidelberg.de. LA - eng PT - Journal Article DEP - 20230904 PL - Germany TA - Clin Neuroradiol JT - Clinical neuroradiology JID - 101526693 SB - IM MH - Humans MH - Rats MH - Animals MH - *Embolism, Air/diagnostic imaging/etiology MH - Cerebral Infarction/diagnostic imaging/etiology MH - Magnetic Resonance Imaging MH - *Endovascular Procedures/adverse effects MH - Iatrogenic Disease PMC - PMC10881616 OTO - NOTNLM OT - Cerebral infarction OT - Endovascular interventions OT - Gas embolism OT - TAVI OT - TEVAR COIS- M.A. Mohlenbruch has received consulting honoraria, speaker honoraria, and travel support outside this work from Codman, Covidien/Medtronic, MicroVention, Phenox, and Stryker. M. Bendszus reports board membership: DSMB Vascular Dynamics; consultancy: Roche, Guerbet, Codman; grants/grants pending: DFG, Hopp Foundation, Novartis, Siemens, Guerbet, Stryker, Covidien; payment for lectures (including service on speaker bureaus): Novartis, Roche, Guerbet, Teva, Bayer, Codman. D.F. Vollherbst reports consultancy for Medtronic and paid lectures for Cerenovus, and a research grant by MicroVention (unrelated to this work). T.C. Schaefer, S. Greive, S. Mencl, S. Heiland, M. Kramer, and C. Kleinschnitz declare that they have no competing interests. EDAT- 2023/09/04 12:42 MHDA- 2024/02/22 06:43 PMCR- 2023/09/04 CRDT- 2023/09/04 11:07 PHST- 2023/05/26 00:00 [received] PHST- 2023/08/22 00:00 [accepted] PHST- 2024/02/22 06:43 [medline] PHST- 2023/09/04 12:42 [pubmed] PHST- 2023/09/04 11:07 [entrez] PHST- 2023/09/04 00:00 [pmc-release] AID - 10.1007/s00062-023-01347-2 [pii] AID - 1347 [pii] AID - 10.1007/s00062-023-01347-2 [doi] PST - ppublish SO - Clin Neuroradiol. 2024 Mar;34(1):135-145. doi: 10.1007/s00062-023-01347-2. Epub 2023 Sep 4. PMID- 37664782 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230904 IS - 1301-5680 (Print) IS - 2149-8156 (Electronic) IS - 1301-5680 (Linking) VI - 31 IP - 3 DP - 2023 Jul TI - The use of artificial intelligence in interventional cardiology. PG - 420-421 LID - 10.5606/tgkdc.dergisi.2023.24791 [doi] AB - Artificial intelligence can be employed in many cardiological applications including image analysis, risk assessment, and patient monitoring. In the catheterization laboratory, it can act as a physician assistant, technician, or co-worker. First, by giving voice commands to the operator of the coronary angiography machine, it can ensure that the C-arm moves to the desired angle. It is able to make recommendations for stent size and type based on the analysis of angiography images which is also possible for peripheral and carotid interventions. For transcatheter aortic valve implantation, it can make recommendations for valve placement and size. Artificial intelligence-based image analysis algorithms can be used to support image analysis during catheter laboratory procedures. The challenges include the need for large, high-quality data sets and the development of accurate, reliable, and interpretable artificial intelligence algorithms. CI - Copyright (c) 2023, Turkish Society of Cardiovascular Surgery. FAU - Gocer, Hakan AU - Gocer H AUID- ORCID: 0000-0002-9644-9579 AD - Department of Cardiology, Korfez Private Hospital, Balikesir, Turkiye. FAU - Durukan, Ahmet Baris AU - Durukan AB AUID- ORCID: 0000-0003-0566-0350 AD - Department of Cardiovascular Surgery, LIV Ankara Hospital, Ankara, Turkiye. AD - Department of Cardiovascular Surgery, Istinye University, School of Medicine, Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20230727 PL - Turkey TA - Turk Gogus Kalp Damar Cerrahisi Derg JT - Turk gogus kalp damar cerrahisi dergisi JID - 100887967 PMC - PMC10472472 OTO - NOTNLM OT - Artificial intelligence OT - cardiovascular diseases OT - interventional cardiology. COIS- Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. EDAT- 2023/09/04 06:43 MHDA- 2023/09/04 06:44 PMCR- 2023/07/27 CRDT- 2023/09/04 05:18 PHST- 2023/02/23 00:00 [received] PHST- 2023/04/11 00:00 [accepted] PHST- 2023/09/04 06:44 [medline] PHST- 2023/09/04 06:43 [pubmed] PHST- 2023/09/04 05:18 [entrez] PHST- 2023/07/27 00:00 [pmc-release] AID - 10.5606/tgkdc.dergisi.2023.24791 [doi] PST - epublish SO - Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jul 27;31(3):420-421. doi: 10.5606/tgkdc.dergisi.2023.24791. eCollection 2023 Jul. PMID- 37663694 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240924 IS - 2049-0801 (Print) IS - 2049-0801 (Electronic) IS - 2049-0801 (Linking) VI - 85 IP - 9 DP - 2023 Sep TI - Postoperative delirium in 47 379 individuals undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis. PG - 4476-4490 LID - 10.1097/MS9.0000000000001096 [doi] AB - OBJECTIVE: The study aims to discuss the assessment methods used for the incidence of in-hospital postoperative delirium (IHPOD) in transcatheter aortic valve replacement (TAVR) patients and explore possible strategies for preventing and reducing postoperative complications in the geriatric population. METHODOLOGY: An electronic search of PubMed, Embase, BioMedCentral, Google Scholar, and the Cochrane Central Register of Controlled Trials was conducted up to August 2021, to identify studies on the IHPOD following TAVR in patients above 70 years. The primary objective of the study was to determine the incidence of delirium following TAVR and procedures like transfemoral (TF) and non-TF approaches. The secondary objectives were to determine the incidence of stroke and incidence according to the confusion assessment method (CAM) diagnostic tool. The authors only included studies published in English and excluded patients with comorbidities and studies with inaccessible full-text. RESULTS: Among the selected 42 studies with 47 379 patients, the incidence of IHPOD following TAVR was 10.5% (95% CI: 9.2-11.9%, I(2)=95.82%, P<0.001). Incidence based on CAM was 15.6% (95% CI: 10.5-20.7%, I(2)=95.36%, P<0.001). The incidence of IHPOD after TF-TAVR was 9.3% (95% CI: 7.6-11.0%, I(2)=94.52%, P<0.001), and after non-TF TAVI was 25.3% (95% CI: 15.4-35.1%, I(2)=92.45%, P<0.001). The incidence of stroke was 3.7% (95% CI: 2.9-4.5%, I(2)=89.76%, P<0.001). Meta-regression analyses between mean age (P=0.146), logistic EuroSCORE (P=0.099), or percentage of participants treated using the TF approach (P=0.276) were nonsignificant while stroke (P=0.010) was significant. When considering these variables, the residual heterogeneity remained high indicating that other variables influence the heterogeneity. CONCLUSION: IHPOD following TAVR was observed in 10.5% of individuals and in 15.6% using CAM. Its incidence was found to be three times higher after non-TF TAVR (25.3%) compared to TF TAVR (9.3%). Stroke showed an incidence of 3.7% after TAVR and was found to be significantly associated with the risk of developing delirium following TAVR. Further studies are needed to evaluate possible causes and risk factors responsible for delirium and to assess the role of anesthesia and cerebral embolic protection in preventing delirium after TAVR. CI - Copyright (c) 2023 The Author(s). Published by Wolters Kluwer Health, Inc. FAU - Ochani, Sidhant AU - Ochani S AD - Department of Medicine, Khairpur Medical College, Khairpur Mir's. FAU - Adnan, Alishba AU - Adnan A AD - Department of Medicine, Karachi Medical and Dental College. FAU - Siddiqui, Amna AU - Siddiqui A AD - Department of Medicine, Karachi Medical and Dental College. FAU - Kalwar, Asifa AU - Kalwar A AD - Department of Medicine, Dow University of Health Sciences. FAU - Kukreja, Sandhaya AU - Kukreja S AD - Department of Medicine, Dow University of Health Sciences. FAU - Ahmad, Mushtaq AU - Ahmad M AD - Department of Medicine, Ziauddin Medical University, Karachi, Pakistan. FAU - Ashraf, Muhammad Hasan AU - Ashraf MH AD - Department of Medicine, Dow University of Health Sciences. FAU - Asghar, Mustafa Ali AU - Asghar MA AD - Department of Medicine, Dow University of Health Sciences. LA - eng PT - Journal Article PT - Review DEP - 20230726 PL - England TA - Ann Med Surg (Lond) JT - Annals of medicine and surgery (2012) JID - 101616869 PMC - PMC10473306 OTO - NOTNLM OT - CAM OT - TAVR OT - confusion assessment method OT - delirium OT - stroke OT - transcatheter aortic valve replacement COIS- The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. EDAT- 2023/09/04 06:42 MHDA- 2023/09/04 06:43 PMCR- 2023/07/26 CRDT- 2023/09/04 05:04 PHST- 2022/11/22 00:00 [received] PHST- 2023/07/13 00:00 [accepted] PHST- 2023/09/04 06:43 [medline] PHST- 2023/09/04 06:42 [pubmed] PHST- 2023/09/04 05:04 [entrez] PHST- 2023/07/26 00:00 [pmc-release] AID - AMSU-D-22-02838 [pii] AID - 10.1097/MS9.0000000000001096 [doi] PST - epublish SO - Ann Med Surg (Lond). 2023 Jul 26;85(9):4476-4490. doi: 10.1097/MS9.0000000000001096. eCollection 2023 Sep. PMID- 37651031 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231126 IS - 1568-5888 (Print) IS - 1876-6250 (Electronic) IS - 1568-5888 (Linking) VI - 31 IP - 12 DP - 2023 Dec TI - Emergency transfemoral valve-in-valve transcatheter aortic valve implantation in patient with chronic type A aortic dissection. PG - 506-508 LID - 10.1007/s12471-023-01809-9 [doi] FAU - Aarts, Hugo M AU - Aarts HM AD - Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands. AD - Department of Utrecht, University Medical Centre Utrecht, Utrecht, The Netherlands. FAU - van Nieuwkerk, Astrid C AU - van Nieuwkerk AC AD - Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands. FAU - Baan, Jan AU - Baan J AD - Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands. FAU - Delewi, Ronak AU - Delewi R AUID- ORCID: 0000-0001-6070-9423 AD - Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands. r.delewi@amsterdamumc.nl. FAU - Beijk, Marcel A M AU - Beijk MAM AD - Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands. LA - eng PT - Journal Article DEP - 20230831 PL - Netherlands TA - Neth Heart J JT - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation JID - 101095458 PMC - PMC10667173 COIS- R. Delewi has received educational grants from Boston Scientific and Edwards Lifesciences. H.M. Aarts, A.C. van Nieuwkerk, J. Baan and M.A.M. Beijk declare that they have no competing interests. EDAT- 2023/08/31 12:43 MHDA- 2023/08/31 12:44 PMCR- 2023/08/31 CRDT- 2023/08/31 11:14 PHST- 2023/07/24 00:00 [accepted] PHST- 2023/08/31 12:44 [medline] PHST- 2023/08/31 12:43 [pubmed] PHST- 2023/08/31 11:14 [entrez] PHST- 2023/08/31 00:00 [pmc-release] AID - 10.1007/s12471-023-01809-9 [pii] AID - 1809 [pii] AID - 10.1007/s12471-023-01809-9 [doi] PST - ppublish SO - Neth Heart J. 2023 Dec;31(12):506-508. doi: 10.1007/s12471-023-01809-9. Epub 2023 Aug 31. PMID- 37648344 OWN - NLM STAT- MEDLINE DCOM- 20230901 LR - 20250507 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 16 DP - 2023 Aug 28 TI - Transcatheter Aortic Valve Replacement for Isolated Aortic Regurgitation Using a New Self-Expanding TAVR System. PG - 1965-1973 LID - S1936-8798(23)01115-9 [pii] LID - 10.1016/j.jcin.2023.07.038 [doi] AB - BACKGROUND: Patients with severe aortic regurgitation (AR) are often not considered for surgery because of increased surgical risk. Because of unique anatomical characteristics among patients with AR, interventional treatment options are limited, and implantation results are inconsistent compared with those among patients with aortic stenosis. OBJECTIVES: The authors describe the initial commercial experience of the first Conformite Europeenne-marked transfemoral transcatheter aortic valve replacement system (JenaValve Trilogy [JV]) for the treatment of patients with AR. METHODS: This multicenter registry included 58 consecutive patients from 6 centers across Germany. Transcatheter aortic valve replacement was performed with the JV system for isolated severe and symptomatic AR. Patient characteristics, primary implantation outcomes, and valve performance up to 30 days were analyzed using Valve Academic Research Consortium 3 definitions. RESULTS: The mean patient age was 76.5 +/- 9 years, with a mean Society of Thoracic Surgeons score of 4.2% +/- 4.3%. Device success was achieved in 98% of patients. The mean gradient was 4.3 +/- 1.6 mm Hg, and no moderate or severe paravalvular regurgitation occurred. No conversion to open heart surgery or valve embolization was reported. There were no major vascular complications or bleeding events. The rate of new permanent pacemaker implantation was 19.6%. At 30 days, 92% of the patients were in NYHA functional class I or II, and the 30-day mortality rate was 1.7%. CONCLUSIONS: Treatment of patients with severe symptomatic AR using the transfemoral JV system is safe and effective. Given its favorable hemodynamic performance and low complication rates, this system may offer a new treatment option for patients with AR not suitable for surgery. CI - Copyright (c) 2023. Published by Elsevier Inc. FAU - Adam, Matti AU - Adam M AD - Department of Internal Medicine III - Cardiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Tamm, Alexander R AU - Tamm AR AD - Heart Valve Center, Heart and Vascular Center, Universitatsmedizin Mainz, Mainz, Germany. FAU - Wienemann, Hendrik AU - Wienemann H AD - Department of Internal Medicine III - Cardiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Unbehaun, Axel AU - Unbehaun A AD - Deutsches Herzzentrum der Charite, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; German Centre for Cardiovascular Research, partner site Berlin, Berlin, Germany. FAU - Klein, Christoph AU - Klein C AD - Deutsches Herzzentrum der Charite, Department of Internal Medicine - Cardiology, Berlin, Germany. FAU - Arnold, Martin AU - Arnold M AD - Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Germany; Department of Cardiology, Herzzentrum, Klinikum, Passau, Germany. FAU - Marwan, Mohamed AU - Marwan M AD - Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Germany. FAU - Theiss, Hans AU - Theiss H AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Munich, Germany; German Centre for Cardiovascular Research, partner site Munich, Munich, Germany. FAU - Braun, Daniel AU - Braun D AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Munich, Germany; German Centre for Cardiovascular Research, partner site Munich, Munich, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Geyer, Martin AU - Geyer M AD - Heart Valve Center, Heart and Vascular Center, Universitatsmedizin Mainz, Mainz, Germany. FAU - Goncharov, Arseniy AU - Goncharov A AD - Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Kuhn, Elmar AU - Kuhn E AD - Department for Cardiothoracic Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Falk, Volkmar AU - Falk V AD - Deutsches Herzzentrum der Charite, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; German Centre for Cardiovascular Research, partner site Berlin, Berlin, Germany; ETH Zurich, Department of Health Sciences and Technology, Translational Cardiovascular Technology Zurich, Switzerland. FAU - von Bardeleben, Ralph Stephan AU - von Bardeleben RS AD - Heart Valve Center, Heart and Vascular Center, Universitatsmedizin Mainz, Mainz, Germany. FAU - Achenbach, Stephan AU - Achenbach S AD - Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Germany. FAU - Massberg, Steffen AU - Massberg S AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Munich, Germany; German Centre for Cardiovascular Research, partner site Munich, Munich, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department of Internal Medicine III - Cardiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. FAU - Treede, Hendrik AU - Treede H AD - Department of Cardiovascular Surgery, Johannes-Gutenberg University, Mainz, Germany. FAU - Rudolph, Tanja Katharina AU - Rudolph TK AD - Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. Electronic address: trudolph@hdz-nrw.de. LA - eng PT - Journal Article PT - Multicenter Study PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Aug 28;16(16):1986-1989. doi: 10.1016/j.jcin.2023.07.025. PMID: 37648346 CIN - Catheter Cardiovasc Interv. 2024 Oct;104(4):869. doi: 10.1002/ccd.31192. PMID: 39154248 MH - Humans MH - Aged MH - Aged, 80 and over MH - *Aortic Valve Insufficiency/diagnostic imaging/etiology/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - Heart MH - *Aortic Valve Stenosis/diagnostic imaging/surgery OTO - NOTNLM OT - JenaValve OT - TAVR OT - aortic regurgitation OT - paravalvular regurgitation COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/08/31 00:42 MHDA- 2023/09/01 06:43 CRDT- 2023/08/30 20:56 PHST- 2023/03/14 00:00 [received] PHST- 2023/07/03 00:00 [revised] PHST- 2023/07/12 00:00 [accepted] PHST- 2023/09/01 06:43 [medline] PHST- 2023/08/31 00:42 [pubmed] PHST- 2023/08/30 20:56 [entrez] AID - S1936-8798(23)01115-9 [pii] AID - 10.1016/j.jcin.2023.07.038 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Aug 28;16(16):1965-1973. doi: 10.1016/j.jcin.2023.07.038. PMID- 37645516 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231102 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Contemporary European practice in transcatheter aortic valve implantation: results from the 2022 European TAVI Pathway Registry. PG - 1227217 LID - 10.3389/fcvm.2023.1227217 [doi] LID - 1227217 AB - BACKGROUND: A steep rise in the use of transcatheter aortic valve implantation (TAVI) for the management of symptomatic severe aortic stenosis occurred. Minimalist TAVI procedures and streamlined patient pathways within experienced Heart Valve Centres are designed to overcome the challenges of ever-increasing procedural volume. AIMS: The 2022 European TAVI Pathway Survey aims to describe contemporary TAVI practice across Europe. MATERIALS AND METHODS: Between October and December 2022, TAVI operators from 32 European countries were invited to complete an online questionnaire regarding their current practice. RESULTS: Responses were available from 147 TAVI centres in 26 countries. In 2021, the participating centres performed a total number of 27,223 TAVI procedures, with a mean of 185 TAVI cases per centre (median 138; IQR 77-194). Treatment strategies are usually (87%) discussed at a dedicated Heart Team meeting. Transfemoral TAVI is performed with local anaesthesia only (33%), with associated conscious sedation (60%), or under general anaesthesia (7%). Primary vascular access is percutaneous transfemoral (99%) with secondary radial access (52%). After uncomplicated TAVI, patients are transferred to a high-, medium-, or low-care unit in 28%, 52%, and 20% of cases, respectively. Time to discharge is day 1 (12%), day 2 (31%), day 3 (29%), or day 4 or more (28%). CONCLUSION: Reported adoption of minimalist TAVI techniques is common among European TAVI centres, but rates of next-day discharge remain low. This survey highlights the significant progress made in refining TAVI treatment and pathways in recent years and identifies possible areas for further improvement. CI - (c) 2023 Rosseel, Mylotte, Cosyns, Vanhaverbeke, Zweiker, Teles, Angeras, Neylon, Rudolph, Wykrzykowska, Patterson, Costa, Ojeda, Tzikas, Abras, Leroux, Van Belle, Tchetche, Bleiziffer, Swaans, Parma, Blackman, Van Mieghem, Grygier, Redwood, Prendergast, Van Camp and De Backer. FAU - Rosseel, Liesbeth AU - Rosseel L AD - Department of Cardiology, Algemeen Stedelijk Hospital, Aalst, Belgium. AD - Faculteit Geneeskunde, Vrije Universiteit Brussel (VUB), Brussels, Belgium. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospital Galway and National University of Ireland, Galway, Ireland. FAU - Cosyns, Bernard AU - Cosyns B AD - Faculteit Geneeskunde, Vrije Universiteit Brussel (VUB), Brussels, Belgium. AD - Centrum Voor Hart- en Vaatziekten (CHVZ), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - Department of Cardiology, AZ Delta, Roeselare, Belgium. FAU - Zweiker, David AU - Zweiker D AD - Division of Cardiology, Department of Cardiology and Intensive Care, Clinic Ottakring, Medical University of Graz, Graz, Austria. FAU - Teles, Rui Campante AU - Teles RC AD - Centro Hospitalar de Lisboa Ocidental (CHLO), Hospital de Santa Cruz. AD - Nova Medical School, Centro de Estudo de Doencas Cronicas (CEDOC), Lisbon, Portugal. FAU - Angeras, Oskar AU - Angeras O AD - Department of Cardiology, Sahlgrenska University Hospital, Gothenberg, Sweden. AD - Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden. FAU - Neylon, Antoinette AU - Neylon A AD - Institut Cardiovasculaire Paris Sud, Ramsay Sante, Massy, France. FAU - Rudolph, Tanja Katharina AU - Rudolph TK AD - Clinic of General and Interventional Cardiology, Heart and Diabetes Center Nordrhine Westfalia, Ruhr-University, Bad Oeynhausen, Germany. FAU - Wykrzykowska, Joanna J AU - Wykrzykowska JJ AD - Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands. FAU - Patterson, Tiffany AU - Patterson T AD - Department of Cardiology, Guys and St Thomas' NHS Foundation Trust London, London, United Kingdom. FAU - Costa, Giulia AU - Costa G AD - Cardiac Catheterization Division, Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Ojeda, Soledad AU - Ojeda S AD - Division of Interventional Cardiology, Reina Sofia Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIV), University of Cordoba, Cordoba, Spain. FAU - Tzikas, Apostolos AU - Tzikas A AD - Department of Cardiology, European Interbalkan Medical Centre, Thessaloniki, Greece. FAU - Abras, Marcel AU - Abras M AD - University Clinic of Interventional Cardiology, Nicolae Testemitanu State University of Medicine and Pharmacy from Republic of Moldova, Chisinau, Moldova. FAU - Leroux, Lionel AU - Leroux L AD - Medico-Surgical Department of Valvulopathies, CHU De Bordaux, Pessac, France. FAU - Van Belle, Eric AU - Van Belle E AD - CHU Lille, Institut Coeur Poumon, Pole Cardiovasculaire et Pulmonaire, ACTION Group, Inserm U1011, Institut Pasteur de Lille, EGID, Universite de Lille, Lille, France. FAU - Tchetche, Didier AU - Tchetche D AD - Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Swaans, Martin J AU - Swaans MJ AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands. FAU - Parma, Radoslaw AU - Parma R AD - Department of Cardiology and Structural Heart Diseases, 3 Division of Cardiology, Medical University of Silesia, Katowice, Poland. FAU - Blackman, Daniel J AU - Blackman DJ AD - Department of Cardiology, Leeds Teaching Hospitals, Leeds, United Kingdom. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Interventional Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - Grygier, Marek AU - Grygier M AD - Chair and 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Redwood, Simon AU - Redwood S AD - Department of Cardiology, Guys and St Thomas' NHS Foundation Trust London, London, United Kingdom. FAU - Prendergast, Bernard AU - Prendergast B AD - Department of Cardiology, Guys and St Thomas' NHS Foundation Trust London, London, United Kingdom. FAU - Van Camp, Guy AU - Van Camp G AD - Department of Cardiology, Heart Center OLV Aalst, Aalst, Belgium. FAU - De Backer, Ole AU - De Backer O AD - Heart Center, Rigshospitalet, Copenhagen, Denmark. LA - eng PT - Journal Article DEP - 20230814 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10461475 OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - aortic stenosis OT - early discharge OT - minimalist TAVI OT - multidisciplinary Heart Team COIS- DM: consultant for Medtronic, Boston Scientific, and Microport. TR: proctor and advisor for JenaValve, speaker's honoraria from Edwards Lifesciences, Boston Scientific, Medtronic, and JenaValve. JW: institutional grant from Medtronic and speaker's honoraria (also to the institution) from Boston Scientific and Sinomed. SO: consulting fees from Medtronic and Edwards, speaker's honoraria from Philips and World Medical, and research grant (PI21/00949) from the Spanish Ministry of Science and Innovation (Instituto de Salud Carlos III). LL: proctoring and consulting honoraria for Abbott, Edwards, and Medtronic. DB: proctoring and consulting honoraria for Abbott, Edwards, and Medtronic. NM: institutional research grant support from Abbott Vascular, Boston Scientific, Biotronik, Medtronic, Daiichi Sankyo, Astra Zeneca, and PulseCath BV; and consultancy fees from Abbott Vascular, Boston Scientific, Biotronik, Medtronic, Daiichi Sankyo, Abiomed, Amgen, JenaValve, Anteris, and PulseCath BV. MG: Boston Scientific-research and travel grants, speaker's honoraria, proctor, and advisory board member; Medtronic-research and travel grants, speaker's honoraria, proctor, advisory board member; Abbott-speaker's honoraria and travel grants; and Edwards Lifesciences-speakers honoraria and travel grants. BP: speaker's fees from Edwards Lifesciences, Abbott, and Medtronic and consulting fees from Anteris and Microport. ODB: institutional research grants and consulting fees from Abbott, Boston Scientific, and Medtronic. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer JS declared a past co-authorship with the author ODB to the handling editor. EDAT- 2023/08/30 06:48 MHDA- 2023/08/30 06:49 PMCR- 2023/01/01 CRDT- 2023/08/30 03:54 PHST- 2023/05/22 00:00 [received] PHST- 2023/07/28 00:00 [accepted] PHST- 2023/08/30 06:49 [medline] PHST- 2023/08/30 06:48 [pubmed] PHST- 2023/08/30 03:54 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1227217 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Aug 14;10:1227217. doi: 10.3389/fcvm.2023.1227217. eCollection 2023. PMID- 37636309 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230829 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Predictive model for severe thrombocytopenia after transfemoral transcatheter aortic valve replacement. PG - 1213248 LID - 10.3389/fcvm.2023.1213248 [doi] LID - 1213248 AB - The aim of this study was to develop a predictive model for severe thrombocytopenia after transfemoral transcatheter aortic valve replacement (TAVR). A total of 155 patients treated with TAVR at our center were retrospectively enrolled in this study. The incidence of severe thrombocytopenia after TAVR was 25.16%, and most patients suffered from severe thrombocytopenia on 4 days after procedure. Multivariate regression analysis showed that weight <60 kg, New York Heart Association Functional Classification (NYHAFC IV), major vascular complications, and lower first post-procedural platelet count were independent risk factors for severe thrombocytopenia after TAVR. The c-statistic for the area under the curve was 0.758, the sensitivity was 0.744, the specificity was 0.784, and the negative predictive value of the model was 91.38%. The overall predictive value was 76.77%. The predictive model developed from this cohort data could effectively identify patients at high risk of severe thrombocytopenia after TAVR, and might be applicable to patients with aortic regurgitation (AR) and severe thrombocytopenia with different definitions. CI - (c) 2023 Li, Wu, Wang, She and Zheng. FAU - Li, Shaoman AU - Li S AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Wu, Yafeng AU - Wu Y AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Wang, Jinju AU - Wang J AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - She, Liping AU - She L AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Zheng, Xuemei AU - Zheng X AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. LA - eng PT - Journal Article DEP - 20230809 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10449450 OTO - NOTNLM OT - aortic regurgitation OT - platelet count OT - predictive model OT - thrombocytopenia OT - transcatheter aortic valve replacement COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/08/28 06:42 MHDA- 2023/08/28 06:43 PMCR- 2023/01/01 CRDT- 2023/08/28 04:34 PHST- 2023/04/29 00:00 [received] PHST- 2023/07/19 00:00 [accepted] PHST- 2023/08/28 06:43 [medline] PHST- 2023/08/28 06:42 [pubmed] PHST- 2023/08/28 04:34 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1213248 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Aug 9;10:1213248. doi: 10.3389/fcvm.2023.1213248. eCollection 2023. PMID- 37634673 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20231216 IS - 1535-6280 (Electronic) IS - 0146-2806 (Linking) VI - 49 IP - 1 Pt B DP - 2024 Jan TI - A Novel Technique for Performing Transfemoral Transcatheter Self-Expanding Aortic Valve Replacement With No Contrast Which Minimizes Acute Kidney Injury. PG - 102046 LID - S0146-2806(23)00463-2 [pii] LID - 10.1016/j.cpcardiol.2023.102046 [doi] AB - Transcatheter aortic valve replacement (TAVR) treats severe aortic stenosis. However, patients with limited renal function may be ineligible for contrast use during valve deployment. We evaluate TAVR via transfemoral approach using 2-wire technique and no contrast injection. Primary endpoints are acute kidney injury and procedural success. Safety analysis includes mortality, stroke, myocardial infarction, coronary obstruction, and more. Forty-six patients were included; most with preserved ejection fraction. Baseline creatinine was 1.63 +/- 0.68 and post-TAVR was significantly better (1.47 +/- 0.64, P < 0.01). No statistical difference existed between creatinine at baseline and 30 days. After TAVR, 91% had no paravalvular leak (PVL). Peak-velocity post-TAVR was 1.32 +/- 0.33 and mean-gradient was 7 +/- 4. No valve repositioning during deployment was required. No mortality at 30 days without incidence of stroke, myocardial infarction or coronary obstruction. One patient had retroperitoneal bleeding requiring transfusion. The noncontrast technique for self-expanding valve deployment is feasible and safe in patients who cannot tolerate contrast. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Gupta, Aashish AU - Gupta A AD - Louisiana Children's Medical Center Health System, New Orleans, LA. FAU - Prince, Marloe AU - Prince M AD - Hospital Corporation of America, Kingwood, Houston, TX. FAU - Tafur-Soto, Jose AU - Tafur-Soto J AD - Gayle and Tom Benson Heart Valve Center, Ochsner Medical Center, New Orleans, LA. FAU - Spindel, Stephen M AU - Spindel SM AD - Division of Cardiothoracic Surgery, Ochsner Medical Center, New Orleans, LA. Electronic address: stephenspindel123@gmail.com. FAU - Su, Jasmine AU - Su J AD - University of Massachusetts, Amherst, MA. FAU - Ramee, Steven AU - Ramee S AD - Gayle and Tom Benson Heart Valve Center, Ochsner Medical Center, New Orleans, LA. LA - eng PT - Journal Article PT - Review DEP - 20230825 PL - Netherlands TA - Curr Probl Cardiol JT - Current problems in cardiology JID - 7701802 RN - AYI8EX34EU (Creatinine) SB - IM MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - Creatinine MH - Risk Factors MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - *Acute Kidney Injury/etiology/prevention & control MH - *Stroke MH - *Myocardial Infarction COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/08/28 00:41 MHDA- 2023/12/17 09:46 CRDT- 2023/08/27 19:25 PHST- 2023/08/21 00:00 [received] PHST- 2023/08/22 00:00 [accepted] PHST- 2023/12/17 09:46 [medline] PHST- 2023/08/28 00:41 [pubmed] PHST- 2023/08/27 19:25 [entrez] AID - S0146-2806(23)00463-2 [pii] AID - 10.1016/j.cpcardiol.2023.102046 [doi] PST - ppublish SO - Curr Probl Cardiol. 2024 Jan;49(1 Pt B):102046. doi: 10.1016/j.cpcardiol.2023.102046. Epub 2023 Aug 25. PMID- 37633682 OWN - NLM STAT- MEDLINE DCOM- 20230828 LR - 20230831 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 203 DP - 2023 Sep 15 TI - Extrathoracic Against Intrathoracic Vascular Accesses for Transcatheter Aortic Valve Replacement: A Systematic Review With Meta-Analysis. PG - 473-483 LID - S0002-9149(23)00624-0 [pii] LID - 10.1016/j.amjcard.2023.07.091 [doi] AB - Alternative vascular accesses to transfemoral access for transcatheter aortic valve replacement (TAVR) can be divided into intrathoracic (IT)-transapical and transaortic- and extrathoracic (ET)-transcarotid, transsubclavian, and transaxillary. This study aimed to compare the outcomes and safety of IT and ET accesses for TAVR as alternatives to transfemoral access. A systematic review with meta-analysis was performed by searching PubMed/MEDLINE and EMBASE databases for all studies comparing IT-TAVR with ET-TAVR published until April 2023. Outcomes included in-hospital or 30-day all-cause mortality (ACM), 1-year ACM, postoperative and 30-day complications. A total of 18 studies with 6,800 IT-TAVR patients and 5,032 ET-TAVR patients were included. IT accesses were associated with a significantly higher risk of in-hospital or 30-day ACM (relative risk 1.99, 95% confidence interval 1.67 to 2.36, p <0.001), and 1-year ACM (relative risk 1.31, 95% confidence interval 1.21 to 1.42, p <0.001). IT-TAVR patients presented more often with postoperative life-threatening bleeding, 30-day new-onset atrial fibrillation or flutter, and 30-day acute kidney injury needing renal replacement therapy. The risks of postoperative permanent pacemaker implantation and significant paravalvular leak were lower with IT-TAVR. ET-TAVR patients were more likely to be directly discharged home. There was no statistically significant difference regarding the 30-day risk of stroke. Compared with ET-TAVR, IT-TAVR was associated with higher risks of in-hospital or 30-day ACM, 1-year ACM and higher risks for some critical postprocedural and 30-day complications. Our results suggest that ET-TAVR could be considered as the first-choice alternative approach when transfemoral access is contraindicated. CI - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Abellan, Christophe AU - Abellan C AD - Service of Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Antiochos, Panagiotis AU - Antiochos P AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Fournier, Stephane AU - Fournier S AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Skali, Hicham AU - Skali H AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Shah, Pinak AU - Shah P AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Maurizi, Niccolo AU - Maurizi N AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Eeckhout, Eric AU - Eeckhout E AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Roguelov, Christan AU - Roguelov C AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Monney, Pierre AU - Monney P AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Tzimas, Georgios AU - Tzimas G AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Kirsch, Matthias AU - Kirsch M AD - Service of Cardiovascular Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Lu, Henri AU - Lu H AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: helu@bwh.harvard.edu. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20230810 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Acute Kidney Injury MH - Databases, Factual MH - Hospitals MH - Postoperative Hemorrhage OTO - NOTNLM OT - TAVI OT - TAVR OT - extrathoracic OT - intrathoracic OT - meta-analysis COIS- Declaration of Competing Interest The authors have no competing interests to declare. EDAT- 2023/08/27 05:43 MHDA- 2023/08/28 06:42 CRDT- 2023/08/26 20:57 PHST- 2023/06/13 00:00 [received] PHST- 2023/07/14 00:00 [accepted] PHST- 2023/08/28 06:42 [medline] PHST- 2023/08/27 05:43 [pubmed] PHST- 2023/08/26 20:57 [entrez] AID - S0002-9149(23)00624-0 [pii] AID - 10.1016/j.amjcard.2023.07.091 [doi] PST - ppublish SO - Am J Cardiol. 2023 Sep 15;203:473-483. doi: 10.1016/j.amjcard.2023.07.091. Epub 2023 Aug 10. PMID- 37629253 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240923 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 16 DP - 2023 Aug 10 TI - Transcatheter Aortic Valve Implantation by Intercostal Access: Initial Experience with a No-Touch Technique. LID - 10.3390/jcm12165211 [doi] LID - 5211 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is now a well-established therapeutic option in an elderly high-risk patient cohort with aortic valve disease. Although most commonly performed via a transfemoral route, alternative approaches for TAVI are constantly being improved. Instead of the classical mini-sternotomy, it is possible to achieve a transaortic access via a right anterior mini-thoracotomy in the second intercostal space. We describe our experience with this sternum- and rib-sparing technique in comparison to the classical transaortic approach. METHODS: Our retrospective study includes 173 patients who were treated in our institution between January 2017 and April 2020 with transaortic TAVI via either upper mini-sternotomy or intercostal thoracotomy. The primary endpoint was 30-day mortality, and secondary endpoints were defined as major postoperative complications that included admission to the intensive care unit and overall hospital stay, according to the Valve Academic Research Consortium 3. RESULTS: Eighty-two patients were treated with TAo-TAVI by upper mini-sternotomy, while 91 patients received the intercostal approach. Both groups were comparable in age (mean age: 82 years) and in the proportion of female patients. The intercostal group had a higher rate of peripheral artery disease (41% vs. 22%, p = 0.008) and coronary artery disease (71% vs. 40%, p < 0.001) with a history of percutaneous coronary intervention or coronary artery bypass grafting, resulting in significantly higher preinterventional risk evaluation (EuroScore II 8% in the intercostal vs. 4% in the TAo group, p = 0.005). Successful device implantation and a reduction of the transvalvular gradient were achieved in all cases with a significantly lower rate of trace to mild paravalvular leakage in the intercostal group (12% vs. 33%, p < 0.001). The intercostal group required significantly fewer blood transfusions (0 vs. 2 units, p = 0.001) and tended to require less reoperation (7% vs. 15%, p = 0.084). Hospital stays (9 vs. 12 d, p = 0.011) were also shorter in the intercostal group. Short- and long-term survival in the follow-up showed comparable results between the two approaches (30-day, 6-month- and 2-year mortality: 7%, 23% and 36% in the intercostal vs. 9%, 26% and 33% in the TAo group) with acute kidney injury (AKI) and reintubation being independent risk factors for mortality. CONCLUSIONS: Transaortic TAVI via an intercostal access offers a safe and effective treatment of aortic valve stenosis. FAU - Pommert, Nina Sophie AU - Pommert NS AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. AD - DZHK-German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/Lubeck, 24105 Kiel, Germany. FAU - Zhang, Xiling AU - Zhang X AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Puehler, Thomas AU - Puehler T AUID- ORCID: 0000-0002-4990-1892 AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. AD - DZHK-German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/Lubeck, 24105 Kiel, Germany. FAU - Seoudy, Hatim AU - Seoudy H AD - Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Huenges, Katharina AU - Huenges K AUID- ORCID: 0000-0002-4329-9087 AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Schoettler, Jan AU - Schoettler J AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Haneya, Assad AU - Haneya A AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Friedrich, Christine AU - Friedrich C AUID- ORCID: 0000-0002-4228-7164 AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Sathananthan, Janarthanan AU - Sathananthan J AD - Cardiovascular Translational Laboratory, Providence Research & UBC Centre for Heart Lung Innovation, Vancouver, BC V6Z 1Y6, Canada. AD - Centre for Heart Valve Innovation and Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. AD - UBC Centre for Cardiovascular Innovation, Vancouver, BC V6Z 1Y6, Canada. FAU - Sellers, Stephanie L AU - Sellers SL AD - Cardiovascular Translational Laboratory, Providence Research & UBC Centre for Heart Lung Innovation, Vancouver, BC V6Z 1Y6, Canada. AD - Centre for Heart Valve Innovation and Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. AD - UBC Centre for Cardiovascular Innovation, Vancouver, BC V6Z 1Y6, Canada. FAU - Meier, David AU - Meier D AUID- ORCID: 0000-0002-5524-5844 AD - Cardiovascular Translational Laboratory, Providence Research & UBC Centre for Heart Lung Innovation, Vancouver, BC V6Z 1Y6, Canada. AD - Centre for Heart Valve Innovation and Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. AD - UBC Centre for Cardiovascular Innovation, Vancouver, BC V6Z 1Y6, Canada. FAU - Mueller, Oliver J AU - Mueller OJ AUID- ORCID: 0000-0001-8223-2638 AD - Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Saad, Mohammed AU - Saad M AD - Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Frank, Derk AU - Frank D AD - DZHK-German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/Lubeck, 24105 Kiel, Germany. AD - Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. FAU - Lutter, Georg AU - Lutter G AUID- ORCID: 0000-0002-9145-3210 AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany. AD - DZHK-German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/Lubeck, 24105 Kiel, Germany. LA - eng PT - Journal Article DEP - 20230810 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10455155 OTO - NOTNLM OT - TAVI OT - aortic valve replacement OT - intercostal OT - minimal invasive surgery OT - transaortic TAVI COIS- D.F., J. Sathananthan and S.L.S are consultants for Edwards Lifesciences and Medtronic. All other authors have no commercial or financial relationships regarding this manuscript. EDAT- 2023/08/26 10:45 MHDA- 2023/08/26 10:46 PMCR- 2023/08/10 CRDT- 2023/08/26 01:18 PHST- 2023/06/28 00:00 [received] PHST- 2023/08/01 00:00 [revised] PHST- 2023/08/03 00:00 [accepted] PHST- 2023/08/26 10:46 [medline] PHST- 2023/08/26 10:45 [pubmed] PHST- 2023/08/26 01:18 [entrez] PHST- 2023/08/10 00:00 [pmc-release] AID - jcm12165211 [pii] AID - jcm-12-05211 [pii] AID - 10.3390/jcm12165211 [doi] PST - epublish SO - J Clin Med. 2023 Aug 10;12(16):5211. doi: 10.3390/jcm12165211. PMID- 37611868 OWN - NLM STAT- MEDLINE DCOM- 20240602 LR - 20240602 IS - 2241-5955 (Electronic) IS - 1109-9666 (Linking) VI - 77 DP - 2024 May-Jun TI - Prognostic benefits of early vascular surgical intervention in patients with major peripheral vascular complications following transcatheter aortic valve implantation. PG - 1-12 LID - S1109-9666(23)00144-6 [pii] LID - 10.1016/j.hjc.2023.08.007 [doi] AB - OBJECTIVES: This study aimed to analyze the incidence, surgical management of major vascular complications, and outcomes in patients undergoing transfemoral (TF) transcatheter aortic valve replacement (TAVR) at our center after strict selection of the access route, carefully considering all known major predictors. METHODS: Data of 494 consecutive patients with pre-interventional multi-slice computed tomography (CT) of the aorta who had undergone TF TAVR from 2009 to 2019 were analyzed. RESULTS: In total, 23/494 (4.7%) patients had major vascular and access-related complications of peripheral vessels and/or infrarenal aorta. These included hematomas that met the Valve Academic Research Consortium 3-criteria of major vascular complications (7/494, 1.4%), arterial dissections (3/494, 0.6%), pseudoaneurysm (6/494, 1.2%), thrombus of the external iliac artery leading to acute limb ischemia (1/494, 0.2%), fistula (1/494, 0.2%), and perforation (5/494, 1.0%). In total, 17/23 (73.9%) major vascular complications required immediate endovascular and/or open surgery. In 16/17 (94%) cases, only 1 surgical procedure was performed. The long-term survival of patients with and without major vascular complications of the peripheral vessels was determined after 2 years. CONCLUSIONS: Early vascular surgery intervention reversed the mortality disadvantage in patients with major complications of the peripheral vessels after TAVR. This underscores the importance of immediate vascular surgery stand-by as an indispensable requirement. CI - Copyright (c) 2023 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved. FAU - Barth, Sebastian AU - Barth S AD - Cardiovascular Center Bad Neustadt/Saale, Department of Cardiology, Bad Neustadt/Saale, Germany. Electronic address: sebastian.barth@campus-nes.de. FAU - Ahmed, Mohammed AU - Ahmed M AD - Cardiovascular Center Bad Neustadt/Saale, Department of Cardiology, Bad Neustadt/Saale, Germany. FAU - Hautmann, Martina B AU - Hautmann MB AD - Cardiovascular Center Bad Neustadt/Saale, Department of Cardiology, Bad Neustadt/Saale, Germany. FAU - Reents, Wilko AU - Reents W AD - Cardiovascular Center Bad Neustadt/Saale, Department Cardiac Surgery, Bad Neustadt/Saale, Germany. FAU - Zacher, Michael AU - Zacher M AD - Department of Medical Documentation, Bad Neustadt/Saale, Germany. FAU - Kerber, Sebastian AU - Kerber S AD - Cardiovascular Center Bad Neustadt/Saale, Department of Cardiology, Bad Neustadt/Saale, Germany. FAU - Lusebrink, Ulrich AU - Lusebrink U AD - Department of Cardiology, Philipps-Universitat Marburg, Germany. FAU - Schmandra, Thomas C AU - Schmandra TC AD - Cardiovascular Center Bad Neustadt/Saale, Department of Vascular Surgery, Bad Neustadt/Saale, Germany. LA - eng PT - Journal Article DEP - 20230821 PL - Netherlands TA - Hellenic J Cardiol JT - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese JID - 101257381 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Male MH - Female MH - Aged, 80 and over MH - *Postoperative Complications/epidemiology/etiology MH - Aged MH - Prognosis MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - Vascular Surgical Procedures/methods/adverse effects MH - Peripheral Vascular Diseases/epidemiology/surgery MH - Incidence MH - Multidetector Computed Tomography/methods MH - Aneurysm, False/etiology/epidemiology MH - Endovascular Procedures/methods/adverse effects MH - Hematoma/etiology/epidemiology MH - Femoral Artery/surgery MH - Iliac Artery/surgery/diagnostic imaging MH - Risk Factors OTO - NOTNLM OT - endovascular treatment OT - major vascular complications OT - transcatheter aortic valve replacement OT - vascular surgery EDAT- 2023/08/24 00:42 MHDA- 2024/06/03 00:42 CRDT- 2023/08/23 19:26 PHST- 2023/06/29 00:00 [received] PHST- 2023/08/08 00:00 [revised] PHST- 2023/08/11 00:00 [accepted] PHST- 2024/06/03 00:42 [medline] PHST- 2023/08/24 00:42 [pubmed] PHST- 2023/08/23 19:26 [entrez] AID - S1109-9666(23)00144-6 [pii] AID - 10.1016/j.hjc.2023.08.007 [doi] PST - ppublish SO - Hellenic J Cardiol. 2024 May-Jun;77:1-12. doi: 10.1016/j.hjc.2023.08.007. Epub 2023 Aug 21. PMID- 37610363 OWN - NLM STAT- MEDLINE DCOM- 20240415 LR - 20240426 IS - 1873-1953 (Electronic) IS - 1474-5151 (Linking) VI - 23 IP - 3 DP - 2024 Apr 12 TI - Early mobilization after transcatheter aortic valve implantation: observational cohort study. PG - 296-304 LID - 10.1093/eurjcn/zvad081 [doi] AB - AIMS: Early mobilization is associated with improved outcomes in hospitalized older patients. We sought to determine the effect of a nurse-led protocol on mobilization 4 h after transfemoral transcatheter aortic valve implantation (TAVI) across different units of care. METHODS AND RESULTS: We conducted a prospective observational cohort single-centre study of consecutive patients. We implemented a standardized protocol for safe early recovery and progressive mobilization in the critical care and cardiac telemetry units. We measured the time to first mobilization and conducted descriptive statistics to identify patient and system barriers to timely ambulation. We recruited 139 patients (82.5 years, SD = 6.7; 46% women). At baseline, patients who were mobilized early (4 h) did not differ, except for higher rates of diabetes (25.5% vs. 43.9%, P = 0.032) and peripheral arterial disease (8.2% vs. 26.8%, P = 0.003) in the late mobilization group. The median time to mobilization was 4 h [inter-quartile range (IQR) 3.25, 4]; 98 patients (70.5%) were mobilized successfully after 4 h of bedrest; 118 (84.9%) were walking by the evening of the procedure (<8 h bedrest); and 21 (15.1%) were on bedrest overnight and mobilized the following day. Primary reasons for overnight bedrest were arrhythmia monitoring (n = 10, 7.2%) and haemodynamic and/or neurological instability (n = 6, 4.3%); six patients (4.3%) experienced delayed ambulation due to system issues. Procedure location in the hybrid operating room and transfer to critical care were associated with longer bedrest times. CONCLUSION: Standardized nurse-led mobilization 4 h after TF TAVI is feasible in the absence of clinical complications and system barriers. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Lauck, Sandra B AU - Lauck SB AUID- ORCID: 0000-0002-0181-559X AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. AD - St. Paul's Hospital, Vancouver, Canada. FAU - Yu, Maggie AU - Yu M AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. FAU - Bancroft, Carrie AU - Bancroft C AD - St. Paul's Hospital, Vancouver, Canada. FAU - Borregaard, Britt AU - Borregaard B AUID- ORCID: 0000-0003-2702-0231 AD - Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital. AD - Department of Clinical Research, University of Southern Denmark. FAU - Polderman, Jopie AU - Polderman J AD - St. Paul's Hospital, Vancouver, Canada. FAU - Stephenson, Anna L AU - Stephenson AL AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. AD - St. Paul's Hospital, Vancouver, Canada. FAU - Durand, Eric AU - Durand E AUID- ORCID: 0000-0002-8117-0022 AD - Department of Cardiology Normandie Universite CHU RouenRouen France. FAU - Akodad, Mariama AU - Akodad M AD - Institut cardiovasculaire Paris Sud, hopital Prive Jacques-Cartier, Ramsay Sante, Massy, France. FAU - Meier, David AU - Meier D AD - Department of Cardiology, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland. FAU - Andrews, Holly AU - Andrews H AD - St. Paul's Hospital, Vancouver, Canada. FAU - Achtem, Leslie AU - Achtem L AD - St. Paul's Hospital, Vancouver, Canada. FAU - Tang, Erin AU - Tang E AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. AD - St. Paul's Hospital, Vancouver, Canada. FAU - Wood, David A AU - Wood DA AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. AD - Centre for Cardiovascular Innovation, Vancouver, Canada. FAU - Sathananthan, Janarthanan AU - Sathananthan J AUID- ORCID: 0000-0001-9513-9440 AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. AD - Centre for Cardiovascular Innovation, Vancouver, Canada. FAU - Webb, John G AU - Webb JG AD - School of Nursing, University of British Columbia, Centre for Heart Valve Innovation, St. Paul's Hospital, 5248-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. AD - St. Paul's Hospital, Vancouver, Canada. AD - Centre for Cardiovascular Innovation, Vancouver, Canada. LA - eng GR - The Providence Health Care/ GR - Practice-Based Research/ PT - Journal Article PT - Observational Study PL - England TA - Eur J Cardiovasc Nurs JT - European journal of cardiovascular nursing JID - 101128793 SB - IM MH - Female MH - Humans MH - Male MH - *Aortic Valve Stenosis/surgery MH - Cohort Studies MH - Early Ambulation MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - Aged MH - Aged, 80 and over MH - Prospective Studies OTO - NOTNLM OT - Clinical pathway OT - Minimalist approach OT - Mobilization OT - Transcatheter aortic valve implantation COIS- Conflict of interest: S.B.L. has been a consultant for Edwards and Medtronic; J.S. has been a consultant for Edwards, Medtronic, and Boston Scientific and received research grants from Edwards and Medtronic; D.A.W. has received research grants from Abbott and Edwards; J.G.W. has been a consultant and/or received research support from Edwards, Abbott, Boston Scientific, and Vivitro Medical. EDAT- 2023/08/23 12:42 MHDA- 2024/04/15 06:42 CRDT- 2023/08/23 10:22 PHST- 2023/01/09 00:00 [received] PHST- 2023/07/27 00:00 [revised] PHST- 2023/07/28 00:00 [accepted] PHST- 2024/04/15 06:42 [medline] PHST- 2023/08/23 12:42 [pubmed] PHST- 2023/08/23 10:22 [entrez] AID - 7248951 [pii] AID - 10.1093/eurjcn/zvad081 [doi] PST - ppublish SO - Eur J Cardiovasc Nurs. 2024 Apr 12;23(3):296-304. doi: 10.1093/eurjcn/zvad081. PMID- 37606754 OWN - NLM STAT- MEDLINE DCOM- 20240104 LR - 20261010 IS - 1615-2573 (Electronic) IS - 0910-8327 (Linking) VI - 39 IP - 1 DP - 2024 Jan TI - Cusp overlap technique decreases paravalvular leakage in self-expandable transcatheter aortic valve replacement. PG - 48-56 LID - 10.1007/s00380-023-02307-z [doi] AB - The cusp overlap technique allows greater visual separation between the basal annular plane and the conduction system and decreases the permanent pacemaker implantation rate. We assessed the impact of the cusp overlap technique on conduction disturbance and paravalvular leakage after transcatheter aortic valve replacement. A total of 97 patients underwent transfemoral transcatheter aortic valve replacement with self-expandable valves at our institution from November 2018 to January 2023. The mean age of the patients was 85 years, and 23% were male. The patients were divided into two groups: the cusp overlap technique group and the non-cusp overlap technique group. We compared the clinical results between the two groups. The 30-day permanent pacemaker implantation rate was similar between the two groups (cusp overlap technique: 6.3% vs. non-cusp overlap technique: 10.2%, p = 0.48). The rate of new-onset conduction disturbance was slightly lower in the cusp overlap than non-cusp overlap technique group (18.8% vs. 34.7%, respectively; p = 0.08). The implanted valve function was similar between the two groups, but the rate of trivial or less paravalvular leakage (PVL) was significantly higher in the cusp overlap technique group on echocardiography (69% vs. 45%, p = 0.02). On multidetector computed tomography, the implantation depth at the membranous septum was significantly shorter in the cusp overlap technique group (2.0 +/- 2.3 vs. 2.9 +/- 1.5 mm, p = 0.02). The degree of canting was slightly smaller in the cusp overlap technique group (1.0 +/- 2.2 vs. 1.7 +/- 1.9 mm, p = 0.07). The relative risk of PVL equal to or greater than mild was 1.76 times higher for valve implantation without the cusp overlap technique (adjusted odds ratio, 3.74; 95% confidence interval, 1.45-9.69; p < 0.01). Transcatheter aortic valve replacement using the cusp overlap technique is associated with an optimized implantation depth, leading to fewer conduction disturbances. Optimal deployment may also maximize the radial force of self-expanding valves to reduce paravalvular leakage. CI - (c) 2023. Springer Nature Japan KK, part of Springer Nature. FAU - Takaseya, Tohru AU - Takaseya T AUID- ORCID: 0000-0002-7813-0273 AD - Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-Shi, Fukuoka, 830-0011, Japan. ttakaseya@kurume-u.ac.jp. FAU - Itaya, Naoki AU - Itaya N AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Sasaki, Ken-Ichiro AU - Sasaki KI AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Sasaki, Masahiro AU - Sasaki M AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Yokomizo, Michiko AU - Yokomizo M AD - Department of Anesthesiology, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Honda, Akihiro AU - Honda A AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Oshita, Kensuke AU - Oshita K AD - Department of Anesthesiology, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Azuma, Junpei AU - Azuma J AD - Division of Radiology, Kurume University Hospital, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Fukumoto, Yoshihiro AU - Fukumoto Y AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan. FAU - Tayama, Eiki AU - Tayama E AD - Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-Shi, Fukuoka, 830-0011, Japan. LA - eng PT - Journal Article DEP - 20230822 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 SB - IM MH - Humans MH - Male MH - Aged, 80 and over MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Multidetector Computed Tomography MH - Cardiac Conduction System Disease MH - Treatment Outcome MH - Prosthesis Design OTO - NOTNLM OT - Conduction disturbance OT - Cusp overlap technique OT - Paravalvular leakage OT - Transcatheter aortic valve replacement EDAT- 2023/08/22 13:42 MHDA- 2024/01/04 11:44 CRDT- 2023/08/22 11:16 PHST- 2023/03/20 00:00 [received] PHST- 2023/08/16 00:00 [accepted] PHST- 2024/01/04 11:44 [medline] PHST- 2023/08/22 13:42 [pubmed] PHST- 2023/08/22 11:16 [entrez] AID - 10.1007/s00380-023-02307-z [pii] AID - 10.1007/s00380-023-02307-z [doi] PST - ppublish SO - Heart Vessels. 2024 Jan;39(1):48-56. doi: 10.1007/s00380-023-02307-z. Epub 2023 Aug 22. PMID- 37601733 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230823 IS - 1756-1485 (Electronic) IS - 1756-1477 (Print) IS - 1756-1485 (Linking) VI - 18 DP - 2023 TI - Outcomes of Transcatheter Aortic Valve Replacement in the United Arab Emirates: Real-world, Single-centre Experience from an Emerging Programme. PG - e08 LID - 10.15420/icr.2022.04 [doi] LID - e08 AB - BACKGROUND: Data on outcomes of transcatheter aortic valve replacement (TAVR) in the Middle East, particularly in the United Arab Emirates (UAE), are limited. Whether centres with a low volume of patients requiring the procedure can achieve similar outcomes as those reported in pivotal clinical trials remains unclear. This study evaluates procedural outcomes of patients undergoing TAVR in a newly established programme in the UAE. METHODS: Procedural outcomes of consecutive patients who underwent transfemoral TAVR at a single centre in the UAE between January 2016 and November 2021 were compared with those at centres in the lowest quartile (Q1) of procedural volume in the Transcatheter Valve Therapy Registry, which covers centres in the US. RESULTS: Among the 183 patients included in the study, the median age was 76 years (interquartile range [IQR] 71-82), and 42.1% of patients were women, with a median Society of Thoracic Surgeons predicted risk of mortality score of 4.6 (IQR 2.9-7.5). Most of the patients (93.3%) received a balloon-expandable valve. All-cause death within 30 days, stroke and major vascular complications occurred in 0.6%, 0.6% and 2.2% of patients, respectively, compared with 3.1%, 2.2% and 4% in patients treated at Q1 hospitals. CONCLUSION: Patients undergoing transfemoral TAVR at an emerging centre in the Middle East had favourable outcomes compared with those performed at Q1 hospitals in the US. These findings suggest that careful patient selection for TAVR is critical and may help optimise patient outcomes, especially when procedural volumes are low. CI - Copyright (c) The Author(s), 2023. Published by Radcliffe Group Ltd. FAU - Edris, Ahmad AU - Edris A AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Manla, Yosef AU - Manla Y AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Al Badarin, Firas AU - Al Badarin F AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Hasan, Khwaja AU - Hasan K AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Hashmani, Shahrukh AU - Hashmani S AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Traina, Mahmoud AU - Traina M AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Khiati, Dhiaedin AU - Khiati D AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Khalouf, Amani AU - Khalouf A AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - El Zouhbi, Anas AU - El Zouhbi A AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. FAU - Tuzcu, Emin Murat AU - Tuzcu EM AD - Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates. LA - eng PT - Journal Article DEP - 20230307 PL - England TA - Interv Cardiol JT - Interventional cardiology (London, England) JID - 101559687 PMC - PMC10433106 OTO - NOTNLM OT - Aortic stenosis OT - outcomes OT - transcatheter aortic valve replacement COIS- Disclosure: AE is a TAVR proctor for Edwards LifeSciences. All other authors have no conflicts of interest to declare. Consent: Informed consent has been waived due to the study's retrospective nature. Data availability: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Ethics: This study was performed in line with the principles of the Declaration of Helsinki. Authors' contributions: Conceptualisation: AE, FAB; data curation: YM, KH, SH, AK, DK, AEZ; methodology: FAB; writing - original draft preparation: AE; writing - review & editing: YM, FAB, MIT, EMT; formal analysis: FA, YM. EDAT- 2023/08/21 06:43 MHDA- 2023/08/21 06:44 PMCR- 2023/03/07 CRDT- 2023/08/21 05:05 PHST- 2022/02/01 00:00 [received] PHST- 2022/05/01 00:00 [accepted] PHST- 2023/08/21 06:44 [medline] PHST- 2023/08/21 06:43 [pubmed] PHST- 2023/08/21 05:05 [entrez] PHST- 2023/03/07 00:00 [pmc-release] AID - 10.15420/icr.2022.04 [doi] PST - epublish SO - Interv Cardiol. 2023 Mar 7;18:e08. doi: 10.15420/icr.2022.04. eCollection 2023. PMID- 37594503 OWN - NLM STAT- MEDLINE DCOM- 20231002 LR - 20261010 IS - 1615-6692 (Electronic) IS - 0340-9937 (Linking) VI - 48 IP - 5 DP - 2023 Oct TI - Computed tomography to guide transcatheter aortic valve implantation. PG - 359-365 LID - 10.1007/s00059-023-05203-4 [doi] AB - Since its introduction in 2022, transcatheter aortic valve implantation (TAVI) has revolutionized the treatment and prognosis of patients with aortic stenosis. Robust clinical trial data and a wealth of scientific evidence support its efficacy and safety. One of the key factors for success of the TAVI procedure is careful preprocedural planning using imaging. Computed tomography (CT) has developed into the standard imaging method for comprehensive patient assessment in this context. Suitability of the femoral and iliac arteries for transfemoral access, exact measurement of aortic annulus size and geometry as the basis for prosthesis selection, quantification of the spatial relationship of the coronary ostia to the aortic annular plane, and identification of optimal fluoroscopic projection angles for the implantation procedure are among the most important information that can be gained from preprocedural CT. Further research is aimed at improving risk stratification, for example, with respect to annular perforation, periprosthetic aortic regurgitation, and need for postprocedural implantation of a permanent pacemaker. CI - (c) 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature. FAU - Daghem, Marwa AU - Daghem M AD - Medizinische Klinik 2, Uniklinikum Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg, 91054, Erlangen, Germany. FAU - Weidinger, Florian AU - Weidinger F AD - Medizinische Klinik 2, Uniklinikum Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg, 91054, Erlangen, Germany. FAU - Achenbach, Stephan AU - Achenbach S AD - Medizinische Klinik 2, Uniklinikum Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg, 91054, Erlangen, Germany. stephan.achenbach@uk-erlangen.de. LA - eng PT - Journal Article PT - Review TT - Computertomographie zur periinterventionellen Diagnostik der Transkatheter-Aortenklappenimplantation. DEP - 20230818 PL - Germany TA - Herz JT - Herz JID - 7801231 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Aortic Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis Implantation/methods MH - Tomography, X-Ray Computed/methods MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Heart Valve Prosthesis MH - Treatment Outcome OTO - NOTNLM OT - Bicuspid aortic valve OT - CT angiography OT - Imaging OT - Transcatheter aortic valve implantation OT - Valve-in-valve EDAT- 2023/08/18 12:41 MHDA- 2023/10/02 06:42 CRDT- 2023/08/18 11:04 PHST- 2023/07/11 00:00 [accepted] PHST- 2023/10/02 06:42 [medline] PHST- 2023/08/18 12:41 [pubmed] PHST- 2023/08/18 11:04 [entrez] AID - 10.1007/s00059-023-05203-4 [pii] AID - 10.1007/s00059-023-05203-4 [doi] PST - ppublish SO - Herz. 2023 Oct;48(5):359-365. doi: 10.1007/s00059-023-05203-4. Epub 2023 Aug 18. PMID- 37571920 OWN - NLM STAT- MEDLINE DCOM- 20240930 LR - 20260624 IS - 1940-1574 (Electronic) IS - 0003-3197 (Linking) VI - 75 IP - 10 DP - 2024 Nov-Dec TI - Carotid Stiffness After Transcatheter Aortic Valve Replacement. PG - 985-991 LID - 10.1177/00033197231195647 [doi] AB - The present study aimed to analyze common carotid artery strain properties in patients (n = 59) with severe aortic valve stenosis who underwent transcatheter aortic valve replacement (TAVR). Arterial compliance of the common carotid artery was assessed by ultrasound speckle-tracking before and after TAVR. For sub-analysis the study cohort was divided according to aortic valve area <.75 cm(2) (n = 30) vs >/=.75 cm(2) (n = 29). Comparison of pre- and post-procedural strain variables showed an improvement in median radial velocity (P < .0001), radial displacement (P = .007), circumferential strain (P = .004), radial strain rate (P = .023), and circumferential strain rate (P < .0001), while the increase of radial strain showed a trend (P = .082). Analysis of aortic valve area revealed an inverse correlation between aortic valve area and the differences (post-procedural-pre-procedural values) for radial strain rate, and circumferential strain. Moreover, sub-analysis revealed that the increase of carotid strain variables before and after TAVR were more pronounced in the sub-group of aortic valve area .75 vs >/=.75 cm(2). TAVR led to a reduction of arterial wall stiffness of the common carotid artery assessed by ultrasound speckle-tracking. The decrease of arterial wall stiffness after TAVR was more pronounced in more severe aortic valve stenosis. FAU - Kavsur, Refik AU - Kavsur R AUID- ORCID: 0000-0002-4035-1142 AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Schaefer, Christian AU - Schaefer C AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Stumpf, Max Jonathan AU - Stumpf MJ AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Weber, Marcel AU - Weber M AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Sugiura, Atsushi AU - Sugiura A AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Becher, Marc Ulrich AU - Becher MU AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Zimmer, Sebastian AU - Zimmer S AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Schahab, Nadjib AU - Schahab N AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany. LA - eng PT - Journal Article DEP - 20230812 PL - United States TA - Angiology JT - Angiology JID - 0203706 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery/physiopathology/diagnostic imaging MH - Male MH - Female MH - *Vascular Stiffness MH - Aged, 80 and over MH - Aged MH - *Carotid Artery, Common/diagnostic imaging/physiopathology MH - Treatment Outcome MH - Severity of Illness Index MH - Aortic Valve/surgery/diagnostic imaging/physiopathology OTO - NOTNLM OT - aortic valve disease OT - aortic valve stenosis OT - carotid artery OT - transcatheter aortic valve replacement OT - vascular stiffness COIS- Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Georg Nickenig has received research funding from the Deutsche Forschungsgemeinschaft, the German Federal Ministry of Education and Research, the EU, Abbott, Edwards Lifesciences, Medtronic, and St Jude Medical and has received honoraria for lectures or advisory boards from Abbott, Edwards Lifesciences, Medtronic, and St Jude Medical, outside the submitted work. The other authors report no conflicts of interest regarding this study. EDAT- 2023/08/12 10:45 MHDA- 2024/09/30 22:18 CRDT- 2023/08/12 04:13 PHST- 2024/09/30 22:18 [medline] PHST- 2023/08/12 10:45 [pubmed] PHST- 2023/08/12 04:13 [entrez] AID - 10.1177/00033197231195647 [doi] PST - ppublish SO - Angiology. 2024 Nov-Dec;75(10):985-991. doi: 10.1177/00033197231195647. Epub 2023 Aug 12. PMID- 37568469 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230814 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 15 DP - 2023 Aug 1 TI - Snaring Self-Expanding Devices to Facilitate Transcatheter Aortic Valve Replacement in Patients with Complex Aortic Anatomies. LID - 10.3390/jcm12155067 [doi] LID - 5067 AB - The snare-assisted technique has been described to facilitate transcatheter aortic valve replacement (TAVR) delivery system advancement in complex aortic anatomies. However, the evidence is limited to case reports. To evaluate the safety profile of the snare-facilitated approach and its impact on self-expanding (SE) TAVR outcomes, we collected consecutive patients who underwent transfemoral SE-TAVR for aortic stenosis, using propensity score matching (PSM) separately in tricuspid and type-0 and type-1 bicuspid aortic valve morphology between the snare and non-snare groups. In 766 patients, despite the snare group having significantly larger annulus angulation and maximal ascending aortic diameter, both groups achieved comparable 30-day device success rates, regardless of first-generation or new-generation valve use. After PSM, the snare group had a significantly lower new permanent pacemaker implantation rate among 193 type-0 patients (3.3% vs. 18.3%, p = 0.01). The ipsilateral group used new-generation valves less frequently (23.0% vs. 75.4%, p < 0.001), but there were no significant inter-group differences in procedure-related events, except for a lower incidence of PVL >/= mild in the ipsilateral group (14.9% vs. 32.3%, p = 0.01). In conclusion, the snare-assisted technique appears useful in SE-TAVR with angulated aortic root anatomy, and the benefits were comparable between ipsilateral and contralateral snare techniques. FAU - Yao, Yi-Jun AU - Yao YJ AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Zhao, Zhen-Gang AU - Zhao ZG AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Wang, Xi AU - Wang X AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Peng, Yong AU - Peng Y AUID- ORCID: 0000-0001-9562-4622 AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Wei, Jia-Fu AU - Wei JF AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - He, Sen AU - He S AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Li, Yi-Jian AU - Li YJ AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - He, Jing-Jing AU - He JJ AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Zhu, Zhong-Kai AU - Zhu ZK AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Feng, Yuan AU - Feng Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. FAU - Chen, Mao AU - Chen M AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. LA - eng GR - 2022ZDZX0030/Sichuan Science and Technology Program/ PT - Journal Article DEP - 20230801 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10420027 OTO - NOTNLM OT - annulus angulation OT - aortic stenosis OT - bicuspid aortic valve OT - snare OT - transcatheter aortic valve replacement COIS- Mao Chen and Yuan Feng are proctors/consultants of Venus MedTech, MicroPort, and Peijia Medical. EDAT- 2023/08/12 10:51 MHDA- 2023/08/12 10:52 PMCR- 2023/08/01 CRDT- 2023/08/12 01:02 PHST- 2023/06/08 00:00 [received] PHST- 2023/07/14 00:00 [revised] PHST- 2023/07/31 00:00 [accepted] PHST- 2023/08/12 10:52 [medline] PHST- 2023/08/12 10:51 [pubmed] PHST- 2023/08/12 01:02 [entrez] PHST- 2023/08/01 00:00 [pmc-release] AID - jcm12155067 [pii] AID - jcm-12-05067 [pii] AID - 10.3390/jcm12155067 [doi] PST - epublish SO - J Clin Med. 2023 Aug 1;12(15):5067. doi: 10.3390/jcm12155067. PMID- 37567022 OWN - NLM STAT- MEDLINE DCOM- 20230904 LR - 20230905 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 204 DP - 2023 Oct 1 TI - Early Safety and Performance of the Premounted Dry-Pericardium Vienna Self-Expandable Transcatheter Aortic Valve System: 30-Day Outcomes of the First-in-Human VIVA Feasibility Study. PG - 302-311 LID - S0002-9149(23)00677-X [pii] LID - 10.1016/j.amjcard.2023.07.109 [doi] AB - The purpose of this first-in-human (FIH) study was to determine the safety and feasibility of the transfemoral premounted dry-pericardium Vienna Self-Expandable Supra-Annular Aortic Valve System. This novel system is repositionable and retrievable and comes already premounted on the delivery system, eliminating the need for assembly and crimping of the device before valve implantation. This is a prospective, nonrandomized, single-arm, single-center, first-stage FIH feasibility study, which will be followed by a second-stage pivotal, multicenter, multinational study in symptomatic patients with severe aortic stenosis. The first-stage FIH study evaluated the safety and feasibility of the device in 10 patients with severe aortic stenosis based on recommendations by the Valve Academic Research Consortium-2 for transcatheter aortic valve implantations. The mean patient age was 79 +/- 5 years, 60% were male, and all patients were in New York Heart Association functional class II to III. The primary safety end point was successful when all patients were alive at 30-day follow-up. Device and technical success were observed in all patients. Two patients had a stroke, 1 of which occurred 5 days after the procedure. New permanent pacemakers were implanted in 2 patients (22.2%), of which only 1 was because of complete heart block. Only 1 patient (10%) had moderate paravalvular leak at 30 days. After the procedure, the mean aortic valve gradient decreased from 48.7 +/- 10.8 mm Hg to 8.8 +/- 4.3 mm Hg. In conclusion, this FIH feasibility study demonstrates successful procedural feasibility, with no 30-day mortality and favorable valve hemodynamic performance, leading to an improvement in quality of life. ClinicalTrials.gov identifier NCT04861805. CI - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Briedis, Kasparas AU - Briedis K AD - Departments of Cardiology. Electronic address: Kasparas.Briedis@lsmu.lt. FAU - Aldujeli, Ali AU - Aldujeli A AD - Departments of Cardiology. FAU - Zaliunas, Remigijus AU - Zaliunas R AD - Departments of Cardiology. FAU - Benetis, Rimantas AU - Benetis R AD - Cardiac, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania. LA - eng SI - ClinicalTrials.gov/NCT04861805 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20230809 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - Male MH - Aged MH - Aged, 80 and over MH - Female MH - Aortic Valve/surgery MH - Feasibility Studies MH - *Aortic Valve Stenosis MH - Prospective Studies MH - Quality of Life MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement OTO - NOTNLM OT - TAVI OT - VIVA trial OT - Vienna TAVI OT - first-in-human COIS- Declaration of Competing Interest Dr. Briedis is a consultant and proctor for P+F Products+Features GmbH and has received honoraria from P+F Products+Features GmbH. The remaining authors have no competing interests to declare. EDAT- 2023/08/12 10:41 MHDA- 2023/09/04 06:42 CRDT- 2023/08/11 18:05 PHST- 2023/06/25 00:00 [received] PHST- 2023/07/15 00:00 [revised] PHST- 2023/07/24 00:00 [accepted] PHST- 2023/09/04 06:42 [medline] PHST- 2023/08/12 10:41 [pubmed] PHST- 2023/08/11 18:05 [entrez] AID - S0002-9149(23)00677-X [pii] AID - 10.1016/j.amjcard.2023.07.109 [doi] PST - ppublish SO - Am J Cardiol. 2023 Oct 1;204:302-311. doi: 10.1016/j.amjcard.2023.07.109. Epub 2023 Aug 9. PMID- 37560819 OWN - NLM STAT- MEDLINE DCOM- 20260310 LR - 20260501 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 4 DP - 2023 Oct TI - A heart valve dedicated for aortic regurgitation: Review of technology and early clinical experience with the transfemoral Trilogy system. PG - 766-771 LID - 10.1002/ccd.30795 [doi] AB - Aortic regurgitation (AR) is associated with morbidity and premature mortality. Surgical aortic valve replacement is not an option for many patients due to an adverse surgical risk profile, whilst transcatheter aortic valve implantation with most available prostheses has demonstrated suboptimal implantation success and outcomes. The JenaValve Trilogy system provides an attractive solution for such patients as it utilizes clips that directly attach onto the native valve leaflets to anchor. Initially designed for transapical delivery, the current transfemoral delivery system is under investigation in the United States and approved for aortic stenosis and regurgitation in Europe. We present an expert review on the technical aspects of the Trilogy system, provide a guide for implantation, discuss the available evidence for the technology and provide illustrative case examples. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Baumbach, Andreas AU - Baumbach A AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK. AD - Barts Heart Centre, St Bartholomew's Hospital, London, UK. FAU - Patel, Kush P AU - Patel KP AUID- ORCID: 0000-0002-3433-8128 AD - Barts Heart Centre, St Bartholomew's Hospital, London, UK. FAU - Kennon, Simon AU - Kennon S AD - Barts Heart Centre, St Bartholomew's Hospital, London, UK. FAU - Ozkor, Mick AU - Ozkor M AD - Barts Heart Centre, St Bartholomew's Hospital, London, UK. FAU - Mathur, Anthony AU - Mathur A AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK. AD - Barts Heart Centre, St Bartholomew's Hospital, London, UK. FAU - Huerta, Frank de la AU - Huerta F AD - JenaValve Technology, Inc., Irvine, California, USA. FAU - Tamm, Alexander R AU - Tamm AR AD - Department of Cardiology, Cardiology I, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20230810 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - *Aortic Valve/physiopathology/surgery/diagnostic imaging MH - *Aortic Valve Insufficiency/physiopathology/surgery/diagnostic imaging MH - *Cardiac Catheterization/instrumentation/adverse effects MH - *Femoral Artery MH - *Heart Valve Prosthesis MH - *Heart Valve Prosthesis Implantation/instrumentation/adverse effects/methods MH - Hemodynamics MH - Prosthesis Design MH - Recovery of Function MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - AVD-aortic valve disease OT - AVDP-aortic valve disease OT - TVI-transcatheter valve implantation OT - percutaneous intervention EDAT- 2023/08/10 06:43 MHDA- 2026/03/11 01:11 CRDT- 2023/08/10 04:37 PHST- 2023/07/04 00:00 [revised] PHST- 2023/05/13 00:00 [received] PHST- 2023/07/28 00:00 [accepted] PHST- 2026/03/11 01:11 [medline] PHST- 2023/08/10 06:43 [pubmed] PHST- 2023/08/10 04:37 [entrez] AID - 10.1002/ccd.30795 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Oct;102(4):766-771. doi: 10.1002/ccd.30795. Epub 2023 Aug 10. PMID- 37553516 OWN - NLM STAT- MEDLINE DCOM- 20240125 LR - 20240702 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 113 IP - 1 DP - 2024 Jan TI - Association between three-year mortality after transcatheter aortic valve implantation and paravalvular regurgitation graded by videodensitometry in comparison with visual grading. PG - 116-125 LID - 10.1007/s00392-023-02280-7 [doi] AB - BACKGROUND: Estimation of regurgitant fraction by videodensitometry (VD-AR) of aortic root angiograms is a new tool for objective grading of paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI). Stratification with boundaries at 6% and 17% has been proposed to reflect "none/trace", "mild" and "moderate or higher" PVR. OBJECTIVE: We sought to investigate the association of strata of VD-AR with 3-year mortality and to compare VD-AR with visual grading of angiograms. METHODS: We interrogated our database for patients undergoing transfemoral TAVI from 2008 to 2018. Vital status of the patients was obtained from population registers. To test differences in survival and estimate adjusted hazard ratios (HRs) we fitted Cox models. RESULTS: Our retrospective study included 699 patients with evaluable angiograms at completion of the TAVI procedure. Cumulative 3-year mortality was 35.0% in 261 (37.3%) patients with VD-AR < 6%, 33.9% in 325 (46.5%) patients with VD-AR between 6 and 17% (HR [95% confidence interval] 1.06 [0.80-1.42]; P = 0.684) and 47.2% in 113 (16.2%) patients with VD-AR > 17% (HR 1.57 [1.11-2.22]; P = 0.011). Visually, PVR was graded as "none/trace" in 470 (67.2%) patients, as "mild" in 219 (31.3%) and as "moderate" in 10 (1.4%). Both mild PVR and moderate PVR on visual grading were significantly associated with mortality (HRs 1.31 [1.12-1.54]; P = 0.001 and 1.92 [1.13-3.24]; P = 0.015; respectively). CONCLUSIONS: VD-AR > 17%, but not VD-AR 6-17%, was independently associated with mortality. Compared with subjective visual evaluation, VD-AR resulted in a smaller proportion of patients with PVR classified as prognostically relevant. CI - (c) 2023. The Author(s). FAU - Elzomor, Hesham AU - Elzomor H AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Neumann, Timotheus J AU - Neumann TJ AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Boas, Linus AU - Boas L AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Ruile, Philipp AU - Ruile P AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Abdelshafy, Mahmoud AU - Abdelshafy M AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Elkoumy, Ahmed AU - Elkoumy A AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Revaiah, Pruthvi C AU - Revaiah PC AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Tsai, Tsung-Ying AU - Tsai TY AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Kaier, Klaus AU - Kaier K AD - Institute of Medical Biometry and Statistics, University of Freiburg Medical Centre, Freiburg, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Soliman, Osama AU - Soliman O AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Ferenc, Miroslaw AU - Ferenc M AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Neumann, Franz-Josef AU - Neumann FJ AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Serruys, Patrick AU - Serruys P AD - Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland. AD - CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland. FAU - Schoechlin, Simon AU - Schoechlin S AUID- ORCID: 0000-0003-0785-8846 AD - Department of Cardiology and Angiology, University of Freiburg Medical Centre, Sudring 15, Bad Krozingen, Germany. schoechlin@diekardiologen-freiburg.de. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. schoechlin@diekardiologen-freiburg.de. LA - eng PT - Journal Article DEP - 20230809 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Insufficiency MH - Retrospective Studies MH - Angiography MH - Proportional Hazards Models MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Severity of Illness Index PMC - PMC10808559 OTO - NOTNLM OT - Angiography OT - Mortality OT - Paravalvular regurgitation OT - Transcatheter aortic valve implantation OT - Videodensitometry COIS- The authors declare, that there are no conflicts of interest. EDAT- 2023/08/09 01:05 MHDA- 2024/01/25 06:43 PMCR- 2023/08/09 CRDT- 2023/08/08 23:28 PHST- 2023/05/24 00:00 [received] PHST- 2023/07/25 00:00 [accepted] PHST- 2024/01/25 06:43 [medline] PHST- 2023/08/09 01:05 [pubmed] PHST- 2023/08/08 23:28 [entrez] PHST- 2023/08/09 00:00 [pmc-release] AID - 10.1007/s00392-023-02280-7 [pii] AID - 2280 [pii] AID - 10.1007/s00392-023-02280-7 [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Jan;113(1):116-125. doi: 10.1007/s00392-023-02280-7. Epub 2023 Aug 9. PMID- 37551700 OWN - NLM STAT- MEDLINE DCOM- 20231102 LR - 20231102 IS - 1559-0879 (Electronic) IS - 1556-9845 (Linking) VI - 18 IP - 4 DP - 2023 Jul-Aug TI - Outcomes of Alternative Access Transcatheter Aortic Valve Replacement Procedures. PG - 326-330 LID - 10.1177/15569845231191096 [doi] AB - Alternative access transcatheter aortic valve replacement (TAVR) consists primarily of 4 different options: transcaval, transaxillary, transcarotid, and transapical. While many centers have a preferred alternative access site, few papers have compared the outcomes of TAVR with each alternative access site. In this review, we examine the outcomes of TAVR at each alternative access site, focusing on mortality, stroke, bleeding, pacemaker insertion, paravalvular leakage, and discharge to home. Notable findings include higher mortality in the transapical group and higher stroke rate in the transaxillary group. On the basis of these data, we suggest that transcarotid TAVR might represent the second choice of approach for TAVR when alternate access is required. FAU - Waterford, Stephen D AU - Waterford SD AD - Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center Hamot, Erie, PA, USA. FAU - Trujillo, John F AU - Trujillo JF AD - Adventist HealthCare Cardiac Associates, Rockville, MD, USA. LA - eng PT - Journal Article PT - Review DEP - 20230808 PL - United States TA - Innovations (Phila) JT - Innovations (Philadelphia, Pa.) JID - 101257528 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Risk Factors MH - Treatment Outcome MH - *Stroke/epidemiology OTO - NOTNLM OT - TAVR OT - alternative access OT - transapical OT - transaxillary OT - transcarotid OT - transcaval EDAT- 2023/08/08 12:42 MHDA- 2023/08/08 12:43 CRDT- 2023/08/08 06:42 PHST- 2023/08/08 12:43 [medline] PHST- 2023/08/08 12:42 [pubmed] PHST- 2023/08/08 06:42 [entrez] AID - 10.1177/15569845231191096 [doi] PST - ppublish SO - Innovations (Phila). 2023 Jul-Aug;18(4):326-330. doi: 10.1177/15569845231191096. Epub 2023 Aug 8. PMID- 37531368 OWN - NLM STAT- MEDLINE DCOM- 20231018 LR - 20250801 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 18 IP - 8 DP - 2023 TI - Effects of low versus high inspired oxygen fraction on myocardial injury after transcatheter aortic valve implantation: A randomized clinical trial. PG - e0281232 LID - 10.1371/journal.pone.0281232 [doi] LID - e0281232 AB - BACKGROUND: Oxygen therapy is used in various clinical situation, but its clinical outcomes are inconsistent. The relationship between the fraction of inspired oxygen (FIO2) during transcatheter aortic valve implantation (TAVI) and clinical outcomes has not been well studied. We investigated the association of FIO2 (low vs. high) and myocardial injury in patients undergoing TAVI. METHODS: Adults undergoing transfemoral TAVI under general anesthesia were randomly assigned to receive FIO2 0.3 or 0.8 during procedure. The primary outcome was the area under the curve (AUC) for high-sensitivity cardiac troponin I (hs-cTnI) during the first 72 h following TAVI. Secondary outcomes included the AUC for postprocedural creatine kinase-myocardial band (CK-MB), acute kidney injury and recovery, conduction abnormalities, pacemaker implantation, stroke, myocardial infarction, and in-hospital mortality. RESULTS: Between October 2017 and April 2022, 72 patients were randomized and 62 were included in the final analysis (n = 31 per group). The median (IQR) AUC for hs-cTnI in the first 72 h was 42.66 (24.82-65.44) and 71.96 (35.38-116.34) h.ng/mL in the FIO2 0.3 and 0.8 groups, respectively (p = 0.066). The AUC for CK-MB in the first 72 h was 257.6 (155.6-322.0) and 342.2 (195.4-485.2) h.ng/mL in the FIO2 0.3 and 0.8 groups, respectively (p = 0.132). Acute kidney recovery, defined as an increase in the estimated glomerular filtration rate >/= 25% of baseline in 48 h, was more common in the FIO2 0.3 group (65% vs. 39%, p = 0.042). Other clinical outcomes were comparable between the groups. CONCLUSIONS: The FIO2 level did not have a significant effect on periprocedural myocardial injury following TAVI. However, considering the marginal results, a benefit of low FIO2 during TAVI could not be ruled out. CI - Copyright: (c) 2023 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. FAU - Cho, Youn Joung AU - Cho YJ AUID- ORCID: 0000-0001-6478-8616 AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Hyeon, Cheun AU - Hyeon C AUID- ORCID: 0000-0001-7477-8438 AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Nam, Karam AU - Nam K AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Lee, Seohee AU - Lee S AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Ju, Jae-Woo AU - Ju JW AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Kang, Jeehoon AU - Kang J AD - Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Han, Jung-Kyu AU - Han JK AD - Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. FAU - Jeon, Yunseok AU - Jeon Y AUID- ORCID: 0000-0001-8686-1124 AD - Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20230802 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - S88TT14065 (Oxygen) SB - IM MH - Humans MH - Male MH - Female MH - Middle Aged MH - Aged MH - Aged, 80 and over MH - Oxygen MH - *Heart Injuries/etiology MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome PMC - PMC10395822 COIS- The authors have declared that no competing interests exist. EDAT- 2023/08/02 19:15 MHDA- 2023/08/04 06:43 PMCR- 2023/08/02 CRDT- 2023/08/02 13:43 PHST- 2023/01/17 00:00 [received] PHST- 2023/07/18 00:00 [accepted] PHST- 2023/08/04 06:43 [medline] PHST- 2023/08/02 19:15 [pubmed] PHST- 2023/08/02 13:43 [entrez] PHST- 2023/08/02 00:00 [pmc-release] AID - PONE-D-23-01231 [pii] AID - 10.1371/journal.pone.0281232 [doi] PST - epublish SO - PLoS One. 2023 Aug 2;18(8):e0281232. doi: 10.1371/journal.pone.0281232. eCollection 2023. PMID- 37519054 OWN - NLM STAT- MEDLINE DCOM- 20240305 LR - 20260510 IS - 1898-018X (Electronic) IS - 1897-5593 (Print) IS - 1898-018X (Linking) VI - 31 IP - 1 DP - 2024 TI - Long-term bio-functional performance of a novel, self-positioning balloon expandable transcatheter biological aortic valve system in the ovine aortic banding model. PG - 124-132 LID - 10.5603/CJ.a2023.0048 [doi] AB - BACKGROUND: The aim of the study was to evaluate bio-functionality of a novel, proprietary balloon-expandable biological transcatheter aortic valve implantation (TAVI) system (InFlow, CardValve Consortium, Poland) in an ovine model of aortic banding. METHODS: Surgical ascending aorta banding was created in 21 sheep. Two weeks later, 18 biological valves were implanted within the model using 15-16 F InFlow TAVI systems and carotid cut-down approach. Follow-up transthoracic echocardiography was performed at 30, 90, and 180-day. At designated time, animals were euthanized and valves harvested for analysis. RESULTS: All sheep survived the banding procedure. There were 4 (22%) procedure related deaths within a 7-day period. During the observation an additional 2 sheep died. In one, the valve dislocated after the procedure - the animal was excluded. Two animals completed 30-day follow up, five 90-day follow-up and four terminal follow-up of 180 days. Valves examined via transesophageal echocardiography showed proper hemodynamic parameters without evidence of structural valve deterioration. The maximum and average flow gradients at 180 days were 31.4 (23.3-37.7) and 17.5 (13.1-20.2) mmHg, respectively. There was one case of moderate insufficiency and no case of perivalvular leaks. By histopathology, there were no inflammation, thrombosis, nor calcifications in any tested valves at long-term follow-up. Neointimal coverage of stent struts increased with time from basal part in "early" groups to nearly 3/4 of stent length in the 180-day group. The pannus tissue showed maturation that increased with time with no stenotic "collar" visible in orthotopically implanted valves. CONCLUSIONS: The study showed good hemodynamic performance, durability and biocompatibility of the novel biological THV. FAU - Buszman, Piotr P AU - Buszman PP AD - Department of Cardiology, Andrzej Frycz Modrzewski Krakow University, Bielsko-Biala, Poland. pbuszman@gmail.com. AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. pbuszman@gmail.com. FAU - Kachel, Mateusz AU - Kachel M AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. AD - Department of Cardiology, Andrzej Frycz Modrzewski Krakow University, Bielsko-Biala, Poland. FAU - Milewski, Krzysztof P AU - Milewski KP AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. AD - Faculty of Medicine, University of Technology, Katowice, Poland. FAU - Michalak, Magdalena AU - Michalak M AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. FAU - Domaradzki, Wojciech AU - Domaradzki W AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. FAU - Pruski, Maciej Jr AU - Pruski M Jr AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. FAU - Sobota, Michal AU - Sobota M AD - Polish Academy of Sciences, Center of Polymer and Carbon Materials, Zabrze, Poland. FAU - Fernandez, Carlos AU - Fernandez C AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. FAU - Lukasik, Karolina AU - Lukasik K AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. FAU - Nozynski, Jerzy AU - Nozynski J AD - Silesian Center for Heart Diseases, Zabrze, Poland. FAU - Hirnle, Piotr AU - Hirnle P AD - Medical University of Bialystok, Poland. FAU - Kazmierczak, Pawel AU - Kazmierczak P AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. FAU - Bochenek, Andrzej AU - Bochenek A AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. AD - Faculty of Medicine, University of Technology, Katowice, Poland. FAU - Buszman, Pawel E AU - Buszman PE AD - American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland. AD - Medical University of Silesia, Katowice, Poland. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230731 PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 SB - IM MH - Animals MH - Sheep MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome PMC - PMC10919571 OTO - NOTNLM OT - aortic stenosis OT - artificial heart valve OT - biological heart valve OT - preclinical study OT - transcatheter aortic valve implantation (TAVI) COIS- Conflict of interest: None declared EDAT- 2023/07/31 06:43 MHDA- 2024/03/05 06:45 PMCR- 2024/02/29 CRDT- 2023/07/31 02:13 PHST- 2022/08/01 00:00 [received] PHST- 2023/04/28 00:00 [accepted] PHST- 2023/04/03 00:00 [revised] PHST- 2024/03/05 06:45 [medline] PHST- 2023/07/31 06:43 [pubmed] PHST- 2023/07/31 02:13 [entrez] PHST- 2024/02/29 00:00 [pmc-release] AID - VM/OJS/J/91223 [pii] AID - cardj-31-1-124 [pii] AID - 10.5603/CJ.a2023.0048 [doi] PST - ppublish SO - Cardiol J. 2024;31(1):124-132. doi: 10.5603/CJ.a2023.0048. Epub 2023 Jul 31. PMID- 37511955 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230801 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 13 IP - 7 DP - 2023 Jul 18 TI - Dual Antiplatelet Therapy: A Concise Review for Clinicians. LID - 10.3390/life13071580 [doi] LID - 1580 AB - Dual antiplatelet therapy (DAPT) combines two antiplatelet agents to decrease the risk of thrombotic complications associated with atherosclerotic cardiovascular diseases. Emerging data about the duration of DAPT is being published continuously. New approaches are trying to balance the time, benefits, and risks for patients taking DAPT for established cardiovascular diseases. Short-term dual DAPT of 3-6 months, or even 1 month in high-bleeding risk patients, is equivalent in terms of efficacy and effectiveness compared to long-term DAPT for patients who experienced percutaneous coronary intervention in an acute coronary syndrome setting. Prolonged DAPT beyond 12 months reduces stent thrombosis, major adverse cardiovascular events, and myocardial infarction rates but increases bleeding risk. Extended DAPT does not significantly benefit stable coronary artery disease patients in reducing stroke, myocardial infarction, or cardiovascular death. Ticagrelor and aspirin reduce cardiovascular events in stable coronary artery disease with diabetes but carry a higher bleeding risk. Antiplatelet therapy duration in atrial fibrillation patients after percutaneous coronary intervention depends on individual characteristics and bleeding risk. Antiplatelet therapy is crucial for post-coronary artery bypass graft and transcatheter aortic valve implantation; Aspirin (ASA) monotherapy is preferred. Antiplatelet therapy duration in peripheral artery disease depends on the scenario. Adding vorapaxar and cilostazol may benefit secondary prevention and claudication, respectively. Carotid artery disease patients with transient ischemic attack or stroke benefit from antiplatelet therapy and combining ASA and clopidogrel is more effective than ASA alone. The optimal duration of DAPT after carotid artery stenting is uncertain. Resistance to ASA and clopidogrel poses an incremental risk of deleterious cardiovascular events and stroke. The selection and duration of antiplatelet therapy in patients with cardiovascular disease requires careful consideration of both efficacy and safety outcomes. The use of combination therapies may provide added benefits but should be weighed against the risk of bleeding. Further research and clinical trials are needed to optimize antiplatelet treatment in different patient populations and clinical scenarios. FAU - Virk, Hafeez Ul Hassan AU - Virk HUH AD - Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH 44101, USA. FAU - Escobar, Johao AU - Escobar J AUID- ORCID: 0000-0002-0061-1595 AD - International Transitional Medical Graduate, American College of Physician, Philadelphia, PA 19106, USA. FAU - Rodriguez, Mario AU - Rodriguez M AD - John T Milliken Department of Medicine, Division of Cardiovascular Disease, Section of Advanced Heart Failure and Transplant, Barnes-Jewish Hospital, Washington University, St. Louis School of Medicine, St. Louis, MO 63110, USA. FAU - Bates, Eric R AU - Bates ER AD - Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA. FAU - Khalid, Umair AU - Khalid U AD - Michael E. DeBakey VA Medical Center, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA. FAU - Jneid, Hani AU - Jneid H AD - Division of Cardiology, University of Texas Medical Branch, Houston, TX 77555, USA. FAU - Birnbaum, Yochai AU - Birnbaum Y AUID- ORCID: 0000-0001-7653-6328 AD - Michael E. DeBakey VA Medical Center, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA. FAU - Levine, Glenn N AU - Levine GN AD - Michael E. DeBakey VA Medical Center, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA. FAU - Smith, Sidney C Jr AU - Smith SC Jr AD - Division of Cardiology, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. FAU - Krittanawong, Chayakrit AU - Krittanawong C AD - Cardiology Division, NYU School of Medicine, NYU Langone Health, New York, NY 10016, USA. LA - eng PT - Journal Article PT - Review DEP - 20230718 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC10381391 OTO - NOTNLM OT - DAPT OT - dual antiplatelet therapy COIS- The authors declare no conflict of interest. EDAT- 2023/07/29 11:45 MHDA- 2023/07/29 11:46 PMCR- 2023/07/18 CRDT- 2023/07/29 01:27 PHST- 2023/06/06 00:00 [received] PHST- 2023/07/05 00:00 [revised] PHST- 2023/07/12 00:00 [accepted] PHST- 2023/07/29 11:46 [medline] PHST- 2023/07/29 11:45 [pubmed] PHST- 2023/07/29 01:27 [entrez] PHST- 2023/07/18 00:00 [pmc-release] AID - life13071580 [pii] AID - life-13-01580 [pii] AID - 10.3390/life13071580 [doi] PST - epublish SO - Life (Basel). 2023 Jul 18;13(7):1580. doi: 10.3390/life13071580. PMID- 37500393 OWN - NLM STAT- MEDLINE DCOM- 20231225 LR - 20260508 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 58 DP - 2024 Jan TI - Safety and feasibility of zero-contrast transcatheter aortic valve implantation using balloon-expandable valves in patients with aortic stenosis and severe renal impairment: A single-center study. PG - 68-76 LID - S1553-8389(23)00711-X [pii] LID - 10.1016/j.carrev.2023.07.014 [doi] AB - BACKGROUND: Aortic stenosis (AS) and chronic kidney disease (CKD) can coexist. Repeat exposure to contrast media in patients undergoing transcatheter aortic valve implantation (TAVI) has latent mortality risks and increased risk for acute kidney injury. We aimed to assess our "zero-contrast TAVI" protocol for patients with advanced CKD. METHODS: Consecutive patients with severe AS who underwent TAVI at a single center registry were enrolled. Zero-contrast TAVI group included patients who underwent TAVI without contrast and who had an estimated glomerular filtration rate <30 mL/min/1.73 m(2). Conventional TAVI group included patients who underwent the regular TAVI procedure. Patients using balloon-expandable valves via transfemoral approach were analyzed. Baseline clinical and procedural characteristics and clinical outcomes were compared between two groups. The primary outcome was early safety as defined by Valve Academic Research Consortium Criteria. Secondary outcomes included the presence of severe prosthesis-patient mismatch, moderate or greater perivalvular leakage, and requirement for new dialysis (within 3 months). RESULTS: A total of 520 patients were analyzed. Among these, 32 (6 %) underwent zero-contrast TAVI and 488 (94 %) conventional TAVI. In the zero-contrast TAVI group, 12 patients (37.5 %) had to use 20.7 (11.0-31.2) mL of contrast media. There were no significant differences in the primary and secondary outcomes between zero-contrast TAVI and conventional TAVI groups (78.1 % vs. 86.8 %, P = 0.184 and 9.4 % vs. 8.1 %, P = 0.738 for the primary and secondary outcomes, respectively). CONCLUSIONS: Zero-contrast TAVI is feasible, safe, and effective in patients with AS and stage 4 CKD. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Koga, Masashi AU - Koga M AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. Electronic address: masashi.koga@marianna-u.ac.jp. FAU - Izumo, Masaki AU - Izumo M AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Kobayashi, Yoshikuni AU - Kobayashi Y AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Kai, Takahiko AU - Kai T AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Okuno, Taishi AU - Okuno T AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Sato, Yukio AU - Sato Y AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Kuwata, Shingo AU - Kuwata S AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Okuyama, Kazuaki AU - Okuyama K AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Ishibashi, Yuki AU - Ishibashi Y AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Tanabe, Yasuhiro AU - Tanabe Y AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. FAU - Akashi, Yoshihiro J AU - Akashi YJ AD - Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan. LA - eng PT - Journal Article DEP - 20230721 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 RN - 0 (Contrast Media) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis MH - Feasibility Studies MH - Contrast Media/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - *Renal Insufficiency, Chronic/complications/diagnosis/therapy MH - Aortic Valve/diagnostic imaging/surgery MH - Treatment Outcome OTO - NOTNLM OT - Aortic stenosis OT - Chronic kidney disease OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest Dr. Izumo is a screening proctor at Edwards Lifesciences. EDAT- 2023/07/28 01:08 MHDA- 2023/12/25 06:43 CRDT- 2023/07/27 22:03 PHST- 2023/04/07 00:00 [received] PHST- 2023/06/23 00:00 [revised] PHST- 2023/07/19 00:00 [accepted] PHST- 2023/12/25 06:43 [medline] PHST- 2023/07/28 01:08 [pubmed] PHST- 2023/07/27 22:03 [entrez] AID - S1553-8389(23)00711-X [pii] AID - 10.1016/j.carrev.2023.07.014 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2024 Jan;58:68-76. doi: 10.1016/j.carrev.2023.07.014. Epub 2023 Jul 21. PMID- 37498966 OWN - NLM STAT- MEDLINE DCOM- 20230731 LR - 20230804 IS - 2474-9842 (Electronic) IS - 2474-9842 (Linking) VI - 7 IP - 4 DP - 2023 Jul 10 TI - Vascular complications of ProGlide versus Prostar in transcatheter aortic valve replacement (TAVR) procedures: meta-analysis. LID - 10.1093/bjsopen/zrad061 [doi] LID - zrad061 AB - BACKGROUND: The aim of this study was to compare the vascular complications of ProGlide and Prostar in percutaneous transfemoral transcatheter aortic valve replacement. METHODS: Electronic databases were searched in July 2022 for studies that compared the vascular complications of ProGlide and Prostar for percutaneous closure in transcatheter aortic valve replacement. The primary outcome was major vascular complications and the secondary outcomes were minor vascular complications, types of access-site vascular complications, device failure, and additional intervention. Estimates of relative effects were pooled to generate ORs and their 95 per cent c.i. using a random-effects model. The risk of bias in non-randomized comparative studies was assessed using the Risk Of Bias In Non-randomized Studies - of Interventions ('ROBINS-I') tool. RESULTS: Nine studies were identified and a total of 7529 patients were included. Among them, 4144 patients received ProGlide and 3385 received Prostar. The pooled data showed that the risk of major vascular complications was significantly lower with ProGlide versus Prostar (OR 0.50, 95 per cent c.i. 0.32 to 0.78). Regarding the types of vascular complications, vascular trauma was the most common complication and the risk was similar between groups (OR 1.02, 95 per cent c.i. 0.55 to 1.91). ProGlide had a lower risk of bleeding complications (OR 0.46, 95 per cent c.i. 0.22 to 0.94), but a higher risk of ischaemia complications (OR 1.90, 95 per cent c.i. 1.10 to 3.27). The risk of device failure was lower in the ProGlide group (OR 0.45, 95 per cent c.i. 0.21 to 0.95). Both groups had a similar risk of having additional interventions for vascular complications (OR 1.02, 95 per cent c.i. 0.75 to 1.39). The use of ProGlide was associated with a lower risk of additional surgical treatments (OR 0.52, 95 per cent c.i. 0.34 to 0.80), but a higher risk of endovascular treatments (OR 2.69, 95 per cent c.i. 1.29 to 5.63). CONCLUSION: In percutaneous transfemoral transcatheter aortic valve replacement procedures, ProGlide has superior safety and efficacy when compared with Prostar; it is associated with fewer major vascular complications and device failures. The vascular complications of ProGlide are more likely to be dealt with using endovascular treatments than surgical treatments. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. FAU - Xiang, Yuwei AU - Xiang Y AD - Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. FAU - Chen, Chen AU - Chen C AD - Division of Cardiology, West China Hospital, Sichuan University, Chengdu, China. FAU - Zhao, Jichun AU - Zhao J AD - Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. FAU - Ma, Yukui AU - Ma Y AD - Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. FAU - Huang, Bin AU - Huang B AD - Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. FAU - Wu, Zhoupeng AU - Wu Z AD - Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PL - England TA - BJS Open JT - BJS open JID - 101722685 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Aortic Valve Stenosis/surgery MH - *Vascular Closure Devices/adverse effects MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Cardiovascular Diseases PMC - PMC10373905 EDAT- 2023/07/27 19:10 MHDA- 2023/07/31 06:43 PMCR- 2023/07/27 CRDT- 2023/07/27 13:55 PHST- 2022/12/11 00:00 [received] PHST- 2023/02/20 00:00 [revised] PHST- 2023/04/30 00:00 [accepted] PHST- 2023/07/31 06:43 [medline] PHST- 2023/07/27 19:10 [pubmed] PHST- 2023/07/27 13:55 [entrez] PHST- 2023/07/27 00:00 [pmc-release] AID - 7232248 [pii] AID - zrad061 [pii] AID - 10.1093/bjsopen/zrad061 [doi] PST - ppublish SO - BJS Open. 2023 Jul 10;7(4):zrad061. doi: 10.1093/bjsopen/zrad061. PMID- 37496781 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230728 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 5 IP - 7 DP - 2023 Jul TI - Temporal Changes in Quality Indicators in a Regional System of Care After Surgical and Transcatheter Aortic Valve Replacement. PG - 508-521 LID - 10.1016/j.cjco.2023.03.015 [doi] AB - BACKGROUND: Historically, quality-of-care monitoring was performed separately for transcatheter and surgical aortic valve replacement (TAVR, SAVR). Using consensus indicators, we provide a global report on the quality of care for treatment of aortic stenosis across the highest-volume treatments: transfemoral (TF) TAVR, isolated SAVR, and SAVR combined with coronary artery bypass graft. METHODS: Retrospective observational cohort study of consecutive patients in a regional system of care. Primary endpoint was 30-day and 1-year mortality (2015-2019). Secondary endpoints included rate of new pacemaker, rate of readmission, and length of stay (2012-2019). Following multivariable logistic regressions, we developed mortality case-mix adjustment models to report risk estimates. RESULTS: The proportion of patients receiving TAVR grew from 32% to 53% (2015-2019). Those receiving TF TAVR were significantly older, with higher rates of comorbidities. Observed 30-day and 1-year all-cause mortality after TF TAVR decreased from 3.1% to 0.6% (P = 0.03), and 13.6% to 6.6% (P = 0.09), respectively; surgical mortality rates for isolated SAVR and SAVR combined with coronary artery bypass graft were low and did not change significantly over time, ranging from 0.3% to 1.4% and from 0.9% to 3.4%, respectively at 30 days, and from 0.9% to 3.4% and from 4.7% to 6.7 at 1 year. In the TF TAVR cohort, the observed vs expected ratio for 30-day and 1-year mortality decreased significantly from 1.9 (95% confidence interval [CI] 0.9, 3.5) to 0.3 (95% CI 0.1, 0.8), and from 1.3 (95% CI 0.9, 1.7) to 0.7 (95% CI 0.5, 0.99), respectively; no change occurred in risk-adjusted surgical mortality. CONCLUSIONS: Consensus quality indicators provide unique insights on the quality of care for patients receiving treatment for aortic stenosis. CI - Crown Copyright (c) 2023 Published by Elsevier Inc. on behalf of the Canadian Cardiovascular Society. FAU - Lauck, Sandra B AU - Lauck SB AD - University of British Columbia, Vancouver, British Columbia, Canada. FAU - Yu, Maggie AU - Yu M AD - University of British Columbia, Vancouver, British Columbia, Canada. FAU - Pu, Aihua AU - Pu A AD - Cardiac Services BC, Vancouver, British Columbia, Canada. FAU - Virani, Sean AU - Virani S AD - Cardiac Services BC, Vancouver, British Columbia, Canada. FAU - Meier, David AU - Meier D AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Akodad, Mariam AU - Akodad M AD - Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques-Cartier, Ramsay Sante, Massy, France. FAU - Sathananthan, Janarthanan AU - Sathananthan J AD - University of British Columbia, Vancouver, British Columbia, Canada. AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Chan, Albert W AU - Chan AW AD - Division of Cardiology, Royal Columbian Hospital, New Westminster, British Columbia, Canada. FAU - Price, Joel AU - Price J AD - Division of Cardiovascular and Thoracic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Wong, Daniel AU - Wong D AD - Department of Cardiac Surgery, Royal Columbian Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Wood, David A AU - Wood DA AD - University of British Columbia, Vancouver, British Columbia, Canada. AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Webb, John G AU - Webb JG AD - University of British Columbia, Vancouver, British Columbia, Canada. AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Abel, James G AU - Abel JG AD - University of British Columbia, Vancouver, British Columbia, Canada. AD - Division of Cardiovascular and Thoracic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. LA - eng PT - Journal Article DEP - 20230414 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC10366640 EDAT- 2023/07/27 06:42 MHDA- 2023/07/27 06:43 PMCR- 2023/04/14 CRDT- 2023/07/27 04:07 PHST- 2023/03/21 00:00 [received] PHST- 2023/03/27 00:00 [accepted] PHST- 2023/07/27 06:43 [medline] PHST- 2023/07/27 06:42 [pubmed] PHST- 2023/07/27 04:07 [entrez] PHST- 2023/04/14 00:00 [pmc-release] AID - S2589-790X(23)00085-9 [pii] AID - 10.1016/j.cjco.2023.03.015 [doi] PST - epublish SO - CJC Open. 2023 Apr 14;5(7):508-521. doi: 10.1016/j.cjco.2023.03.015. eCollection 2023 Jul. PMID- 37495094 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20231216 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 98 DP - 2024 Jan TI - Outcomes of Using Balloon-Expandable Covered Stent for Percutaneous Treatment of Access-Site Vascular Injury after Transfemoral Aortic Valve Implantation: A Single Center Experience. PG - 228-234 LID - S0890-5096(23)00527-7 [pii] LID - 10.1016/j.avsg.2023.07.098 [doi] AB - BACKGROUND: Access-site vascular injury (ASVI) remains a challenge for transfemoral transcatheter aortic valve implantation (TAVI). Although surgery is the gold standard, endovascular therapy gains growing acceptance as primary treatment option for ASVI. The aim of this study was to analyze the safety and efficacy of covered balloon-expandable stents (BXSs) placement for ASVI after transfemoral TAVI. METHODS: All patients treated with a covered BXS between January 2018 and December 2020 for access-site related bleeding complications following femoral TAVI were included in this single center retrospective study. Primary measure outcome of this study was the primary patency at 12 months. Technical success, limb clinical worsening and device related complications were additionally analyzed. RESULTS: During the study period, 576 percutaneous femoral TAVIs were performed. Of these, 36 patients (6%) underwent covered stent deployment for a femoral access-site complication (19 men, median age 83 years old). Procedural success was 97%. The median follow-up was 12 months (interquartile range [IQR] = 9.7, range 0-36 months). One patient was lost to follow-up. The primary patency rates at 6 and 12 months were 100% and 95% respectively. No clinical deterioration or stent fracture was described during this period. CONCLUSIONS: Our results suggest that covered BXS deployment is a safe and effective alternative to surgery and may be a promising option for treating ASVI after femoral TAVI. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Benic, Clement AU - Benic C AD - Department of Cardiology, University Hospital of Brest, Brest, France; INSERM UMR 1304 GETBO, Brest, France. FAU - Stavroulakis, Konstantinos AU - Stavroulakis K AD - Department of Vascular and Endovascular Surgery, Ludwig-Maximilians University Hospital, Munich, Germany. FAU - Carret, Melanie AU - Carret M AD - Department of Vascular and Endovascular Surgery, University Hospital of Brest, Brest, France. FAU - Pluchon, Kevin AU - Pluchon K AD - Department of Cardiovascular and Thoracic Surgery, University Hospital of Brest, Brest, France. FAU - Didier, Romain AU - Didier R AD - Department of Cardiology, University Hospital of Brest, Brest, France; INSERM UMR 1304 GETBO, Brest, France. FAU - Nasr, Bahaa AU - Nasr B AD - Department of Vascular and Endovascular Surgery, University Hospital of Brest, Brest, France; INSERM UMR 1101, LaTIM, Brest, France. Electronic address: nasr.bahaa@gmail.com. LA - eng PT - Journal Article DEP - 20230724 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 SB - IM MH - Male MH - Humans MH - Aged, 80 and over MH - Aortic Valve MH - *Vascular System Injuries/etiology MH - Retrospective Studies MH - Treatment Outcome MH - Stents/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Femoral Artery/diagnostic imaging/surgery EDAT- 2023/07/27 01:09 MHDA- 2023/12/17 09:44 CRDT- 2023/07/26 19:22 PHST- 2023/05/15 00:00 [received] PHST- 2023/07/09 00:00 [revised] PHST- 2023/07/12 00:00 [accepted] PHST- 2023/12/17 09:44 [medline] PHST- 2023/07/27 01:09 [pubmed] PHST- 2023/07/26 19:22 [entrez] AID - S0890-5096(23)00527-7 [pii] AID - 10.1016/j.avsg.2023.07.098 [doi] PST - ppublish SO - Ann Vasc Surg. 2024 Jan;98:228-234. doi: 10.1016/j.avsg.2023.07.098. Epub 2023 Jul 24. PMID- 37485260 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230725 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Predicting the risk of iliofemoral vascular complication in complex transfemoral-TAVR using new generation transcatheter devices. PG - 1167212 LID - 10.3389/fcvm.2023.1167212 [doi] LID - 1167212 AB - OBJECTIVE: Design a predictive risk model for minimizing iliofemoral vascular complications (IVC) in a contemporary era of transfemoral-transcatheter aortic valve replacement (TF-TAVR). BACKGROUND: IVC remains a common complication of TF-TAVR despite the technological improvement in the new-generation transcatheter systems (NGTS) and enclosed poor outcomes and quality of life. Currently, there is no accepted tool to assess the IVC risk for calcified and tortuous vessels. METHODS: We reconstructed CT images of 516 propensity-matched TF-TAVR patients using the NGTS to design a predictive anatomical model for IVC and validated it on a new cohort of 609 patients. Age, sex, peripheral artery disease, valve size, and type were used to balance the matched cohort. RESULTS: IVC occurred in 214 (7.2%) patients. Sheath size (p = 0.02), the sum of angles (SOA) (p < .0001), number of curves (NOC) (p < .0001), minimal lumen diameter (MLD) (p < .001), and sheath-to-femoral artery diameter ratio (SFAR) (p = 0.012) were significant predictors for IVC. An indexed risk score (CSI) consisting of multiplying the SOA and NOC divided by the MLD showed 84.3% sensitivity and 96.8% specificity, when set to >100, in predicting IVC (C-stat 0.936, 95% CI 0.911-0.959, p < 0.001). Adding SFAR > 1.00 in a tree model increased the overall accuracy to 97.7%. In the validation cohort, the model predicted 89.5% of the IVC cases with an overall 89.5% sensitivity, 98.9% specificity, and 94.2% accuracy (C-stat 0.842, 95% CI 0.904-0.980, p < .0001). CONCLUSION: Our CT-based validated-model is the most accurate and easy-to-use tool assessing IVC risk and should be used for calcified and tortuous vessels in preprocedural planning. CI - (c) 2023 Koren, Patel, Tamir, Koseki, Kaewkes, Sanders, Naami, Naami, Cheng, Natanzon, Shechter, Gornbein, Chakravarty, Nakamura, Cheng, Jilaihawi and Makkar. FAU - Koren, Ofir AU - Koren O AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. AD - Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel. FAU - Patel, Vivek AU - Patel V AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Tamir, Yuval AU - Tamir Y AD - Weizmann Institute of Science, Rehovot, Israel. FAU - Koseki, Keita AU - Koseki K AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. AD - Department of Cardiology, The University of Tokyo Hospital, Tokyo, Japan. FAU - Kaewkes, Danon AU - Kaewkes D AD - Queen Sirikit Heart Center of the Northeast, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. FAU - Sanders, Troy AU - Sanders T AD - David Geffen School of Medicine, University of California (UCLA), Los Angeles, California. FAU - Naami, Robert AU - Naami R AD - Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve, University School of Medicine, Cleveland, United States. FAU - Naami, Edmund AU - Naami E AD - School of Medicine, University of Illinois, Chicago, IL, United States. FAU - Cheng, Daniel Eugene AU - Cheng DE AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Natanzon, Sharon Shalom AU - Natanzon SS AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Shechter, Alon AU - Shechter A AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. AD - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. AD - Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel. FAU - Gornbein, Jeffrey AU - Gornbein J AD - David Geffen School of Medicine, University of California (UCLA), Los Angeles, California. FAU - Chakravarty, Tarun AU - Chakravarty T AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Nakamura, Mamoo AU - Nakamura M AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Cheng, Wen AU - Cheng W AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Jilaihawi, Hasan AU - Jilaihawi H AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California. LA - eng PT - Journal Article DEP - 20230706 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10357287 OTO - NOTNLM OT - TAVR OT - aortic stenosis OT - calcification OT - crossability OT - iliofemoral vascular complications OT - risk model OT - tortuosity OT - validation & verification component COIS- RM received grant support from Edwards Lifesciences Corporation; he is a consultant for Abbott Vascular, Cordis and Medtronic and holds equity in Entourage Medical. TC is a consultant, proctor, and speaker for Edwards Lifesciences and Medtronic; he is a consultant for Abbott Lifesciences and a consultant and speaker for Boston Scientific. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/07/24 06:42 MHDA- 2023/07/24 06:43 PMCR- 2023/01/01 CRDT- 2023/07/24 04:55 PHST- 2023/02/16 00:00 [received] PHST- 2023/06/15 00:00 [accepted] PHST- 2023/07/24 06:43 [medline] PHST- 2023/07/24 06:42 [pubmed] PHST- 2023/07/24 04:55 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1167212 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Jul 6;10:1167212. doi: 10.3389/fcvm.2023.1167212. eCollection 2023. PMID- 37480891 OWN - NLM STAT- MEDLINE DCOM- 20230901 LR - 20240216 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 16 DP - 2023 Aug 28 TI - Incidence, Predictors, and Prognostic Impact of New Permanent Pacemaker Implantation After TAVR With Self-Expanding Valves. PG - 2004-2017 LID - S1936-8798(23)00846-4 [pii] LID - 10.1016/j.jcin.2023.05.020 [doi] AB - OBJECTIVES: The authors sought to evaluate the incidence, predictors, and outcomes of new permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) with contemporary self-expanding valves (SEV). BACKGROUND: Need for PPI is frequent post-TAVR, but conflicting data exist on new-generation SEV and on the prognostic impact of PPI. METHODS: This study included 3,211 patients enrolled in the multicenter NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) and NEOPRO-2 (A Multicenter Comparison of ACURATE NEO2 Versus Evolut PRO/PRO+ Transcatheter Heart Valves 2) registries (January 2012 to December 2021) who underwent transfemoral TAVR with SEV. Implanted transcatheter heart valves (THV) were Acurate neo (n = 1,090), Acurate neo2 (n = 665), Evolut PRO (n = 1,312), and Evolut PRO+ (n = 144). Incidence and predictors of new PPI and 1-year outcomes were evaluated. RESULTS: New PPI was needed in 362 patients (11.3%) within 30 days after TAVR (8.8%, 7.7%, 15.2%, and 10.4%, respectively, after Acurate neo, Acurate neo2, Evolut PRO, and Evolut PRO+). Independent predictors of new PPI were Society of Thoracic Surgeons Predicted Risk of Mortality score, baseline right bundle branch block and depth of THV implantation, both in patients treated with Acurate neo/neo2 and in those treated with Evolut PRO/PRO+. Predischarge reduction in ejection fraction (EF) was more frequent in patients requiring PPI (P = 0.014). New PPI was associated with higher 1-year mortality (16.9% vs 10.8%; adjusted HR: 1.66; 95% CI: 1.13-2.43; P = 0.010), particularly in patients with baseline EF <40% (P for interaction = 0.049). CONCLUSIONS: New PPI was frequently needed after TAVR with SEV (11.3%) and was associated with higher 1-year mortality, particularly in patients with EF <40%. Baseline right bundle branch block and depth of THV implantation independently predicted the need of PPI. CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Pagnesi, Matteo AU - Pagnesi M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany. FAU - Baggio, Sara AU - Baggio S AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore," Enna, Italy. FAU - De Marco, Federico AU - De Marco F AD - Centro Cardiologico Monzino IRCCS, Milan, Italy. FAU - Adamo, Marianna AU - Adamo M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Eitan, Amnon AU - Eitan A AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel. FAU - Estevez-Loureiro, Rodrigo AU - Estevez-Loureiro R AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart and Vascular Center, Hamburg, Germany. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Heart Center Lucerne, Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, Galway University Hospitals, Galway, Ireland. FAU - Veulemans, Verena AU - Veulemans V AD - Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Dusseldorf, Dusseldorf, Germany. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Wolf, Alexander AU - Wolf A AD - Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Essen, Germany. FAU - Giannini, Francesco AU - Giannini F AD - Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Montorfano, Matteo AU - Montorfano M AD - Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. FAU - Zweiker, David AU - Zweiker D AD - Division of Cardiology, Medical University of Graz, Graz, Austria. FAU - Ferlini, Marco AU - Ferlini M AD - Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Kornowski, Ran AU - Kornowski R AD - Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel. FAU - Hildick-Smith, David AU - Hildick-Smith D AD - Department of Cardiology, Royal Sussex County Hospital, Brighton, United Kingdom. FAU - Taramasso, Maurizio AU - Taramasso M AD - Heart Valve Clinic, University Hospital of Zurich, Zurich, Switzerland. FAU - Abizaid, Alexandre AU - Abizaid A AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. FAU - Schofer, Joachim AU - Schofer J AD - Department for Percutaneous Treatment of Structural Heart Disease, Albertinen Heart Center, Hamburg, Germany; MVZ Department Structural Heart Disease, Asklepios St. Georg Clinic, Hamburg, Germany. FAU - Sinning, Jan-Malte AU - Sinning JM AD - Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Wohrle, Jochen AU - Wohrle J AD - Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany. FAU - Khogali, Saib AU - Khogali S AD - Heart and Lung Centre, New Cross Hospital, Wolverhampton, United Kingdom. FAU - Van der Heyden, Jan A S AU - Van der Heyden JAS AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands; Interventional Cardiology Unit, AZ Sint-Jan Hospital, Bruges, Belgium. FAU - Wood, David A AU - Wood DA AD - Centre for Heart Valve and Cardiovascular Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada. FAU - Ielasi, Alfonso AU - Ielasi A AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy. FAU - MacCarthy, Philip AU - MacCarthy P AD - Department of Cardiology, King's College Hospital, London, United Kingdom. FAU - Brugaletta, Salvatore AU - Brugaletta S AD - Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany. FAU - Costa, Giuliano AU - Costa G AD - Department of Cardiology, C.A.S.T. Policlinico G. Rodolico, Catania, Italy. FAU - Testa, Luca AU - Testa L AD - Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy. FAU - Massussi, Mauro AU - Massussi M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Alarcon, Robert AU - Alarcon R AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain. FAU - Schafer, Ulrich AU - Schafer U AD - Department of Internal Medicine, Marienkrankenhaus, Hamburg, Germany. FAU - Brunner, Stephanie AU - Brunner S AD - Heart Center Lucerne, Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Reimers, Bernhard AU - Reimers B AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Department of Cardiology, Galway University Hospitals, Galway, Ireland. FAU - Zeus, Tobias AU - Zeus T AD - Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Dusseldorf, Dusseldorf, Germany. FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Naber, Christoph K AU - Naber CK AD - Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Essen, Germany. FAU - Di Ienno, Luca AU - Di Ienno L AD - Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy. FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Schmidt, Albrecht AU - Schmidt A AD - Division of Cardiology, Medical University of Graz, Graz, Austria. FAU - Lanzillo, Giuseppe AU - Lanzillo G AD - Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Vaknin-Assa, Hana AU - Vaknin-Assa H AD - Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel. FAU - Arunothayaraj, Sandeep AU - Arunothayaraj S AD - Department of Cardiology, Royal Sussex County Hospital, Brighton, United Kingdom. FAU - Saccocci, Matteo AU - Saccocci M AD - Cardiac Surgery Unit, Fondazione Poliambulanza, Brescia, Italy. FAU - Siqueira, Dimytri AU - Siqueira D AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. FAU - Brinkmann, Christina AU - Brinkmann C AD - MVZ Department Structural Heart Disease, Asklepios St. Georg Clinic, Hamburg, Germany. FAU - Sedaghat, Alexander AU - Sedaghat A AD - Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Ziviello, Francesca AU - Ziviello F AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Seeger, Julia AU - Seeger J AD - Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany. FAU - Rottbauer, Wolfgang AU - Rottbauer W AD - Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany. FAU - Brouwer, Jorn AU - Brouwer J AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. FAU - Buysschaert, Ian AU - Buysschaert I AD - Interventional Cardiology Unit, AZ Sint-Jan Hospital, Bruges, Belgium. FAU - Jelisejevas, Julius AU - Jelisejevas J AD - Centre for Heart Valve and Cardiovascular Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada. FAU - Bharucha, Apurva AU - Bharucha A AD - Department of Cardiology, King's College Hospital, London, United Kingdom. FAU - Regueiro, Ander AU - Regueiro A AD - Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. FAU - Metra, Marco AU - Metra M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Colombo, Antonio AU - Colombo A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Mangieri, Antonio AU - Mangieri A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. Electronic address: antonio.mangieri@gmail.com. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20230719 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Aug 28;16(16):2018-2020. doi: 10.1016/j.jcin.2023.06.005. PMID: 37480888 CIN - JACC Cardiovasc Interv. 2023 Nov 13;16(21):2685. doi: 10.1016/j.jcin.2023.09.014. PMID: 37968034 MH - Humans MH - Incidence MH - Bundle-Branch Block MH - Prognosis MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Pacemaker, Artificial OTO - NOTNLM OT - Acurate neo OT - Evolut PRO OT - mortality OT - pacemaker OT - self-expanding OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Pagnesi has received personal fees from Abbott, AstraZeneca, Boehringer Ingelheim, and Vifor Pharma. Dr Kim is a proctor for Boston Scientific and Abbott Vascular; and has received personal fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic and Meril outside the submitted work. Dr Barbanti has served as a consultant for Edwards Lifesciences. Dr De Marco has served as a proctor for Boston Scientific and Kardia. Dr Adamo has received speaker fees from Abbott Vascular and Medtronic. Dr Estevez-Loureiro has served as a consultant for Abbott Vascular and Boston Scientific; and is a proctor for Lifetech Scientific. Dr Conradi has served as an advisory board member for Abbott, Medtronic, JenaValve, and Neovasc; and has received personal fees from Edwards Lifesciences, Boston Scientific, and MicroInterventions. Dr Toggweiler is a proctor for Abbott Vascular, Boston Scientific, Medtronic, and Biosensors/NVT; and is a consultant for Boston Scientific, Medtronic, Biosensors/NVT, Medira, Shockwave, Teleflex, AtHeart, VeoSource, and Equity in Hi-D Imaging. Dr Mylotte is a proctor for Medtronic and Microport. Dr Veulemans has received lecture fees and travel support from Medtronic, Edwards Lifesciences, and Boston Scientific. Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic and SMT. Dr Wolf is a proctor for Medtronic, Boston Scientific, and Edwards Lifesciences. Dr Pilgrim has received institutional research grants from Boston Scientific, Edwards Lifesciences, and Biotronik; and has received personal fees from Boston Scientific, Biotronik, Abbott, Medtronic, and HighLifeSAS outside the submitted work. Dr Montorfano serves as a proctor for Edwards Lifesciences, Abbott Vascular, and Kardia. Dr Hildick-Smith has served as an adviser or proctor for Edwards Lifesciences, Boston Scientific, and Medtronic. Dr Taramasso is a consultant for Boston Scientific, Abbott Vascular, 4Tech, and CoreMedic; and has received speaker fees from Edwards Lifesciences. Dr Sinning is a proctor for Medtronic and Boston Scientific; has received speaker honoraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic; and has received research grants from Boston Scientific, Edwards Lifesciences, and Medtronic outside the submitted work. Dr Van Mieghem has received research grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, PulseCath BV, and Daiichi Sankyo; and has received advisory fees from Abbott Vascular, Boston Scientific, Ancora, Medtronic, PulseCath BV, and Daiichi Sankyo. Dr Khogali is a proctor for Medtronic and Boston Scientific. Dr Wood has received grant support from Boston Scientific; and is a consultant for Medtronic. Dr MacCarthy is a proctor for Edwards Lifesciences. Dr Hamm has served on advisory boards for Medtronic. Dr Schafer is a proctor for Boston Scientific and Medtronic; and has received lecture fees and travel support from both companies. Dr Zeus is a proctor for Medtronic; and has received speaker fees and financial scientific support from Medtronic and Edwards Lifesciences. Dr Naber has received lecture fees from Boston Scientific, Medtronic, and Abbott Vascular; and has served on advisory boards for Boston Scientific and Abbott Vascular. Dr Windecker has received institutional research and educational grants from Abbott Vascular, Amgen, AstraZeneca, Bristol Myers Squibb, Bayer, Biotronik, Boston Scientific, Cardinal Health, CardioValve, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Johnson & Johnson, Medicure, Medtronic, Novartis, Polares, OrPha Suisse, Pfizer, Regeneron, Sanofi, Sinomed, Terumo, and V-Wave. Dr Siqueira is a proctor for Medtronic and Edwards Lifesciences. Dr Sedaghat has received travel grants and support from Medtronic. Dr Metra has received personal fees from Amgen, Vifor Pharma, AstraZeneca, Abbott Vascular, Bayer, Servier, Edwards Therapeutics, Actelion, LivaNova, and Windtree Therapeutics. Dr Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences. and Abbott Vascular. Dr Mangieri has received an institutional research grant from Boston Scientific; has served on a medical advisory board for Boston Scientific; and has received speaker honoraria from Concept Medical and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/07/23 01:11 MHDA- 2023/09/01 06:43 CRDT- 2023/07/22 18:43 PHST- 2023/01/02 00:00 [received] PHST- 2023/04/23 00:00 [revised] PHST- 2023/05/08 00:00 [accepted] PHST- 2023/09/01 06:43 [medline] PHST- 2023/07/23 01:11 [pubmed] PHST- 2023/07/22 18:43 [entrez] AID - S1936-8798(23)00846-4 [pii] AID - 10.1016/j.jcin.2023.05.020 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Aug 28;16(16):2004-2017. doi: 10.1016/j.jcin.2023.05.020. Epub 2023 Jul 19. PMID- 37462856 OWN - NLM STAT- MEDLINE DCOM- 20240125 LR - 20241023 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 113 IP - 1 DP - 2024 Jan TI - Comparison of contemporary transcatheter heart valve prostheses: data from the German Aortic Valve Registry (GARY). PG - 75-85 LID - 10.1007/s00392-023-02242-z [doi] AB - BACKGROUND: Various second-generation transcatheter heart valve (THV) prostheses with high clinical efficacy and safety are available, but there is limited large-scale data available comparing their hemodynamic performance and clinical implications. OBJECTIVE: To compare the hemodynamic performance and short-term clinical outcome of four second-generation THV prostheses. METHODS: 24,124 patients out of the German Aortic Valve Registry who underwent transfemoral transcatheter aortic valve implantation (TAVI) (Evolut R n = 7028, Acurate neo n = 2922, Portico n = 878 and Sapien 3 n = 13,296) were included in this analysis. Propensity-score weighted analysis was performed to control for differences in age, left ventricular function, STS score and sex. Primary endpoint was survival at one-year, secondary endpoints were 30 days survival, pre-discharge transvalvular gradients, paravalvular leakage and peri-procedural complications. RESULTS: Thirty-day and one-year survival were not significantly different between the four patient groups. Transvalvular gradients in Evolut R and Acurate neo were significantly lower as compared to Portico and Sapien 3 at hospital discharge. This difference exists across all annulus sizes. Paravalvular leakage >/= II occurred significantly less often in the Sapien 3 group (1.2%, p < 0.0001). Rate of severe procedural complications was low and comparable in all groups. Permanent pacemaker implantation rate at one year was lowest in the ACUARATE neo group (13.0%) and highest in the Evolut R group (21.9%). CONCLUSION: Albeit comparable short-term clinical outcomes there are certain differences regarding hemodynamic performance and permanent pacemaker implantation rate between currently available THV prostheses which should be considered for individual prosthesis selection. CI - (c) 2023. The Author(s). FAU - Rudolph, Tanja K AU - Rudolph TK AUID- ORCID: 0000-0001-8839-7476 AD - Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany. trudolph@hdz-nrw.de. FAU - Herrmann, Eva AU - Herrmann E AD - Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt am Main, Germany. AD - German Center for Cardiovascular Research, DZHK, Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Bon, Dimitria AU - Bon D AD - Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt am Main, Germany. AD - German Center for Cardiovascular Research, DZHK, Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Walther, Thomas AU - Walther T AD - Department of Cardiac Surgery, Goethe University Hospital, Frankfurt, Germany. FAU - Bauer, Timm AU - Bauer T AD - Department of Cardiology, Intensive Care and General Internal Medicine, Sana Klinikum Offenbach, Offenbach, Germany. FAU - Ensminger, Stephan AU - Ensminger S AD - Department of Thoracic and Cardiovascular Surgery, University Hospital, Lubeck, Germany. FAU - Frerker, Christian AU - Frerker C AD - Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Beckmann, Andreas AU - Beckmann A AD - German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Medizinische Klinik I, St.-Johannes-Hospital Dortmund, Dortmund, Germany. FAU - Bekeredjian, Raffi AU - Bekeredjian R AD - Department of Cardiology, Robert-Bosch Hospital, Stuttgart, Germany. FAU - Beyersdorf, Friedhelm AU - Beyersdorf F AD - Department of Cardiovascular Surgery, University Heart Center, Freiburg, Germany. FAU - Hamm, Christian AU - Hamm C AD - Department of Cardiology, Kerckhoff Clinic, Bad Nauheim, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. FAU - Boning, Andreas AU - Boning A AD - Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany. FAU - Gummert, Jan AU - Gummert J AD - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. FAU - Rudolph, Volker AU - Rudolph V AD - Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany. LA - eng PT - Journal Article DEP - 20230718 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - Registries PMC - PMC10808310 OTO - NOTNLM OT - All-comers data OT - Aortic stenosis OT - Head-to-head comparison OT - Transcatheter valve prosthesis COIS- T. Rudolph is a proctor for Edwards Lifesciences and Boston Scientific and received speaker s honoraria from Edwards Lifesciences, Medtronic, Abbott and Boston Scientific/Symetis SA. S. Ensminger is a consultant for Edwards LifeSciences and received speaker's honoraria from Edwards LifeSciences and Medtronic. C. Frerker received speaker's honoraria and travel support from Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Vascular, Biotronik. H. Mollmann received speaker 's honoraria and / or consulting fees from Abbott, Boston Scientific, Edwards Lifesciences, and SMT. C. Hamm is an Advisory Board member of Medtronic. S. Baldus has received a research grant from Abbott and lecture fees from Abbott and Edwards. A. Boning has received speaker's honoraria/consulting fees from Abiomed, Bayer, Edwards Lifesciences, Orion Pharma, Maquet, Smith & Nephew, Somahlution, Resuscitec, and Zoll, and is Advisory Board Member of Nordic Pharma and Guard Therapeutics. V. Rudolph has received research grants from Abbott Vascular and Edwards Lifesciences. S. Bleiziffer is a proctor for Medtronic and received speaker s honoraria from Medtronic, Abbott, and Boston Scientific. E. Herrmann, D. Bon, T. Walther, T. Bauer, A. Beckmann, R. Bekeredijan, F. Beyersdorf, J. Gummert on have nothing to disclose. EDAT- 2023/07/18 13:10 MHDA- 2024/01/25 06:43 PMCR- 2023/07/18 CRDT- 2023/07/18 11:11 PHST- 2023/01/25 00:00 [received] PHST- 2023/06/02 00:00 [accepted] PHST- 2024/01/25 06:43 [medline] PHST- 2023/07/18 13:10 [pubmed] PHST- 2023/07/18 11:11 [entrez] PHST- 2023/07/18 00:00 [pmc-release] AID - 10.1007/s00392-023-02242-z [pii] AID - 2242 [pii] AID - 10.1007/s00392-023-02242-z [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Jan;113(1):75-85. doi: 10.1007/s00392-023-02242-z. Epub 2023 Jul 18. PMID- 37445282 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230718 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 13 DP - 2023 Jun 24 TI - Efficacy and Safety of Low-Dose Protamine in Reducing Bleeding Complications during TAVI: A Propensity-Matched Comparison. LID - 10.3390/jcm12134243 [doi] LID - 4243 AB - OBJECTIVES: We aimed to evaluate the efficacy and safety of low-dose protamine in reducing access site-related complications during Transcatheter Aortic Valve Implantation (TAVI) as compared to full-dose protamine. BACKGROUND: Access site-related complications represent an independent predictor of poor outcomes of TAVI. Data regarding heparin reversal with protamine and the dosage needed to prevent bleeding complications are scarce among patients undergoing TAVI. METHODS: A total of 897 patients were retrospectively included in the study. Patients who underwent percutaneous coronary intervention within 4 weeks before or concomitantly with TAVI (n = 191) were given 0.5 mg protamine for each 100 units of unfractionated heparin. All other patients (n = 706) were considered as a control group and 1 mg protamine for each 100 units of heparin was administered. RESULTS: The combined intra-hospital endpoint of death, life-threatening major bleeding, and major vascular complications were significantly more frequent in patients receiving low-dose protamine [29 (15.2%) vs. 50 (7.1%), p < 0.001]. After propensity matching (n = 130 for each group) for relevant clinical characteristics including anti-platelet therapy [19 (14.6%) vs. 6 (4.6%), p = 0.006], low-dose protamine predicted the combined endpoint (OR 3.54, 95%-CI 1.36-9.17, p = 0.009), and even in multivariable analysis, low-dose protamine continued to be a predictor of the combined endpoint in the matched model (OR 3.07, 95%-CI 1.17-8.08, p = 0.023) alongside baseline hemoglobin. CONCLUSIONS: In this propensity-matched retrospective analysis, a low-dose protamine regime is associated with a higher rate of major adverse events compared to a full-dose protamine regime following transfemoral TAVI. FAU - Kneizeh, Kinan AU - Kneizeh K AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Milzi, Andrea AU - Milzi A AUID- ORCID: 0000-0001-7580-8029 AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Vogt, Felix AU - Vogt F AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Witte, Klaus AU - Witte K AUID- ORCID: 0000-0002-7146-7105 AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Marx, Nikolaus AU - Marx N AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Lehrke, Michael AU - Lehrke M AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Almalla, Mohammad AU - Almalla M AUID- ORCID: 0000-0003-4765-109X AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. FAU - Schroder, Jorg AU - Schroder J AD - Department of Cardiology, Angiology and Critical Care (Medical Clinic 1), University Hospital RWTH Aachen, 52074 Aachen, Germany. LA - eng PT - Journal Article DEP - 20230624 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10342582 OTO - NOTNLM OT - bleeding OT - protamine OT - transcatheter aortic valve implantation (TAVI) OT - vascular complications COIS- The authors declare no conflict of interest. EDAT- 2023/07/14 13:07 MHDA- 2023/07/14 13:08 PMCR- 2023/06/24 CRDT- 2023/07/14 01:10 PHST- 2023/05/02 00:00 [received] PHST- 2023/06/09 00:00 [revised] PHST- 2023/06/21 00:00 [accepted] PHST- 2023/07/14 13:08 [medline] PHST- 2023/07/14 13:07 [pubmed] PHST- 2023/07/14 01:10 [entrez] PHST- 2023/06/24 00:00 [pmc-release] AID - jcm12134243 [pii] AID - jcm-12-04243 [pii] AID - 10.3390/jcm12134243 [doi] PST - epublish SO - J Clin Med. 2023 Jun 24;12(13):4243. doi: 10.3390/jcm12134243. PMID- 37438029 OWN - NLM STAT- MEDLINE DCOM- 20230714 LR - 20230718 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 13 DP - 2023 Jul 10 TI - First-in-Human Multicenter Experience of the Newest Generation Supra-Annular Self-Expanding Evolut FX TAVR System. PG - 1626-1635 LID - S1936-8798(23)00824-5 [pii] LID - 10.1016/j.jcin.2023.05.004 [doi] AB - BACKGROUND: The latest-generation Evolut FX TAVR system (Medtronic) offers several potential design improvements over its predecessors, but early reported experience has been limited. OBJECTIVES: This study sought to report our multicenter, limited market release, first-in-human experience of transcatheter aortic valve replacement (TAVR) with the Evolut FX system and compare it with a single-center PRO+ (Medtronic) experience. METHODS: From June 27 to September 16, 2022, 226 consecutive patients from 9 US centers underwent transfemoral TAVR with the Evolut FX system for native aortic stenosis (89.4%) or prosthetic valve degeneration (10.6%). Commissural alignment was defined as 0 degrees to 30 degrees between native and FX commissures. Patient, anatomical, and procedural characteristics were retrospectively reviewed, and 30-day clinical and echocardiographic outcomes per Valve Academic Research Consortium-3 definitions were reported. RESULTS: Of 226 patients, 34.1% were low risk, 4% had a bicuspid valve, and 11.5% had a horizontal root (>/=60 degrees ). Direct Inline sheath (Medtronic) was used in 67.6% and Lunderquist stiff wire (Cook Medical) in 35.4% of cases. Optimal hat marker orientation during deployment was achieved in 98.4%, with commissural alignment in 96.5%. At 30 days, 14.3% mild, 0.9% moderate, and no severe paravalvular leak were observed. Compared with the Evolut PRO+ experience from 1 center, FX had a more symmetrical implantation with shallower depth at the left coronary cusp (P < 0.001), fewer device recaptures (26.1% vs 39.5%; P = 0.004), and improved commissural alignment (96.5% vs 80.2%; P < 0.001). CONCLUSIONS: The Evolut FX system demonstrated favorable 30-day outcomes with a significant improvement over PRO+ in achieving commissural alignment, fewer device recaptures, and more symmetrical implantation. These features may benefit younger patients undergoing TAVR with the supra-annular, self-expanding valve, where lifetime management would be important. CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Zaid, Syed AU - Zaid S AD - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Attizzani, Guilherme F AU - Attizzani GF AD - University Hospitals of Cleveland, Cleveland, Ohio, USA. FAU - Krishnamoorthy, Parasuram AU - Krishnamoorthy P AD - Mount Sinai Hospital, New York, New York, USA. FAU - Yoon, Sung-Han AU - Yoon SH AD - University Hospitals of Cleveland, Cleveland, Ohio, USA. FAU - Palma Dallan, Luis A AU - Palma Dallan LA AD - University Hospitals of Cleveland, Cleveland, Ohio, USA. FAU - Chetcuti, Stanley AU - Chetcuti S AD - University of Michigan, Ann Arbor, Michigan, USA. FAU - Fukuhara, Shinichi AU - Fukuhara S AD - University of Michigan, Ann Arbor, Michigan, USA. FAU - Grossman, P Michael AU - Grossman PM AD - University of Michigan, Ann Arbor, Michigan, USA. FAU - Goel, Sachin S AU - Goel SS AD - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Atkins, Marvin D AU - Atkins MD AD - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Kleiman, Neal S AU - Kleiman NS AD - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Puri, Rishi AU - Puri R AD - Cleveland Clinic, Cleveland, Ohio, USA. FAU - Bakhtadze, Beka AU - Bakhtadze B AD - Cleveland Clinic, Cleveland, Ohio, USA. FAU - Byrne, Timothy AU - Byrne T AD - Abrazo Arizona Heart Hospital, Phoenix, Arizona, USA. FAU - Ibrahim, Akram W AU - Ibrahim AW AD - Abrazo Arizona Heart Hospital, Phoenix, Arizona, USA. FAU - Grubb, Kendra J AU - Grubb KJ AD - Emory University, Atlanta, Georgia, USA. FAU - Tully, Andy AU - Tully A AD - Emory University, Atlanta, Georgia, USA. FAU - Herrmann, Howard C AU - Herrmann HC AD - University of Pennsylvania Perlman School of Medicine, Philadelphia, Pennsylvania, USA. FAU - Faggioni, Michela AU - Faggioni M AD - University of Pennsylvania Perlman School of Medicine, Philadelphia, Pennsylvania, USA. FAU - Ramlawi, Basel AU - Ramlawi B AD - Lankenau Medical Center, Wynnewood, Pennsylvania, USA. FAU - Khera, Sahil AU - Khera S AD - Mount Sinai Hospital, New York, New York, USA. FAU - Lerakis, Stamatios AU - Lerakis S AD - Mount Sinai Hospital, New York, New York, USA. FAU - Dangas, George D AU - Dangas GD AD - Mount Sinai Hospital, New York, New York, USA. FAU - Kini, Annapoorna S AU - Kini AS AD - Mount Sinai Hospital, New York, New York, USA. FAU - Sharma, Samin K AU - Sharma SK AD - Mount Sinai Hospital, New York, New York, USA. FAU - Reardon, Michael J AU - Reardon MJ AD - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Tang, Gilbert H L AU - Tang GHL AD - Mount Sinai Hospital, New York, New York, USA. Electronic address: gilbert.tang@mountsinai.org. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Jul 10;16(13):1636-1639. doi: 10.1016/j.jcin.2023.05.037. PMID: 37438030 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - Treatment Outcome MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Catheters OTO - NOTNLM OT - Evolut FX OT - TAVR OT - commissural alignment COIS- Funding Support and Author Disclosures Dr Attizzani is a consultant for Medtronic and Abbott Vascular; and serves as a proctor and is on the advisory board for Medtronic. Dr Chetcuti has received personal fees from Medtronic for proctoring and consulting; institutional grants from Edwards Lifesciences, Boston Scientific, and Jena during the conduct of the study; and serves on advisory boards for JenaValve without remuneration. Dr Fukuhara is a consultant for Medtronic, Terumo Aortic, and Artivion. Dr Grossman is a physician proctor for Medtronic; and receives research support from Medtronic, Edwards Lifesciences, Abbott, Cardiovascular Systems, Inc., and Boston Scientific. Dr Goel is a consultant for Medtronic and W. L. Gore & Associates; and is on the Speakers Bureau for Abbott Structural Heart. Dr Kleiman is a local principal investigator in trials sponsored by Boston Scientific, Medtronic, Abbott, and Edwards Lifesciences. Dr Puri is a speaker and proctor for Medtronic; is a consultant for Medtronic, Centerline Biomedical, Boston Scientific, Abbott, Philips, Products & Features, Shockwave Medical, VDyne, VahatiCor, Advanced Nanotherapies, NuevoSono, TherOx, GE Healthcare, BioVentrix, and Protembis; and has equity interest in Centerline Biomedical, VahatiCor, and NuevoSono. Dr Byrne is a physician proctor for Abbott Structural Heart and Medtronic; a consultant for Medtronic and Abiomed; and has received speakers honoraria from Abbott Structural Heart and Abiomed. Dr Grubb is a physician proctor for Medtronic and Edwards Lifesciences; and has served as a consultant for Medtronic, Boston Scientific, Ancora, HLT, BioVentrics, 4C Medical, W.L. Gore, and Abbott Vascular. Dr Herrmann has received institutional research funding from Boston Scientific, Abbott Structural Heart, Edwards Lifesciences, and Medtronic; and has received consultant fees and speaking honoraria from Medtronic. Dr Ramlawi is a consultant for Boston Scientific, Medtronic, Liva Nova, and Atricure. Dr Khera is a speaker for Medtronic and Zoll Medical; a proctor for Medtronic; and a consultant for Terumo, Medtronic, Abbott, and Boston Scientific. Dr Reardon is a consultant for Medtronic, Boston Scientific, Abbott, and W. L. Gore & Associates. Dr Tang is a physician proctor for Medtronic; a consultant for Medtronic, Abbott Structural Heart, and NeoChord; a physician advisory board member for Abbott Structural Heart, Boston Scientific, and JenaValve; and receives speakers honoraria from Siemens Healthineers and East End Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/07/13 01:06 MHDA- 2023/07/14 13:07 CRDT- 2023/07/12 20:59 PHST- 2023/01/29 00:00 [received] PHST- 2023/04/25 00:00 [revised] PHST- 2023/05/02 00:00 [accepted] PHST- 2023/07/14 13:07 [medline] PHST- 2023/07/13 01:06 [pubmed] PHST- 2023/07/12 20:59 [entrez] AID - S1936-8798(23)00824-5 [pii] AID - 10.1016/j.jcin.2023.05.004 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Jul 10;16(13):1626-1635. doi: 10.1016/j.jcin.2023.05.004. PMID- 37419247 OWN - NLM STAT- MEDLINE DCOM- 20231113 LR - 20231122 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 39 IP - 11 DP - 2023 Nov TI - Vascular Complications in Transcatheter Aortic Valve Replacement With Plug-Based vs Suture-Based Closure Devices. PG - 1528-1534 LID - S0828-282X(23)01466-6 [pii] LID - 10.1016/j.cjca.2023.06.425 [doi] AB - BACKGROUND: There are conflicting data regarding the efficacy and safety of suture vs plug-based vascular closure devices (VCDs) for large-bore catheter management in patients undergoing transcatheter aortic valve replacement (TAVR). We compared the rates of vascular complications (VCs) associated with 2 commonly used VCDs in a large cohort of patients undergoing TAVR. METHODS: We conducted a single-centre, all-comer, prospective registry study, enrolling patients undergoing TAVR for symptomatic severe aortic stenosis (AS) between the years 2009 and 2022. Clinical outcomes were compared between patients undergoing closure of the femoral access point using the MANTA VCD (M-VCD) (Teleflex, Wayne, PA) vs the ProGlide VCD (P-VCD) (Abbott Vascular, Abbott Park, IL). The main outcome measures were researcher adjudicated events of VARC-2 defined major and minor VCs. RESULTS: Overall, 2368 patients were enrolled in the registry; 1315 (51.0% male, 81.0 +/- 7.0 years) patients were included in the current analysis. P-VCD was used in 813 patients, whereas M-VCD was used in 502 patients. In-hospital VCs were more frequent in the M-VCD vs the P-VCD group (17.3% vs 9.8%; P < 0.001). This outcome was mainly driven by elevated rates of minor VCs in the M-VCD group, whereas no significant difference was observed for major VCs (15.1% vs 8.4%; P < 0.001 and 2.2% vs 1.5%; P = 0.33, respectively). CONCLUSIONS: In patients undergoing TAVR for severe AS, M-VCD was associated with higher rates of VCs. This outcome was mainly driven by minor VCs. The rate of major VCs was low in both groups. CI - Copyright (c) 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Zornitzki, Lior AU - Zornitzki L AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Internal Medicine B, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Lior.zoz@gmail.com. FAU - Zahler, David AU - Zahler D AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Frydman, Shir AU - Frydman S AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Internal Medicine B, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Itach, Tamar AU - Itach T AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Ben-Shoshan, Jeremy AU - Ben-Shoshan J AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Halkin, Amir AU - Halkin A AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Bazan, Samuel AU - Bazan S AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Arbel, Yaron AU - Arbel Y AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Konigstein, Maayan AU - Konigstein M AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Finkelstein, Ariel AU - Finkelstein A AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Banai, Shmuel AU - Banai S AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Steinvil, Arie AU - Steinvil A AD - Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Tel Aviv, Israel. LA - eng PT - Journal Article DEP - 20230705 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - Male MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - Femoral Artery/surgery MH - *Vascular Closure Devices/adverse effects MH - *Cardiovascular Diseases/etiology MH - *Aortic Valve Stenosis/surgery/etiology MH - Aortic Valve/surgery MH - Hemostatic Techniques/adverse effects EDAT- 2023/07/08 10:42 MHDA- 2023/11/13 06:42 CRDT- 2023/07/07 19:25 PHST- 2023/02/06 00:00 [received] PHST- 2023/06/27 00:00 [revised] PHST- 2023/06/29 00:00 [accepted] PHST- 2023/11/13 06:42 [medline] PHST- 2023/07/08 10:42 [pubmed] PHST- 2023/07/07 19:25 [entrez] AID - S0828-282X(23)01466-6 [pii] AID - 10.1016/j.cjca.2023.06.425 [doi] PST - ppublish SO - Can J Cardiol. 2023 Nov;39(11):1528-1534. doi: 10.1016/j.cjca.2023.06.425. Epub 2023 Jul 5. PMID- 37417229 OWN - NLM STAT- MEDLINE DCOM- 20230721 LR - 20230723 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 16 IP - 7 DP - 2023 Jul TI - Final 3-Year Outcomes of a Randomized Trial Comparing a Self-Expanding to a Balloon-Expandable Transcatheter Aortic Valve. PG - e012873 LID - 10.1161/CIRCINTERVENTIONS.123.012873 [doi] AB - BACKGROUND: In the SCOPE I trial (Safety and Efficacy of the Symetis ACURATE Neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis), transcatheter aortic valve implantation with the self-expanding ACURATE neo (NEO) did not meet noninferiority compared with the balloon-expandable SAPIEN 3 (S3) device regarding a composite end point at 30 days due to higher rates of prosthetic valve regurgitation and acute kidney injury. Data on long-term durability of NEO are scarce. Here, we report whether early differences between NEO and S3 translate into differences in clinical outcomes or bioprosthetic valve failure 3 years after transcatheter aortic valve implantation. METHODS: Patients with severe aortic stenosis were randomized to transfemoral transcatheter aortic valve implantation with NEO or S3 at 20 European centers. Clinical outcomes at 3 years are compared using Cox proportional or Fine-Gray subdistribution hazard models by intention-to-treat. Bioprosthetic valve failure is reported for the valve-implant cohort. RESULTS: Among 739 patients, 84 of 372 patients (24.3%) had died in the NEO and 85 of 367 (25%) in the S3 group at 3 years. Comparing NEO with S3, the 3-year rates of all-cause death (hazard ratio, 0.98 [95% CI, 0.73-1.33]), stroke (subhazard ratio, 1.04 [95% CI, 0.56-1.92]), and hospitalization for congestive heart failure (subhazard ratio, 0.74 [95% CI, 0.51-1.07]) were similar between the groups. Aortic valve reinterventions were required in 4 NEO and 3 S3 patients (subhazard ratio, 1.32 [95% CI, 0.30-5.85]). New York Heart Association functional class /=3a were evaluated for TAVI using four non-contrast imaging modalities for procedural planning: transesophageal echocardiogram (TEE), cardiac magnetic resonance, multidetector computed tomography (MDCT), and aortoiliac CO(2) angiography. Patients underwent transfemoral (TF) TAVI using the self-expandable Evolut R/Pro, and the procedures were guided by fluoroscopy and TEE. Contrast MDCT and contrast injection at certain checkpoints during the procedure were used in a blinded fashion to guarantee patient safety. RESULTS: A total of 25 patients underwent TF-TAVI with the zero-contrast technique. The mean age was 79.9 +/- 6.1 years, 72% in NYHA class III/IV, with a mean STS-PROM of 3.0% +/- 1.5%, and creatinine clearance of 49 +/- 7 ml/min. The self-expandable Evolut R and Pro were implanted in 80% and 20% of patients, respectively. In 36% of the cases, the transcatheter heart valve (THV) chosen was one size larger than the one by contrast MDCT, but none of these cases presented adverse events. Device success and the combined safety endpoint (at 30 days) both achieved 92%. Pacemaker implantation was needed in 17%. CONCLUSION: This pilot study demonstrated that the zero-contrast technique for procedural planning and THV implantation was feasible and safe and might become the preferable strategy for a significant population of CKD patients undergoing TAVR. Future studies with a larger number of patients are still needed to confirm such interesting findings. CI - (c) 2023 Freire, Nicz, Ribeiro, Filippini, Accorsi, Liberato, Nomura, Cassar, Vieira, Mathias, Pomerantzeff, Tarasoutchi, Abizaid, Kalil Filho and Brito. FAU - Freire, Antonio Fernando Diniz AU - Freire AFD AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Nicz, Pedro Felipe Gomes AU - Nicz PFG AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Ribeiro, Henrique Barbosa AU - Ribeiro HB AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Filippini, Filippe Barcellos AU - Filippini FB AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Accorsi, Tarso Duenas AU - Accorsi TD AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Liberato, Gabriela AU - Liberato G AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Nomura, Cesar Higa AU - Nomura CH AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Cassar, Renata de Sa AU - Cassar RS AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Vieira, Marcelo Luiz Campos AU - Vieira MLC AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Mathias, Wilson Jr AU - Mathias W Jr AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Pomerantzeff, Pablo Maria Alberto AU - Pomerantzeff PMA AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Tarasoutchi, Flavio AU - Tarasoutchi F AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Abizaid, Alexandre AU - Abizaid A AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - Kalil Filho, Roberto AU - Kalil Filho R AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. FAU - de Brito, Fabio Sandoli Jr AU - de Brito FS Jr AD - Department of Interventional Cardiology, Heart Institute of University of Sao Paulo (InCor), Sao Paulo, Brazil. LA - eng PT - Journal Article DEP - 20230614 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10305775 OTO - NOTNLM OT - aortic stenosis OT - renal failure OT - renal insufficiency OT - transcatheter aortic valve replacement OT - zero contrast COIS- FB and HR are proctors and consultants for Edwards Lifesciences, Medtronic, and Boston Scientific. AA is a proctor for Boston Scientific. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/06/30 13:11 MHDA- 2023/06/30 13:12 PMCR- 2023/01/01 CRDT- 2023/06/30 10:06 PHST- 2023/03/03 00:00 [received] PHST- 2023/05/19 00:00 [accepted] PHST- 2023/06/30 13:12 [medline] PHST- 2023/06/30 13:11 [pubmed] PHST- 2023/06/30 10:06 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1175600 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Jun 14;10:1175600. doi: 10.3389/fcvm.2023.1175600. eCollection 2023. PMID- 37386379 OWN - NLM STAT- MEDLINE DCOM- 20230703 LR - 20231121 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 23 IP - 1 DP - 2023 Jun 29 TI - Transfemoral transcatheter aortic valve replacement for pure native aortic regurgitation: one-year outcomes of a single-center study. PG - 330 LID - 10.1186/s12872-023-03329-1 [doi] LID - 330 AB - BACKGROUND: Evidence about safety and efficacy of transcatheter aortic valve replacement (TAVR) with the Venus A-Valve system (Venus Medtech, Hangzhou, China) remains limited for patients with pure native aortic regurgitation (PNAR). OBJECTIVES: The single-center study sought to report the one-year clinical outcomes of the Venus A-Valve in the treatment of PNAR. METHODS: This study was a retrospective analysis of prospectively collected data. Data was from all consecutive patients who had PNAR and underwent TAVR with the Venus A-Valve system at our center from July 2020 and June 2021. Procedural and clinical outcomes up to one year were analyzed using Valve Academic Research Consortium-2 criteria. RESULTS: A total of 45 consecutive patients with PNAR underwent transfemoral TAVR with the Venus A-Valve system. The Mean age was 73.5 +/- 5.5 years and 26.7% were female. All the TAVR procedures were performed via transfemoral access. Implantations were successful in 44 cases (97.8%). Only one patient was converted to surgical aortic valve replacement. No patient died intraoperatively. No second valve was implanted. In-hospital mortality rate was 2.3%. The one-year all-cause mortality rate was 4.7% without cardiovascular related death. No patient had moderate or severe paravalvular leakage during follow-up. At one year, the mean pressure gradient was 8.8 +/- 0.9 mmHg, and left ventricular ejection fraction increased to 61.5 +/- 3.6%. CONCLUSIONS: This single-center study demonstrated the safety and efficacy of transfemoral TAVR with the Venus A-Valve in the treatment of patients with PNAR. CI - (c) 2023. The Author(s). FAU - Zheng, Hua-Jie AU - Zheng HJ AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. FAU - Cheng, Yong-Bo AU - Cheng YB AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. FAU - Yan, Chao-Jun AU - Yan CJ AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. FAU - Lin, De-Qing AU - Lin DQ AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. FAU - Yu, San-Jiu AU - Yu SJ AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. FAU - Li, Jun AU - Li J AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. FAU - He, Ping AU - He P AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. yhp0130@sina.com. FAU - Cheng, Wei AU - Cheng W AD - Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. yjchw@126.com. LA - eng PT - Journal Article DEP - 20230629 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Humans MH - Female MH - Aged MH - Male MH - *Aortic Valve Insufficiency/diagnostic imaging/etiology/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - Stroke Volume MH - Ventricular Function, Left PMC - PMC10311875 OTO - NOTNLM OT - Clinical outcomes OT - Pure native aortic regurgitation OT - Transcatheter aortic valve replacement OT - Venus A-Valve COIS- The authors declare that they have no competing interests. EDAT- 2023/06/30 01:06 MHDA- 2023/07/03 06:42 PMCR- 2023/06/29 CRDT- 2023/06/29 23:36 PHST- 2023/04/14 00:00 [received] PHST- 2023/05/31 00:00 [accepted] PHST- 2023/07/03 06:42 [medline] PHST- 2023/06/30 01:06 [pubmed] PHST- 2023/06/29 23:36 [entrez] PHST- 2023/06/29 00:00 [pmc-release] AID - 10.1186/s12872-023-03329-1 [pii] AID - 3329 [pii] AID - 10.1186/s12872-023-03329-1 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2023 Jun 29;23(1):330. doi: 10.1186/s12872-023-03329-1. PMID- 37370923 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230701 IS - 2075-4418 (Print) IS - 2075-4418 (Electronic) IS - 2075-4418 (Linking) VI - 13 IP - 12 DP - 2023 Jun 11 TI - Ultrasound-Guided Femoral Vascular Access for Percutaneous Coronary and Structural Interventions. LID - 10.3390/diagnostics13122028 [doi] LID - 2028 AB - Radial access has largely substituted femoral access for coronary interventions. Nevertheless, the femoral artery remains indispensable for gaining access to structural and complex percutaneous coronary interventions such as transcatheter aortic valve implantation and chronic total occlusion interventions, respectively. Ultrasound-guided femoral puncture is a broadly available, inexpensive, and relatively easy-to-learn technique. According to the existing evidence, ultrasound guidance for gaining femoral access has improved the effectiveness and safety of the technique. In the present paper, we sought to review the current literature in order to provide the reader with up-to-date data regarding the benefits of ultrasound-guided femoral access compared with the conventional technique as well as describing the state-of-the-art technique for gaining femoral access under ultrasound guidance. FAU - Xenogiannis, Iosif AU - Xenogiannis I AD - Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece. AD - Department of Cardiology, Mitera General Hospital, 151 23 Athens, Greece. FAU - Varlamos, Charalampos AU - Varlamos C AD - Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece. FAU - Keeble, Thomas R AU - Keeble TR AUID- ORCID: 0000-0001-8695-7994 AD - Department of Cardiology, Essex Cardiothoracic Centre, Basildon SS16 5NL, UK. FAU - Kalogeropoulos, Andreas S AU - Kalogeropoulos AS AD - Department of Cardiology, Mitera General Hospital, 151 23 Athens, Greece. FAU - Karamasis, Grigoris V AU - Karamasis GV AUID- ORCID: 0000-0002-4560-7629 AD - Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece. AD - Department of Cardiology, Essex Cardiothoracic Centre, Basildon SS16 5NL, UK. LA - eng PT - Journal Article PT - Review DEP - 20230611 PL - Switzerland TA - Diagnostics (Basel) JT - Diagnostics (Basel, Switzerland) JID - 101658402 PMC - PMC10297166 OTO - NOTNLM OT - coronary angiography OT - femoral artery OT - percutaneous coronary interventions (PCI) OT - transaortic valve implantation (TAVI) OT - ultrasound-guided access COIS- The authors declare no conflict of interest. EDAT- 2023/06/28 06:42 MHDA- 2023/06/28 06:43 PMCR- 2023/06/11 CRDT- 2023/06/28 01:04 PHST- 2023/05/06 00:00 [received] PHST- 2023/06/02 00:00 [revised] PHST- 2023/06/07 00:00 [accepted] PHST- 2023/06/28 06:43 [medline] PHST- 2023/06/28 06:42 [pubmed] PHST- 2023/06/28 01:04 [entrez] PHST- 2023/06/11 00:00 [pmc-release] AID - diagnostics13122028 [pii] AID - diagnostics-13-02028 [pii] AID - 10.3390/diagnostics13122028 [doi] PST - epublish SO - Diagnostics (Basel). 2023 Jun 11;13(12):2028. doi: 10.3390/diagnostics13122028. PMID- 37355356 OWN - NLM STAT- MEDLINE DCOM- 20230710 LR - 20231118 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 200 DP - 2023 Aug 1 TI - Meta-Analysis of the Prognostic Significance of Carotid Artery Stenosis in Patients Who Underwent Transcatheter Aortic Valve Implantation. PG - 225-231 LID - S0002-9149(23)00246-1 [pii] LID - 10.1016/j.amjcard.2023.04.031 [doi] AB - Stroke is a known complication of both transcatheter aortic valve implantation (TAVI) and carotid artery stenosis (CAS). Whether CAS is a predictor of worse prognosis after TAVI is unclear. We performed a meta-analysis to assess the impact of CAS on the incidence of neurovascular complications and mortality after TAVI. We searched PubMed/MEDLINE and EMBASE databases from inception to January 2023. CAS was defined by >/=50% stenosis of at least 1 carotid artery. Studies comparing CAS versus non-CAS TAVI populations were included. Patients' baseline characteristics and 30-day clinical outcomes were extracted. End points included the 30-day incidence of neurovascular complications (stroke or transient ischemic attack) and 30-day all-cause mortality. We identified six studies, totaling 6,763 patients in the CAS group and 23,861 patients in the non-CAS group. Patients with CAS had a higher prevalence of hypertension, diabetes mellitus, dyslipidemia, previous myocardial infarction, coronary artery bypass graft, peripheral artery disease, previous neurovascular disease, and chronic kidney disease. There was no significant difference in the rates of 30-day neurovascular complications between CAS and non-CAS groups (relative risk 1.23, 95% confidence interval 0.63 to 2.40, p = 0.54). CAS was associated with a higher risk of 30-day all-cause mortality (relative risk 1.28, 95% confidence interval 1.12 to 1.47, p <0.001), not found in a sensitivity analysis. In conclusion, patients with CAS presented with a significantly higher co-morbidity burden. CAS was not associated with an increased risk of 30-day neurovascular complications. 30-day mortality was higher in the CAS group but that may be a surrogate of the heavy co-morbidity burden of patients with CAS. CI - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Vella, Agnese AU - Vella A AD - Service of Cardiology, Geneva University Hospital and University of Geneva, Geneva, Switzerland. FAU - Roux, Olivier AU - Roux O AD - HerzHirslanden Group, Herzzentrum im Park AG, Zurich, Switzerland. FAU - Antiochos, Panagiotis AU - Antiochos P AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Monney, Pierre AU - Monney P AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Maurizi, Niccolo AU - Maurizi N AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Skalidis, Ioannis AU - Skalidis I AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Fournier, Stephane AU - Fournier S AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Eeckhout, Eric AU - Eeckhout E AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Roguelov, Christan AU - Roguelov C AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Oestreicher, Simon AU - Oestreicher S AD - Service of Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Kirsch, Matthias AU - Kirsch M AD - Service of Cardiovascular Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Lu, Henri AU - Lu H AD - Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address: henri.lu@chuv.ch. LA - eng PT - Journal Article PT - Meta-Analysis DEP - 20230622 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2023 Aug 1;200:234-235. doi: 10.1016/j.amjcard.2023.05.040. PMID: 37328362 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Prognosis MH - *Carotid Stenosis/epidemiology/surgery/complications MH - *Aortic Valve Stenosis/complications MH - Risk Factors MH - *Stroke/etiology MH - Treatment Outcome MH - Aortic Valve/surgery COIS- Declaration of Competing Interest The authors have no conflicts of interest to declare. EDAT- 2023/06/25 01:08 MHDA- 2023/07/10 06:42 CRDT- 2023/06/24 21:53 PHST- 2023/02/01 00:00 [received] PHST- 2023/04/10 00:00 [revised] PHST- 2023/04/18 00:00 [accepted] PHST- 2023/07/10 06:42 [medline] PHST- 2023/06/25 01:08 [pubmed] PHST- 2023/06/24 21:53 [entrez] AID - S0002-9149(23)00246-1 [pii] AID - 10.1016/j.amjcard.2023.04.031 [doi] PST - ppublish SO - Am J Cardiol. 2023 Aug 1;200:225-231. doi: 10.1016/j.amjcard.2023.04.031. Epub 2023 Jun 22. PMID- 37355243 OWN - NLM STAT- MEDLINE DCOM- 20230731 LR - 20230916 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 387 DP - 2023 Sep 15 TI - Virtual reality-assisted distraction during transcatheter aortic valve implantation under local anaesthesia: A randomised study. PG - 131130 LID - S0167-5273(23)00937-3 [pii] LID - 10.1016/j.ijcard.2023.131130 [doi] AB - BACKGROUND: A minimal approach, using local anaesthesia alone, has been advocated to promote faster transcatheter aortic valve replacement (TAVR) procedures in intermediate-risk patients. Pre- and periprocedural anxiety and pain remain a concern. Virtual reality (VR) is a form of non-pharmacological distraction that can potentially modulate pain and anxiety. This randomised study explored whether VR reduces pain and anxiety during TAVR without sedation and compared the effects of VR with those of standard care. METHODS AND RESULTS: Between June 2022 and March 2023, 207 patients underwent transfemoral TAVR (TF-TAVR). Of these, 117 (56.5%) patients were willing to participate in the study and met the educational background and mental status criteria for assessment. Fifty-nine patients underwent TF-TAVR with VR glasses (VR group). Fifty-eight patients underwent standard TF-TAVR without VR (control group; CG). Post-interventional anxiety scores (STAI-S) (31.5 +/- 13.4 vs. 38.5 +/- 19.2, p = 0.02) and the perceived duration of the procedure (60.1 +/- 32.3 vs. 73.0 +/- 32.4, p = 0.04) were lower in the VR than in the CG. Procedure time, pain, and anxiety scores (visual analogue scale) were similar between the groups. The complication rate was low and not associated with VR. Post-interventional delirium occurred in nine patients, and was similar between the groups (VR: 4 [6.8%] vs. CG: 5 [8.6%], p = 0.71). No periprocedural strokes were observed. CONCLUSION: VR for TAVR is feasible and safe and expands the non-drug spectrum of therapy for anxiety and pain in patients undergoing TAVR with a minimalistic approach. CI - Copyright (c) 2023 Elsevier B.V. All rights reserved. FAU - Lind, Alexander AU - Lind A AD - Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. Electronic address: alexander.lind@uk-essen.de. FAU - Ahsan, Majid AU - Ahsan M AD - Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Totzeck, Matthias AU - Totzeck M AD - Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Al-Rashid, Fadi AU - Al-Rashid F AD - Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Haddad, Ali AU - Haddad A AD - Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Dubler, Simon AU - Dubler S AD - Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Brenner, Thorsten AU - Brenner T AD - Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Skarabis, Annabell AU - Skarabis A AD - Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - El Gabry, Mohamed AU - El Gabry M AD - Department of Heart Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Rassaf, Tienush AU - Rassaf T AD - Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Janosi, Rolf Alexander AU - Janosi RA AD - Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, University Duisburg-Essen, Essen, Germany. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20230622 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Anesthesia, Local MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Treatment Outcome MH - Risk Factors MH - Pain MH - *Virtual Reality MH - Aortic Valve/surgery OTO - NOTNLM OT - Interventional devices OT - Local anaesthesia OT - Percutaneous valve therapy OT - TAVR OT - Virtual-reality COIS- Declaration of Competing Interest None. EDAT- 2023/06/25 01:08 MHDA- 2023/07/31 06:43 CRDT- 2023/06/24 19:18 PHST- 2023/05/17 00:00 [received] PHST- 2023/06/05 00:00 [revised] PHST- 2023/06/20 00:00 [accepted] PHST- 2023/07/31 06:43 [medline] PHST- 2023/06/25 01:08 [pubmed] PHST- 2023/06/24 19:18 [entrez] AID - S0167-5273(23)00937-3 [pii] AID - 10.1016/j.ijcard.2023.131130 [doi] PST - ppublish SO - Int J Cardiol. 2023 Sep 15;387:131130. doi: 10.1016/j.ijcard.2023.131130. Epub 2023 Jun 22. PMID- 37352670 OWN - NLM STAT- MEDLINE DCOM- 20230731 LR - 20230802 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 201 DP - 2023 Aug 15 TI - Transcatheter Aortic Valve Implantation Using the Transcervical Vascular Access (from a 7-Year Experience from a Swiss Tertiary Center). PG - 86-91 LID - S0002-9149(23)00357-0 [pii] LID - 10.1016/j.amjcard.2023.05.055 [doi] AB - The gold-standard transfemoral (TF) access for transcatheter aortic valve implantation (TAVI) is not suitable in 10% to 15% of patients, and alternative accesses are needed. Studies have suggested that the transcervical (TC) access might yield outcomes comparable to the TF access. In our center, TC-TAVI is the first-line alternative to TF-TAVI. We herein present our 7-year experience regarding the use of the TC access in TAVI. We included all consecutive patients referred for TC-TAVI between January 1, 2016 and December 31, 2022. Data regarding the patients' characteristics,perioperative and 30-day outcomes were prospectively collected. Patients were separated into 2 temporal groups (group 1: January 1, 2016 to June 30, 2019; group 2: July 1, 2019 to December 31, 2022) to assess the changes of their characteristics and outcomes over time. A total of 95 patients were included, with more belonging to group 2 (n = 56 vs n = 39 in group 1). Patients in group 2 were significantly younger (81.0 [interquartile range 77.0 to 87.0] vs 89.0 [interquartile range 83.0 to 92.0] years, p <0.001) and had a higher prevalence of hypertension (87.5% vs 66.7%, p = 0.028) and chronic pulmonary disease (35.7% vs 15.4%, p = 0.029). There was no significant difference regarding other co-morbidities or surgical scores. All-cause mortality and the risk of stroke at 30 days were low and similar (group 2 vs group 1, 3.6% vs 2.5%, p = 0.787 and 1.8% vs 0%, p = 0.397, respectively), as were the risks of permanent pacemaker implantation, postoperative acute kidney injury, cardiac tamponade, life-threatening bleeding, and major vascular complications. In conclusion, the use of the TC access increased over time. The rates of adverse events did not change, despite patients from mid-2019 onward having slightly more co-morbidities. CI - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Pongan, Damiano AU - Pongan D AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Nowacka, Anna AU - Nowacka A AD - Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Antiochos, Panagiotis AU - Antiochos P AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Muller, Olivier AU - Muller O AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Fournier, Stephane AU - Fournier S AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Monney, Pierre AU - Monney P AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Roguelov, Christan AU - Roguelov C AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Rancati, Valentina AU - Rancati V AD - Anesthesiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Kirsch, Matthias AU - Kirsch M AD - Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. FAU - Lu, Henri AU - Lu H AD - Services of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address: henri.lu@chuv.ch. LA - eng PT - Journal Article DEP - 20230621 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2023 Aug 15;201:308-309. doi: 10.1016/j.amjcard.2023.06.039. PMID: 37399595 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis MH - Switzerland/epidemiology MH - Postoperative Complications MH - Femoral Artery/surgery MH - Treatment Outcome MH - Aortic Valve/surgery COIS- Declaration of Competing Interest Dr. Muller reports a relation with Abbott Cardiovascular and Edwards Lifesciences that includes funding grants. The remaining authors have no conflicts of interest to declare. EDAT- 2023/06/23 19:11 MHDA- 2023/07/31 06:43 CRDT- 2023/06/23 18:05 PHST- 2023/02/12 00:00 [received] PHST- 2023/05/17 00:00 [revised] PHST- 2023/05/31 00:00 [accepted] PHST- 2023/07/31 06:43 [medline] PHST- 2023/06/23 19:11 [pubmed] PHST- 2023/06/23 18:05 [entrez] AID - S0002-9149(23)00357-0 [pii] AID - 10.1016/j.amjcard.2023.05.055 [doi] PST - ppublish SO - Am J Cardiol. 2023 Aug 15;201:86-91. doi: 10.1016/j.amjcard.2023.05.055. Epub 2023 Jun 21. PMID- 37351289 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240109 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - The safety and efficacy of balloon-expandable versus self-expanding trans-catheter aortic valve replacement in high-risk patients with severe symptomatic aortic stenosis. PG - 1130354 LID - 10.3389/fcvm.2023.1130354 [doi] LID - 1130354 AB - AIM: Transfemoral Trans-catheter Aortic Valve Replacement (TF-TAVR) is a safe and effective therapy compared with surgical aortic valve replacement (SAVR) in patients across all risk profiles using balloon-expandable valves (BEV) and self-expanding valves (SEV). Our aim was to compare safety and efficacy of BEV vs. SEV in high-risk patients undergoing TF-TAVR. METHODS AND RESULTS: We searched PubMed, EMBASE, Clinicaltrials.gov, Scopus, and Web of sciences for studies on patients with severe aortic stenosis undergoing TAVR. Primary outcome was 30-day all-cause mortality. Secondary outcomes defined by Valve Academic Research Consortium 2 (VARC-2) criteria were also examined. Six studies with 2,935 patients (1,439 to BEV and 1,496 to SEV) were included. BEV was associated with lower risk of all-cause mortality (2.2% vs. 4.5%; RR: 0.51; 95% CI: 0.31-0.82; p < 0.006) and cardiovascular mortality [(2.5% vs. 4.3%; RR: 0.54; 95% CI: 0.32-0.90; p = 0.01) at 30 days compared with SEV. Implantation of more than one valve per procedure (0.78% vs. 5.11%; RR: 0.15; 95% CI: 0.07-0.31; p < 0.00001), and moderate/severe AR/PVL (2.5% vs. 9.01%; RR: 0.3; 95% CI: 0.17-0.48); p < 0.00001) were also lower in the BEV arm. CONCLUSION: BEV TAVR is associated with reduced all-cause mortality (High level of GRADE evidence), cardiovascular mortality (very low level) at 30 days compared with SEV TAVR in high surgical risk patients. Data are necessary to determine if the difference in outcomes persists in longer-term and if the same effects are seen in lower-risk patients. SYSTEMATIC REVIEW REGISTRATION: identifier, CRD42020181190. CI - (c) 2023 Senguttuvan, Bhatt, Balakrishnan, Krishnamoorthy, Goel, Reddy, Subramanian, Claessen, Kumar, Majmundar, Ro, Lerakis, Jayaraj, Kalra, Flather, Dangas and Tang. FAU - Senguttuvan, Nagendra Boopathy AU - Senguttuvan NB AD - Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India. AD - Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. FAU - Bhatt, Hemal AU - Bhatt H AD - Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. AD - Department of Cardiology, Hackensack Meridian Health, New Jersey, NJ, United States. FAU - Balakrishnan, Vinod Kumar AU - Balakrishnan VK AD - Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India. FAU - Krishnamoorthy, Parasuram AU - Krishnamoorthy P AD - Department of Cardiology, Hackensack Meridian Health, New Jersey, NJ, United States. FAU - Goel, Sunny AU - Goel S AD - Department of Cardiology, Hackensack Meridian Health, New Jersey, NJ, United States. FAU - Reddy, Pothireddy M K AU - Reddy PMK AD - Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India. FAU - Subramanian, Vinodhini AU - Subramanian V AD - Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India. FAU - Claessen, Bimmer E AU - Claessen BE AD - Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. AD - Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, the Netherlands. FAU - Kumar, Ashish AU - Kumar A AD - Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, United States. FAU - Majmundar, Monil AU - Majmundar M AD - Department of Internal Medicine, New York Medical College, Metropolitan Hospital, New York, NY, United States. FAU - Ro, Richard AU - Ro R AD - Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. FAU - Lerakis, Stamatios AU - Lerakis S AD - Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. FAU - Jayaraj, Ramamoorthi AU - Jayaraj R AD - Jindal Institute of Behavioral Sciences (JIBS), Jindal Global Institution of Eminence Deemed to Be University, Sonipat, India. FAU - Kalra, Ankur AU - Kalra A AD - Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, United States. AD - Department of Cardiovascular Medicine, Franciscan Health, Indiana, IN, USA; Co-CEO, Kalra Hospitals, New Delhi, India. FAU - Flather, Marcus AU - Flather M AD - Professor of Cardiology, Norwich Medical School, University of East Anglia, Norwich, United Kingdom. FAU - Dangas, George AU - Dangas G AD - Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. FAU - Tang, Gilbert H L AU - Tang GHL AD - Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States. LA - eng PT - Journal Article PT - Review DEP - 20230525 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 EIN - Front Cardiovasc Med. 2023 Oct 13;10:1282812. doi: 10.3389/fcvm.2023.1282812. PMID: 37904807 CIN - Front Cardiovasc Med. 2023 Dec 18;10:1295274. doi: 10.3389/fcvm.2023.1295274. PMID: 38193022 PMC - PMC10283153 OTO - NOTNLM OT - aortic stenosis OT - balloon expandable OT - self-expanding OT - trans catheter aortic valve replacement OT - valve COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/06/23 13:07 MHDA- 2023/06/23 13:08 PMCR- 2023/01/01 CRDT- 2023/06/23 10:32 PHST- 2022/12/23 00:00 [received] PHST- 2023/05/02 00:00 [accepted] PHST- 2023/06/23 13:08 [medline] PHST- 2023/06/23 13:07 [pubmed] PHST- 2023/06/23 10:32 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1130354 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 May 25;10:1130354. doi: 10.3389/fcvm.2023.1130354. eCollection 2023. PMID- 37337594 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230621 IS - 1178-6981 (Print) IS - 1178-6981 (Electronic) IS - 1178-6981 (Linking) VI - 15 DP - 2023 TI - A Systematic Review and Statistical Analysis of Factors Influencing the Cost-Effectiveness of Transcatheter Aortic Valve Implantation for Symptomatic Severe Aortic Stenosis. PG - 459-475 LID - 10.2147/CEOR.S392566 [doi] AB - OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is a disruptive technology recommended for patients with symptomatic severe aortic stenosis (sSAS). Despite being available for over 15 years in Europe, with an extensive volume of clinical and economic evaluations across all surgical risk groups, there is little evidence on the identification of the key drivers of TAVI's cost-effectiveness. This study sought to identify these factors and quantify their role. METHODS: A systematic literature review was conducted to identify published economic evaluations of TAVI. This was supplemented by health technology assessment reports. The primary outcome was the likelihood of TAVI being found cost-effective. Secondary outcomes of TAVI being dominant, and the incremental health benefits of TAVI were also explored. RESULTS: Forty-two studies, reporting 65 unique analyses, were identified. TAVI was found to be cost-effective and dominant in 74% and 20% of analyses, respectively. The latest generation balloon-expandable TAVI device (SAPIEN 3) was more likely to be found cost-effective, as was TAVI use in low-risk populations and when performed via transfemoral access route. There was heterogeneity in the approach taken to economic modelling, which may also influence estimates of cost-effectiveness. Analyses that found TAVI to be dominant always compared it to surgery and usually considered the latest generation balloon-expandable TAVI device. Largest health benefits were observed for the inoperable risk group. CONCLUSION: For patients with sSAS, TAVI is typically a cost-effective treatment option. There are important differences by device generation, risk group and access route. It is crucial to consider these differences when appraising the health economic evidence-base for TAVI. CI - (c) 2023 Heathcote et al. FAU - Heathcote, Laura AU - Heathcote L AUID- ORCID: 0000-0001-8063-7447 AD - School for Health and Related Research, the University of Sheffield, Sheffield, UK. FAU - Srivastava, Tushar AU - Srivastava T AD - School for Health and Related Research, the University of Sheffield, Sheffield, UK. FAU - Sarmah, Archita AU - Sarmah A AD - Edwards Lifesciences SA, Nyon, Switzerland. FAU - Kearns, Ben AU - Kearns B AD - School for Health and Related Research, the University of Sheffield, Sheffield, UK. FAU - Sutton, Anthea AU - Sutton A AD - School for Health and Related Research, the University of Sheffield, Sheffield, UK. FAU - Candolfi, Pascal AU - Candolfi P AD - Edwards Lifesciences SA, Nyon, Switzerland. LA - eng PT - Journal Article DEP - 20230614 PL - New Zealand TA - Clinicoecon Outcomes Res JT - ClinicoEconomics and outcomes research : CEOR JID - 101560564 PMC - PMC10277006 OTO - NOTNLM OT - cost-effectiveness OT - severe aortic stenosis OT - statistical analysis OT - systematic review OT - transcatheter aortic valve implantation COIS- Archita Sarmah and Pascal Candolfi are employees and stock options holder of Edwards Lifesciences. The authors report no other conflicts of interest in this work. EDAT- 2023/06/20 06:42 MHDA- 2023/06/20 06:43 PMCR- 2023/06/14 CRDT- 2023/06/20 02:29 PHST- 2022/11/23 00:00 [received] PHST- 2023/05/15 00:00 [accepted] PHST- 2023/06/20 06:43 [medline] PHST- 2023/06/20 06:42 [pubmed] PHST- 2023/06/20 02:29 [entrez] PHST- 2023/06/14 00:00 [pmc-release] AID - 392566 [pii] AID - 10.2147/CEOR.S392566 [doi] PST - epublish SO - Clinicoecon Outcomes Res. 2023 Jun 14;15:459-475. doi: 10.2147/CEOR.S392566. eCollection 2023. PMID- 37324071 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230619 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 15 IP - 5 DP - 2023 May 30 TI - Effectiveness and feasibility of transcatheter aortic valve replacement in treating combined aortic and mitral regurgitation: a retrospective observational study. PG - 2763-2768 LID - 10.21037/jtd-23-505 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is emerging as a less invasive procedure for aortic valve replacement. However, its effectiveness and feasibility in treating combined valvular disease remain controversial. In this study, we explored the clinical effectiveness and safety of TAVR in the treatment of combined aortic and mitral regurgitation. METHODS: The basic clinical characteristics and 1-month follow-up of 11 patients with combined aortic and mitral regurgitation who were treated with TAVR at center of structural heart disease, Zhongnan Hospital of Wuhan University from December 2021 to November 2022 were retrospectively analyzed. Echocardiographic parameters of aortic and mitral valve, complications, and all-cause mortality were compared pre- and post-TAVR. RESULTS: Retrievable self-expanding valve protheses were used in all patients, and the protheses were implanted via the transfemoral route in 8 patients and via the transapical route in 3 patients. There were 9 male and 2 female patients with an average age of 74.7+/-2.7 years. The mean Society of Thoracic Surgeons score was 8.5+/-1.2. Among the patients, 1 required retroperitoneal sarcoma semi-elective surgery, and 3 of the 5 patients with atrial fibrillation had their rhythm converted to sinus rhythm after operation. No perioperative deaths were recorded. Two patients underwent permanent pacemaker implantations due to high-grade atrioventricular blocks after TAVR. Moderate/severe mitral regurgitation (MR) were mostly secondary to aortic regurgitation (AR) as no rupture of the subvalvular tendon cords or rheumatic changes being recognized during echocardiography before operation. The mean left ventricular end-diastolic diameter (65.5+/-10.7 vs. 58.6+/-8.8 mm, P<0.001) and mitral annular diameter (36.7+/-5.4 vs. 31.5+/-2.8 mm, P<0.001) was significantly reduced after operation. MR was improved as the ratio of the regurgitant jet area to the left atrial area decreased significantly after operation (24.7%+/-11.5% vs. 42.4%+/-6.8% before operation, P<0.001). During the 1-month follow-up, the mean left ventricular ejection fraction was significantly improved (50.0%+/-9.4% vs. 44.6%+/-9.3% at admission, P=0.022). CONCLUSIONS: TAVR is effective and feasible for high-risk patients with combined aortic and mitral regurgitation. CI - 2023 Journal of Thoracic Disease. All rights reserved. FAU - Cao, Jinsong AU - Cao J AD - Structural Heart Disease Center, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Zheng, Xuan AU - Zheng X AD - Structural Heart Disease Center, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Chen, Ming AU - Chen M AD - Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Liu, Xintan AU - Liu X AD - Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Liu, Jinping AU - Liu J AD - Department of Cardiac Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China. FAU - Zhang, Gangcheng AU - Zhang G AD - Structural Heart Disease Center, Zhongnan Hospital of Wuhan University, Wuhan, China. LA - eng PT - Journal Article DEP - 20230524 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC10267927 OTO - NOTNLM OT - Transcatheter aortic valve replacement (TAVR) OT - aortic regurgitation (AR) OT - combined valvular disease OT - mitral regurgitation COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-505/coif). The authors have no conflicts of interest to declare. EDAT- 2023/06/16 06:42 MHDA- 2023/06/16 06:43 PMCR- 2023/05/30 CRDT- 2023/06/16 04:06 PHST- 2023/02/23 00:00 [received] PHST- 2023/05/17 00:00 [accepted] PHST- 2023/06/16 06:43 [medline] PHST- 2023/06/16 06:42 [pubmed] PHST- 2023/06/16 04:06 [entrez] PHST- 2023/05/30 00:00 [pmc-release] AID - jtd-15-05-2763 [pii] AID - 10.21037/jtd-23-505 [doi] PST - ppublish SO - J Thorac Dis. 2023 May 30;15(5):2763-2768. doi: 10.21037/jtd-23-505. Epub 2023 May 24. PMID- 37304920 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230613 IS - 1923-2829 (Print) IS - 1923-2837 (Electronic) IS - 1923-2829 (Linking) VI - 14 IP - 3 DP - 2023 Jun TI - In-Hospital and One-Year Outcomes of Transcatheter Aortic Valve Replacement in Patients Requiring Supplemental Home Oxygen Use. PG - 228-236 LID - 10.14740/cr1497 [doi] AB - BACKGROUND: There have been limited reports with inconsistent results on the impact of long-term use of oxygen therapry (LTOT) in patients treated with transcatheter aortic valve replacement (TAVR). METHODS: We compared in-hospital and intermediate TAVR outcomes in 150 patients requiring LTOT (home O(2) cohort) with 2,313 non-home O(2) patients. RESULTS: Home O(2) patients were younger, and had more comorbidities including chronic obstructive pulmonary disease (COPD), diabetes, carotid artery disease, lower forced expiratory volume (FEV(1)) (50.3+/-21.1% vs. 75.0+/-24.7%, P < 0.001), and lower diffusion capacity (DLCO, 48.6+/-19.2% vs. 74.6+/-22.4%, P < 0.001). These differences represented higher baseline Society of Thoracic Surgeons (STS) risk score (15.5+/-10.2% vs. 9.3+/-7.0%, P < 0.001) and lower pre-procedure Kansas City Cardiomyopathy Questionnaire (KCCQ-12) scores (32.5 +/- 22.2 vs. 49.1 +/- 25.4, P < 0.001). The home O(2) cohort required higher use of alternative TAVR vascular access (24.0% vs. 12.8%, P = 0.002) and general anesthesia (51.3% vs. 36.0%, P < 0.001). Compared to non-home O(2) patients, home O(2) patients showed increased in-hospital mortality (5.3% vs. 1.6%, P = 0.001), procedural cardiac arrest (4.7% vs. 1.0%, P < 0.001), and postoperative atrial fibrillation (4.0% vs. 1.5%, P = 0.013). At 1-year follow-up, the home O(2) cohort had a higher all-cause mortality (17.3% vs. 7.5%, P < 0.001) and lower KCCQ-12 scores (69.5 +/- 23.8 vs. 82.1 +/- 19.4, P < 0.001). Kaplan-Meir analysis revealed a lower survival rate in the home O(2) cohort with an overall mean (95% confidence interval (CI)) survival time of 6.2 (5.9 - 6.5) years (P < 0.001). CONCLUSION: Home O(2) patients represent a high-risk TAVR cohort with increased in-hospital morbidity and mortality, less improvement in 1-year KCCQ-12, and increased mortality at intermediate follow-up. CI - Copyright 2023, Patail et al. FAU - Patail, Haris AU - Patail H AUID- ORCID: 0000-0003-2342-9224 AD - Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, CT, USA. FAU - Kompella, Ritika AU - Kompella R AD - Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, CT, USA. FAU - Hoover, Nicole E AU - Hoover NE AD - Department of Cardiology, Hartford Hospital, Hartford, CT, USA. FAU - Reis, Wyona AU - Reis W AD - Department of Cardiology, Hartford Hospital, Hartford, CT, USA. FAU - Masih, Rohit AU - Masih R AD - Department of Internal Medicine, Hartford Hospital, Hartford, CT, USA. FAU - Mather, Jeff F AU - Mather JF AD - Department of Research Administration, Hartford Hospital, Hartford, CT, USA. FAU - Sutton, Trevor S AU - Sutton TS AD - Integrated Anesthesia Associates, Hartford Hospital, Hartford, CT, USA. FAU - McKay, Raymond G AU - McKay RG AD - Department of Cardiology, Hartford Hospital, Hartford, CT, USA. LA - eng PT - Journal Article DEP - 20230526 PL - Canada TA - Cardiol Res JT - Cardiology research JID - 101557543 PMC - PMC10257506 OTO - NOTNLM OT - Aortic stenosis OT - COPD OT - Chronic lung disease OT - Home oxygen OT - Long-term oxygen therapy OT - TAVR COIS- None to declare. EDAT- 2023/06/12 06:42 MHDA- 2023/06/12 06:43 PMCR- 2023/05/26 CRDT- 2023/06/12 04:16 PHST- 2023/03/15 00:00 [received] PHST- 2023/04/28 00:00 [accepted] PHST- 2023/06/12 06:43 [medline] PHST- 2023/06/12 06:42 [pubmed] PHST- 2023/06/12 04:16 [entrez] PHST- 2023/05/26 00:00 [pmc-release] AID - 10.14740/cr1497 [doi] PST - ppublish SO - Cardiol Res. 2023 Jun;14(3):228-236. doi: 10.14740/cr1497. Epub 2023 May 26. PMID- 37301870 OWN - NLM STAT- MEDLINE DCOM- 20230612 LR - 20231120 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 23 IP - 1 DP - 2023 Jun 10 TI - Is the outcome of elective vs non-elective patients undergoing transcatheter aortic valve implantation different? Results of a single-centre, observational assessment of outcomes at a large university clinic. PG - 295 LID - 10.1186/s12872-023-03317-5 [doi] LID - 295 AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) can either be conducted as an elective (scheduled in advance) or a non-elective procedure performed during an unplanned hospital admission. The objective of this study was to compare the outcomes of elective and non-elective TAVI patients. METHODS: This single-centre study included 512 patients undergoing transfemoral TAVI between October 2018 and December 2020; 378 (73.8%) were admitted for elective TAVI, 134 (26.2%) underwent a non-elective procedure. Our TAVI programme entails an optimized fast-track concept aimed at minimizing the total length of stay to /= grade II (OR 0.98; 95% CI: 0.97-0.99; p = 0.03) in the SE device group. CONCLUSIONS: In transfemoral TAVI, case sequence number influenced mid-term mortality irrespective of prosthesis type, but the learning curve was longer in the case of SE devices. CI - (c) 2023 S. Karger AG, Basel. FAU - Istrate, Mihnea AU - Istrate M AD - "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Cardiology, Cluj-Napoca, Romania. FAU - Dregoesc, Mihaela Ioana AU - Dregoesc MI AD - "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Cardiology, Cluj-Napoca, Romania. AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. FAU - Bolboaca, Sorana D AU - Bolboaca SD AD - Department of Medical Informatics and Biostatistics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Solomonean, Aurelia G AU - Solomonean AG AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. AD - Department of Cardiovascular Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Botis, Catalin AU - Botis C AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. FAU - Stef, Adrian AU - Stef A AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. AD - Department of Cardiovascular Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Hagiu, Radu AU - Hagiu R AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. FAU - Mot, Stefan D C AU - Mot SDC AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. FAU - Bindea, Dan I AU - Bindea DI AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. AD - Department of Cardiovascular Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Oprea, Alexandru AU - Oprea A AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. AD - Department of Cardiovascular Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Trifan, Catalin A AU - Trifan CA AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. AD - Department of Cardiovascular Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. FAU - Iancu, Adrian C AU - Iancu AC AD - "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Cardiology, Cluj-Napoca, Romania. AD - "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania. LA - eng PT - Journal Article DEP - 20230606 PL - Switzerland TA - Cardiology JT - Cardiology JID - 1266406 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/surgery MH - Learning Curve MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Aortic Valve/surgery MH - Prosthesis Design OTO - NOTNLM OT - Balloon-expandable valve OT - Learning curve OT - Outcomes OT - Self-expandable valve OT - Transfemoral TAVI EDAT- 2023/06/07 01:07 MHDA- 2023/08/22 06:42 CRDT- 2023/06/06 18:23 PHST- 2023/03/15 00:00 [received] PHST- 2023/05/28 00:00 [accepted] PHST- 2023/08/22 06:42 [medline] PHST- 2023/06/07 01:07 [pubmed] PHST- 2023/06/06 18:23 [entrez] AID - 000531401 [pii] AID - 10.1159/000531401 [doi] PST - ppublish SO - Cardiology. 2023;148(4):335-346. doi: 10.1159/000531401. Epub 2023 Jun 6. PMID- 37275315 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230607 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 7 IP - 1 DP - 2023 Jan TI - Comparison of Outcomes and Discharge Location After Transcatheter vs. Surgical Aortic Valve Replacement With Prior Coronary Artery Bypass Grafting. PG - 100120 LID - 10.1016/j.shj.2022.100120 [doi] LID - 100120 AB - BACKGROUND: Published trials have shown that transcatheter aortic valve replacement (TAVR) is a safe alternative to surgical aortic valve replacement (SAVR) after prior coronary artery bypass grafting (CABG). However, differences in morbidity and discharge location between the 2 procedures are less thoroughly characterized. METHODS: From January 1, 2006 to January 7, 2020, 1059 patients with severe aortic stenosis after CABG underwent either SAVR (n = 315/30%), transfemoral TAVR (TF-TAVR) (n = 575/54%), or alternative access TAVR (n = 169/16%) at a single, tertiary care, academic institution. Propensity-weighted matching was used to compare morbidity, mortality, length of postprocedure stay, and nonhome discharge between TF-TAVR (effective n = 163) and SAVR (effective n = 163) groups. RESULTS: Among propensity-weighted groups, the TF-TAVR group experienced fewer transfusions than the SAVR group (effective n = 16 [9.5%] vs. 132 [81%]; p < 0 .0001), less new-onset atrial fibrillation (effective n = 5.1 [3.1%] vs. 43 [27%]; p = 0.009), and less prolonged mechanical ventilation >24 ​hours (effective n = 0.41 [0.25%] vs. 30 [18%]; p <0.0001). Permanent pacemaker implant was 9.3% (effective n = 13) after TF-TAVR vs. 5.5% (effective n = 7.9; p = 0.2) after SAVR, stroke 0.41% (effective n = 0.67) vs. 2.1% (effective n = 3.5; p = 0.2), and operative mortality 0.5% (effective n = 0.8) vs. 1.7% (effective n = 2.8; p = 0.8). The TF-TAVR group had shorter postprocedure lengths of stay (2.0 vs. 7.6 days; p < 0.0001). Discharge home was more common after TF-TAVR than SAVR (effective n = 156 [95%] vs. 118 [73%]; p = 0.01). CONCLUSIONS: For patients developing severe aortic stenosis after CABG, TF-TAVR rather than SAVR should be strongly considered because of lower morbidity, shorter length of stay, and greater likelihood of home discharge. CI - (c) 2022 The Author(s). FAU - Hasan, Saad M AU - Hasan SM AD - Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio, USA. FAU - Cikach, Frank AU - Cikach F AD - Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio, USA. FAU - Toth, Andrew J AU - Toth AJ AD - Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Blackstone, Eugene H AU - Blackstone EH AD - Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio, USA. AD - Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Kapadia, Samir AU - Kapadia S AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Roselli, Eric E AU - Roselli EE AD - Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio, USA. FAU - Gillinov, A Marc AU - Gillinov AM AD - Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio, USA. FAU - Svensson, Lars G AU - Svensson LG AD - Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio, USA. FAU - Mick, Stephanie L AU - Mick SL AD - Department of Cardiothoracic Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York, USA. LA - eng PT - Journal Article DEP - 20221129 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC10236859 OTO - NOTNLM OT - Aortic stenosis OT - Coronary artery bypass grafting OT - Nonhome discharge OT - Procedure outcomes OT - Propensity scores OT - Random forests OT - Reintervention EDAT- 2023/06/05 19:10 MHDA- 2023/06/05 19:11 PMCR- 2022/11/29 CRDT- 2023/06/05 12:14 PHST- 2022/02/01 00:00 [received] PHST- 2022/10/04 00:00 [revised] PHST- 2022/10/06 00:00 [accepted] PHST- 2023/06/05 19:11 [medline] PHST- 2023/06/05 19:10 [pubmed] PHST- 2023/06/05 12:14 [entrez] PHST- 2022/11/29 00:00 [pmc-release] AID - S2474-8706(22)01919-4 [pii] AID - 100120 [pii] AID - 10.1016/j.shj.2022.100120 [doi] PST - epublish SO - Struct Heart. 2022 Nov 29;7(1):100120. doi: 10.1016/j.shj.2022.100120. eCollection 2023 Jan. PMID- 37273856 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230606 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 7 IP - 3 DP - 2023 May TI - Cardiac Computed Tomography Angiography Anatomical Characterization of Patients Screened for a Dedicated Transfemoral Transcatheter Valve System for Primary Aortic Regurgitation. PG - 100164 LID - 10.1016/j.shj.2023.100164 [doi] LID - 100164 AB - BACKGROUND: Cardiac computed tomography angiography was used to identify anatomical characteristics of the aortic root in patients with severe aortic regurgitation (AR) as compared to those with aortic stenosis (AS) to judge feasibility of transcatheter aortic valve replacement (TAVR) with the JenaValve Trilogy system. METHODS: Cardiac computed tomography angiography was performed prior to planned TAVR for 107 patients with severe AR and 92 patients with severe AS. Measurements related to aortic root and coronary artery anatomy were obtained and compared between groups. Perimeter >90 mm and aortic annulus angle ​>70 degrees were defined as the theoretical exclusion criteria for TAVR. A combination of sinus of Valsalva diameter <30 mm and coronary height <12 mm was defined as high risk for coronary occlusion. RESULTS: The mean age of patients in the AR group was 74.9 +/- 11.2 years, 46% were women, and the mean Society of Thoracic Surgeons risk score for mortality was 3.6 +/- 2.1. Comparatively, the mean age of patients in the AS group was 82.3 +/- 5.53 years, 65% were women, and the mean Society of Thoracic Surgeonsrisk score was 5.5 +/- 3.3. Annulus area, perimeter, diameter, and angle were larger in patients with severe AR. Sinus of Valsalva diameters and heights were larger in patients with severe AR. More AR patients were excluded based on perimeter (14 vs. 2%) and annulus angle (6 vs. 1%). More AS patients exhibited high-risk anatomy for left main coronary occlusion (21 vs. 7%) and right coronary occlusion (14 vs. 3%). The maximum dimension of the ascending aorta was larger in patients with severe AR (39 vs. 35 mm). The percentage of referred AR patients with significant aortopathy requiring surgical intervention was very low (only 1 AR patient with ascending aorta diameter >5.5 cm). CONCLUSIONS: A significantly larger proportion of patients with severe AR are excluded from TAVR as compared to AS due to large aortic annulus size and steep annulus angulation. By far the most prevalent excluding factor is aortic annulus size, with fewer patients excluded due to angulation. AR patients have lower-risk anatomy for coronary occlusion. Larger transcatheter valve sizes and further delivery system modifications are required to treat a larger proportion of AR patients. CI - (c) 2023 The Authors. FAU - Gogia, Shawnbir AU - Gogia S AD - Structural Heart and Valve Center, Columbia University Medical Center, New York, New York, USA. FAU - Vahl, Torsten P AU - Vahl TP AD - Structural Heart and Valve Center, Columbia University Medical Center, New York, New York, USA. FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, Georgia, USA. FAU - Yadav, Pradeep K AU - Yadav PK AD - Piedmont Heart Institute, Atlanta, Georgia, USA. FAU - George, Isaac AU - George I AD - Structural Heart and Valve Center, Columbia University Medical Center, New York, New York, USA. FAU - Kodali, Susheel K AU - Kodali SK AD - Structural Heart and Valve Center, Columbia University Medical Center, New York, New York, USA. FAU - Hamid, Nadira AU - Hamid N AD - Minneapolis Heart Institute, Minneapolis, Minnesota, USA. FAU - Ranard, Lauren AU - Ranard L AD - Structural Heart and Valve Center, Columbia University Medical Center, New York, New York, USA. FAU - Chen, Tiffany AU - Chen T AD - Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Matsumura, Mitsuaki AU - Matsumura M AD - Cardiovascular Research Foundation, New York, New York, USA. FAU - Maehara, Akiko AU - Maehara A AD - Cardiovascular Research Foundation, New York, New York, USA. FAU - Treede, Hendrik AU - Treede H AD - Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department of Internal Medicine and Cardiology, University Heart Center, Cologne, Germany. FAU - Daniels, David AU - Daniels D AD - California Pacific Medical Center, San Francisco, California, USA. FAU - Sheridan, Brett C AU - Sheridan BC AD - California Pacific Medical Center, San Francisco, California, USA. FAU - Zahr, Firas AU - Zahr F AD - Division of Cardiovascular Medicine, Oregon Health Sciences University, Portland, Oregon, USA. FAU - Russo, Mark J AU - Russo MJ AD - Department of Cardiac Surgery, Robert Wood Johnson Hospital, New Brunswick, New Jersey, USA. FAU - McCabe, James M AU - McCabe JM AD - Division of Cardiology, University of Washington, Seattle, Washington, USA. FAU - Chetcuti, Stanley J AU - Chetcuti SJ AD - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA. FAU - Leon, Martin B AU - Leon MB AD - Structural Heart and Valve Center, Columbia University Medical Center, New York, New York, USA. AD - Cardiovascular Research Foundation, New York, New York, USA. FAU - Makkar, Raj R AU - Makkar RR AD - Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, California, USA. FAU - Khalique, Omar K AU - Khalique OK AD - Division of Cardiovascular Imaging, Saint Francis Hospital and Catholic Health, Roslyn, New York, USA. LA - eng PT - Journal Article DEP - 20230308 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 PMC - PMC10236804 OTO - NOTNLM OT - Aortic insufficiency OT - Aortic stenosis OT - Aortic valve OT - Computed tomography OT - Transcatheter aortic valve replacement COIS- Dr. George is a consultant for Durvena, Cardiomech, Vdyne, Valcare Medical, Atricure, Zimmer Biomet, MITrx, Mitremedical and has institutional grants from Edwards, Medtronic, Abbott. Dr. Khalique is a consultant for Edwards, Abbott Structural, Triflo, Cardiac Implants, Restore Medical, and Croivalve and is a member of a corelab (he receives no direct industry compensation) with contracts with Ancora, Jenavalve, Atricure, and Abbott Structural and holds equity in Triflo and Cardiac Implants. Dr. Vahl reports institutional funding to Columbia University Medical Center from Abbott, Boston Scientific, Edwards, Jenavalve, and Medtronic, and has received consulting fees from 4D Medical Technologies and Baylis Medical. Dr. Chen is a member of a corelab (she receives no direct industry compensation) with contracts with Ancora and Jenavalve and is a consultant for Intrinsic Imaging, LLC. Dr. McCabe is a consultant for Edwards, Boston Scientific, Medtronic and CSI and holds equity in ConKay Medical and Excision Medical. Vinod Thourani is a medical advisor for Edwards, is a national PI for the Jenavalve Pivotal trial, and is co-founder of Apica cardiovascular. Dr. Treede reports consulting fees from TRICARES. Dr. Baldus reports honoraria from Edwards and Abbott, and a research grant from Abbott. Dr. Zahr reports institutional research support from Edwards and Medtronic. Dr. Russo reports honoraria from Edwards and Abbott. Dr. Leon has received institutional grants from Abbott, Boston Scientific, Edwards, Jenavalve, and Medtronic and holds equity in Valve Medical, Picardia, and Venus MedTech. Dr. Makkar received grant support from Edwards and is a consultant for Abbott, Cordis, and Medtronic. EDAT- 2023/06/05 13:04 MHDA- 2023/06/05 13:05 PMCR- 2023/03/08 CRDT- 2023/06/05 11:52 PHST- 2022/10/06 00:00 [received] PHST- 2023/01/18 00:00 [revised] PHST- 2023/01/19 00:00 [accepted] PHST- 2023/06/05 13:05 [medline] PHST- 2023/06/05 13:04 [pubmed] PHST- 2023/06/05 11:52 [entrez] PHST- 2023/03/08 00:00 [pmc-release] AID - S2474-8706(23)00011-8 [pii] AID - 100164 [pii] AID - 10.1016/j.shj.2023.100164 [doi] PST - epublish SO - Struct Heart. 2023 Mar 8;7(3):100164. doi: 10.1016/j.shj.2023.100164. eCollection 2023 May. PMID- 37265025 OWN - NLM STAT- MEDLINE DCOM- 20230807 LR - 20230807 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 2 DP - 2023 Aug TI - Impact of vascular complications after transcatheter aortic valve implantation. VASC-OBSERVANT II sub-study. PG - 381-391 LID - 10.1002/ccd.30695 [doi] AB - BACKGROUND: Trans-femoral (TF) access is the commonest approach for transcatheter aortic valve implantation (TAVI). However this vascular approach is associated with vascular complications (VC) which in turn have prognostic implications. The aim of this study is to evaluate the clinical impact of access site VC in patients undergoing TAVI with newer generation transcatheter prostheses enrolled in the national observational prospective multicenter study OBSERVANT II. METHODS: Vascular events were defined according to the Valve Academic Research Consortium (VARC)-2 criteria. The population enrolled in OBSERVANT II was divided into 3 groups: patients without VC (No-VC), patients with minor VC or percutaneous closure device failure (Minor-VC) and patients with major VC (Major-VC). The primary endpoint was 1-year major adverse cardiac and cerebrovascular event (MACCE), a composite endpoint of all-cause mortality, stroke, myocardial infarction and coronary revascularization. A multivariate Cox regression model was used for risk estimation of MACCE between the three analyzed groups. RESULTS: 2.504 patients were included in this analysis: 2.167 patients in No-VC group; 249 patients in the Minor-VC and 88 patients in the Major-VC. At 1-year Minor-VC group had a freedom from MACCE comparable to the No-VC group, while Major-VC patients had significantly worse outcome (Log-rank test: p = 0.003). These results were driven by higher 1-year mortality in the Major-VC (p < 0.0001). Major-VC was an independent predictor of MACCE in adjusted analysis (hazard ratio 1.89, 95% confidence interval 1.18-3.03, p = 0.008). CONCLUSIONS: Despite a low incidence of major VC with current TF-TAVI devices, our data confirm that major VC is still associated with a significantly worse clinical outcome. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Aurigemma, Cristina AU - Aurigemma C AD - Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy. FAU - Trani, Carlo AU - Trani C AUID- ORCID: 0000-0001-9777-013X AD - Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy. AD - Universita Cattolica del Sacro Cuore Roma, Roma, Italy. FAU - D'Errigo, Paola AU - D'Errigo P AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Universita degli Studi di Enna "Kore", Enna, Italy. FAU - Biancari, Fausto AU - Biancari F AUID- ORCID: 0000-0001-5028-8186 AD - Heart and Lung Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. FAU - Tarantini, Giuseppe AU - Tarantini G AUID- ORCID: 0000-0002-5055-2917 AD - Department of Cardiac, Thoracic and Vascular Sciences, Division of Cardiology, University of Padova, Padova, Italy. FAU - Santoro, Gennaro AU - Santoro G AD - Fondazione " G. Monasterio" CNR/Regione Toscana per la Ricerca Medica e la Sanita Pubblica, Massa, Italy. FAU - Baiocchi, Massimo AU - Baiocchi M AD - Policlinico Sant'Orsola, Bologna, Italy. FAU - Baglio, Giovanni AU - Baglio G AD - Italian National Agency for Regional Healthcare Services, Rome, Italy. FAU - Seccareccia, Fulvia AU - Seccareccia F AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. FAU - Rosato, Stefano AU - Rosato S AD - National Centre for Global Health, Istituto Superiore di Sanita, Rome, Italy. CN - OBSERVANT II Research Group LA - eng GR - ricerca finalizzata code PE-2016-02364619/ PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20230602 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/etiology MH - Prospective Studies MH - Treatment Outcome MH - Prognosis MH - Aortic Valve/diagnostic imaging/surgery MH - Risk Factors OTO - NOTNLM OT - TAVI OT - aortic stenosis OT - bleeding OT - femoral approach OT - vascular complications EDAT- 2023/06/02 13:15 MHDA- 2023/08/07 06:42 CRDT- 2023/06/02 06:23 PHST- 2023/01/21 00:00 [revised] PHST- 2022/09/14 00:00 [received] PHST- 2023/05/07 00:00 [accepted] PHST- 2023/08/07 06:42 [medline] PHST- 2023/06/02 13:15 [pubmed] PHST- 2023/06/02 06:23 [entrez] AID - 10.1002/ccd.30695 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Aug;102(2):381-391. doi: 10.1002/ccd.30695. Epub 2023 Jun 2. PMID- 37229228 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230528 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Transcatheter aortic valve durability: a contemporary clinical review. PG - 1195397 LID - 10.3389/fcvm.2023.1195397 [doi] LID - 1195397 AB - Encouraged by randomized controlled trials demonstrating non-inferiority of transfemoral transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement (SAVR) across all surgical risk categories, there has been a dramatic increase in the use of TAVI in a younger patient cohort with severe aortic stenosis, endorsed by both European and American Cardiac Societies. However, the standard use of TAVI in younger, less co-morbid patients with a longer life expectancy can only be supported if there is sound data demonstrating long-term durability of transcatheter aortic valves (TAVs). In this article, we have reviewed available randomized and observational registry clinical data pertaining to TAV long-term durability, placing emphasis on trials and registries using the new standardized definitions of bioprosthetic valve dysfunction (BVD) and bioprosthetic valve failure (BVF). Despite inherent difficulties in interpreting the available data, the determination reached is that the risk of structural valve deterioration (SVD) is potentially lower after TAVI than SAVR at 5 to 10 years, and that the two treatment modalities have a similar risk of BVF. This supports the adoption of TAVI in younger patients evident in current practice. However, the routine use of TAVI in younger patients with bicuspid aortic valve stenosis should be cautioned due to insufficient long-term TAV durability data in this particular patient population. Finally, we highlight the importance of future research into the unique potential mechanisms that can potentially contribute to TAV degeneration. CI - (c) 2023 Montarello, Willemen, Tirado-Conte, Travieso, Bieliauskas, Sondergaard and De Backer. FAU - Montarello, Nicholas J AU - Montarello NJ AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Willemen, Yannick AU - Willemen Y AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tirado-Conte, Gabriela AU - Tirado-Conte G AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Travieso, Alejandro AU - Travieso A AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Bieliauskas, Gintautas AU - Bieliauskas G AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - De Backer, Ole AU - De Backer O AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. LA - eng PT - Journal Article PT - Review DEP - 20230509 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10203628 OTO - NOTNLM OT - bioprosthetic valve failure OT - durability OT - structural valve degeneration (SVD) OT - transcatheter aortic valve OT - transcatheter aortic valve implantation COIS- GB, LS and ODB received institutional research grants and consulting fees from Abbott, Boston Scientific, and Medtronic. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/05/25 19:12 MHDA- 2023/05/25 19:13 PMCR- 2023/01/01 CRDT- 2023/05/25 14:20 PHST- 2023/03/28 00:00 [received] PHST- 2023/04/21 00:00 [accepted] PHST- 2023/05/25 19:13 [medline] PHST- 2023/05/25 19:12 [pubmed] PHST- 2023/05/25 14:20 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1195397 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 May 9;10:1195397. doi: 10.3389/fcvm.2023.1195397. eCollection 2023. PMID- 37225545 OWN - NLM STAT- MEDLINE DCOM- 20230912 LR - 20260127 IS - 1532-8422 (Electronic) IS - 1053-0770 (Linking) VI - 37 IP - 10 DP - 2023 Oct TI - Comparison of Procedural Sedation With Propofol and Dexmedetomidine During Transcatheter Aortic Valve Replacement Using the Transfemoral Approach. PG - 1894-1900 LID - S1053-0770(23)00313-0 [pii] LID - 10.1053/j.jvca.2023.05.009 [doi] AB - OBJECTIVES: Although procedural sedation is an established method of anesthesia for transcatheter aortic valve replacement (TAVR), reliable evidence to guide the choice of a suitable sedative agent remains scarce. Accordingly, this trial aimed to compare the effect of procedural sedation with dexmedetomidine versus propofol on postoperative neurocognitive and related clinical outcomes in patients undergoing TAVR. DESIGN: Prospective, randomized, double-blind clinical trial. SETTING: The study was conducted at the University Medical Centre Ljubljana, Slovenia. PARTICIPANTS: The study enrolled 78 patients who underwent TAVR under procedural sedation between January 2019 and June 2021. Seventy-one patients randomized into the propofol group (n = 34) and dexmedetomidine group (n = 37) were included in the final analysis. INTERVENTIONS: Patients in the propofol group received sedation with propofol (continuous intravenous infusion of 0.5-2.5 mg/kg/h), whereas patients in the dexmedetomidine group received sedation with dexmedetomidine (loading dose of 0.5 microg/kg over 10 minutes followed by continuous intravenous infusion of 0.2-1.0 microg/kg/h). MEASUREMENTS AND MAIN RESULTS: Minimental state examination (MMSE) was performed before and 48 hours after TAVR. There was no statistically significant difference in MMSE scores between groups before TAVR (p = 0.253), but the MMSE after the procedure revealed a significantly lower incidence of delayed neurocognitive recovery (p = 0.005) and thus better cognitive outcomes in the dexmedetomidine group (p = 0.022). CONCLUSIONS: Compared with propofol, procedural sedation with dexmedetomidine in TAVR was associated with a significantly lower incidence of delayed neurocognitive recovery. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Vovk Racman, Pia AU - Vovk Racman P AD - Clinical Department of Anaesthesiology and Perioperative Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia. FAU - Ksela, Jus AU - Ksela J AD - Clinical Department of Cardiovascular Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia; University of Ljubljana Faculty of Medicine, Ljubljana, Slovenia. FAU - Racman, Mark AU - Racman M AD - Clinical Department of Cardiovascular Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia. FAU - Zerjav, Urska AU - Zerjav U AD - Clinical Department of Anaesthesiology and Perioperative Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia. FAU - Sostaric, Maja AU - Sostaric M AD - Clinical Department of Anaesthesiology and Perioperative Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia; University of Ljubljana Faculty of Medicine, Ljubljana, Slovenia. Electronic address: maja.sostaric@kclj.si. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20230506 PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 RN - YI7VU623SF (Propofol) RN - 67VB76HONO (Dexmedetomidine) RN - 0 (Hypnotics and Sedatives) SB - IM CIN - J Cardiothorac Vasc Anesth. 2023 Oct;37(10):1901-1903. doi: 10.1053/j.jvca.2023.05.049. PMID: 37419753 MH - Humans MH - *Propofol MH - *Dexmedetomidine MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Prospective Studies MH - Hypnotics and Sedatives MH - *Anesthesia MH - Procedural Sedation/methods OTO - NOTNLM OT - Transcatheter aortic valve replacement OT - delayed neurocognitive recovery OT - dexmedetomidine OT - postoperative cognitive dysfunction OT - procedural sedation OT - propofol COIS- Declaration of Competing Interest None. EDAT- 2023/05/25 01:07 MHDA- 2023/09/12 06:42 CRDT- 2023/05/24 21:58 PHST- 2022/11/24 00:00 [received] PHST- 2023/03/24 00:00 [revised] PHST- 2023/05/03 00:00 [accepted] PHST- 2023/09/12 06:42 [medline] PHST- 2023/05/25 01:07 [pubmed] PHST- 2023/05/24 21:58 [entrez] AID - S1053-0770(23)00313-0 [pii] AID - 10.1053/j.jvca.2023.05.009 [doi] PST - ppublish SO - J Cardiothorac Vasc Anesth. 2023 Oct;37(10):1894-1900. doi: 10.1053/j.jvca.2023.05.009. Epub 2023 May 6. PMID- 37218985 OWN - NLM STAT- MEDLINE DCOM- 20230524 LR - 20250626 IS - 2076-3271 (Electronic) IS - 2076-3271 (Linking) VI - 11 IP - 2 DP - 2023 May 9 TI - Gender Disparities after Transcatheter Aortic Valve Replacement with Newer Generation Transcatheter Heart Valves: A Systematic Review and Meta-Analysis. LID - 10.3390/medsci11020033 [doi] LID - 33 AB - Previous studies have demonstrated gender disparities in mortality and vascular complications after transcatheter aortic valve replacement (TAVR) with early generation transcatheter heart valves (THVs). It is unclear, however, whether gender-related differences persist with the newer generation THVs. We aim to assess gender disparities after TAVR with newer generation THVs. The MEDLINE and Embase databases were thoroughly searched from inception to April 2023 to identify studies that reported gender-specific outcomes after TAVR with newer generation THVs (Sapien 3, Corevalve Evolut R, and Evolut Pro). The outcomes of interest included 30-day mortality, 1-year mortality, and vascular complications. In total, 5 studies (4 databases) with a total of 47,933 patients (21,073 females and 26,860 males) were included. Ninety-six percent received TAVR via the transfemoral approach. The females had higher 30-day mortality rates (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.31-1.79, p-value (p) < 0.001) and vascular complications (OR = 1.43, 95% CI 1.23-1.65, p < 0.001). However, one-year mortality was similar between the two groups (OR = 0.78, 95% CI 0.61-1.00, p = 0.28). The female gender continues to be associated with higher 30-day mortality rates and vascular complications after TAVR with newer generation transcatheter heart valves, while there was no difference in 1-year mortality between the genders. More data is needed to explore the causes and whether we can improve TAVR outcomes in females. FAU - Trongtorsak, Angkawipa AU - Trongtorsak A AUID- ORCID: 0000-0003-1855-029X AD - Ascension Saint Francis Hospital, Internal Medicine Residency Program, Evanston, IL 60202, USA. FAU - Thangjui, Sittinun AU - Thangjui S AUID- ORCID: 0000-0002-5846-4620 AD - Bassett Healthcare Network, Internal Medicine Residency Program, New York, NY 13326, USA. FAU - Adhikari, Pabitra AU - Adhikari P AUID- ORCID: 0000-0002-5153-629X AD - Ascension Saint Francis Hospital, Internal Medicine Residency Program, Evanston, IL 60202, USA. FAU - Shrestha, Biraj AU - Shrestha B AD - Reading Hospital-Tower Health, Internal Medicine Residency Program, West Reading, PA 19611, USA. FAU - Kewcharoen, Jakrin AU - Kewcharoen J AUID- ORCID: 0000-0003-0959-5576 AD - Division of Cardiovascular Medicine, Loma Linda University Health, Loma Linda, CA 92350, USA. FAU - Navaravong, Leenhapong AU - Navaravong L AUID- ORCID: 0000-0001-7087-1707 AD - Division of Cardiovascular Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84112, USA. FAU - Kanjanauthai, Somsupha AU - Kanjanauthai S AD - Division of Cardiovascular Medicine, University of Southern California, Los Angeles, CA 90007, USA. FAU - Attanasio, Steve AU - Attanasio S AD - Rush University Medical Center, Division of Cardiovascular Medicine, Chicago, IL 60612, USA. FAU - Saudye, Hammad A AU - Saudye HA AD - Ascension Saint Francis Hospital, Division of Cardiovascular Medicine, Evanston, IL 60202, USA. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20230509 PL - Switzerland TA - Med Sci (Basel) JT - Medical sciences (Basel, Switzerland) JID - 101629322 SB - IM MH - Humans MH - Female MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Risk Factors MH - *Heart Valve Prosthesis PMC - PMC10204443 OTO - NOTNLM OT - TAVR OT - gender disparities OT - newer generation transcatheter heart valves COIS- The authors declare no conflict of interest. EDAT- 2023/05/23 13:06 MHDA- 2023/05/24 06:42 PMCR- 2023/05/09 CRDT- 2023/05/23 07:44 PHST- 2023/02/26 00:00 [received] PHST- 2023/05/04 00:00 [revised] PHST- 2023/05/04 00:00 [accepted] PHST- 2023/05/24 06:42 [medline] PHST- 2023/05/23 13:06 [pubmed] PHST- 2023/05/23 07:44 [entrez] PHST- 2023/05/09 00:00 [pmc-release] AID - medsci11020033 [pii] AID - medsci-11-00033 [pii] AID - 10.3390/medsci11020033 [doi] PST - epublish SO - Med Sci (Basel). 2023 May 9;11(2):33. doi: 10.3390/medsci11020033. PMID- 39076739 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240731 IS - 2153-8174 (Electronic) IS - 2153-8174 (Print) IS - 1530-6550 (Linking) VI - 24 IP - 5 DP - 2023 May TI - The Place of Transaxillary Access in Transcatheter Aortic Valve Implantation (TAVI) Compared to Alternative Routes-A Systematic Review Article. PG - 150 LID - 10.31083/j.rcm2405150 [doi] LID - 150 AB - BACKGROUND: Transfemoral transcatheter aortic valve implantation (TAVI) has proven non-inferior or superior against surgical aortic valve replacement (SAVR) for patients at high, intermediate or low surgical risk. However, transfemoral access is not always feasible in patients with severely atherosclerotic or tortuous iliofemoral arteries. For these cases, alternative access techniques have been developed, such as transcarotid, transcaval, direct aortic or transaxillary access. In recent years, growing preference towards the transaxillary access has emerged. To provide a summary of data available on transaxillary TAVI and compare this approach to other alternative access techniques. METHODS: A literature search was performed in PubMed by two independent reviewers. Studies reporting the outcome of at least 10 patients who underwent transaxillary TAVI, either in case series or in comparative studies, were included in this review. Articles not reporting outcomes according to the Valve Academic Research Consortium (VARC) 1-3 definitions were excluded. RESULTS: In total 193 records were found of which 18 were withheld for inclusion in this review. This review reports on the combined data of the 1519 patients who underwent transaxillary TAVI. Procedural success was achieved in 1203 (92.2%) of 1305 cases. Life-threatening, major, and minor bleeding occurred respectively in 4.5% (n = 50 in 1112 cases), 12.9% (n = 143 in 1112 cases) and 8.8% (n = 86 in 978 cases). Major and minor vascular complications were reported in respectively 6.6% (n = 83 in 1256 cases) and 10.0% (n = 105 in 1048 cases) of patients. 30-day mortality was 5.2% (n = 76 out of 1457 cases). At one year follow-up, the mortality rate was 1% (n = 184 out of 1082 cases). Similar 30-day and 1-year mortality is observed in studies that compare with transaxillary, transfemoral or other alternative access techniques (p > 0.05). CONCLUSIONS: A wide application of transaxillary access as an alternative approach for TAVI has emerged. This technique has an excellent procedural success rate up to 92.0%, with low procedural complication rates. Clinical outcome of transaxillary TAVI is comparable to the other alternative TAVI approaches. However, these conclusions are solely based on observational data. CI - Copyright: (c) 2023 The Author(s). Published by IMR Press. FAU - Herremans, Andries AU - Herremans A AD - Department of Cardiology, Algemeen Stedelijk Ziekenhuis, 9300 Aalst, Oost-Vlaanderen, Belgium. AD - Faculty of Medicine and Health Sciences, University Gent, 9000 Gent, Oost-Vlaanderen, Belgium. FAU - Stevesyns, Dylan Thomas AU - Stevesyns DT AD - Department of Cardiology, Algemeen Stedelijk Ziekenhuis, 9300 Aalst, Oost-Vlaanderen, Belgium. AD - Faculty of Medicine and Health Sciences, University Gent, 9000 Gent, Oost-Vlaanderen, Belgium. FAU - El Jattari, Hicham AU - El Jattari H AD - Department of Cardiology, Algemeen Stedelijk Ziekenhuis, 9300 Aalst, Oost-Vlaanderen, Belgium. FAU - Rosseel, Michael AU - Rosseel M AD - Department of Cardiology, Algemeen Stedelijk Ziekenhuis, 9300 Aalst, Oost-Vlaanderen, Belgium. FAU - Rosseel, Liesbeth AU - Rosseel L AD - Department of Cardiology, Algemeen Stedelijk Ziekenhuis, 9300 Aalst, Oost-Vlaanderen, Belgium. LA - eng PT - Journal Article PT - Systematic Review DEP - 20230519 PL - Singapore TA - Rev Cardiovasc Med JT - Reviews in cardiovascular medicine JID - 100960007 PMC - PMC11273050 OTO - NOTNLM OT - TAVI OT - aortic valve stenosis OT - interventional cardiology OT - transaxillary OT - transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2023/05/19 00:00 MHDA- 2023/05/19 00:01 PMCR- 2023/05/19 CRDT- 2024/07/30 04:59 PHST- 2022/08/29 00:00 [received] PHST- 2023/01/10 00:00 [revised] PHST- 2023/02/03 00:00 [accepted] PHST- 2023/05/19 00:01 [medline] PHST- 2023/05/19 00:00 [pubmed] PHST- 2024/07/30 04:59 [entrez] PHST- 2023/05/19 00:00 [pmc-release] AID - S1530-6550(23)00892-X [pii] AID - 10.31083/j.rcm2405150 [doi] PST - epublish SO - Rev Cardiovasc Med. 2023 May 19;24(5):150. doi: 10.31083/j.rcm2405150. eCollection 2023 May. PMID- 37200971 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240918 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Treatment of pure aortic regurgitation using surgical or transcatheter aortic valve replacement between 2018 and 2020 in Germany. PG - 1091983 LID - 10.3389/fcvm.2023.1091983 [doi] LID - 1091983 AB - BACKGROUND: In pure aortic regurgitation, transcatheter aortic valve replacement (TAVR) is not yet used on a regular base. Due to constant development of TAVR, it is necessary to analyze current data. METHODS: By use of health records, we analyzed all isolated TAVR or surgical aortic valve replacements (SAVR) for pure aortic regurgitation between 2018 and 2020 in Germany. RESULTS: 4,861 procedures-4,025 SAVR and 836 TAVR-for aortic regurgitation were identified. Patients treated with TAVR were older, showed a higher logistic EuroSCORE, and had more pre-existing diseases. While results indicate a slightly higher unadjusted in-hospital mortality for transapical TAVR (6.00%) vs. SAVR (5.71%), transfemoral TAVR showed better outcomes, with self-expanding compared to balloon-expandable transfemoral TAVR having significantly lower in-hospital mortality (2.41% vs. 5.17%; p = 0.039). After risk adjustment, balloon-expandable as well as self-expanding transfemoral TAVR were associated with a significantly lower mortality vs. SAVR (balloon-expandable: risk adjusted OR = 0.50 [95% CI 0.27; 0.94], p = 0.031; self-expanding: OR = 0.20 [0.10; 0.41], p < 0.001). Furthermore, the observed in-hospital outcomes of stroke, major bleeding, delirium, and mechanical ventilation >48 h were significantly in favor of TAVR. In addition, TAVR showed a significantly shorter length of hospital stay compared to SAVR (transapical: risk adjusted Coefficient = -4.75d [-7.05d; -2.46d], p < 0.001; balloon-expandable: Coefficient = -6.88d [-9.06d; -4.69d], p < 0.001; self-expanding: Coefficient = -7.22 [-8.95; -5.49], p < 0.001). CONCLUSIONS: TAVR is a viable alternative to SAVR in the treatment of pure aortic regurgitation for selected patients, showing overall low in-hospital mortality and complication rates, especially with regard to self-expanding transfemoral TAVR. CI - (c) 2023 Oettinger, Hilgendorf, Wolf, Stachon, Heidenreich, Zehender, Westermann, Kaier and von zur Muhlen. FAU - Oettinger, Vera AU - Oettinger V AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Hilgendorf, Ingo AU - Hilgendorf I AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Wolf, Dennis AU - Wolf D AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Stachon, Peter AU - Stachon P AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Heidenreich, Adrian AU - Heidenreich A AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. LA - eng PT - Journal Article DEP - 20230502 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10187752 OTO - NOTNLM OT - aortic regurgitation OT - in-hospital outcomes OT - national electronic health records OT - surgical aortic valve replacement OT - transcatheter aortic valve implantation OT - transcatheter aortic valve replacement COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/05/18 19:12 MHDA- 2023/05/18 19:13 PMCR- 2023/01/01 CRDT- 2023/05/18 16:52 PHST- 2022/11/07 00:00 [received] PHST- 2023/04/17 00:00 [accepted] PHST- 2023/05/18 19:13 [medline] PHST- 2023/05/18 19:12 [pubmed] PHST- 2023/05/18 16:52 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1091983 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 May 2;10:1091983. doi: 10.3389/fcvm.2023.1091983. eCollection 2023. PMID- 37168251 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230516 IS - 2572-9292 (Electronic) IS - 2572-9292 (Linking) VI - 7 IP - 2 DP - 2023 Mar 13 TI - Development of In-Hospital Outcomes in Patients undergoing Transcatheter Aortic Valve Implantation (TAVI) at an Interdisciplinary Heart Center: A Single-Center Experience of 489 Consecutive Cases. PG - 52-68 LID - 10.26502/fccm.92920309 [doi] AB - BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) has emerged over time, reflected in appropriate adjustments in the European Society of Cardiology (ESC) guidelines in 2007, 2012 and 2017. OBJECTIVE: The aim of this study was to analyze in-hospital outcomes after TAVI in the development within a single heart center over a period of 10 years depending on adjustments in the guidelines, infrastructural and procedural determinants. METHODS: 489 consecutive patients who underwent TAVI from 2010 and 2019 at our center were analyzed retrospectively. Patients were divided into 3 groups of different treatment circumstances depending on guidelines adjustments and local infrastructural progress (group 1: 2010-2015 (n = 132), group 2: 2016-2017 (n = 155), group 3: 2018-2019 (n = 202). The primary endpoint was defined as all-cause in-hospital mortality. Secondary endpoints were selected according to the Valve Academic Research Consortium (VARC)-2 definitions. Multivariate logistic regression analysis was performed to determine predictors of in-hospital mortality. Statistical significance was assumed for p < 0.05. RESULTS: 489 patients (346 (70.8 %) transfemoral and 143 (29.2 %) transapical) underwent TAVI. Comparing periods (group 1 vs. 2 vs. 3) age (82.1 +/- 6.2 vs. 82.5 +/- 4.8 vs. 81.1 +/- 5.1 years, p = 0.012) and EuroSCORE II (8.4 +/- 6.0 vs. 5.8 +/- 4.9 vs. 5.5 +/- 5.0 %, p < 0.001) declined over time. Rates of in-hospital mortality decreased significantly (9.1 % vs. 5.8 % vs. 2.5 %, p = 0.029), especially with observed-to-expected mortality ratios indicating a disproportionate decline of in-hospital mortality (1.08 vs. 1.00 vs. 0.45). Furthermore, post-procedural complications, such as acute kidney injury stage 3 (10.6 % vs. 3.2 % vs. 4.5 %, p = 0.016) and bleeding complications (14.4 % vs. 11.6 % vs 7.9 %, p = 0.165) decreased from group 1 to 3. However, rates of permanent pacemaker implantations (7.6 % vs. 11.0 % vs. 22.8 %, p < 0.001) increased, associated with a switch towards self-expanding valves (0.0 % vs. 61.3 % vs. 76.7 %, p < 0.001). Length of hospitalization as well as stay at intensive care and intermediate care unit could be reduced significantly during the observation period. In multivariate analysis age (OR: 1.103; 95 % CI: 1.013 - 1.202; p = 0.025), creatinine level before TAVI (OR: 1.497; 95 % CI: 1.013 - 2.212; p = 0.043), atrial fibrillation (OR: 2.956; 95 % CI: 1.127 - 7.749; p = 0.028) and procedure duration (OR: 1.017; 95 % CI: 1.009 - 1.025; p < 0.001) could be identified as independent predictors of in-hospital mortality. CONCLUSION: This study identified age, creatinine level before TAVI, the presence of atrial fibrillation and procedure duration as independent predictors for in-hospital mortality. Although these predictors decreased during the observation period, the decline in hospital-mortality was disproportionate, which was indicated by an observed-to-expected mortality ratio of 0.45 for the last observation period. However, it can be assumed that apart from patient-related factors, there were further institutional, technical and procedural developments, which ran in parallel and affected in-hospital mortality rates after TAVI. FAU - Rana, Mukaram AU - Rana M AD - Herz-Thorax-Zentrum Fulda, Medizinische Klinik I (Kardiologie, Angiologie, Intensivmedizin), Klinikum Fulda, Universitatsmedizin Marburg - Campus Fulda, Fulda. FAU - Niethammer, Margit AU - Niethammer M AD - Herz-Thorax-Zentrum Fulda, Medizinische Klinik I (Kardiologie, Angiologie, Intensivmedizin), Klinikum Fulda, Universitatsmedizin Marburg - Campus Fulda, Fulda. FAU - Sellin, Christian AU - Sellin C AD - Herz-Thorax-Zentrum Fulda, Klinik fur Herz- und Thoraxchirurgie, Klinikum Fulda, Universitatsmedizin Marburg - Campus Fulda, Fulda. FAU - Dorge, Hilmar AU - Dorge H AD - Herz-Thorax-Zentrum Fulda, Klinik fur Herz- und Thoraxchirurgie, Klinikum Fulda, Universitatsmedizin Marburg - Campus Fulda, Fulda. FAU - Eggebrecht, Holger AU - Eggebrecht H AD - Herz-Thorax-Zentrum Fulda, Medizinische Klinik I (Kardiologie, Angiologie, Intensivmedizin), Klinikum Fulda, Universitatsmedizin Marburg - Campus Fulda, Fulda. AD - Cardiologisches Centrum Bethanien (CCB), Frankfurt a. M. FAU - Schachinger, Volker AU - Schachinger V AD - Herz-Thorax-Zentrum Fulda, Medizinische Klinik I (Kardiologie, Angiologie, Intensivmedizin), Klinikum Fulda, Universitatsmedizin Marburg - Campus Fulda, Fulda. LA - eng GR - R01 HL147662/HL/NHLBI NIH HHS/United States PT - Journal Article PL - United States TA - Cardiol Cardiovasc Med JT - Cardiology and cardiovascular medicine JID - 101721428 PMC - PMC10167775 MID - NIHMS1883380 OTO - NOTNLM OT - Aortic stenosis (AS) OT - In-hospital outcomes OT - Transcatheter Aortic Valve Implantation (TAVI) COIS- Conflicts of Interest The authors state that they have no conflicts of interest. EDAT- 2023/05/12 01:07 MHDA- 2023/05/12 01:08 PMCR- 2023/05/09 CRDT- 2023/05/11 19:17 PHST- 2023/05/12 01:08 [medline] PHST- 2023/05/12 01:07 [pubmed] PHST- 2023/05/11 19:17 [entrez] PHST- 2023/05/09 00:00 [pmc-release] AID - 10.26502/fccm.92920309 [doi] PST - ppublish SO - Cardiol Cardiovasc Med. 2023 Mar 13;7(2):52-68. doi: 10.26502/fccm.92920309. PMID- 37166498 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240919 IS - 2753-670X (Electronic) IS - 2753-670X (Linking) VI - 36 IP - 6 DP - 2023 Jun 1 TI - Results and insights after 413 TAVI procedures performed by cardiac surgeons on their own. LID - 10.1093/icvts/ivad074 [doi] LID - ivad074 AB - OBJECTIVES: Current evidence on transcatheter aortic valve implantation (TAVI) has been generated exclusively by cardiology studies and no operative data from cardiac surgeons are available. Here, we describe the development of our TAVI programme and report the results of transfemoral (TF) TAVI done by cardiac surgeons on their own. METHODS: This study included all the TAVI procedures on native valve performed at Cardiac Surgery Unit, Ospedali Riuniti di Ancona, during the period October 2018 to July 2022. Relevant prospectively collected preoperative, intraprocedural and postoperative data were retrieved from the Institutional database. RESULTS: A total of 413 patients were included in the study. Mean patients' age was 82 years and among them 44% (180/413) were male. STS score was 3.1% (2.2-4.4). Eighty patients underwent transapical TAVI and 333 patients had a TF approach. We progressively moved from transapical TAVI towards TF procedures that are now routinely performed on conscious sedation and using a fully percutaneous approach. After TF TAVI, 30-day mortality rate was 1%, cerebral stroke occurred in 2% of the cases, permanent pacemaker implantation was necessary in 23% of the patients and in 6% of the cases there was a moderate/severe degree of aortic regurgitation. There was no association between operators performing TAVI and 30-day mortality. CONCLUSIONS: The acquisition of catheter-based skills and an adequate training allowed cardiac surgeons to perform on their own awake and fully percutaneous TF TAVI with similar results when compared with major randomized clinical trials and registries' experiences. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Malvindi, Pietro Giorgio AU - Malvindi PG AUID- ORCID: 0000-0002-3508-2670 AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Berretta, Paolo AU - Berretta P AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Capestro, Filippo AU - Capestro F AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Bifulco, Olimpia AU - Bifulco O AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Alfonsi, Jacopo AU - Alfonsi J AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Cefarelli, Mariano AU - Cefarelli M AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Pierri, Michele Danilo AU - Pierri MD AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. FAU - Di Eusanio, Marco AU - Di Eusanio M AD - Cardiac Surgery Unit, Lancisi Cardiovascular Center, Polytechnic University of Marche, Ancona, Italy. LA - eng PT - Journal Article PL - England TA - Interdiscip Cardiovasc Thorac Surg JT - Interdisciplinary cardiovascular and thoracic surgery JID - 9918540787006676 SB - IM PMC - PMC10243841 OTO - NOTNLM OT - Aortic valve OT - Aortic valve replacement OT - TAVI OT - Transcatheter EDAT- 2023/05/11 13:18 MHDA- 2023/05/11 13:19 PMCR- 2023/05/11 CRDT- 2023/05/11 11:05 PHST- 2023/03/03 00:00 [received] PHST- 2023/04/17 00:00 [revised] PHST- 2023/05/10 00:00 [accepted] PHST- 2023/05/11 13:19 [medline] PHST- 2023/05/11 13:18 [pubmed] PHST- 2023/05/11 11:05 [entrez] PHST- 2023/05/11 00:00 [pmc-release] AID - 7160148 [pii] AID - ivad074 [pii] AID - 10.1093/icvts/ivad074 [doi] PST - ppublish SO - Interdiscip Cardiovasc Thorac Surg. 2023 Jun 1;36(6):ivad074. doi: 10.1093/icvts/ivad074. PMID- 37154049 OWN - NLM STAT- MEDLINE DCOM- 20230526 LR - 20231114 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 147 IP - 21 DP - 2023 May 23 TI - Economic Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis and Low Surgical Risk: Results from the PARTNER 3 Trial. PG - 1594-1605 LID - 10.1161/CIRCULATIONAHA.122.062481 [doi] AB - BACKGROUND: In patients with severe symptomatic aortic stenosis at low surgical risk, transfemoral transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 valve has been shown to reduce the composite of death, stroke, or rehospitalization at 2-year follow-up compared with surgical aortic valve replacement (SAVR). Whether TAVR is cost-effective compared with SAVR for low-risk patients remains uncertain. METHODS: Between 2016 and 2017, 1000 low-risk patients with aortic stenosis were randomly assigned to TAVR with the SAPIEN 3 valve or SAVR in the PARTNER 3 trial (Placement of Aortic Transcatheter Valves). Of these patients, 929 underwent valve replacement, were enrolled in the United States, and were included in the economic substudy. Procedural costs were estimated using measured resource use. Other costs were determined by linkage with Medicare claims or by regression models when linkage was not feasible. Health utilities were estimated using the EuroQOL 5-item questionnaire. With the use of a Markov model informed by in-trial data, lifetime cost-effectiveness from the perspective of the US health care system was estimated in terms of cost per quality-adjusted life-year gained. RESULTS: Although procedural costs were nearly $19 000 higher with TAVR, total index hospitalization costs were only $591 more with TAVR compared with SAVR. Follow-up costs were lower with TAVR such that TAVR led to 2-year cost savings of $2030/patient compared with SAVR (95% CI, -$6222 to $1816) and a gain of 0.05 quality-adjusted life-years (95% CI, -0.003 to 0.102). In our base-case analysis, TAVR was projected to be an economically dominant strategy with a 95% probability that the incremental cost-effectiveness ratio for TAVR would be <$50 000/quality-adjusted life-year gained (consistent with high economic value from a US health care perspective). These findings were sensitive to differences in long-term survival, however, such that a modest long-term survival advantage with SAVR would render SAVR cost-effective (although not cost saving) compared with TAVR. CONCLUSIONS: For patients with severe aortic stenosis and low surgical risk similar to those enrolled in the PARTNER 3 trial, transfemoral TAVR with the SAPIEN 3 valve is cost saving compared with SAVR at 2 years and is projected to be economically attractive in the long run as long as there are no substantial differences in late death between the 2 strategies. Long-term follow-up will be critical to ultimately determine the preferred treatment strategy for low-risk patients from both a clinical and economic perspective. FAU - Galper, Benjamin Z AU - Galper BZ AD - Mid-Atlantic Permanente Medical Group, McLean, VA (B.Z.G.). FAU - Chinnakondepalli, Khaja M AU - Chinnakondepalli KM AD - Saint-Luke's Mid America Heart Institute, Kansas City, MO (K.M.C., K.W., E.A.M.). FAU - Wang, Kaijun AU - Wang K AD - Saint-Luke's Mid America Heart Institute, Kansas City, MO (K.M.C., K.W., E.A.M.). FAU - Magnuson, Elizabeth A AU - Magnuson EA AUID- ORCID: 0000-0002-8631-6211 AD - Saint-Luke's Mid America Heart Institute, Kansas City, MO (K.M.C., K.W., E.A.M.). FAU - Lu, Michael AU - Lu M AUID- ORCID: 0000-0002-7898-7867 AD - Edwards Lifesciences, Irvine, CA (M.L.). FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, GA (V.H.T.). FAU - Kodali, Susheel AU - Kodali S AD - New York-Presbyterian/Columbia University Irving Medical Center, New York (S. Kodali, C.R.S., M.B.L.). FAU - Makkar, Raj AU - Makkar R AD - Cedars-Sinai Medical Center, Los Angeles, CA (R.M.). FAU - Herrmann, Howard C AU - Herrmann HC AUID- ORCID: 0000-0003-3322-9568 AD - University of Pennsylvania, Philadelphia (H.C.H.). FAU - Kapadia, Samir AU - Kapadia S AUID- ORCID: 0000-0002-0026-3391 AD - Cleveland Clinic, OH (S. Kapadia). FAU - Williams, Mathew AU - Williams M AD - NYU-Langone Medical Center, New York, NY (M.W.). FAU - Webb, John AU - Webb J AD - St. Paul's Hospital, Vancouver, BC, Canada (J.W.). FAU - Smith, Craig R AU - Smith CR AD - New York-Presbyterian/Columbia University Irving Medical Center, New York (S. Kodali, C.R.S., M.B.L.). FAU - Mack, Michael J AU - Mack MJ AUID- ORCID: 0000-0002-3148-9158 AD - Baylor Scott & White Health, Plano, TX (M.J.M.). FAU - Leon, Martin B AU - Leon MB AD - New York-Presbyterian/Columbia University Irving Medical Center, New York (S. Kodali, C.R.S., M.B.L.). AD - Cardiovascular Research Foundation, New York, NY (M.B.L., D.J.C.). FAU - Cohen, David J AU - Cohen DJ AUID- ORCID: 0000-0001-9163-724X AD - Cardiovascular Research Foundation, New York, NY (M.B.L., D.J.C.). AD - St. Francis Hospital, Roslyn, NY (D.J.C.). CN - PARTNER Investigators LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20230508 PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM CIN - J Cardiothorac Vasc Anesth. 2023 Dec;37(12):2425-2427. doi: 10.1053/j.jvca.2023.08.127. PMID: 37709609 MH - Humans MH - Aged MH - United States MH - Aortic Valve/surgery MH - *Heart Valve Prosthesis Implantation/methods MH - Treatment Outcome MH - Medicare MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis MH - Risk Factors OTO - NOTNLM OT - aortic valve stenosis OT - cost-benefit analysis OT - cost-effectiveness analysis OT - quality of life OT - transcatheter aortic valve replacement COIS- Disclosures Dr Lu is an employee of Edwards Lifesciences. Dr Thourani has received grants from Edwards Lifesciences, consulting fees from Atricure, Abbott, Boston Scientific, Artivion, Shockwave, and Edwards Lifesciences, and holds equity in Dasi Simulations. Dr Kodali reports institutional research grants from Edwards Lifesciences, Medtronic, and Abbott; consulting fees from Abbott, Admedus, and Meril Lifesciences; and equity options from Biotrace Medical and Thubrikar Aortic Valve Inc. Dr Makkar reports grant support/research contract from Edwards Lifesciences, St. Jude Medical, and consultant fee/honoraria/speaker's bureau from Abbott Vascular, Cordis Corporation, Medtronic. Dr Herrmann reports institutional research funding from Abbott Vascular, Ancora, Boston Scientific, Edwards Lifesciences, and Medtronic; consultant fees from Abbott Vascular, Edwards Lifesciences, Medtronic; and equity in Microinterventional Devices. Dr Williams has received consulting fees from Edwards Lifesciences. Dr Webb has received consulting fees from Edwards Lifesciences. Dr Mack served as coprimary investigator for the PARTNER Trial (Placement of Aortic Transcatheter Valves) for Edwards Lifesciences and COAPT trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation [The COAPT Trial] and COAPT CAS [COAPT]) for Abbott; served as study chair for the APOLLO trial (Transcatheter Mitral Valve Replacement With the Medtronic Intrepid TMVR System in Patients With Severe Symptomatic Mitral Regurgitation) for Medtronic (all activities unpaid). Dr Leon serves on the PARTNER Trial Executive Committee, Edwards Lifesciences (nonpaid), and reports institutional research grants and being a nonpaid advisor for Abbott, Boston Scientific, Medtronic, and Sinomed; and holds equity in Medinol. Dr Cohen reports research grant support from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic and consulting fees from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic. The other authors have nothing to disclose. EDAT- 2023/05/08 06:42 MHDA- 2023/05/26 06:42 CRDT- 2023/05/08 05:27 PHST- 2023/05/26 06:42 [medline] PHST- 2023/05/08 06:42 [pubmed] PHST- 2023/05/08 05:27 [entrez] AID - 10.1161/CIRCULATIONAHA.122.062481 [doi] PST - ppublish SO - Circulation. 2023 May 23;147(21):1594-1605. doi: 10.1161/CIRCULATIONAHA.122.062481. Epub 2023 May 8. PMID- 37138103 OWN - NLM STAT- MEDLINE DCOM- 20240125 LR - 20261010 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 113 IP - 1 DP - 2024 Jan TI - Procedural success in transaxillary transcatheter aortic valve implantation according to type of transcatheter heart valve: results from the multicenter TAXI registry. PG - 48-57 LID - 10.1007/s00392-023-02216-1 [doi] AB - BACKGROUND: Transaxillary (TAx) transcatheter aortic valve implantation (TAVI) is a preferred alternative access in patients ineligible for transfemoral TAVI. AIMS: This study used the Trans-AXillary Intervention (TAXI) registry to compare procedural success according to different types of transcatheter heart valves (THV). METHODS: For the TAXI registry anonymized data of patients treated with TAx-TAVI were collected from 18 centers. Acute procedural, early and 1-month clinical outcomes were adjudicated in accordance with standardized VARC-3 definitions. RESULTS: From 432 patients, 368 patients (85.3%, SE group) received self-expanding (SE) THV and 64 patients (14.8%, BE group) received balloon-expandable (BE) THV. Imaging revealed lower axillary artery diameters in the SE group (max/min diameter in mm: 8.4/6.6 vs 9.4/6.8 mm; p < 0.001/p = 0.04) but a higher proportion of axillary tortuosity in BE group (62/368, 23.6% vs 26/64, 42.6%; p = 0.004) with steeper aorta-left ventricle (LV) inflow (55 degrees vs 51 degrees ; p = 0.002) and left ventricular outflow tract (LVOT)-LV inflow angles (40.0 degrees vs 24.5 degrees ; 0.002). TAx-TAVI was more often conducted by right sided axillary artery in the BE group (33/368, 9.0% vs 17/64, 26.6%; p < 0.001). Device success was higher in the SE group (317/368, 86.1% vs 44/64, 68.8%, p = 0.0015). In logistic regression analysis, BE THV were a risk factor for vascular complications and axillary stent implantation. CONCLUSIONS: Both, SE and BE THV can be safely used in TAx-TAVI. However, SE THV were more often used and were associated with a higher rate of device success. While SE THV were associated with lower rates of vascular complications, BE THV were more often used in cases with challenging anatomical circumstances. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. FAU - Schaefer, Andreas AU - Schaefer A AUID- ORCID: 0000-0001-7304-6083 AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. and.schaefer@uke.de. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Kellner, Caroline AU - Kellner C AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center-Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Bajoras, Vilhelmas AU - Bajoras V AD - The Heart Center-Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. AD - Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. AD - Department of Interventional Cardiology, Division of Cardiology and Vascular Diseases, Vilnius University, Hospital Santaros Clinics, Vilnius, Lithuania. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Center-Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Qureshi, Waqas T AU - Qureshi WT AD - Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA. FAU - Kakouros, Nikolaos AU - Kakouros N AD - Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA. FAU - Aldrugh, Summer AU - Aldrugh S AD - Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA. FAU - Amat-Santos, Ignacio AU - Amat-Santos I AD - Cardiology Department, CIBERCV, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Kaneko, Tsuyoshi AU - Kaneko T AD - Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. FAU - Harloff, Morgan AU - Harloff M AD - Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. FAU - Teles, Rui AU - Teles R AD - Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal. FAU - Nolasco, Tiago AU - Nolasco T AD - Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal. FAU - Neves, Jose Pedro AU - Neves JP AD - Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal. FAU - Abecasis, Miguel AU - Abecasis M AD - Cardiothoracic Surgery Department, Hospital de Santa Cruz, Carnaxide, Lisbon, Portugal. FAU - Werner, Nikos AU - Werner N AD - Department of Medicine 3, Barmherzige Bruder Hospital, Trier, Germany. FAU - Lauterbach, Michael AU - Lauterbach M AD - Department of Medicine 3, Barmherzige Bruder Hospital, Trier, Germany. FAU - Sacha, Jerzy AU - Sacha J AD - Department of Cardiology, Institute of Medical Sciences, University Hospital, University of Opole, Opole, Poland. FAU - Krawczyk, Krzysztof AU - Krawczyk K AD - Department of Cardiology, Institute of Medical Sciences, University Hospital, University of Opole, Opole, Poland. FAU - Trani, Carlo AU - Trani C AD - Institute of Cardiology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Institute of Cardiology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Condello, Francesco AU - Condello F AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Regueiro, Ander AU - Regueiro A AD - Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Cardiovascular Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain. FAU - Brugaletta, Salvatore AU - Brugaletta S AD - Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Cardiovascular Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain. FAU - Biancari, Fausto AU - Biancari F AD - Clinica Montevergine, GVM Care & Research, Mercogliano, Italy. AD - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. FAU - Niemela, Matti AU - Niemela M AD - Department of Internal Medicine, Oulu University Hospital, Oulu, Finland. FAU - Giannini, Francesco AU - Giannini F AD - Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy. FAU - Toselli, Marco AU - Toselli M AD - Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy. FAU - Ruggiero, Rossella AU - Ruggiero R AD - Interventional Cardiology Unit, GVM Care and Research Maria Cecilia Hospital, Cotignola, Italy. FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Bruno, Francesco AU - Bruno F AD - Department of Medical Science, Division of Cardiology, Citta Della Salute e della Scienza, Turin, Italy. FAU - Conrotto, Federico AU - Conrotto F AD - Department of Medical Science, Division of Cardiology, Citta Della Salute e della Scienza, Turin, Italy. FAU - D'Ascenzo, Fabrizio AU - D'Ascenzo F AD - Department of Medical Science, Division of Cardiology, Citta Della Salute e della Scienza, Turin, Italy. FAU - Savontaus, Mikko AU - Savontaus M AD - Heart Center, Turku University Hospital, University of Turku, Turku, Finland. FAU - Pykari, Jouni AU - Pykari J AD - Heart Center, Turku University Hospital, University of Turku, Turku, Finland. FAU - Ielasi, Alfonso AU - Ielasi A AD - IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy. FAU - Tespili, Maurizio AU - Tespili M AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan, Italy. FAU - Cimmino, Michele AU - Cimmino M AD - Interventional Cardiology Unit, Santa Lucia Clinic, S. Giuseppe Vesuviano, Naples, Italy. FAU - Albanese, Michele AU - Albanese M AD - Interventional Cardiology Unit, Santa Lucia Clinic, S. Giuseppe Vesuviano, Naples, Italy. FAU - Biondi-Zoccai, Giuseppe AU - Biondi-Zoccai G AD - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. AD - Mediterranea Cardiocentro, Naples, Italy. FAU - Corcione, Nicola AU - Corcione N AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Morello, Alberto AU - Morello A AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. FAU - Giordano, Arturo AU - Giordano A AD - Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230504 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Aortic Valve/surgery MH - Registries MH - Prosthesis Design OTO - NOTNLM OT - TAVI OT - TAVR OT - Transaxillary OT - Transcatheter valve therapy OT - Valve disease EDAT- 2023/05/04 00:42 MHDA- 2024/01/25 06:44 CRDT- 2023/05/03 23:27 PHST- 2023/01/26 00:00 [received] PHST- 2023/04/25 00:00 [accepted] PHST- 2024/01/25 06:44 [medline] PHST- 2023/05/04 00:42 [pubmed] PHST- 2023/05/03 23:27 [entrez] AID - 10.1007/s00392-023-02216-1 [pii] AID - 10.1007/s00392-023-02216-1 [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Jan;113(1):48-57. doi: 10.1007/s00392-023-02216-1. Epub 2023 May 4. PMID- 37137251 OWN - NLM STAT- MEDLINE DCOM- 20230522 LR - 20230623 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 197 DP - 2023 Jun 15 TI - Pacing-Related Differences After SAPIEN-3 TAVI: Clinical and Echocardiographic Correlates. PG - 24-33 LID - S0002-9149(23)00199-6 [pii] LID - 10.1016/j.amjcard.2023.04.001 [doi] AB - Data regarding the impact of pacing on outcomes after transcatheter aortic valve implantation (TAVI) is evolving especially with regards to pre-existing permanent pacemaker (PPM). We examined the impact of new and previous PPM on the clinical and hemodynamic outcomes after SAPIEN-3 TAVI. We included all consecutive patients who underwent transfemoral TAVI using SAPIEN-3 valve from 2015 to 2018 at our institution. Among 1,028 patients, 10.2% required a new PPM within 30 days, whereas 14% had a pre-existing PPM. The presence of either previous or new PPM had no impact on the 3-year mortality (log-rank p = 0.6) or 1-year major adverse cardiac and cerebrovascular events (log-rank p = 0.65). New PPM was associated with lower left ventricular (LV) ejection fraction (LVEF) at both 30 days (54.4 +/- 11.3% vs 58.4 +/- 10.1%, p = 0.001) and 1 year (54.2 +/- 12% vs 59.1 +/- 9.9%, p = 0.009) than no PPM. Similarly, previous PPM was associated with worse LVEF at 30 days (53.6 +/- 12.3%, p <0.001) and 1 year (55.5 +/- 12.1%, p = 0.006) than no PPM. Interestingly, new PPM was associated with lower 1-year mean gradient (11.4 +/- 3.8 vs 12.6 +/- 5.6 mm Hg, p = 0.04) and peak gradient (21.3 +/- 6.5 vs 24.1 +/- 10.4 mm Hg, p = 0.01), despite no baseline differences. Previous PPM was also associated with lower 1-year mean gradient (10.3 +/- 4.4 mm Hg, p = 0.001) and peak gradient (19.4 +/- 8 mm Hg, p <0.001) and higher Doppler velocity index (0.51 +/- 0.12 vs 0.47 +/- 0.13, p = 0.039). Moreover, 1-year LV end-systolic volume index was higher with new (23.2 +/- 16.1 vs 20 +/- 10.8 ml/m(2), p = 0.038) and previous PPM (24.5 +/- 19.7, p = 0.038) than no PPM. Previous PPM was associated with higher moderate-to-severe tricuspid regurgitation (35.3% vs 17.7%, p <0.001). There were no differences regarding the rest of the studied echocardiographic outcomes at 1 year. In conclusion, new and previous PPM did not affect 3-year mortality or 1-year major adverse cardiac and cerebrovascular events; however, they were associated with worse LVEF, higher 1-year LV end-systolic volume index, and lower mean and peak gradients on follow-up than no PPM. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Sammour, Yasser M AU - Sammour YM AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Lak, Hassan AU - Lak H AD - Section of Clinical Cardiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Gajulapalli, Rama Dilip AU - Gajulapalli RD AD - Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Chawla, Sanchit AU - Chawla S AD - Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Abushouk, Abdelrahman AU - Abushouk A AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Parikh, Parth AU - Parikh P AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Alkhalaileh, Feras AU - Alkhalaileh F AD - Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Kumar, Sachin AU - Kumar S AD - Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Svensson, Lars AU - Svensson L AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Yun, James AU - Yun J AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Popovic, Zoran AU - Popovic Z AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Harb, Serge AU - Harb S AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Tarakji, Khaldoun AU - Tarakji K AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Wazni, Oussama AU - Wazni O AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Reed, Grant W AU - Reed GW AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Puri, Rishi AU - Puri R AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Kapadia, Samir R AU - Kapadia SR AD - Aortic Valve Center, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: Kapadis@ccf.org. LA - eng PT - Journal Article DEP - 20230502 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Aortic Valve Stenosis/complications MH - Echocardiography MH - Ventricular Function, Left MH - Aortic Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis MH - *Pacemaker, Artificial EDAT- 2023/05/04 00:42 MHDA- 2023/05/22 06:42 CRDT- 2023/05/03 18:04 PHST- 2022/11/17 00:00 [received] PHST- 2023/03/15 00:00 [revised] PHST- 2023/04/02 00:00 [accepted] PHST- 2023/05/22 06:42 [medline] PHST- 2023/05/04 00:42 [pubmed] PHST- 2023/05/03 18:04 [entrez] AID - S0002-9149(23)00199-6 [pii] AID - 10.1016/j.amjcard.2023.04.001 [doi] PST - ppublish SO - Am J Cardiol. 2023 Jun 15;197:24-33. doi: 10.1016/j.amjcard.2023.04.001. Epub 2023 May 2. PMID- 37129922 OWN - NLM STAT- MEDLINE DCOM- 20230609 LR - 20230703 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 24 IP - 7 DP - 2023 Jul 1 TI - Large-bore sheath insertion using a slip-through technique in transcatheter aortic valve replacement. PG - 475-477 LID - 10.2459/JCM.0000000000001474 [doi] FAU - Nakase, Masaaki AU - Nakase M AD - Division of Cardiology. FAU - Asami, Masahiko AU - Asami M AD - Division of Cardiology. FAU - Miura, Sumio AU - Miura S AD - Division of Cardiovascular Surgery. FAU - Yokozuka, Motoi AU - Yokozuka M AD - Division of Anesthesia, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Tanabe, Kengo AU - Tanabe K AD - Division of Cardiology. LA - eng PT - Journal Article DEP - 20230502 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Femoral Artery/surgery EDAT- 2023/05/02 12:43 MHDA- 2023/06/09 06:41 CRDT- 2023/05/02 11:43 PHST- 2023/06/09 06:41 [medline] PHST- 2023/05/02 12:43 [pubmed] PHST- 2023/05/02 11:43 [entrez] AID - 01244665-202307000-00015 [pii] AID - 10.2459/JCM.0000000000001474 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2023 Jul 1;24(7):475-477. doi: 10.2459/JCM.0000000000001474. Epub 2023 May 2. PMID- 37122629 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240917 IS - 2352-9067 (Print) IS - 2352-9067 (Electronic) IS - 2352-9067 (Linking) VI - 46 DP - 2023 Jun TI - Impact of transradial versus transfemoral access for preprocedural coronary angiography on TAVR-associated complications. PG - 101205 LID - 10.1016/j.ijcha.2023.101205 [doi] LID - 101205 AB - BACKGROUND: Vascular injury and bleeding complications remain frequent after transcatheter aortic valve replacement (TAVR). Whether the access-site of preprocedural coronary angiography (CAG) affects TAVR-related complications is not known. The aim of this study was to evaluate the impact of transradial (TRA) versus transfemoral access (TFA) for preprocedural CAG on outcomes in patients undergoing subsequent TAVR. METHODS: The study cohort included 1002 patients undergoing transfemoral TAVR, of whom 39.4% (395/1002) had undergone radial and 60.6% (607/1002) femoral access for pre-TAVR CAG. The primary endpoint was a composite of 30-day mortality and major vascular complications after TAVR. Key secondary endpoints included VARC-3-defined complications. RESULTS: The primary endpoint occurred less frequently in patients with prior TRA (3.3%) as compared to patients with prior TFA (6.3%, p = 0.04), which was mainly driven by significantly lower rates of major vascular complications (0.8% vs 2.5%, p = 0.05). Moreover, incidences of periprocedural access-related vascular injury and unplanned endovascular interventions were lower in TRA patients (13.2% vs 18.0%, p = 0.05). The rate of major bleeding tended to be lower in the TRA (1.5%) as compared to the TFA group (3.5%) but was not significantly different (p = 0.07). Moreover, the rate of life-threatening bleeding was comparable between both groups (0.5% vs 0.8%, p = 0.71). CONCLUSION: Transradial access for preprocedural CAG was associated with significantly lower rates of vascular complications following subsequent TAVR as compared to transfemoral access. However, despite the tendency to lower major bleedings with transradial access, no significant association was detectable between the access-site of coronary angiography and TAVR-related bleeding complications. CI - (c) 2023 The Authors. FAU - Al-Kassou, Baravan AU - Al-Kassou B AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Al-Shaikh, Hasanin AU - Al-Shaikh H AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Aksoy, Adem AU - Aksoy A AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Shamekhi, Jasmin AU - Shamekhi J AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Zietzer, Andreas AU - Zietzer A AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Sugiura, Atsushi AU - Sugiura A AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Veulemans, Verena AU - Veulemans V AD - Division of Cardiology, University Hospital of Duesseldorf, Germany. AD - CARID, Cardiovascular Research Institute Duesseldorf, Germany. FAU - Adam, Matti AU - Adam M AD - Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany. FAU - Grube, Eberhard AU - Grube E AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Bakhtiary, Farhad AU - Bakhtiary F AD - Heart Center, Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany. FAU - Zimmer, Sebastian AU - Zimmer S AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Kelm, Malte AU - Kelm M AD - CARID, Cardiovascular Research Institute Duesseldorf, Germany. AD - Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. FAU - Sedaghat, Alexander AU - Sedaghat A AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. AD - RheinAhrCardio, Praxis fur Kardiologie, Bad Neuenahr-Ahrweiler, Germany. LA - eng PT - Journal Article DEP - 20230413 PL - Ireland TA - Int J Cardiol Heart Vasc JT - International journal of cardiology. Heart & vasculature JID - 101649525 PMC - PMC10130599 OTO - NOTNLM OT - Coronary angiography OT - TAVR OT - Vascular access way OT - Vascular complication COIS- The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Georg Nickenig reports financial support was provided by German Research Foundation. Drs. Grube, Zimmer, Adam, and Nickenig have received speaker honoraria and research grants from Abbott, Abiomed, Medtronic, Boston Scientific, and Edwards Lifesciences. Dr. Veulemans has received speaker and/or study honoraria from Edwards Lifesciences, Medtronic, and Boston Scientific. Dr. Kelm has received institutional grant support and/or personal fees from Philips, Abbott, Medtronik, Boston Scientific, Mars, Boehringer Ingelheim, Daiichi-Sanyko GmbH, Amgen, Ancora Heart, and B. Braun. Dr. Grube is a proctor for Boston Scientific and Medtronic. The other authors report no conflicts of interest. EDAT- 2023/05/01 06:42 MHDA- 2023/05/01 06:43 PMCR- 2023/04/13 CRDT- 2023/05/01 03:20 PHST- 2023/01/21 00:00 [received] PHST- 2023/03/28 00:00 [revised] PHST- 2023/04/04 00:00 [accepted] PHST- 2023/05/01 06:43 [medline] PHST- 2023/05/01 06:42 [pubmed] PHST- 2023/05/01 03:20 [entrez] PHST- 2023/04/13 00:00 [pmc-release] AID - S2352-9067(23)00036-2 [pii] AID - 101205 [pii] AID - 10.1016/j.ijcha.2023.101205 [doi] PST - epublish SO - Int J Cardiol Heart Vasc. 2023 Apr 13;46:101205. doi: 10.1016/j.ijcha.2023.101205. eCollection 2023 Jun. PMID- 37116649 OWN - NLM STAT- MEDLINE DCOM- 20230821 LR - 20250418 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 82 IP - 4 DP - 2023 Oct TI - Vascular access for transcatheter aortic valve replacement: A network meta-analysis. PG - 227-233 LID - S0914-5087(23)00098-9 [pii] LID - 10.1016/j.jjcc.2023.04.015 [doi] AB - BACKGROUND: The choice of an alternative access for transcatheter aortic valve replacement (TAVR) remains controversial when transfemoral (TF) access is not feasible. METHODS: We conducted a network meta-analysis to compare the outcomes of TAVR via various peripheral vascular accesses. MEDLINE and EMBASE were searched through July 2022 to identify studies that investigated outcomes in patients who underwent TAVR via TF, trans-subclavian (Tsc), transcarotid (TC), or transcaval (Tcav) access. A network meta-analysis was conducted via random-effects model. Outcomes of interest were major or life-threatening bleeding, stroke, major vascular complication, and 30-day mortality. RESULTS: No randomized trial was identified. Our analysis included 33 observational studies that enrolled a total of 43,455 patients who underwent TAVR via TF (n = 36,202), Tsc (n = 3869), TC (n = 3066), or Tcav (n = 318) access. The risk of major or life-threatening bleeding was higher via Tsc compared with TF [odds ratio (OR); 95 % confidence interval (CI) =1.51 (1.03-2.23), p = 0.034]. The risk of stroke was higher via Tsc compared with TF and Tcav [OR (95 % CI) =2.00 (1.14-3.52), p = 0.018, OR (95 % CI) =2.43 (1.03-5.74), p = 0.044, respectively]. The risk of major vascular complications was lower via TC compared with Tsc, and Tcav and higher with Tcav compared with TF and Tsc. 30-day mortality was higher via Tsc compared with TF. Tsc was associated with higher risk of major or life-threatening bleeding compared with TF, and higher risk of stroke compared to TF and Tcav. Tcav had the highest risk of major vascular complications. CONCLUSION: In patients who underwent TF, Tsc, TC, or Tcav TAVR, Tsc had a higher rate of stroke compared to TF and Tcav, and major or life-threatening bleeding compared to TF. The rate of major vascular complications in Tcav was the highest among the four approaches. CI - Copyright (c) 2023 Elsevier Ltd. All rights reserved. FAU - Yokoyama, Yujiro AU - Yokoyama Y AD - Department of Surgery, St. Luke's University Health Network, Bethlehem, PA, USA. FAU - Sakata, Tomoki AU - Sakata T AD - Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. FAU - Mikami, Takahisa AU - Mikami T AD - Department of Neurology, Tufts Medical Center, Medford and Somerville, MA, USA. FAU - Misumida, Naoki AU - Misumida N AD - Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, USA. FAU - Scotti, Andrea AU - Scotti A AD - Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Takagi, Hisato AU - Takagi H AD - Department of Cardiovascular Surgery, Shizuoka Medical Center, Shimizu, Shizuoka, Japan. FAU - Sugiura, Tadahisa AU - Sugiura T AD - Department of Cardiothoracic & Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Kuno, Toshiki AU - Kuno T AD - Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address: tkuno@montefiore.org. FAU - Latib, Azeem AU - Latib A AD - Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. LA - eng PT - Journal Article PT - Network Meta-Analysis DEP - 20230426 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis MH - Risk Factors MH - Treatment Outcome MH - Femoral Artery/surgery MH - *Stroke/epidemiology/etiology MH - Aortic Valve/surgery MH - Risk Assessment MH - Observational Studies as Topic OTO - NOTNLM OT - Trans-subclavian OT - Transcarotid OT - Transcatheter aortic valve replacement OT - Transcaval OT - Transfemoral COIS- Declaration of competing interest Dr. Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, and Abbott. EDAT- 2023/04/29 06:04 MHDA- 2023/08/21 06:42 CRDT- 2023/04/28 19:26 PHST- 2023/01/09 00:00 [received] PHST- 2023/03/13 00:00 [revised] PHST- 2023/04/06 00:00 [accepted] PHST- 2023/08/21 06:42 [medline] PHST- 2023/04/29 06:04 [pubmed] PHST- 2023/04/28 19:26 [entrez] AID - S0914-5087(23)00098-9 [pii] AID - 10.1016/j.jjcc.2023.04.015 [doi] PST - ppublish SO - J Cardiol. 2023 Oct;82(4):227-233. doi: 10.1016/j.jjcc.2023.04.015. Epub 2023 Apr 26. PMID- 37115228 OWN - NLM STAT- MEDLINE DCOM- 20240125 LR - 20241023 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 113 IP - 1 DP - 2024 Jan TI - Multicenter comparison of transcatheter aortic valve implantation with the self-expanding ACURATE neo2 versus Evolut PRO transcatheter heart valves. PG - 38-47 LID - 10.1007/s00392-023-02194-4 [doi] AB - BACKGROUND: New-generation self-expanding transcatheter aortic heart valves (THV) were designed to overcome technical constraints of their preceding generations. We sought to compare the efficacy and safety of the self-expanding ACURATE neo2 (Neo2) versus Evolut PRO (PRO) devices. METHODS: Seven hundred nine patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) with either Neo2 (n = 496) or PRO (n = 213) were included. Propensity score matching (PSM) was performed to account for differences in baseline characteristics. In-hospital and 30-day clinical outcomes were evaluated according to Valve Academic Research Consortium-3 criteria. RESULTS: Baseline characteristics were comparable between both groups after PSM (Neo2: n = 155, Evolut Pro: n = 155). Technical success rates were high in both groups (Neo2: 94.8% vs PRO: 97.4%; p = 0.239). Need for permanent pacemaker implantation was less frequent with Neo2 compared with PRO (7.5% vs 20.6%; p = 0.002), whereas major vascular complications were more frequent with Neo2 (Neo2: 11.6% vs PRO: 4.5%; p = 0.022). Intended valve performance at discharge was high in both groups without relevant differences among groups (Neo2: 97.4% vs. 95.3%; p = 0.328). CONCLUSIONS: Short-term outcomes after TAVI using latest-generation self-expanding THV were excellent, with overall low rates of adverse events. However, Neo2 was associated with lower pacemaker rates and reduced the prevalence of moderate-severe paravalvular leakage. Transprosthetic gradients after TAVI were higher with Neo2 compared with PRO. CI - (c) 2023. The Author(s). FAU - Rheude, Tobias AU - Rheude T AUID- ORCID: 0000-0002-3426-6080 AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstr. 36, 80636, Munich, Germany. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstr. 36, 80636, Munich, Germany. FAU - Landt, Martin AU - Landt M AD - Heart Center, Segeberger Kliniken, Bad Segeberg, Germany. FAU - Bleiziffer, Sabine AU - Bleiziffer S AD - Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Wolf, Alexander AU - Wolf A AD - Department of Cardiology, Elisabeth Hospital Essen, Essen, Germany. FAU - Renker, Matthias AU - Renker M AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Neuser, Jonas AU - Neuser J AD - Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. FAU - Dorr, Oliver AU - Dorr O AD - Medical Clinic I, Department of Cardiology and Angiology, University of Giessen, Giessen, Germany. FAU - Allali, Abdelhakim AU - Allali A AD - Heart Center, Segeberger Kliniken, Bad Segeberg, Germany. FAU - Rudolph, Tanja K AU - Rudolph TK AD - Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. FAU - Wambach, Jan Martin AU - Wambach JM AD - Department of Cardiology, Elisabeth Hospital Essen, Essen, Germany. FAU - Widder, Julian D AU - Widder JD AD - Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. FAU - Singh, Parminder AU - Singh P AD - Medical Clinic I, Department of Cardiology and Angiology, University of Giessen, Giessen, Germany. FAU - Berliner, Dominik AU - Berliner D AD - Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. FAU - Alvarez-Covarrubias, Hector A AU - Alvarez-Covarrubias HA AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstr. 36, 80636, Munich, Germany. AD - Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Cd. de Mexico, Mexico. FAU - Richardt, Gert AU - Richardt G AD - Heart Center, Segeberger Kliniken, Bad Segeberg, Germany. FAU - Xhepa, Erion AU - Xhepa E AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstr. 36, 80636, Munich, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Joner, Michael AU - Joner M AD - Klinik fur Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstr. 36, 80636, Munich, Germany. joner@dhm.mhn.de. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. joner@dhm.mhn.de. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230428 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Prosthesis Design MH - *Heart Valve Prosthesis MH - Treatment Outcome PMC - PMC10808401 OTO - NOTNLM OT - ACURATE Neo2 OT - Evolut PRO OT - Self-expanding OT - Transcatheter aortic valve implantation OT - Transcatheter heart valves COIS- TR received lecture fees from SIS Medical and AstraZeneca. AA is a proctor and consultant for Boston Scientific. TKR: Speaker' honoraria from Medtronic and Boston Scientific. WK received personal fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Meril Life Sciences, Shockwave Med. MJ received lecture fees and research grants from Edwards Lifesciences and Boston Scientific and is a consultant for Biotronik and Orbus Neich. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/04/28 12:42 MHDA- 2024/01/25 06:43 PMCR- 2023/04/28 CRDT- 2023/04/28 11:05 PHST- 2022/10/20 00:00 [received] PHST- 2023/03/27 00:00 [accepted] PHST- 2024/01/25 06:43 [medline] PHST- 2023/04/28 12:42 [pubmed] PHST- 2023/04/28 11:05 [entrez] PHST- 2023/04/28 00:00 [pmc-release] AID - 10.1007/s00392-023-02194-4 [pii] AID - 2194 [pii] AID - 10.1007/s00392-023-02194-4 [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Jan;113(1):38-47. doi: 10.1007/s00392-023-02194-4. Epub 2023 Apr 28. PMID- 37076413 OWN - NLM STAT- MEDLINE DCOM- 20231106 LR - 20231107 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 55 DP - 2023 Oct TI - Safety and performance parameters of the Myval transcatheter aortic valve bioprosthesis: The SAPPHIRE prospective registry. PG - 22-27 LID - S1553-8389(23)00155-0 [pii] LID - 10.1016/j.carrev.2023.04.014 [doi] AB - BACKGROUND: TAVR is an established treatment for patients with severe symptomatic aortic stenosis. Different THV platforms are nowadays available, each of them with its inherent limitations and others are under development aiming at overcoming such limitations. We thus sought to investigate the performance and 1-year clinical outcome of a new generation, balloon expandable, THV: the Myval (Meril Life Sciences Pvt. Ltd., Vapi, Gujarat, India). METHODS: This registry included the first 100 consecutive patients (mean age 80.7 +/- 7.7; STS 4.3 +/- 3.3 %), who underwent transcatheter aortic valve implantation for severe stenosis of the native aortic valve from May 2020 to December 2020, in two Italian Centers. Clinical and procedural outcomes were defined according to VARC-3 criteria. RESULTS: Transfemoral Myval THV was successfully implanted in all patients, with no intra-hospital mortality (technical success 100 %): vascular access complications were all "minor" (16 %), and managed by compression/balloon inflation; no cases of annular rupture or coronary obstruction occurred; 5 % of patients required an in-hospital pacemaker implantation (PM). Device success was 99 %. Overall and cardiovascular mortality were 6 % (CI 5 %-7 %) and 4 % (CI 2 %-5 %) at 1- year, while 12 % (CI 9 %-14 %) and 7 % (6-9 %) at 2 years. A total of 9 % of the patients required a PM within 12 months, and no further PM implantation occurred afterwards. No cerebrovascular events, renal failure and myocardial infarction occurred between discharge and 2-year follow-up. No events of structural valve deterioration but a sustained improvement of echocardiographic parameters were observed. CONCLUSION: The Myval THV has a promising safety/efficacy profile at 2 year follow up. This performance should be further evaluated in the context of randomized trials to better elucidate its potential. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Testa, Luca AU - Testa L AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. Electronic address: luctes@gmail.com. FAU - Criscione, Enrico AU - Criscione E AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. FAU - Popolo Rubbio, Antonio AU - Popolo Rubbio A AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. FAU - Squillace, Mattia AU - Squillace M AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - Cardiology Division, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy. FAU - Tespili, Maurizio AU - Tespili M AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. FAU - Brambilla, Nedy AU - Brambilla N AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan, Italy. LA - eng PT - Journal Article DEP - 20230417 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/etiology MH - *Bioprosthesis MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis MH - Registries MH - Prosthesis Design COIS- Declaration of competing interest None inherent to the present manuscript. EDAT- 2023/04/20 00:41 MHDA- 2023/11/06 06:41 CRDT- 2023/04/19 22:02 PHST- 2023/03/02 00:00 [received] PHST- 2023/03/31 00:00 [revised] PHST- 2023/04/12 00:00 [accepted] PHST- 2023/11/06 06:41 [medline] PHST- 2023/04/20 00:41 [pubmed] PHST- 2023/04/19 22:02 [entrez] AID - S1553-8389(23)00155-0 [pii] AID - 10.1016/j.carrev.2023.04.014 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2023 Oct;55:22-27. doi: 10.1016/j.carrev.2023.04.014. Epub 2023 Apr 17. PMID- 37060038 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230417 IS - 2047-0525 (Print) IS - 2047-0525 (Electronic) IS - 2047-0525 (Linking) VI - 12 IP - 1 DP - 2023 Apr 14 TI - High-flow nasal oxygen vs. standard oxygen therapy for patients undergoing transcatheter aortic valve replacement with conscious sedation: a randomised controlled trial. PG - 11 LID - 10.1186/s13741-023-00300-8 [doi] LID - 11 AB - BACKGROUND: Minimally invasive surgery is becoming more common and transfemoral transcatheter aortic valve replacement is offered to older patients with multiple comorbidities. Sternotomy is not required but patients must lie flat and still for up to 2-3 h. This procedure is increasingly being performed under conscious sedation with supplementary oxygen, but hypoxia and agitation are commonly observed. METHODS: In this randomised controlled trial, we hypothesised that high-flow nasal oxygen would provide superior oxygenation as compared with our standard practice, 2 l min(-1) oxygen by dry nasal specs. This was administered using the Optiflow THRIVE Nasal High Flow delivery system (Fisher and Paykel, Auckland, New Zealand) at a flow rate of 50 l min(-1) and FiO(2) 0.3. The primary endpoint was the change in arterial partial pressure of oxygen (pO(2)) during the procedure. Secondary outcomes included the incidence of oxygen desaturation, airway interventions, the number of times the patient reached for the oxygen delivery device, incidence of cerebral desaturation, peri-operative oxygen therapy duration, hospital length of stay and patient satisfaction scores. RESULTS: A total of 72 patients were recruited. There was no difference in change in pO(2) from baseline using high-flow compared with standard oxygen therapy: median [IQR] increase from 12.10 (10.05-15.22 [7.2-29.8]) to 13.69 (10.85-18.38 [8.5-32.3]) kPa vs. decrease from 15.45 (12.17-19.33 [9.2-22.8]) to 14.20 (11.80-19.40 [9.7-35.1]) kPa, respectively. The percentage change in pO2 after 30 min was also not significantly different between the two groups (p = 0.171). There was a lower incidence of oxygen desaturation in the high-flow group (p = 0.027). Patients in the high-flow group assigned a significantly higher comfort score to their treatment (p /=40 kg/m(2) (i.e., morbid obesity). Delivery sheath size was 14-French in 859 (73%) patients, 16-French in 311 (26%), and 18-French in 6 (1%). Vascular complication occurred in 53 (5%) patients, including 39 (7%) among the first half of procedures and 14 (2%) among the second half (p < 0.001). When stratified by obesity status (BMI < or >/=30 kg/m(2) , p < 0.001), the complication rate was 4% in nonobese patients and 5% in obese patients. Multivariable analysis showed no overall association between risk of vascular complication and BMI categories (p = 0.583)BMI continuous values (p = 0.529), or sheath size (p = 0.217). CONCLUSIONS: Obesity is not associated with a vascular complication during percutaneous transfemoral transcatheter aortic valve insertion. The operation should not be denied in obese patients. CI - (c) 2023 Wiley Periodicals LLC. FAU - Hosseini, Motahar AU - Hosseini M AUID- ORCID: 0000-0001-9729-3134 AD - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA. FAU - Lahr, Brian D AU - Lahr BD AD - Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA. FAU - Greason, Kevin L AU - Greason KL AD - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA. FAU - Arghami, Arman AU - Arghami A AD - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA. FAU - Gulati, Rajiv AU - Gulati R AD - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA. FAU - Eleid, Mackram F AU - Eleid MF AUID- ORCID: 0000-0001-6082-5379 AD - Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA. FAU - Crestanello, Juan A AU - Crestanello JA AD - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA. LA - eng PT - Journal Article DEP - 20230410 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Male MH - Humans MH - Aged, 80 and over MH - Female MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/etiology MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Obesity/complications/epidemiology MH - Femoral Artery/diagnostic imaging/surgery OTO - NOTNLM OT - TAVI OT - obesity OT - vascular complication EDAT- 2023/04/11 06:00 MHDA- 2023/06/12 06:42 CRDT- 2023/04/10 09:23 PHST- 2023/02/01 00:00 [revised] PHST- 2022/08/23 00:00 [received] PHST- 2023/03/19 00:00 [accepted] PHST- 2023/06/12 06:42 [medline] PHST- 2023/04/11 06:00 [pubmed] PHST- 2023/04/10 09:23 [entrez] AID - 10.1002/ccd.30658 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Jun;101(7):1221-1228. doi: 10.1002/ccd.30658. Epub 2023 Apr 10. PMID- 37036268 OWN - NLM STAT- MEDLINE DCOM- 20230511 LR - 20260127 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 101 IP - 6 DP - 2023 May TI - Impact of coronary artery disease on clinical outcomes after TAVR: Insights from the BRAVO-3 randomized trial. PG - 1134-1143 LID - 10.1002/ccd.30647 [doi] AB - OBJECTIVE: To determine the prognostic impact of coronary artery disease (CAD) in patients randomized to bivalirudin or unfractionated heparin (UFH) during transcatheter aortic valve replacement (TAVR). BACKGROUND: CAD is a common comorbidity among patients undergoing TAVR and studies provide conflicting data on its prognostic impact. METHODS: The Bivalirudin on Aortic Valve Intervention Outcomes-3 (BRAVO-3) randomized trial compared the use of bivalirudin versus UFH in 802 high-surgical risk patients undergoing transfemoral TAVR for severe symptomatic aortic stenosis. Patients were stratified according to the presence or absence of history of CAD as well as periprocedural anticoagulation. The coprimary endpoints were net adverse cardiac events (NACE; a composite of all-cause mortality, myocardial infarction, stroke, or major bleeding) and major Bleeding Academic Research Consortium (BARC) bleeding >/=3b at 30 days postprocedure. RESULTS: Among 801 patients, 437 (54.6%) had history of CAD of whom 223 (51.0%) received bivalirudin. There were no significant differences in NACE (adjusted odds ratio [OR]: 1.04; 95% confidence interval [CI]: 0.69-1.58) or BARC >/= 3b bleeding (adjusted OR: 0.84; 95% CI: 0.51-1.39) in patients with vs without CAD at 30 days. Among CAD patients, periprocedural use of bivalirudin was associated with similar NACE (OR: 0.80; 95% CI: 0.47-1.35) and BARC >/= 3b bleeding (OR: 0.64; 95% CI: 0.33-1.25) compared with UFH, irrespective of history of CAD (p-interaction = 0.959 for NACE; p-interaction = 0.479 for major bleeding). CONCLUSION: CAD was not associated with a higher short-term risk of NACE or major bleeding after TAVR. Periprocedural anticoagulation with bivalirudin did not show any advantage over UFH in patients with and without CAD. CI - (c) 2023 Wiley Periodicals LLC. FAU - Feldman, Daniel AU - Feldman D AUID- ORCID: 0000-0002-9249-3468 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. AD - Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Cao, Davide AU - Cao D AUID- ORCID: 0000-0001-7755-4069 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Sartori, Samantha AU - Sartori S AUID- ORCID: 0000-0003-0618-9409 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Zhang, Zhongjie AU - Zhang Z AUID- ORCID: 0000-0002-9615-0518 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Hengstenberg, Christian AU - Hengstenberg C AD - Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria. FAU - Tron, Christophe AU - Tron C AD - Division of Cardiology, Rouen University Hospital, Rouen, France. FAU - Anthopoulos, Prodromos AU - Anthopoulos P AD - European Medical, Arena Pharmaceuticals Inc, Zurich, Switzerland. FAU - Widder, Julian D AU - Widder JD AD - Department of Medicine, Cardiology and Angiology, Municipial Hospital Karlsruhe, Karlsruhe, Germany. FAU - Meneveau, Nicolas AU - Meneveau N AD - Department of Cardiology, University Hospital Jean Minjoz, Besancon, France. FAU - Stella, Pieter R AU - Stella PR AD - Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Ferrari, Markus AU - Ferrari M AD - Division of Interventional Cardiology, Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany. FAU - Jeger, Raban AU - Jeger R AD - Department of Cardiology, Triemli Hospital, Zurich, Switzerland. AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. FAU - Violini, Roberto AU - Violini R AD - Department of Interventional Cardiology, Azienda Ospedaliera S.Camillo Forlanini, Rome, Italy. FAU - Dumonteil, Nicolas AU - Dumonteil N AD - Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France. FAU - Chen, Shiwei AU - Chen S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Yan, Ruiqi AU - Yan R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Nicolas, Johny AU - Nicolas J AUID- ORCID: 0000-0002-3015-3361 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Razuk, Victor AU - Razuk V AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. AD - Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Spirito, Alessandro AU - Spirito A AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Vogel, Birgit AU - Vogel B AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Dangas, George AU - Dangas G AUID- ORCID: 0000-0001-7502-8049 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20230410 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 9005-49-6 (Heparin) RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - J718M71A7A (tetrachloroisophthalonitrile) RN - 0 (Nitriles) SB - IM MH - Humans MH - Heparin/adverse effects MH - *Coronary Artery Disease/complications/diagnostic imaging/therapy MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Antithrombins/adverse effects MH - Treatment Outcome MH - Hirudins/adverse effects MH - Hemorrhage/chemically induced MH - Peptide Fragments/adverse effects MH - Recombinant Proteins/adverse effects MH - Nitriles OTO - NOTNLM OT - TAVR OT - aortic stenosis OT - coronary artery disease OT - outcomes EDAT- 2023/04/11 06:00 MHDA- 2023/05/11 06:42 CRDT- 2023/04/10 09:22 PHST- 2023/02/15 00:00 [revised] PHST- 2022/11/18 00:00 [received] PHST- 2023/03/08 00:00 [accepted] PHST- 2023/05/11 06:42 [medline] PHST- 2023/04/11 06:00 [pubmed] PHST- 2023/04/10 09:22 [entrez] AID - 10.1002/ccd.30647 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 May;101(6):1134-1143. doi: 10.1002/ccd.30647. Epub 2023 Apr 10. PMID- 37029997 OWN - NLM STAT- MEDLINE DCOM- 20230411 LR - 20250722 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 35 IP - 4 DP - 2023 Apr TI - Long-Sheath Assisted Transcatheter Aortic Valve Replacement: The Best and Worst Cases. PG - E221-E222 AB - Transfemoral transcatheter aortic valve replacement (TAVR) is quite challenging in patients with tortuous aorta. Recently, the combined method of buddy wire and long-sheath use was reported. We describe 2 cases having tortuous aorta undergoing transfemoral TAVR following opposite clinical courses. A long-sheath supported transfemoral approach is an effective method in patients with tortuous aorta; however, the tip of a large-bore sheath could cause an aortic injury during the procedure. The advantage of the transfemoral approach and risk of aortic injury should be counterbalanced, especially in patients with fragile tortuous aorta. FAU - Higuchi, Ryosuke AU - Higuchi R AD - Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan. rhiguchi@shi.heart.or.jp. FAU - Nishida, Kota AU - Nishida K FAU - Saji, Mike AU - Saji M FAU - Ohno, Makoto AU - Ohno M FAU - Takamisawa, Itaru AU - Takamisawa I LA - eng PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnosis/surgery MH - *Heart Valve Prosthesis MH - Femoral Artery/diagnostic imaging/surgery MH - *Vascular System Injuries/surgery MH - Treatment Outcome MH - Risk Factors OTO - NOTNLM OT - aortic dissection OT - long sheath OT - tortuous aorta OT - transcatheter aortic valve replacement OT - vascular complication EDAT- 2023/04/09 06:00 MHDA- 2023/04/11 06:42 CRDT- 2023/04/08 14:42 PHST- 2023/04/11 06:42 [medline] PHST- 2023/04/08 14:42 [entrez] PHST- 2023/04/09 06:00 [pubmed] AID - 10.25270/jic/22.00263 [doi] PST - ppublish SO - J Invasive Cardiol. 2023 Apr;35(4):E221-E222. doi: 10.25270/jic/22.00263. PMID- 37027228 OWN - NLM STAT- MEDLINE DCOM- 20230614 LR - 20230804 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 63 IP - 6 DP - 2023 Jun 1 TI - Incidence and outcomes of emergency intraprocedural surgical conversion during transcatheter aortic valve implantation: Insights from a large tertiary care centre. LID - ezad142 [pii] LID - 10.1093/ejcts/ezad142 [doi] AB - OBJECTIVE: During a transcatheter aortic valve implant (TAVI) procedure, intraprocedural complications that are manageable only by conversion to emergency open-heart surgery (E-OHS) occasionally occur. Contemporary data on the incidence and outcome of TAVI patients undergoing E-OHS are scarce. This study aimed to evaluate early and midterm outcomes following E-OHS of patients undergoing TAVI in a large tertiary care centre with immediate surgical backup availability for all TAVI procedures over a 15-year period. METHODS: Data from all patients undergoing transfemoral TAVI between 2006 and 2020 at the Heart Centre Leipzig were analysed. The study time was divided into 3 periods: 2006-2010 (P1), 2011-2015 (P2) and 2016-2020 (P3). Patients were grouped according to their surgical risk (high risk: EuroSCORE II >/= 6%; low/intermediate risk: EuroSCORE II <6%). Primary outcomes were intraprocedural and in-hospital death and 1-year survival. RESULTS: During the study period, a total of 6903 patients underwent transfemoral TAVI. Among them, 74 (1.1%) required E-OHS [high risk, n = 66 (89.2%); low/intermediate risk, n = 8 (10.8%)]. The rate of patients requiring E-OHS was 3.5% (20/577 patients), 1.8% (35/1967 patients) and 0.4% (19/4359 patients) in study periods P1 to P3, respectively (P < 0.001). The proportion of patients who had E-OHS who were low/intermediate risk increased considerably over time (P1:0%; P28.6%; P3:26.3%; P = 0.077). Intraprocedural deaths occurred in 10 patients (13.5%), all of whom were high-risk. In-hospital mortality was 62.1% in high-risk patients and 12.5% in low/intermediate risk patients (P = 0.007). One-year survival was 37.8% in all patients undergoing E-OHS, 31.8% in high-risk patients and 87.5% in low/intermediate risk patients (log-rank P = 0.002). CONCLUSIONS: In-hospital and 1-year survival rates following E-OHS are higher in low/intermediate risk than in high-risk patients undergoing TAVI. An on-site cardiac surgical department with immediately available E-OHS capabilities is an important component of the TAVI team. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Marin-Cuartas, Mateo AU - Marin-Cuartas M AUID- ORCID: 0000-0003-1000-4710 AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - de Waha, Suzanne AU - de Waha S AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Naumann, Stefanie AU - Naumann S AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Deo, Salil V AU - Deo SV AD - Louis Stokes Cleveland VA Medical Centre, Department of Veterans Affairs, Cleveland, Ohio, USA. FAU - Kang, Jagdip AU - Kang J AUID- ORCID: 0000-0002-5555-9616 AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Noack, Thilo AU - Noack T AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Hoyer, Alexandro AU - Hoyer A AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Holzhey, David AU - Holzhey D AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Leontyev, Sergey AU - Leontyev S AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Saeed, Diyar AU - Saeed D AUID- ORCID: 0000-0001-7449-9455 AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Misfeld, Martin AU - Misfeld M AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Meineri, Massimiliano AU - Meineri M AD - Heart Centre Leipzig at University of Leipzig, Department of Anesthesiology, Leipzig, Germany. FAU - Ender, Joerg AU - Ender J AD - Heart Centre Leipzig at University of Leipzig, Department of Anesthesiology, Leipzig, Germany. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiology, Leipzig, Germany. FAU - Desch, Steffen AU - Desch S AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiology, Leipzig, Germany. FAU - Thiele, Holger AU - Thiele H AUID- ORCID: 0000-0002-0169-998X AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiology, Leipzig, Germany. FAU - Borger, Michael A AU - Borger MA AUID- ORCID: 0000-0003-1046-1364 AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. FAU - Kiefer, Philipp AU - Kiefer P AD - Heart Centre Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. LA - eng PT - Journal Article PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM CIN - Eur J Cardiothorac Surg. 2023 Jun 1;63(6):ezad216. doi: 10.1093/ejcts/ezad216. PMID: 37255326 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Tertiary Care Centers MH - Incidence MH - Hospital Mortality MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/surgery MH - Treatment Outcome MH - Risk Factors MH - *Heart Valve Prosthesis Implantation/methods OTO - NOTNLM OT - Aortic Valve Replacement OT - Emergency OT - Open Heart Surgery OT - Transcatheter aortic valve implantation EDAT- 2023/04/08 06:00 MHDA- 2023/06/14 06:42 CRDT- 2023/04/07 12:13 PHST- 2022/11/10 00:00 [received] PHST- 2023/03/21 00:00 [revised] PHST- 2023/04/05 00:00 [accepted] PHST- 2023/06/14 06:42 [medline] PHST- 2023/04/08 06:00 [pubmed] PHST- 2023/04/07 12:13 [entrez] AID - 7110896 [pii] AID - 10.1093/ejcts/ezad142 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2023 Jun 1;63(6):ezad142. doi: 10.1093/ejcts/ezad142. PMID- 37011554 OWN - NLM STAT- MEDLINE DCOM- 20230425 LR - 20250418 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 195 DP - 2023 May 15 TI - Network Meta-Analysis Comparing Transcatheter, Minimally Invasive, and Conventional Surgical Aortic Valve Replacement. PG - 45-56 LID - S0002-9149(23)00098-X [pii] LID - 10.1016/j.amjcard.2023.02.017 [doi] AB - The landscape of aortic valve replacement (AVR) has evolved dramatically over the years, but time-varying outcomes have yet to be comprehensively explored. This study aimed to compare the all-cause mortality among 3 AVR techniques: transcatheter (TAVI), minimally invasive (MIAVR), and conventional AVR (CAVR). An electronic literature search was performed for randomized controlled trials (RCTs) comparing TAVI with CAVR and RCTs or propensity score-matched (PSM) studies comparing MIAVR with CAVR or MIAVR to TAVI. Individual patient data for all-cause mortality were derived from graphical reconstruction of Kaplan-Meier curves. Pairwise comparisons and network meta-analysis were conducted. Sensitivity analyses were performed in the TAVI arm for high risk and low/intermediate risk, as well as patients who underwent transfemoral (TF) TAVI. A total of 27 studies with 16,554 patients were included. In the pairwise comparisons, TAVI showed superior mortality to CAVR until 37.5 months, beyond which there was no significant difference. When restricted to TF TAVI versus CAVR, a consistent mortality benefit favoring TF TAVI was seen (shared frailty hazard ratio [HR] = 0.86, 95% confidence interval [CI] = 0.76 to 0.98, p = 0.024). In the network meta-analysis involving majority PSM data, MIAVR demonstrated significantly lower mortality than TAVI (HR = 0.70, 95% CI = 0.59 to 0.82) and CAVR (HR = 0.69, 95% CI = 0.59 to 0.80); this association remained compared with TF TAVI but with a lower extent of benefit (HR = 0.80, 95% CI = 0.65 to 0.99). In conclusion, the initial short- to medium-term mortality benefit for TAVI over CAVR was attenuated over the longer term. In the subset of patients who underwent TF TAVI, a consistent benefit was found. Among majority PSM data, MIAVR showed improved mortality compared with TAVI and CAVR but less than the TF TAVI subset, which requires validation by robust RCTs. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Fong, Khi Yung AU - Fong KY AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. FAU - Yap, Jonathan J L AU - Yap JJL AD - Department of Cardiology. FAU - Chan, Yiong Huak AU - Chan YH AD - Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. FAU - Ewe, See Hooi AU - Ewe SH AD - Department of Cardiology. FAU - Chao, Victor T T AU - Chao VTT AD - Department of Cardiothoracic Surgery, National Heart Center Singapore, Singapore. FAU - Amanullah, Mohammed Rizwan AU - Amanullah MR AD - Department of Cardiology. FAU - Govindasamy, Sivaraj Pillai AU - Govindasamy SP AD - Department of Cardiothoracic Surgery, National Heart Center Singapore, Singapore. FAU - Aziz, Zameer Abdul AU - Aziz ZA AD - Department of Cardiothoracic Surgery, National Heart Center Singapore, Singapore. FAU - Tan, Vern Hsen AU - Tan VH AD - Department of Cardiology, Changi General Hospital, Singapore. FAU - Ho, Kay Woon AU - Ho KW AD - Department of Cardiology. Electronic address: ho.kay.woon@singhealth.com.sg. LA - eng PT - Journal Article PT - Network Meta-Analysis DEP - 20230401 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - Aortic Valve/surgery MH - *Heart Valve Prosthesis Implantation MH - *Heart Valve Prosthesis MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome COIS- Disclosures The authors have no conflicts of interest to declare. EDAT- 2023/04/04 06:00 MHDA- 2023/04/25 10:20 CRDT- 2023/04/03 18:06 PHST- 2022/12/13 00:00 [received] PHST- 2023/02/11 00:00 [revised] PHST- 2023/02/14 00:00 [accepted] PHST- 2023/04/25 10:20 [medline] PHST- 2023/04/04 06:00 [pubmed] PHST- 2023/04/03 18:06 [entrez] AID - S0002-9149(23)00098-X [pii] AID - 10.1016/j.amjcard.2023.02.017 [doi] PST - ppublish SO - Am J Cardiol. 2023 May 15;195:45-56. doi: 10.1016/j.amjcard.2023.02.017. Epub 2023 Apr 1. PMID- 36983397 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240915 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 6 DP - 2023 Mar 20 TI - One-Year Outcomes after Myval Implantation in Patients with Bicuspid Aortic Valve Stenosis-A Multicentre Real-World Experience. LID - 10.3390/jcm12062398 [doi] LID - 2398 AB - BACKGROUND: Bicuspid aortic valve (BAV) affects approximately 1.5% of the general population and is seen in nearly 50% of candidates for aortic valve replacement (AVR). Despite increasingly utilised transcatheter aortic valve implantation (TAVI) in aortic stenosis (AS) patients, its use among patients with severe bicuspid AS is limited as BAV is a heterogeneous disease associated with multiple and complex anatomical challenges. AIM: To investigate the one-year outcomes of TAVI using the balloon-expandable Myval transcatheter heart valve (THV) (Meril Life Sciences Pvt. Ltd., Vapi, India) in patients with severe bicuspid AS. METHODS AND RESULTS: We collected data from consecutive patients with bicuspid AS who underwent TAVI with the Myval THV and had at least one-year follow-up. Baseline characteristics, procedural, and 30-day echocardiographic and clinical outcomes were collected. Sixty-two patients were included in the study. The median age was 72 [66.3, 77.0] years, 45 (72.6%) were males, and the mean STS PROM score was 3.2 +/- 2.2%. All TAVI procedures were performed via the transfemoral route. The median follow-up duration was 13.5 [12.2, 18.3] months; all-cause mortality was reported in 7 (11.3%) patients and cardiovascular hospitalisation in 6 (10.6%) patients. All-stroke was reported in 2 (3.2%), permanent pacemaker implantation 5 (8.3%), and myocardial infarction 1 (1.6%) patients. The echocardiographic assessment revealed a mean pressure gradient of 10 [8, 16.5] mmHg, effective orifice area 1.7 [1.4, 1.9] cm(2), moderate AR in 1 (2%), mild AR in 14 (27%), and none/trace AR in 37 (71%). In total, 1 patient was diagnosed with valve thrombosis (2.1%), Stage II (moderate) haemodynamic deterioration was seen in 3 (6.4%), and stage III (severe) haemodynamic deterioration in 1 (2.1%) patient. CONCLUSIONS: TAVI with the Myval THV in selected BAV anatomy is associated with favourable one-year hemodynamic and clinical outcomes. FAU - Elkoumy, Ahmed AU - Elkoumy A AUID- ORCID: 0000-0002-6325-1056 AD - Health Service Executive and CORRIB Core Lab, Discipline of Cardiology, Saolta Group, Galway University Hospital, University of Galway, H91 V4AY Galway, Ireland. AD - Islamic Center of Cardiology, Al-Azhar University, Cairo 11651, Egypt. FAU - Jose, John AU - Jose J AUID- ORCID: 0000-0002-2849-815X AD - Christian Medical College & Hospital, Vellore 632004, India. FAU - Terkelsen, Christian Juhl AU - Terkelsen CJ AD - Department of Cardiology, Aarhus University Hospital, 8200 Aarhus, Denmark. FAU - Nissen, Henrik AU - Nissen H AD - Department of Cardiology, Odense University Hospital, 5000 Odense, Denmark. FAU - Gunasekaran, Sengottuvelu AU - Gunasekaran S AD - Department of Cardiology, Apollo Main Hospital, Greams Road, Chennai 600006, India. FAU - Abdelshafy, Mahmoud AU - Abdelshafy M AUID- ORCID: 0000-0003-1040-0019 AD - Health Service Executive and CORRIB Core Lab, Discipline of Cardiology, Saolta Group, Galway University Hospital, University of Galway, H91 V4AY Galway, Ireland. AD - Department of Cardiology, Al-Azhar University, Cairo 11311, Egypt. FAU - Seth, Ashok AU - Seth A AD - Fortis Escorts Heart Institute, New Delhi 110025, India. FAU - Elzomor, Hesham AU - Elzomor H AD - Health Service Executive and CORRIB Core Lab, Discipline of Cardiology, Saolta Group, Galway University Hospital, University of Galway, H91 V4AY Galway, Ireland. FAU - Kumar, Sreenivas AU - Kumar S AD - Department of Cardiology, Apollo Hospitals, Apollo Health City, Jubilee Hills, Hyderabad 500050, India. FAU - Bedogni, Francesco AU - Bedogni F AD - Department of Cardiology, IRCCS Policlinico San Donato, 20097 Milan, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AUID- ORCID: 0000-0002-5982-1669 AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, 20149 Milan, Italy. FAU - Arsang-Jang, Shahram AU - Arsang-Jang S AD - Health Service Executive and CORRIB Core Lab, Discipline of Cardiology, Saolta Group, Galway University Hospital, University of Galway, H91 V4AY Galway, Ireland. AD - CURAM-SFI Research Centre for Medical Devices, H91 TK33 Galway, Ireland. FAU - Dora, Santosh Kumar AU - Dora SK AD - Asian Heart Institute, Mumbai 400051, India. FAU - Chandra, Sharad AU - Chandra S AD - Department of Cardiology, King George's Medical University, Lucknow 226003, India. FAU - Parikh, Keyur AU - Parikh K AD - Care Institute of Medical Sciences, Ahmedabad 380060, India. FAU - Unic, Daniel AU - Unic D AD - Department of Cardiac and Transplant Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia. FAU - Baumbach, Andreas AU - Baumbach A AUID- ORCID: 0000-0001-7707-2254 AD - Barts Heart Centre, William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK. FAU - Serruys, Patrick AU - Serruys P AD - Health Service Executive and CORRIB Core Lab, Discipline of Cardiology, Saolta Group, Galway University Hospital, University of Galway, H91 V4AY Galway, Ireland. AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, 20149 Milan, Italy. AD - National Heart and Lung Institute (NHLI), Imperial College London, London SW7 2AZ, UK. FAU - Soliman, Osama AU - Soliman O AUID- ORCID: 0000-0003-0758-3539 AD - Health Service Executive and CORRIB Core Lab, Discipline of Cardiology, Saolta Group, Galway University Hospital, University of Galway, H91 V4AY Galway, Ireland. AD - CURAM-SFI Research Centre for Medical Devices, H91 TK33 Galway, Ireland. LA - eng PT - Journal Article DEP - 20230320 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10054138 OTO - NOTNLM OT - BAV OT - Myval OT - aortic stenosis OT - bicuspid aortic valve OT - transcatheter aortic valve implantation COIS- C.T. has received a proctor fee from Meril Life, Edwards, Boston and a lecture fee from Terumo and Bristol-Myers Squibb. S.G. is working as a proctor for Myval and received honoraria from Meril Life sciences. F.B. reports a proctor fee from Meril life. A.S. serves as an Advisory Board Member/Speaker's bureau/received consulting honoraria Abbott Vascular, Medtronic, Boston Scientific and Meril Life sciences. A.B. reports grants from Abbott Vascular, personal fees from Microport, personal fees from Sinomed, personal fees from Medtronic, and personal fees from KSH, outside the submitted work; P.S. reports personal fees from SMT, Philips/Volcano, Xeltis, Novartis, and Meril life. O.S. reports institutional research grants outside the submitted work. All other authors have no conflict of interest to declare. EDAT- 2023/03/30 06:00 MHDA- 2023/03/30 06:01 PMCR- 2023/03/20 CRDT- 2023/03/29 01:43 PHST- 2023/01/30 00:00 [received] PHST- 2023/03/08 00:00 [revised] PHST- 2023/03/09 00:00 [accepted] PHST- 2023/03/30 06:01 [medline] PHST- 2023/03/29 01:43 [entrez] PHST- 2023/03/30 06:00 [pubmed] PHST- 2023/03/20 00:00 [pmc-release] AID - jcm12062398 [pii] AID - jcm-12-02398 [pii] AID - 10.3390/jcm12062398 [doi] PST - epublish SO - J Clin Med. 2023 Mar 20;12(6):2398. doi: 10.3390/jcm12062398. PMID- 36957987 OWN - NLM STAT- MEDLINE DCOM- 20230406 LR - 20260127 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 24 IP - 5 DP - 2023 May 1 TI - Acute expansion of nitinol-based self-expandable device in patients undergoing transfemoral aortic valve implantation. PG - 308-312 LID - 10.2459/JCM.0000000000001459 [doi] AB - BACKGROUND: The acute adaptation of the nitinol-based stent frame self expandable valve to the aortic root after deployment is poorly understood. Accordingly, this study aimed to assess the occurrence, degree and determinants of acute adaptation of the nitinol-based stent frame self-expandable valves after implantation. METHODS: This is a single-site prospective registry including patients undergoing transcatheter aortic valve replacement (TAVR) with a widely used second-generation nitinol-based self-expandable device (Evolut R, Medtronic, Minneapolis, Minnesota, USA). We measured valve diameters at three different sections: distal (aortic) level, central (annulus) level and proximal (ventricular) level. Valve expansion was estimated by the difference between the diameters calculated immediately after valve deployment (A) and at the end of the procedure (B). The absolute and relative stent changes were defined as B-A and (B-A)/B *100, respectively. A linear regression model was performed to test the association between the degree of valve extension at each segment with baseline and procedural characteristics. RESULTS: A total of 58 consecutive TAVR patients were included in this analysis, with a mean age of 82.12 +/- 5.28 years. Out of the total, 46% of the patients had chronic kidney disease, 32% had diabetes and 76% had dyslipidaemia. The mean procedural time was 28.11 +/- 11.6 min, with 53.45% of predilation. Postdilation was performed only in 3.5% of patients. Final stent diameters were significantly higher than those achieved immediately after valve implantation - an observation that was consistent for all the segments: 0.50 +/- 0.51 mm and 2.48 +/- 2.57% ( P < 0.01) in the proximal, 0.46 +/- 0.57 mm and 2.39 +/- 2.96% ( P < 0.01) in the central, as well as 0.58 +/- 0.59 mm and 2.14 +/- 2.14% ( P < 0.01) at the distal segments. Postdilation significantly affected the expansion of the central segment, and, albeit not significantly, the proximal one, while no changes were observed for the distal portion of the platform. CONCLUSION: This is the first study to have documented a significant degree of the Evolut R self-expandable valve expansion after deployment. However, further studies are required to assess the short- and long-term time course of self-expandable valve enlargement and the clinical relevance of this finding. CI - Copyright (c) 2023 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Spaccarotella, Carmen A M AU - Spaccarotella CAM AD - Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples. FAU - Sorrentino, Sabato AU - Sorrentino S AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Mongiardo, Annalisa AU - Mongiardo A AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Riverso, Vincenzo AU - Riverso V AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Mancuso, Cinzia AU - Mancuso C AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Giordano, Salvatore AU - Giordano S AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples. FAU - Indolfi, Ciro AU - Indolfi C AD - Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. LA - eng PT - Journal Article DEP - 20230320 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - 2EWL73IJ7F (nitinol) RN - 0 (Alloys) SB - IM MH - Humans MH - Aged MH - Aged, 80 and over MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement MH - Prosthesis Design MH - Alloys EDAT- 2023/03/24 06:00 MHDA- 2023/04/06 06:41 CRDT- 2023/03/23 17:40 PHST- 2023/04/06 06:41 [medline] PHST- 2023/03/24 06:00 [pubmed] PHST- 2023/03/23 17:40 [entrez] AID - 01244665-202305000-00007 [pii] AID - 10.2459/JCM.0000000000001459 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2023 May 1;24(5):308-312. doi: 10.2459/JCM.0000000000001459. Epub 2023 Mar 20. PMID- 36950893 OWN - NLM STAT- MEDLINE DCOM- 20230619 LR - 20240620 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 19 IP - 3 DP - 2023 Jun 19 TI - Implantation of contemporary transcatheter aortic valves in small aortic annuli: the international multicentre TAVI-SMALL 2 registry. PG - 256-266 LID - EIJ-D-22-00843 [pii] LID - 10.4244/EIJ-D-22-00843 [doi] AB - BACKGROUND: Treatment of aortic stenosis in patients with small annuli is challenging and can result in prosthesis-patient mismatch (PPM). AIMS: We aimed to compare the forward flow haemodynamics and clinical outcomes of contemporary transcatheter valves in patients with small annuli. METHODS: The TAVI-SMALL 2 international retrospective registry included 1,378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm(2)) treated with transfemoral self-expanding (SEV; n=1,092) and balloon-expandable valves (BEV; n=286) in 16 high-volume centres between 2011 and 2020. Analyses comparing SEV versus BEV and supra-annular (SAV; n=920) versus intra-annular valves (IAV; n=458) included inverse probability of treatment weighting (IPTW). The primary endpoints were the predischarge mean aortic gradient and incidence of severe PPM. The secondary endpoint was the incidence of more than mild paravalvular leak (PVL). RESULTS: The predischarge mean aortic gradient was lower after SAV versus IAV (7.8+/-3.9 vs 12.0+/-5.1; p<0.001) and SEV versus BEV implantation (8.0+/-4.1 vs 13.6+/-4.7; p<0.001). Severe PPM was more common with IAV and BEV when compared to SAV and SEV implantation, respectively, (8.8% vs 3.6%; p=0.007 and 8.7% vs 4.6%; p=0.041). At multivariable logistic regression weighted by IPTW, SAV protected from severe PPM regardless of its definition. More than mild PVL occurred more often with SEV versus BEV (11.6% vs 2.6%; p<0.001). CONCLUSIONS: In small aortic annuli, implantation of SAV and SEV was associated with a more favourable forward haemodynamic profile than after IAV and BEV implantation, respectively. More than mild PVL was more common after SEV than BEV implantation. FAU - Leone, Pier Pasquale AU - Leone PP AD - Montefiore Medical Center, New York, NY, USA. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Regazzoli, Damiano AU - Regazzoli D AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Pagnesi, Matteo AU - Pagnesi M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Cannata, Francesco AU - Cannata F AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Hokken, Thijmen W AU - Hokken TW AD - Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. FAU - Costa, Giuliano AU - Costa G AD - U.O.C. Cardiologia, Centro Alte Specialita e Trapianti, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - U.O.C. Cardiologia, Centro Alte Specialita e Trapianti, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy. FAU - Teles, Rui Campante AU - Teles RC AD - Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal. FAU - Adamo, Marianna AU - Adamo M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Taramasso, Maurizio AU - Taramasso M AD - HerzZentrum Hirslanden Zurich, Zurich, Switzerland and University of Zurich, Zurich, Switzerland. FAU - Reifart, Jorg AU - Reifart J AD - DZHK (German Center for Cardiovascular Research), Partner Site RheinMain, Frankfurt am Main, Germany. FAU - De Marco, Federico AU - De Marco F AD - Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Giannini, Francesco AU - Giannini F AD - GVM Care & Research, Maria Cecilia Hospital, Ravenna, Italy. FAU - Kargoli, Faraj AU - Kargoli F AD - Montefiore Medical Center, New York, NY, USA. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University Hospital, Kanagawa, Japan. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Sant'Orsola Polyclinic, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy. FAU - Pighi, Michele AU - Pighi M AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Chiarito, Mauro AU - Chiarito M AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Bongiovanni, Dario AU - Bongiovanni D AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Cozzi, Ottavia AU - Cozzi O AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Ribichini, Flavio L AU - Ribichini FL AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Chizzola, Giuliano AU - Chizzola G AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - GVM Care & Research, Maria Cecilia Hospital, Ravenna, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Maisano, Francesco AU - Maisano F AD - Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy.Misc. FAU - Tamburino, Corrado AU - Tamburino C AD - Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. FAU - Colombo, Antonio AU - Colombo A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore Medical Center, New York, NY, USA. LA - eng PT - Journal Article PT - Multicenter Study PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - Aortic Valve/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Aortic Valve Stenosis/surgery MH - Registries MH - Treatment Outcome PMC - PMC10266383 COIS- M. Barbanti is a consultant for Medtronic, Boston Scientific, and Edwards Lifesciences. R. Teles has received a received a research grant (to the institution) from Abbott. M. Adamo discloses speaker fees from Abbott and Medtronic. M. Taramasso discloses consultant or consultancy fees from Abbott Vascular, Edwards Lifesciences, Boston Scientific, Medtronic, Shenqi Medical, VentriMend, Simulands, Occlufit, MTEx, MEDIRA, and HI-D Imaging; and serves on the advisory board of Abbott. G. Stefanini has received a research grant (to the institution) from Boston Scientific; and has received speaking and consulting fees from Abbott Vascular, Boston Scientific, and Pfizer/BMS. W-K. Kim is a proctor for Boston Scientific, Meril Life Sciences, and Abbott; and has received speaking fees from Boston Scientific, Abbott, Medtronic, Edwards Lifesciences, Meril Life, and Shockwave Medical. F. Maisano discloses grant and/or research institutional support from Abbott, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific, NVT, and Terumo; consulting fees, personal and institutional honoraria from Abbott, Medtronic, Edwards Lifesciences, Xeltis, Cardiovalve, Occlufit, Simulands, and Mtex; royalty income/IP rights from Edwards Lifesciences; a shareholder position (including share options) at Cardiogard, Cardiovalve, Magenta, SwissVortex, Transseptal Solutions, 4Tech, and Perifect. N.M. Van Mieghem has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Abiomed, PulseCath BV, Daiichi Sankyo, and Biotronik. B. Reimers has received speaking honoraria from Boston Scientific. A. Latib serves on the advisory boards of Medtronic, Edwards Lifesciences, Boston Scientific, Philips, and Abbott. The other authors have no conflicts of interest to declare, relevant to the contents of this paper. The Guest Editor reports lecture fees paid to his institution from Amgen, Bayer Healthcare, Biotronik, Boehringer Ingelheim, Boston Scientific, Daiichi Sankyo, Edwards Lifesciences, Ferrer, Pfizer, and Novartis; consultancy fees paid to his institution from Boehringer Ingelheim; and grant support from Bayer Healthcare, Boston Scientific, Biotronik, Edwards Lifesciences, GlaxoSmithKline, Medtronic, and Pfizer. EDAT- 2023/03/24 06:00 MHDA- 2023/06/19 13:08 PMCR- 2024/06/19 CRDT- 2023/03/23 03:55 PHST- 2023/06/19 13:08 [medline] PHST- 2023/03/24 06:00 [pubmed] PHST- 2023/03/23 03:55 [entrez] PHST- 2024/06/19 00:00 [pmc-release] AID - EIJ-D-22-00843 [pii] AID - 10.4244/EIJ-D-22-00843 [doi] PST - ppublish SO - EuroIntervention. 2023 Jun 19;19(3):256-266. doi: 10.4244/EIJ-D-22-00843. PMID- 36922042 OWN - NLM STAT- MEDLINE DCOM- 20230320 LR - 20231213 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 5 DP - 2023 Mar 13 TI - Clinical Impact of Standardized TAVR Technique and Care Pathway: Insights From the Optimize PRO Study. PG - 558-570 LID - S1936-8798(23)00017-1 [pii] LID - 10.1016/j.jcin.2023.01.016 [doi] AB - BACKGROUND: Procedural success and clinical outcomes after transcatheter aortic valve replacement (TAVR) have improved, but residual aortic regurgitation (AR) and new permanent pacemaker implantation (PPI) rates remain variable because of a lack of uniform periprocedural management and implantation. OBJECTIVES: The Optimize PRO study evaluates valve performance and procedural outcomes using an "optimized" TAVR care pathway and the cusp overlap technique (COT) in patients receiving the Evolut PRO/PRO+ (Medtronic) self-expanding valves. METHODS: Optimize PRO, a nonrandomized, prospective, postmarket study conducted in the United States, Canada, Europe, Middle East, and Australia, is enrolling patients with severe symptomatic aortic stenosis and no pre-existing pacemaker. Sites follow a standardized TAVR care pathway, including early discharge and a conduction disturbance management algorithm, and transfemoral deployment using the COT. RESULTS: A total of 400 attempted implants from the United States and Canada comprised the main cohort of this second interim analysis. The mean age was 78.7 +/- 6.6 years, and the mean Society of Thoracic Surgeons predictive risk of mortality was 3.0 +/- 2.4. The median length of stay was 1 day. There were no instances of moderate or severe AR at discharge. At 30 days, all-cause mortality or stroke was 3.8%, all-cause mortality was 0.8%, disabling stroke was 0.7%, hospital readmission was 10.1%, and cardiovascular rehospitalization was 6.1%. The new PPI rate was 9.8%, 5.8% with 4-step COT compliance. In the multivariable model, right bundle branch block and the depth of the implant increased the risk of PPI, whereas using the 4-step COT lowered 30-day PPI. CONCLUSIONS: The use of the TAVR care pathway and COT resulted in favorable clinical outcomes with no moderate or severe AR and low PPI rates at 30 days while facilitating early discharge and reproducible outcomes across various sites and operators. (Optimize PRO; NCT04091048). CI - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Grubb, Kendra J AU - Grubb KJ AD - Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA. Electronic address: kjgrubb@emory.edu. FAU - Gada, Hemal AU - Gada H AD - Department of Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle, Wormleysburg, Pennsylvania, USA; Center for Heart Valve Disease, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. FAU - Mittal, Suneet AU - Mittal S AD - Division of Cardiology and the Snyder Center for Comprehensive Atrial Fibrillation at Valley Health System, Ridgewood, New Jersey, USA. FAU - Nazif, Tamim AU - Nazif T AD - NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada; Hospital Clinic de Barcelona, Barcelona, Spain. FAU - Fraser, Douglas G W AU - Fraser DGW AD - Cardiology Department, Manchester Heart Centre, Central Manchester University Hospitals, Manchester Royal Infirmary, Manchester, United Kingdom. FAU - Lin, Lang AU - Lin L AD - Department of Interventional Cardiology, Morton Plant Hospital, Clearwater, Florida, USA; Department of Cardiovascular Surgery, Morton Plant Hospital, Clearwater, Florida, USA. FAU - Rovin, Joshua D AU - Rovin JD AD - Department of Interventional Cardiology, Morton Plant Hospital, Clearwater, Florida, USA; Department of Cardiovascular Surgery, Morton Plant Hospital, Clearwater, Florida, USA. FAU - Khalil, Ramzi AU - Khalil R AD - Department of Cardiology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA. FAU - Sultan, Ibrahim AU - Sultan I AD - Department of Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle, Wormleysburg, Pennsylvania, USA; Center for Heart Valve Disease, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. FAU - Gardner, Blake AU - Gardner B AD - Saint George Regional Hospital, St. George, Utah, USA. FAU - Lorenz, David AU - Lorenz D AD - Saint Vincent's Medical Center, Bridgeport, Connecticut, USA. FAU - Chetcuti, Stanley J AU - Chetcuti SJ AD - Department of Interventional Cardiology, University of Michigan Hospitals, Ann Arbor, Michigan, USA; Department of Cardiovascular Surgery, University of Michigan Hospitals, Ann Arbor, Michigan, USA. FAU - Patel, Nainesh C AU - Patel NC AD - Division of Cardiology, Lehigh Valley Health Network/University of South Florida College of Medicine, Allentown, Pennsylvania, USA. FAU - Harvey, James E AU - Harvey JE AD - Department of Cardiovascular Diseases, York Hospital-Wellspan Health System, York, Pennsylvania, USA. FAU - Mahoney, Paul AU - Mahoney P AD - Structural Heart Center, Sentara Heart Hospital, Norfolk, Virginia, USA. FAU - Schwartz, Brian AU - Schwartz B AD - Department of Cardiology, Kettering Medical Center, Dayton, Ohio, USA. FAU - Jafar, Zubair AU - Jafar Z AD - Department of Cardiology, Vassar Brothers Medical Center, Poughkeepsie, New York, USA. FAU - Wang, John AU - Wang J AD - Section of Interventional Cardiology, MedStar Union Memorial Hospital, Baltimore, Maryland, USA. FAU - Potluri, Srinivasa AU - Potluri S AD - Department of Interventional Cardiology, Baylor Scott and White The Heart Hospital, Plano, Texas, USA. FAU - Vora, Amit N AU - Vora AN AD - Department of Interventional Cardiology, University of Pittsburgh Medical Center Pinnacle, Wormleysburg, Pennsylvania, USA; Center for Heart Valve Disease, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. FAU - Sanchez, Carlos AU - Sanchez C AD - Department of Interventional Cardiology, Riverside Methodist-OhioHealth, Columbus, Ohio, USA. FAU - Corrigan, Amy AU - Corrigan A AD - Department of Clinical Research, Medtronic, Minneapolis, Minnesota, USA. FAU - Li, Shuzhen AU - Li S AD - Department of Structural Heart and Aortic Clinical Research and Medical Science, Medtronic, Minneapolis, Minnesota, USA. FAU - Yakubov, Steven J AU - Yakubov SJ AD - Department of Interventional Cardiology, Riverside Methodist-OhioHealth, Columbus, Ohio, USA. LA - eng SI - ClinicalTrials.gov/NCT04091048 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Mar 13;16(5):571-573. doi: 10.1016/j.jcin.2023.01.372. PMID: 36922043 CIN - JACC Cardiovasc Interv. 2023 May 22;16(10):1304. doi: 10.1016/j.jcin.2023.04.009. PMID: 37225301 CIN - JACC Cardiovasc Interv. 2023 May 22;16(10):1305. doi: 10.1016/j.jcin.2023.04.017. PMID: 37225302 MH - Humans MH - United States MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Critical Pathways MH - Prospective Studies MH - Risk Factors MH - Treatment Outcome MH - *Aortic Valve Insufficiency/etiology MH - *Stroke MH - *Heart Valve Prosthesis/adverse effects OTO - NOTNLM OT - TAVR care pathway OT - cusp overlap technique OT - pacemaker implantation COIS- Funding Support and Author Disclosures This study was funded by Medtronic. Dr Grubb is a proctor, principal investigator, and on the advisory board for Medtronic; and serves on the advisory board or is a consultant for Ancora Heart, Boston Scientific, Abbott, Gore, BioVentrix, and Edwards Lifesciences. Dr Gada has served as a consultant to Abbott, Bard Medical Corporation, Boston Scientific, Edwards Lifesciences, and Medtronic. Dr Mittal has received honoraria/consultant fees from Abbott, Boston Scientific, and Medtronic. Dr Nazif is consultant for and has received institutional grants from Edwards LifeSciences, Medtronic, and Boston Scientific. Dr Rodes-Cabau has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific. Dr Fraser is a proctor for Medtronic; and receives speaker fees from Edwards and Medtronic. Dr Rovin is a physician proctor with Medtronic and Abbott; and is a consultant for Medtronic and Abbott. Dr Sultan receives institutional research support from Abbott, Atrivion, Boston Scientific, Edwards Lifesciences, and Medtronic; and is a consultant for Medtronic Vascular. Dr Gardner has received research support from Abbott; and is on the advisory board, is a consultant, and has received research support from Medtronic. Dr Chetcuti has received grant support and fees for proctoring from Medtronic; and is a consultant for Jena valve. Dr Patel is a speaker for Medtronic and Penumbra; and is on the advisory board of St. Jude Medical. Dr Harvey has served as a consultant; and is on the advisory board for Boston Scientific. Dr Mahoney is a proctor and consultant for Medtronic, Edwards Lifesciences, and Boston Scientific. Dr Schwartz is an investigator for Medtronic. Dr Jafar is an investigator for Medtronic. Dr Wang is a speaker and consultant for Boston Scientific; is a consultant for Cordis; and is a consultant for Edwards Lifesciences. Dr Potluri has received honoraria from Boston Scientific, Medtronic, Edwards Lifesciences, Zoll, Gore, Abbott, and Cardinal. Dr Vora serves as a consultant for Medtronic. Dr Sanchez is a consultant for Edwards Lifesciences and Medtronic. Ms Corrigan is an employee and shareholder of Medtronic. Dr Li is an employee and shareholder of Medtronic. Dr Yakubov has received institutional research grants from Medtronic; and serves on an advisory board for Medtronic and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/03/16 06:00 MHDA- 2023/03/21 06:00 CRDT- 2023/03/15 21:56 PHST- 2022/08/11 00:00 [received] PHST- 2022/12/21 00:00 [revised] PHST- 2023/01/03 00:00 [accepted] PHST- 2023/03/15 21:56 [entrez] PHST- 2023/03/16 06:00 [pubmed] PHST- 2023/03/21 06:00 [medline] AID - S1936-8798(23)00017-1 [pii] AID - 10.1016/j.jcin.2023.01.016 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Mar 13;16(5):558-570. doi: 10.1016/j.jcin.2023.01.016. PMID- 36880333 OWN - NLM STAT- MEDLINE DCOM- 20230425 LR - 20240425 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 18 IP - 17 DP - 2023 Apr 24 TI - One-year outcomes after transcatheter aortic valve implantation with the latest-generation SAPIEN balloon-expandable valve: the S3U registry. PG - 1418-1427 LID - EIJ-D-22-01022 [pii] LID - 10.4244/EIJ-D-22-01022 [doi] AB - BACKGROUND: Initial data about the performance of the new-generation SAPIEN 3 Ultra (S3U) valve are highly promising. However, evidence about the longer-term performance and safety of the S3U is scarce. AIMS: We aimed to investigate the 1-year clinical and echocardiographic outcomes of transcatheter aortic valve implantation (TAVI) using the S3U compared with its predecessor, the SAPIEN 3 valve (S3). METHODS: The SAPIEN 3 Ultra registry included consecutive patients who underwent transfemoral TAVI at 12 European centres with the S3U or S3 between October 2016 and December 2020. One-to-one propensity score (PS) matching was performed to account for differences in baseline characteristics. The primary outcomes of interest were all-cause death and the composite of all-cause death, disabling stroke and hospitalisation for heart failure at 1 year. RESULTS: The overall study cohort encompassed 1,692 patients treated with either the S3U (n=519) or S3 (n=1,173). The PS-matched population had a total of 992 patients (496 per group). At 1 year, the rate of death from any cause was 4.9% in the S3U group and 6.3% in the S3 group (p=0.743). Similarly, there were no significant differences in the rates of the primary composite outcome (9.5% in the S3 group and 6.6% in the S3U group; p=0.162). The S3U was associated with lower rates of mild paravalvular leak (PVL) compared with the S3 (odds ratio 0.63, 95% confidence interval: 0.44 to 0.88; p<0.01). No significant differences in transprosthetic gradients were observed between the two groups. CONCLUSIONS: Compared with the S3, the S3U transcatheter heart valve was associated with similar 1-year clinical outcomes but reduced rates of mild PVL. FAU - Cannata, Stefano AU - Cannata S AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), UPMC, Palermo, Italy. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), UPMC, Palermo, Italy. FAU - Ribichini, Flavio L AU - Ribichini FL AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - van Mieghem, Nicolas AU - van Mieghem N AD - Department of Cardiology, Erasmus University Medical Center, Thorax Center, Rotterdam, the Netherlands. FAU - Buccheri, Sergio AU - Buccheri S AD - Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, AOU Policlinico "G. Rodolico - San Marco", Catania, Italy. FAU - Berti, Sergio AU - Berti S AD - UOC Cardiologia Diagnostica e Interventistica, Fondazione C.N.R. Reg. Toscana G. Monasterio, Massa, Italy. FAU - Teles, Rui Campante AU - Teles RC AD - Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon, Portugal. FAU - Bartorelli, Antonio L AU - Bartorelli AL AD - Centro Cardiologico Monzino IRCCS, University of Milan, Milan, Italy. FAU - Musumeci, Giuseppe AU - Musumeci G AD - Department of Cardiology, Mauriziano Hospital, Turin, Italy. FAU - Piva, Tommaso AU - Piva T AD - Interventional Cardiology, Ospedali Riuniti di Ancona, Ancona, Italy. FAU - Nombela-Franco, Luis AU - Nombela-Franco L AD - Cardiovascular Institute, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria San Carlos, Madrid, Spain. FAU - La Spina, Ketty AU - La Spina K AD - Unit of Interventional Cardiology, Department of Cardiothoracic Surgery, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), UPMC, Palermo, Italy. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. FAU - Adrichem, Rik AU - Adrichem R AD - Department of Cardiology, Erasmus University Medical Center, Thorax Center, Rotterdam, the Netherlands. FAU - Esposito, Augusto AU - Esposito A AD - UOC Cardiologia Diagnostica e Interventistica, Fondazione C.N.R. Reg. Toscana G. Monasterio, Massa, Italy. FAU - Lopes, Pedro AU - Lopes P AD - Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon, Portugal. FAU - Olivares, Paolo AU - Olivares P AD - Centro Cardiologico Monzino IRCCS, University of Milan, Milan, Italy. FAU - Annibali, Gianmarco AU - Annibali G AD - Department of Cardiology, Mauriziano Hospital, Turin, Italy. FAU - Nicolini, Elisa AU - Nicolini E AD - Interventional Cardiology, Ospedali Riuniti di Ancona, Ancona, Italy. FAU - Marroquin, Luis AU - Marroquin L AD - Cardiovascular Institute, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria San Carlos, Madrid, Spain. FAU - Tamburino, Corrado AU - Tamburino C AD - UOC Cardiologia Diagnostica e Interventistica, Fondazione C.N.R. Reg. Toscana G. Monasterio, Massa, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy. LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis/adverse effects MH - Treatment Outcome MH - Registries MH - Aortic Valve/diagnostic imaging/surgery MH - Prosthesis Design PMC - PMC10111124 COIS- N. Van Mieghem has received research grants from Abbott Vascular, Biotronik, Boston Scientific, Medtronic, Edwards Lifesciences, PulseCath BV, Abiomed, Daiichi Sankyo, FEops, and Pie Medical; and is a physician proctor for Edwards Lifesciences and Medtronic. M. Barbanti is a consultant for Boston Scientific, Edwards Lifesciences, and Medtronic. L. Nombela-Franco has been a proctor for Abbott Vascular and Edwards Lifesciences. T. Piva is a consultant for Boston Scientific, Edwards Lifesciences, Innova SRL, and Teleflex Medica. C. Tamburino is a consultant for Medtronic. The Guest Editor reports lecture fees paid to his institution from Amgen, Bayer Healthcare, Biotronik, Boehringer Ingelheim, Boston Scientific, Daiichi Sankyo, Edwards Lifesciences, Ferrer, Pfizer, and Novartis; consultancy fees paid to his institution from Boehringer Ingelheim; and grant support from Bayer Healthcare, Boston Scientific, Biotronik, Edwards Lifesciences, GlaxoSmithKline, Medtronic, and Pfizer. The other authors have no conflicts of interest to declare. EDAT- 2023/03/08 06:00 MHDA- 2023/04/25 06:42 PMCR- 2024/04/24 CRDT- 2023/03/07 04:23 PHST- 2023/04/25 06:42 [medline] PHST- 2023/03/08 06:00 [pubmed] PHST- 2023/03/07 04:23 [entrez] PHST- 2024/04/24 00:00 [pmc-release] AID - EIJ-D-22-01022 [pii] AID - 10.4244/EIJ-D-22-01022 [doi] PST - ppublish SO - EuroIntervention. 2023 Apr 24;18(17):1418-1427. doi: 10.4244/EIJ-D-22-01022. PMID- 36863420 OWN - NLM STAT- MEDLINE DCOM- 20230411 LR - 20230626 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 379 DP - 2023 May 15 TI - Clinical outcomes in women and men with small aortic annuli undergoing transcatheter aortic valve implantation: A multicenter, retrospective, propensity score-matched comparison. PG - 16-23 LID - S0167-5273(23)00270-X [pii] LID - 10.1016/j.ijcard.2023.02.044 [doi] AB - BACKGROUND: Sex-specific characteristics in patients with aortic stenosis and small annuli undergoing transcatheter aortic valve implantation (TAVI) might affect clinical outcomes and hemodynamics. METHODS: TAVI-SMALL 2 international retrospective registry included 1378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area < 400 mm2) treated with transfemoral TAVI at 16 high-volume centers between 2011 and 2020. Women (n = 1233) were compared with men (n = 145). One-to-one propensity score (PS) matching resulted in 99 pairs. Primary endpoint was incidence of all-cause mortality. Incidence of pre-discharge severe prosthesis-patient mismatch (PPM) and its association with all-cause mortality were investigated. Binary logistic and Cox regression were performed to adjust the treatment effect for PS quintiles. RESULTS: Incidence of all-cause mortality at a median follow-up of 377 days did not differ between sex in the overall (10.3 vs. 9.8%, p = 0.842) and PS-matched (8.5 vs. 10.9%, p = 0.586) populations. After PS matching, pre-discharge severe PPM was numerically higher in women vs. men (10.2 vs. 4.3%), even though no evidence of a difference was found (p = 0.275). Within the overall population, women with severe PPM suffered a higher incidence of all-cause mortality when compared to those with less than moderate PPM (log-rank p = 0.024) and less than severe PPM (p = 0.027). CONCLUSIONS: No difference in all-cause mortality at medium-term follow-up was observed between women and men with aortic stenosis and small annuli undergoing TAVI. Incidence of pre-discharge severe PPM was numerically higher in women than men, and it was associated with increased all-cause mortality in women. CI - Copyright (c) 2023 Elsevier B.V. All rights reserved. FAU - Leone, Pier Pasquale AU - Leone PP AD - Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Gohar, Aisha AU - Gohar A AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Pagnesi, Matteo AU - Pagnesi M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Cacia, Michele AU - Cacia M AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Cozzi, Ottavia AU - Cozzi O AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - U.O.C. Cardiologia, Centro Alte Specialita e Trapianti, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy. FAU - Teles, Rui AU - Teles R AD - Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal. FAU - Adamo, Marianna AU - Adamo M AD - Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Taramasso, Maurizio AU - Taramasso M AD - HerzZentrum Hirslanden Zurich, Switzerland and University of Zurich, Switzerland. FAU - De Marco, Federico AU - De Marco F AD - Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Giannini, Francesco AU - Giannini F AD - GVM Care and Research, Maria Cecilia Hospital, Ravenna, Italy. FAU - Ohno, Yohei AU - Ohno Y AD - Department of Cardiology, Tokai University Hospital, Kanagawa, Japan. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy. FAU - Pighi, Michele AU - Pighi M AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Ribichini, Flavio AU - Ribichini F AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Maisano, Francesco AU - Maisano F AD - Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - U.O.C. Cardiologia, Centro Alte Specialita e Trapianti, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. FAU - Colombo, Antonio AU - Colombo A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Latib, Azeem AU - Latib A AD - Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA. Electronic address: alatib@gmail.com. FAU - Regazzoli, Damiano AU - Regazzoli D AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. Electronic address: damiano.regazzoli@gmail.com. CN - TAVI-SMALL Investigators LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230228 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Male MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement MH - Aortic Valve/surgery MH - Retrospective Studies MH - Propensity Score MH - Treatment Outcome MH - *Aortic Valve Stenosis/diagnosis/surgery MH - *Heart Valve Prosthesis MH - Risk Factors OTO - NOTNLM OT - Prosthesis-patient mismatch OT - Sex OT - Small annuli OT - TAVI OT - Women EDAT- 2023/03/03 06:00 MHDA- 2023/04/11 06:42 CRDT- 2023/03/02 19:22 PHST- 2022/12/17 00:00 [received] PHST- 2023/02/05 00:00 [revised] PHST- 2023/02/26 00:00 [accepted] PHST- 2023/04/11 06:42 [medline] PHST- 2023/03/03 06:00 [pubmed] PHST- 2023/03/02 19:22 [entrez] AID - S0167-5273(23)00270-X [pii] AID - 10.1016/j.ijcard.2023.02.044 [doi] PST - ppublish SO - Int J Cardiol. 2023 May 15;379:16-23. doi: 10.1016/j.ijcard.2023.02.044. Epub 2023 Feb 28. PMID- 36858659 OWN - NLM STAT- MEDLINE DCOM- 20230303 LR - 20230314 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 4 DP - 2023 Feb 27 TI - Vascular Access in Patients With Peripheral Arterial Disease Undergoing TAVR: The Hostile Registry. PG - 396-411 LID - S1936-8798(22)02245-2 [pii] LID - 10.1016/j.jcin.2022.12.009 [doi] AB - BACKGROUND: The optimal access route in patients with severe peripheral artery disease (PAD) undergoing transcatheter aortic valve replacement (TAVR) remains undetermined. OBJECTIVES: This study sought to compare clinical outcomes with transfemoral access (TFA), transthoracic access (TTA), and nonthoracic transalternative access (TAA) in TAVR patients with severe PAD. METHODS: Patients with PAD and hostile femoral access (TFA impossible, or possible only after percutaneous treatment) undergoing TAVR at 28 international centers were included in this registry. The primary endpoint was the propensity-adjusted risk of 30-day major adverse events (MAE) defined as the composite of all-cause mortality, stroke/transient ischemic attack (TIA), or main access site-related Valve Academic Research Consortium 3 major vascular complications. Outcomes were also stratified according to the severity of PAD using a novel risk score (Hostile score). RESULTS: Among the 1,707 patients included in the registry, 518 (30.3%) underwent TAVR with TFA after percutaneous treatment, 642 (37.6%) with TTA, and 547 (32.0%) with TAA (mostly transaxillary). Compared with TTA, both TFA (adjusted HR: 0.58; 95% CI: 0.45-0.75) and TAA (adjusted HR: 0.60; 95% CI: 0.47-0.78) were associated with lower 30-day rates of MAE, driven by fewer access site-related complications. Composite risks at 1 year were also lower with TFA and TAA compared with TTA. TFA compared with TAA was associated with lower 1-year risk of stroke/TIA (adjusted HR: 0.49; 95% CI: 0.24-0.98), a finding confined to patients with low Hostile scores (P(interaction) = 0.049). CONCLUSIONS: Among patients with PAD undergoing TAVR, both TFA and TAA were associated with lower 30-day and 1-year rates of MAE compared with TTA, but 1-year stroke/TIA rates were higher with TAA compared with TFA. CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Palmerini, Tullio AU - Palmerini T AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. Electronic address: tulliopalmerini@hotmail.com. FAU - Saia, Francesco AU - Saia F AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Renker, Matthias AU - Renker M AD - Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Iadanza, Alessandro AU - Iadanza A AD - UOSA Cardiologia Interventistica, Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - Fineschi, Massimo AU - Fineschi M AD - UOSA Cardiologia Interventistica, Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - Bruno, Antonio Giulio AU - Bruno AG AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Ghetti, Gabriele AU - Ghetti G AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Sondergaard, Lars AU - Sondergaard L AD - Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - De Backer, Ole AU - De Backer O AD - Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Romagnoli, Enrico AU - Romagnoli E AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Trani, Carlo AU - Trani C AD - U.O.C. di Interventistica Cardiologica e Diagnostica Invasiva, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy. FAU - Adrichem, Rik AU - Adrichem R AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Nardi, Elena AU - Nardi E AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Chietera, Francesco AU - Chietera F AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Orzalkiewicz, Mateusz AU - Orzalkiewicz M AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Tomii, Daijiro AU - Tomii D AD - Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Aranzulla, Tiziana Claudia AU - Aranzulla TC AD - A.O. Mauriziano Umberto I Hospital, Turin, Italy. FAU - Musumeci, Giuseppe AU - Musumeci G AD - A.O. Mauriziano Umberto I Hospital, Turin, Italy. FAU - Adam, Matti AU - Adam M AD - Klinik III fur Innere Medizin - Kardiologie, Pneumologie und Internistische Intensivmedizin, University Hospital Cologne - Heart Center, Cologne, Germany. FAU - Meertens, Max M AU - Meertens MM AD - Klinik III fur Innere Medizin - Kardiologie, Pneumologie und Internistische Intensivmedizin, University Hospital Cologne - Heart Center, Cologne, Germany. FAU - Taglieri, Nevio AU - Taglieri N AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Marrozzini, Cinzia AU - Marrozzini C AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Alvarez Covarrubias, Hector Alfonso AU - Alvarez Covarrubias HA AD - German Heart Centre Munich, Munich, Germany; Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, Institutio Mexicano de Seguro Social, Mexico City, Mexico. FAU - Joner, Michael AU - Joner M AD - German Heart Centre Munich, Munich, Germany. FAU - Nardi, Giulia AU - Nardi G AD - University Hospital Careggi, Florence, Italy. FAU - Di Muro, Francesca Maria AU - Di Muro FM AD - University Hospital Careggi, Florence, Italy. FAU - Di Mario, Carlo AU - Di Mario C AD - University Hospital Careggi, Florence, Italy. FAU - Loretz, Lucca AU - Loretz L AD - Cardiology, Heart Center Lucerne, Lucerne, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Cardiology, Heart Center Lucerne, Lucerne, Switzerland. FAU - Gallitto, Enrico AU - Gallitto E AD - Vascular Surgery, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Gargiulo, Mauro AU - Gargiulo M AD - Vascular Surgery, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Testa, Luca AU - Testa L AD - Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy. FAU - Bedogni, Francesco AU - Bedogni F AD - Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy. FAU - Berti, Sergio AU - Berti S AD - Unit of Diagnostic and Interventional Cardiology, C.N.R. Reg. Toscana G. Monasterio Foundation, Ospedale del Cuore, Massa, Italy. FAU - Ancona, Marco B AU - Ancona MB AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Montorfano, Matteo AU - Montorfano M AD - Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. FAU - Leone, Alessandro AU - Leone A AD - Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Savini, Carlo AU - Savini C AD - Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Pacini, Davide AU - Pacini D AD - Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. FAU - Gmeiner, Jonas AU - Gmeiner J AD - Department of Medicine I, University Hospital Munich, Medical Faculty, Ludwig Maximilian University of Munich, Munich, Germany. FAU - Braun, Daniel AU - Braun D AD - Department of Medicine I, University Hospital Munich, Medical Faculty, Ludwig Maximilian University of Munich, Munich, Germany. FAU - Nerla, Roberto AU - Nerla R AD - Cardioangiology Cath Lab, Cotignola, Italy. FAU - Castriota, Fausto AU - Castriota F AD - Cardioangiology Cath Lab, Cotignola, Italy. FAU - De Carlo, Marco AU - De Carlo M AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Petronio, Anna Sonia AU - Petronio AS AD - Cardiothoracic and Vascular Department, Pisa University Hospital, Pisa, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania, Italy. FAU - Leone, Pier Pasquale AU - Leone PP AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Italy. FAU - Stefanini, Giulio AU - Stefanini G AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Italy. FAU - Sudo, Mitsumasa AU - Sudo M AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn, Universitatsklinikum Bonn, Bonn, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn, Universitatsklinikum Bonn, Bonn, Germany. FAU - Piva, Tommaso AU - Piva T AD - Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I - GM Lancisi, Torette, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Latib, Azeem AU - Latib A AD - Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Vercellino, Matteo AU - Vercellino M AD - Cardiology Unit, Cardio-Thoraco Vascular Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. FAU - Porto, Italo AU - Porto I AD - Cardiology Unit, Cardio-Thoraco Vascular Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. FAU - Codner, Pablo AU - Codner P AD - Rabin Medical Center, Petah Tikva, Israel. FAU - Kornowski, Ran AU - Kornowski R AD - Rabin Medical Center, Petah Tikva, Israel. FAU - Bartorelli, Antonio L AU - Bartorelli AL AD - Centro Cardiologico Monzino, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. FAU - Fraccaro, Chiara AU - Fraccaro C AD - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Grube, Eberhard AU - Grube E AD - Medizinische Klinik und Poliklinik II, Herzzentrum Bonn, Universitatsklinikum Bonn, Bonn, Germany. FAU - Galie, Nazzareno AU - Galie N AD - Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Cardiac, Thoracic and Vascular Department, Universita di Bologna, Bologna, Italy. FAU - Stone, Gregg W AU - Stone GW AD - Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230118 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Feb 27;16(4):412-414. doi: 10.1016/j.jcin.2022.12.010. PMID: 36669980 MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Ischemic Attack, Transient MH - Treatment Outcome MH - *Peripheral Arterial Disease MH - Registries MH - *Stroke OTO - NOTNLM OT - alternative access OT - critical patient OT - femoral access OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Palmerini has received speaker fees from Edwards Lifesciences and Medtronic. Dr Saia has received consulting and lecture fees from Abbott, Edwards Lifesciences, and Medtronic. Dr Kim has received personal fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Merill Life Sciences, and Shockwave Medical. Dr Sondergaard has received consulting fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic, and Sahajanand Medical Technologies. Dr Burzotta has received speaker fees from Abiomed, Abbott, Medtronic, and Terumo. Dr Romagnoli has received speaker fees by Abbott Vascular, Abiomed, and Medtronic. Dr Van Mieghem has received research grant support from Abbott Vascular, Biotronik, Boston Scientific, Medtronic, Edwards Lifesciences, Abiomed, PulseCath BV, and Daiichi Sankyo. Dr Pilgrim has received research grants to his institution from Boston Scientific, Biotronik, and Edwards Lifesciences; and honoraria from Biotronik, Boston Scientific, Medtronic, Abbott, and HighLife SAS. Dr Adam has received personal and proctoring fees from Abbott, Boston Scientific, Edwards Lifesciences, JenaValve, and Medtronic (during the conduct of the study). Dr Di Mario has received research grants to his institution from Abbott, Amgen, Boston Scientific, Chiesi, Daiichi Sankyo, Edwards Lifesciences, and Volcano Philips. Dr Toggweiler has served as a proctor/consultant for Medtronic, Edwards Lifesciences, Biosensors, Boston Scientific, and Abbott Vascular; has served consultant for Medira, AtHeart Medical, Veosource, Shockwave, Teleflex, and Polares Medical; has received institutional research grants from Biosensors, Boston Scientific, and Fumedica; and holds equity in Hi-D Imaging. Dr Testa has received consulting fees from and served as a proctor Abbott, Boston Scientific, Medtronic, and Merrill. Dr Berti has served as a proctor for Edwards Lifesciences, Abbott, and Boston Scientific. Dr Ancona has received consultant fees from Abbott. Dr Montorfano has received proctor fees from Abbott, Edwards Lifesciences, and Boston Scientific. Dr Castriota has received proctoring fees from Abbott and Medtronic. Dr Petronio has received consultant and research funds from Medtronic, Boston Scientific, and Abbott. Dr Barbanti has served as a consultant for Medtronic, Edwards Lifesciences, and Boston Scientific. Dr Tamburino has received speaker honoraria from Abbott and Medtronic. Dr Nickenig has received lecture or advisory board honoraria from Abbott, Amarin, AstraZeneca, Bayer, Berlin Chemie, Biosensus, Biotronik, Bristol Myers Squibb, Boehringer Ingelheim, CardioValve, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Novartis, Pfizer, and Sanofi; owns stock options with Beren, Cardiovalve; has served in clinical trials with Abbott, AstraZeneca, Bayer, Berlin Chemie, Biosensus, Biotronik, Bristol Myers Squibb, Boehringer Ingelheim, CardioValve, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Novartis, Pfizer, and Sanofi; and has received research funding from the Deutsche Forschungsgemeinschaft, the Bundeministerium fur Bildung und Forschun, the European Union, Abbott, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Edwards Lifesciences, Medtronic, Novartis, and Pfizer. Dr Stefanini has received speaker fees from Abbott Vascular, Boston Scientific, and Pfizer/Bristol Myers Squibb; research grants to his institution from Boston Scientific. Dr Latib has served as a consultant for Abbott, Medtronic, Edwards Lifesciences, Boston Scientific, Neovasc, Shifamed, and Philips. Dr Porto has received consulting or speaker fees from Biotronik, Abiomed, Medtronic, Terumo, Philips, Sanofi, Amgen, Daiichi Sankyo, AstraZeneca, and Bayer, not related to this work. Dr Grube has served on the Speakers Bureau/Scientific Advisory Board for Medtronic, Boston Scientific, JenaValve, and High Life; and owns equity interest in Millipede, Pi-Cardia, Ancora, Laminar, ReNiva Medical, and Shockwave. Dr Stone has received speaker honoraria from Medtronic, Pulnovo, and Infraredx; has served as a consultant for Valfix, TherOx, Robocath, HeartFlow, Ablative Solutions, Vectorious, Miracor, Neovasc, Abiomed, Ancora, Elucid Bio, Occlutech, CorFlow, Apollo Therapeutics, Impulse Dynamics, Cardiomech, Gore, Amgen, and Adona Medical; owns equity/options in Ancora, Cagent, Applied Therapeutics, the Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, Valfix, and Xenter; has a daughter who is an employee at Medtronic; and his employer (Mount Sinai Hospital) has received research support from Abbott, Abiomed, Bioventrix, Cardiovascular Systems, Philips, Biosense Webster, Shockwave, Vascular Dynamics, and V-wave. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/03/02 06:00 MHDA- 2023/03/04 06:00 CRDT- 2023/03/01 20:57 PHST- 2022/09/26 00:00 [received] PHST- 2022/12/01 00:00 [revised] PHST- 2022/12/05 00:00 [accepted] PHST- 2023/03/01 20:57 [entrez] PHST- 2023/03/02 06:00 [pubmed] PHST- 2023/03/04 06:00 [medline] AID - S1936-8798(22)02245-2 [pii] AID - 10.1016/j.jcin.2022.12.009 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Feb 27;16(4):396-411. doi: 10.1016/j.jcin.2022.12.009. Epub 2023 Jan 18. PMID- 36858658 OWN - NLM STAT- MEDLINE DCOM- 20230303 LR - 20250530 IS - 1876-7605 (Electronic) IS - 1936-8798 (Print) IS - 1936-8798 (Linking) VI - 16 IP - 4 DP - 2023 Feb 27 TI - Transcaval Access and Closure Best Practices. PG - 371-395 LID - S1936-8798(22)02238-5 [pii] LID - 10.1016/j.jcin.2022.12.005 [doi] AB - Transcaval aortic access is a versatile electrosurgical technique for large-bore arterial access through the wall of the abdominal aorta from the adjoining inferior vena cava. Although counterintuitive, its relative safety derives from the recognition that interstitial hydraulic pressure exceeds venous pressure, so arterial bleeding harmlessly decompresses into the nearby caval venous hole. Transcaval access has been performed in thousands of patients for transcatheter aortic valve replacement and endovascular thoracic aneurysm repair and to avoid limb ischemia in percutaneous mechanical circulatory support. Transcaval access may have value compared with transaxillary or subclavian access and with surgical transcarotid access when standard transfemoral access is not optimal. The dissemination of transcaval access and closure techniques has been hampered by the unavailability of commercially marketed devices. This state-of-the-art review details exemplary transcaval technique, patient selection, computed tomographic planning, step-by-step access and closure, management of complications, and procedural troubleshooting in special situations. These contemporary best practices can help operators gain or maintain proficiency. CI - Published by Elsevier Inc. FAU - Lederman, Robert J AU - Lederman RJ AD - Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. Electronic address: lederman@nih.gov. FAU - Greenbaum, Adam B AU - Greenbaum AB AD - Structural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA. Electronic address: https://twitter.com/AdamGreenbaumMD. FAU - Khan, Jaffar M AU - Khan JM AD - Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; St. Francis Hospital and Heart Center, Roslyn, New York, USA. FAU - Bruce, Christopher G AU - Bruce CG AD - Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Babaliaros, Vasilis C AU - Babaliaros VC AD - Structural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA. FAU - Rogers, Toby AU - Rogers T AD - Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; MedStar Washington Hospital Center, Washington, District of Columbia, USA. LA - eng GR - ZIA HL006040/ImNIH/Intramural NIH HHS/United States GR - ZIA HL006045/ImNIH/Intramural NIH HHS/United States GR - ZID HL006061/ImNIH/Intramural NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Intramural PT - Review PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Treatment Outcome MH - *Aorta, Abdominal MH - *Arteries MH - Endovascular Aneurysm Repair MH - Patient Selection PMC - PMC9989507 MID - NIHMS1857130 OTO - NOTNLM OT - TAVR OT - TEVAR OT - mechanical circulatory support OT - nonfemoral access OT - transcaval OT - vascular access COIS- Funding Support and Author Disclosures This work was supported by the Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health (grant Z01-HL006040) (to Dr Lederman). All authors are coinventors of patents, assigned to the National Institutes of Health, for transcaval- or electrosurgery-related devices. Drs Greenbaum and Babaliaros have received institutional research support from Abbott Vascular, Ancora Heart, Edwards Lifesciences, Gore Medical, JenaValve, Medtronic, Polares Medical, Transmural Systems, and 4C Medical; have received consulting fees from Abbott Vascular, Edwards Lifesciences, and Medtronic; and have equity interest in Transmural Systems. Dr Rogers is a consultant and physician proctor for Edwards Lifesciences, Medtronic, and Boston Scientific; is an advisory board member for Medtronic; and holds equity interest in Transmural Systems. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/03/02 06:00 MHDA- 2023/03/04 06:00 PMCR- 2023/03/07 CRDT- 2023/03/01 20:57 PHST- 2022/10/12 00:00 [received] PHST- 2022/11/15 00:00 [revised] PHST- 2022/12/05 00:00 [accepted] PHST- 2023/03/01 20:57 [entrez] PHST- 2023/03/02 06:00 [pubmed] PHST- 2023/03/04 06:00 [medline] PHST- 2023/03/07 00:00 [pmc-release] AID - S1936-8798(22)02238-5 [pii] AID - 10.1016/j.jcin.2022.12.005 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Feb 27;16(4):371-395. doi: 10.1016/j.jcin.2022.12.005. PMID- 36846884 OWN - NLM STAT- MEDLINE DCOM- 20230608 LR - 20240606 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 19 IP - 2 DP - 2023 Jun 5 TI - Prophylactic intra-aortic balloon pump in transfemoral transcatheter aortic valve implantation. PG - e188-e190 LID - EIJ-D-22-00798 [pii] LID - 10.4244/EIJ-D-22-00798 [doi] FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. AD - Cardiovascular Research Foundation, New York, NY, USA. FAU - Leone, Pier Pasquale AU - Leone PP AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Sturla, Matteo AU - Sturla M AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Curio, Jonathan AU - Curio J AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Spring, Alexander M AU - Spring AM AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Ressa, Gaia AU - Ressa G AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Ludwig, Sebastian AU - Ludwig S AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. AD - Cardiovascular Research Foundation, New York, NY, USA. FAU - Sugiura, Tadahisa AU - Sugiura T AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Assafin, Manaf AU - Assafin M AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Granada, Juan F AU - Granada JF AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. AD - Cardiovascular Research Foundation, New York, NY, USA. FAU - Chau, Mei AU - Chau M AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Doolittle, James AU - Doolittle J AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA. LA - eng PT - Journal Article DEP - 20230605 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - *Balloon Valvuloplasty PMC - PMC10240718 COIS- A. Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, and Abbott. S. Ludwig has received travel compensation from Edwards Lifesciences and consulting fees from Bayer. The other authors have no conflicts of interest to declare related to the content of this paper. EDAT- 2023/02/28 06:00 MHDA- 2023/06/08 06:42 PMCR- 2024/06/05 CRDT- 2023/02/27 06:14 PHST- 2023/06/08 06:42 [medline] PHST- 2023/02/28 06:00 [pubmed] PHST- 2023/02/27 06:14 [entrez] PHST- 2024/06/05 00:00 [pmc-release] AID - EIJ-D-22-00798 [pii] AID - 10.4244/EIJ-D-22-00798 [doi] PST - epublish SO - EuroIntervention. 2023 Jun 5;19(2):e188-e190. doi: 10.4244/EIJ-D-22-00798. PMID- 36836084 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230301 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 4 DP - 2023 Feb 16 TI - A Referral Center Experience with Cerebral Protection Devices: Challenging Cardiac Thrombus in the EP Lab. LID - 10.3390/jcm12041549 [doi] LID - 1549 AB - BACKGROUND: Cerebral protection devices (CPD) are designed to prevent cardioembolic stroke and most evidence that exists relates to TAVR procedures. There are missing data on the benefits of CPD in patients that are considered high risk for stroke undergoing cardiac procedures like left atrial appendage (LAA) closure or catheter ablation of ventricular tachycardia (VT) when cardiac thrombus is present. PURPOSE: This work aimed to examine the feasibility and safety of the routine use of CPD in patients with cardiac thrombus undergoing interventions in the electrophysiology (EP) lab of a large referral center. METHODS: The CPD was placed under fluoroscopic guidance in all procedures in the beginning of the intervention. Two different CPDs were used according to the physician's discretion: (1) a capture device consisting of two filters for the brachiocephalic and left common carotid arteries placed over a 6F sheath from a radial artery; or (2) a deflection device covering all three supra-aortic vessels placed over an 8F femoral sheath. Retrospective periprocedural and safety data were obtained from procedural reports and discharge letters. Long-term safety data were obtained by clinical follow-up in our institution and telephone consultations. RESULTS: We identified 30 consecutive patients in our EP lab who underwent interventions (21 LAA closure, 9 VT ablation) with placement of a CPD due to cardiac thrombus. Mean age was 70 +/- 10 years and 73% were male, while mean LVEF was 40 +/- 14%. The location of the cardiac thrombus was the LAA in all 21 patients (100%) undergoing LAA-closure, whereas, in the 9 patients undergoing VT ablation, thrombus was present in the LAA in 5 cases (56%), left ventricle (n = 3, 33%) and aortic arch (n = 1, 11%). The capture device was used in 19 out of 30 (63%) and the deflection device in 11 out of 30 cases (37%). There were no periprocedural strokes or transitory ischemic attacks (TIA). CPD-related complications comprised the vascular access and were as follows: two cases of pseudoaneurysm of the femoral artery not requiring surgery (7%), 1 hematoma at the arterial puncture site (3%) and 1 venous thrombosis (3%) resolved by warfarin. At long-term follow-up, 1 TIA and 2 non-cardiovascular deaths occurred, with a mean follow-up time of 660 days. CONCLUSIONS: Placement of a cerebral protection device prior to LAA closure or VT ablation in patients with cardiac thrombus proved feasible, but possible vascular complications needed to be taken into account. A benefit in periprocedural stroke prevention for these interventions seemed plausible but has yet to be proven in larger and randomized trials. FAU - Berg, Jan AU - Berg J AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. AD - Division of Cardiology, Cantonal Hospital of Aarau, 5001 Aarau, Switzerland. FAU - Preda, Alberto AU - Preda A AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. FAU - Fierro, Nicolai AU - Fierro N AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. FAU - Marzi, Alessandra AU - Marzi A AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. FAU - Radinovic, Andrea AU - Radinovic A AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. FAU - Della Bella, Paolo AU - Della Bella P AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. FAU - Mazzone, Patrizio AU - Mazzone P AD - Division of Arrhythmology, San Raffaele Hospital, 20132 Milan, Italy. LA - eng PT - Journal Article DEP - 20230216 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9967427 OTO - NOTNLM OT - catheter ablation OT - cerebral protection OT - left atrial appendage closure OT - stroke COIS- The authors declare no conflict of interest. EDAT- 2023/02/26 06:00 MHDA- 2023/02/26 06:01 PMCR- 2023/02/16 CRDT- 2023/02/25 03:06 PHST- 2022/12/29 00:00 [received] PHST- 2023/01/30 00:00 [revised] PHST- 2023/02/13 00:00 [accepted] PHST- 2023/02/25 03:06 [entrez] PHST- 2023/02/26 06:00 [pubmed] PHST- 2023/02/26 06:01 [medline] PHST- 2023/02/16 00:00 [pmc-release] AID - jcm12041549 [pii] AID - jcm-12-01549 [pii] AID - 10.3390/jcm12041549 [doi] PST - epublish SO - J Clin Med. 2023 Feb 16;12(4):1549. doi: 10.3390/jcm12041549. PMID- 36829650 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230228 IS - 2306-5354 (Print) IS - 2306-5354 (Electronic) IS - 2306-5354 (Linking) VI - 10 IP - 2 DP - 2023 Jan 24 TI - Similar 5-Year Survival in Transfemoral and Transapical TAVI Patients: A Single-Center Experience. LID - 10.3390/bioengineering10020156 [doi] LID - 156 AB - Transapical transcatheter aortic valve implantation (TA-TAVI) is generally considered to be associated with increased morbidity and mortality compared with transfemoral transcatheter aortic valve implantation TAVI (TF-TAVI). We aimed to compare different patient risk profiles, access-related complications, and long-term survival using inverse probability treatment weighting. This is a retrospective, single-center analysis of 925 consecutive patients with aortic valve stenosis undergoing TF-TAVI (n = 802) or TA-TAVI (n = 123) at the University Hospital Basel, Switzerland, as a single procedure between September 2011 and August 2020. Baseline characteristics revealed a higher perioperative risk as reflected in the EuroSCORE II (geometric mean 2.3 (95% confidence interval (CI) 2.2 to 2.4) vs. 3.7 (CI 3.1 to 4.5); before inverse probability of treatment weighting (IPTW) p < 0.001) in the transfemoral than in the transapical group, respectively. After 30 days, TF-TAVI patients had a higher incidence of any bleeding than TA-TAVI patients (TF-TAVI n = 146 vs. TA-TAVI n = 15; weighted hazard ratio (HR) 0.52 (0.29 to 0.95); p = 0.032). After 5 years, all-cause mortality did not differ between the two groups (TF-TAVI n = 162 vs. TA-TAVI n = 45; weighted HR 1.31, (0.92 to 1.88); p = 0.138). With regard to our data, we could demonstrate, despite a higher perioperative risk, the short- and long-term safety and efficacy of the transapical approach for TAVI therapies. Though at higher perioperative risk, transapically treated patients suffered from less bleeding or vascular complications than transfemorally treated patients. It is of utmost interest that 5-year mortality did not differ between the groups. FAU - Mork, Constantin AU - Mork C AUID- ORCID: 0000-0001-7928-850X AD - Department of Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland. AD - Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland. FAU - Twerenbold, Raphael AU - Twerenbold R AUID- ORCID: 0000-0003-3814-6542 AD - Department of Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland. AD - University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, 20251 Hamburg, Germany. AD - Department of Cardiology, University Heart and Vascular Center Hamburg, 20251 Hamburg, Germany. FAU - Gahl, Brigitta AU - Gahl B AD - Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland. FAU - Eckstein, Friedrich AU - Eckstein F AD - Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland. FAU - Jeger, Raban AU - Jeger R AUID- ORCID: 0000-0003-1290-5491 AD - Department of Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland. AD - Department of Cardiology, Triemli Hospital Zurich, 8063 Zurich, Switzerland. FAU - Kaiser, Christoph AU - Kaiser C AD - Department of Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland. AD - Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland. FAU - Reuthebuch, Oliver AU - Reuthebuch O AUID- ORCID: 0000-0003-1386-0686 AD - Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland. LA - eng PT - Journal Article DEP - 20230124 PL - Switzerland TA - Bioengineering (Basel) JT - Bioengineering (Basel, Switzerland) JID - 101676056 PMC - PMC9952102 OTO - NOTNLM OT - aortic valve replacement OT - mortality OT - transcatheter COIS- The authors declare no conflict of interest. EDAT- 2023/02/26 06:00 MHDA- 2023/02/26 06:01 PMCR- 2023/01/24 CRDT- 2023/02/25 01:05 PHST- 2022/12/29 00:00 [received] PHST- 2023/01/16 00:00 [revised] PHST- 2023/01/20 00:00 [accepted] PHST- 2023/02/25 01:05 [entrez] PHST- 2023/02/26 06:00 [pubmed] PHST- 2023/02/26 06:01 [medline] PHST- 2023/01/24 00:00 [pmc-release] AID - bioengineering10020156 [pii] AID - bioengineering-10-00156 [pii] AID - 10.3390/bioengineering10020156 [doi] PST - epublish SO - Bioengineering (Basel). 2023 Jan 24;10(2):156. doi: 10.3390/bioengineering10020156. PMID- 36821875 OWN - NLM STAT- MEDLINE DCOM- 20230314 LR - 20230426 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 192 DP - 2023 Apr 1 TI - Meta-Analysis on Transcarotid Versus Transfemoral and Other Alternate Accesses for Transcatheter Aortic Valve Implantation. PG - 196-205 LID - S0002-9149(23)00023-1 [pii] LID - 10.1016/j.amjcard.2023.01.023 [doi] AB - Transcarotid access has emerged as the preferred access site for transcatheter aortic valve implantation (TAVI) in patients with prohibitive iliofemoral anatomy. This study aimed to compare outcomes with transcarotid with those of other accesses in patients who underwent TAVI. Cochrane, EMBASE, and MEDLINE databases were searched for all published studies that compared outcomes with transcarotid with those of other accesses (transfemoral, transaxillary/subclavian, transaortic, and transapical) in patients who underwent TAVI. The primary outcome was all-cause mortality. Secondary outcomes included major bleeding, major vascular complications, stroke, myocardial infarction, permanent pacemaker implantation, and peri-aortic valve insufficiency. We included 22 observational studies with a total of 11,896 patients. Outcomes were reported during hospitalization and at 1-month follow-up. The transcarotid approach had higher mortality at 1 month (3.7% vs 2.6%, p = 0.02) but lower major vascular complications during hospitalization (1.5% vs 3.4%, p = 0.04) than did transfemoral access. The transcarotid approach had lower major vascular complications (2% vs 2.3%, p = 0.04) than did the transaxillary/subclavian but higher major bleeding (5.3% vs 2.6%, p = 0.03). The transaortic approach was associated with higher in-hospital (11.7% vs 1.9%, p = 0.02) and 1-month mortality (14.4% vs 3.9%, p = 0.007) rates than was transcarotid access. The transcarotid approach numerically reduced mortality and the risk of major vascular complications and major bleeding compared with the transapical approach; however, this did not reach statistical significance. The transcarotid approach did not increase the risk of stroke compared with transfemoral or the other alternative accesses. In conclusion, the transcarotid or transaxillary/subclavian approach had associated comparable outcomes that were better than those of the transapical and transaortic approaches. There was no difference in stroke risk between transcarotid access and other accesses. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Abraham, Bishoy AU - Abraham B AD - Department of Cardiovascular Disease, Mayo Clinic Hospital, Phoenix, Arizona. Electronic address: bisho.abraham@gmail.com. FAU - Sous, Mina AU - Sous M AD - Department of Medicine, Amita Health Saint Francis Hospital, Evanston, Illinois. FAU - Sedhom, Ramy AU - Sedhom R AD - Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania. FAU - Megaly, Michael AU - Megaly M AD - Department of Cardiovascular Disease, Willis-Knighton Health System, Shreveport, Louisiana. FAU - Roman, Sherif AU - Roman S AD - Department of Medicine, St Joseph's University, Clifton, New Jersey. FAU - Sweeney, John AU - Sweeney J AD - Department of Cardiovascular Disease, Mayo Clinic Hospital, Phoenix, Arizona. FAU - Alkhouli, Mohamad AU - Alkhouli M AD - Department of Cardiovascular Disease, Mayo Clinic Hospital, Rochester, Minnesota. FAU - Pollak, Peter AU - Pollak P AD - Department of Cardiovascular Disease, Mayo Clinic Hospital, Rochester, Minnesota. FAU - El Sabbagh, Abdallah AU - El Sabbagh A AD - Department of Cardiovascular Disease, Mayo Clinic Hospital, Jacksonville, Florida. FAU - Garcia, Santigao AU - Garcia S AD - Department of Cardiovascular Disease, the Christ Hospital, Cincinnati, Ohio. FAU - Goel, Sachin S AU - Goel SS AD - Department of Cardiovascular Disease, Houston Methodist Hospital, Houston, Texas. FAU - Saad, Marwan AU - Saad M AD - Department of Medicine, Division of Cardiovascular Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. FAU - Fortuin, David AU - Fortuin D AD - Department of Cardiovascular Disease, Mayo Clinic Hospital, Phoenix, Arizona. LA - eng PT - Journal Article PT - Meta-Analysis DEP - 20230221 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - *Aortic Valve Insufficiency/etiology MH - *Myocardial Infarction/etiology MH - *Stroke/etiology MH - Treatment Outcome MH - Aortic Valve/surgery MH - Risk Factors COIS- Disclosures The authors have no conflicts of interest to declare. EDAT- 2023/02/24 06:00 MHDA- 2023/03/15 06:00 CRDT- 2023/02/23 18:04 PHST- 2022/10/21 00:00 [received] PHST- 2023/01/02 00:00 [revised] PHST- 2023/01/13 00:00 [accepted] PHST- 2023/02/24 06:00 [pubmed] PHST- 2023/03/15 06:00 [medline] PHST- 2023/02/23 18:04 [entrez] AID - S0002-9149(23)00023-1 [pii] AID - 10.1016/j.amjcard.2023.01.023 [doi] PST - ppublish SO - Am J Cardiol. 2023 Apr 1;192:196-205. doi: 10.1016/j.amjcard.2023.01.023. Epub 2023 Feb 21. PMID- 36819291 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230224 IS - 2223-4292 (Print) IS - 2223-4306 (Electronic) IS - 2223-4306 (Linking) VI - 13 IP - 2 DP - 2023 Feb 1 TI - Improved image quality in transcatheter aortic valve implantation planning CT using deep learning-based image reconstruction. PG - 970-981 LID - 10.21037/qims-22-639 [doi] AB - BACKGROUND: This study aims to evaluate the impact of a novel deep learning-based image reconstruction (DLIR) algorithm on the image quality in computed tomographic angiography (CTA) for pre-interventional planning of transcatheter aortic valve implantation (TAVI). METHODS: We analyzed 50 consecutive patients (median age 80 years, 25 men) who underwent TAVI planning CT on a 256-dectector-row CT. Images were reconstructed with adaptive statistical iterative reconstruction V (ASIR-V) and DLIR. Intravascular image noise, edge sharpness, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were quantified for ascending aorta, descending aorta, abdominal aorta and iliac arteries. Two readers (one radiologist and one interventional cardiologist) scored task-specific subjective image quality on a five-point scale. RESULTS: DLIR significantly reduced median image noise by 29-57% at all anatomical locations (all P<0.001). Accordingly, median SNR improved by 44-133% (all P<0.001) and median CNR improved by 44-125% (all P<0.001). DLIR significantly improved subjective image quality for all four pre-specified TAVI-specific tasks (measuring the annulus, assessing valve morphology and calcifications, the coronary ostia, and the suitability of the aorto-iliac access route) for both the radiologist and the interventional cardiologist (P0.05). CONCLUSIONS: DLIR significantly improves objective and subjective image quality in TAVI planning CT compared to a state-of-the-art iterative reconstruction without affecting measurements of the aortic annulus. This may provide an opportunity for further reductions in contrast medium volume in this population. CI - 2023 Quantitative Imaging in Medicine and Surgery. All rights reserved. FAU - Heinrich, Andra AU - Heinrich A AD - Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany. FAU - Yucel, Seyrani AU - Yucel S AD - Department of Internal Medicine, Division of Cardiology, University Medical Centre Rostock, Rostock, Germany. FAU - Bottcher, Benjamin AU - Bottcher B AD - Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany. FAU - Oner, Alper AU - Oner A AD - Department of Internal Medicine, Division of Cardiology, University Medical Centre Rostock, Rostock, Germany. FAU - Manzke, Mathias AU - Manzke M AD - Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany. FAU - Klemenz, Ann-Christin AU - Klemenz AC AD - Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany. FAU - Weber, Marc-Andre AU - Weber MA AD - Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany. FAU - Meinel, Felix G AU - Meinel FG AD - Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany. LA - eng PT - Journal Article DEP - 20221220 PL - China TA - Quant Imaging Med Surg JT - Quantitative imaging in medicine and surgery JID - 101577942 PMC - PMC9929406 OTO - NOTNLM OT - Transcatheter aortic valve implantation (TAVI) OT - computed tomography OT - deep learning OT - image quality OT - image reconstruction COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-639/coif). FGM reports that he was supported by a research grant from GE Healthcare. The other authors have no conflicts of interest to declare. EDAT- 2023/02/24 06:00 MHDA- 2023/02/24 06:01 PMCR- 2023/02/01 CRDT- 2023/02/23 10:02 PHST- 2022/06/20 00:00 [received] PHST- 2022/11/10 00:00 [accepted] PHST- 2023/02/23 10:02 [entrez] PHST- 2023/02/24 06:00 [pubmed] PHST- 2023/02/24 06:01 [medline] PHST- 2023/02/01 00:00 [pmc-release] AID - qims-13-02-970 [pii] AID - 10.21037/qims-22-639 [doi] PST - ppublish SO - Quant Imaging Med Surg. 2023 Feb 1;13(2):970-981. doi: 10.21037/qims-22-639. Epub 2022 Dec 20. PMID- 36802100 OWN - NLM STAT- MEDLINE DCOM- 20230314 LR - 20230411 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 101 IP - 4 DP - 2023 Mar TI - Outcomes with plug-based versus suture-based vascular closure device after transfemoral transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 817-827 LID - 10.1002/ccd.30597 [doi] AB - BACKGROUND: Studies comparing plug-based (i.e., MANTA) with suture-based (i.e., ProStar XL and ProGlide) vascular closure devices (VCDs) for large-bore access closure after transcatheter aortic valve replacement (TAVR) have yielded mixed results. AIMS: To examine the comparative safety and efficacy of both types of VCDs among TAVR recipients. METHODS: An electronic database search was performed through March 2022 for studies comparing access-site related vascular complications with plug-based versus suture-based VCDs for large-bore access site closure after transfemoral (TF) TAVR. RESULTS: Ten studies (2 randomized controlled trials [RCTs] and 8 observational studies) with 3113 patients (MANTA = 1358, ProGlide/ProStar XL = 1755) were included. There was no difference between plug-based and suture-based VCD in the incidence of access-site major vascular complications (3.1% vs. 3.3%, odds ratio [OR]: 0.89; 95% confidence interval [CI]: 0.52-1.53). The incidence of VCD failure was lower in plug-based VCD (5.2% vs. 7.1%, OR: 0.64; 95% CI: 0.44-0.91). There was a trend toward a higher incidence of unplanned vascular intervention in plug-based VCD (8.2% vs. 5.9%, OR: 1.35; 95% CI: 0.97-1.89). Length of stay was shorter with MANTA. Subgroup analyses suggested significant interaction based on study designs such that there was higher incidence of access-site vascular complications and bleeding events with plug-based versus suture-based VCD among RCTs. CONCLUSION: In patients undergoing TF-TAVR, large-bore access site closure with plug-based VCD was associated with a similar safety profile as suture-based VCD. However, subgroup analysis showed that plug-based VCD was associated with higher incidence of vascular and bleeding complications in RCTs. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Sedhom, Ramy AU - Sedhom R AUID- ORCID: 0000-0002-9395-0851 AD - Division of Cardiology, Loma Linda University Health, Loma Linda, California, USA. FAU - Dang, Alexander T AU - Dang AT AD - Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA. FAU - Elwagdy, Amr AU - Elwagdy A AD - Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USA. FAU - Megaly, Michael AU - Megaly M AD - Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA. FAU - Elgendy, Islam Y AU - Elgendy IY AUID- ORCID: 0000-0001-9853-7591 AD - Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky, USA. FAU - Zahr, Firas AU - Zahr F AUID- ORCID: 0000-0001-8448-8880 AD - Division of Cardiology, Oregon Health and Science University, Portland, Oregon, USA. FAU - Gafoor, Samir AU - Gafoor S AD - Swedish Heart and Vascular Institute, Seattle, Washington, USA. FAU - Mamas, Mamas AU - Mamas M AD - Centre for Prognosis Research, Keele Cardiovascular Research Group, Keele University, Keele, UK. AD - Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK. FAU - Elbadawi, Ayman AU - Elbadawi A AUID- ORCID: 0000-0002-4248-781X AD - Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20230219 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2023 Apr;101(5):965-966. doi: 10.1002/ccd.30640. PMID: 36950827 MH - Humans MH - *Vascular Closure Devices MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery MH - Sutures MH - Femoral Artery/surgery MH - Hemostatic Techniques MH - Aortic Valve/surgery OTO - NOTNLM OT - MANTA OT - ProGlide OT - ProStar OT - vascular closure device EDAT- 2023/02/22 06:00 MHDA- 2023/03/15 06:00 CRDT- 2023/02/21 16:57 PHST- 2022/10/25 00:00 [revised] PHST- 2022/05/11 00:00 [received] PHST- 2023/02/04 00:00 [accepted] PHST- 2023/02/22 06:00 [pubmed] PHST- 2023/03/15 06:00 [medline] PHST- 2023/02/21 16:57 [entrez] AID - 10.1002/ccd.30597 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Mar;101(4):817-827. doi: 10.1002/ccd.30597. Epub 2023 Feb 19. PMID- 36799217 OWN - NLM STAT- MEDLINE DCOM- 20230323 LR - 20250530 IS - 1941-7632 (Electronic) IS - 1941-7640 (Print) IS - 1941-7640 (Linking) VI - 16 IP - 3 DP - 2023 Mar TI - Transcatheter Electrosurgery: A Narrative Review. PG - e012019 LID - 10.1161/CIRCINTERVENTIONS.122.012019 [doi] AB - Transcatheter electrosurgery describes the ability to cut and traverse tissue, at a distance, without an open surgical field and is possible using either purpose-built or off-the-shelf devices. Tissue traversal requires focused delivery of radiofrequency energy to a guidewire tip. Initially employed to cross atretic pulmonary valves, tissue traversal has enabled transcaval aortic access, recanalization of arterial and venous occlusions, transseptal access, and many other techniques. To cut tissue, the selectively denuded inner curvature of a kinked guidewire (the Flying-V) or a single-loop snare is energized during traction. Adjunctive techniques may complement or enable contemporary transcatheter procedures, whereas myocardial slicing or excision of ectopic masses may offer definitive therapy. In this contemporary review we discuss the principles of transcatheter electrosurgery, and through exemplary clinical applications highlight the range of therapeutic options offered by this versatile family of procedures. FAU - Bruce, Christopher G AU - Bruce CG AUID- ORCID: 0000-0002-7442-4303 AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.G.B., J.M.K., T.R., D.K.Y., R.J.L.). FAU - Khan, Jaffar M AU - Khan JM AUID- ORCID: 0000-0001-6099-0753 AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.G.B., J.M.K., T.R., D.K.Y., R.J.L.). FAU - Rogers, Toby AU - Rogers T AUID- ORCID: 0000-0002-6043-3137 AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.G.B., J.M.K., T.R., D.K.Y., R.J.L.). AD - MedStar Washington Hospital Center, Washington, DC (T.R.). FAU - Yildirim, D Korel AU - Yildirim DK AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.G.B., J.M.K., T.R., D.K.Y., R.J.L.). FAU - Babaliaros, Vasilis C AU - Babaliaros VC AUID- ORCID: 0000-0002-9438-0846 AD - Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA (V.C.B., A.B.G.). FAU - Greenbaum, Adam B AU - Greenbaum AB AUID- ORCID: 0000-0001-7496-5954 AD - Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA (V.C.B., A.B.G.). FAU - Lederman, Robert J AU - Lederman RJ AUID- ORCID: 0000-0003-1202-6673 AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (C.G.B., J.M.K., T.R., D.K.Y., R.J.L.). LA - eng GR - ZIA HL006040/ImNIH/Intramural NIH HHS/United States GR - ZIA HL006041/ImNIH/Intramural NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Intramural PT - Review DEP - 20230217 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Humans MH - Electrosurgery/adverse effects/methods MH - Treatment Outcome MH - Catheterization MH - *Vascular Diseases MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis PMC - PMC10108249 MID - NIHMS1868723 OTO - NOTNLM OT - catheter OT - catheterization OT - electrode OT - electrosurgery OT - transcatheter aortic valve replacement EDAT- 2023/02/18 06:00 MHDA- 2023/03/24 06:00 PMCR- 2024/03/01 CRDT- 2023/02/17 05:02 PHST- 2023/02/18 06:00 [pubmed] PHST- 2023/03/24 06:00 [medline] PHST- 2023/02/17 05:02 [entrez] PHST- 2024/03/01 00:00 [pmc-release] AID - 10.1161/CIRCINTERVENTIONS.122.012019 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2023 Mar;16(3):e012019. doi: 10.1161/CIRCINTERVENTIONS.122.012019. Epub 2023 Feb 17. PMID- 36792752 OWN - NLM STAT- MEDLINE DCOM- 20230508 LR - 20240918 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 112 IP - 5 DP - 2023 May TI - Temporal changes of patient characteristics over 12 years in a single-center transcatheter aortic valve implantation cohort. PG - 691-701 LID - 10.1007/s00392-023-02166-8 [doi] AB - BACKGROUND: Beneficial results of transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement (SAVR) in patients at all risk strata have led to substantial changes in guideline recommendations for valvular heart disease. AIM: To examine influence of these guideline changes on a real-world TAVI cohort, we evaluated how risk profiles and outcomes of TAVI patients developed in our single-center patient cohort over a period of 12 years. METHODS: Baseline, procedural and 30-day outcome parameters of TAVI patients were retrospectively compared between three time periods (period 1: 2008-2012, period 2: 2013-2017, period 3: 2018-2020). RESULTS: Between 03/2008 and 12/2020, a total of 3678 patients underwent TAVI at our center. The median age was 81.1 years (25th, 75th percentile: 76.7, 84.9) with no significant change over time. The EuroSCORE II showed a continuous and significant decline from 5.3% (3.3, 8.6) in period 1 to 2.8% (1.7, 5.0) in period 3 (p < 0.001). Furthermore, rates of permanent pacemaker implantation, acute kidney injury, and paravalvular leakage >/= moderate continuously declined over time. Accordingly, the 30-day mortality fell from 9.3% in period 1 to 4.3% in period 3 (p < 0.001). CONCLUSION: Despite substantial guideline alterations, median patient age remained largely unchanged in our TAVI cohort over the past 12 years. Therefore, increased age still appears to be the main reason to choose TAVI over SAVR. However, risk profiles declined substantially. Significant improvements in early outcomes suggest favorable influence of less invasive access routes, improved device platforms and growing user experience. CI - (c) 2023. The Author(s). FAU - Demal, Till Joscha AU - Demal TJ AUID- ORCID: 0000-0001-8978-9914 AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. t.demal@uke.de. FAU - Weimann, Jessica AU - Weimann J AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Ojeda, Francisco Miguel AU - Ojeda FM AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Linder, Matthias AU - Linder M AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Ludwig, Sebastian AU - Ludwig S AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Grundmann, David AU - Grundmann D AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Voigtlander, Lisa AU - Voigtlander L AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Waldschmidt, Lara AU - Waldschmidt L AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Schirmer, Johannes AU - Schirmer J AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Schofer, Niklas AU - Schofer N AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Blankenberg, Stefan AU - Blankenberg S AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Reichenspurner, Hermann AU - Reichenspurner H AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - Department of Cardiology, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany. LA - eng GR - Clinician Scientist Programme/Deutsches Zentrum fur Herz-Kreislaufforschung/ GR - FKZ 81X3710109/Deutsches Zentrum fur Herz-Kreislaufforschung/ PT - Journal Article DEP - 20230215 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Aged, 80 and over MH - Child MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Aortic Valve Stenosis/diagnosis/surgery/etiology MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome MH - Aortic Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis Implantation/adverse effects/methods PMC - PMC10160189 OTO - NOTNLM OT - Guidelines OT - Low risk OT - Surgical risk OT - TAVI OT - TAVR COIS- Sebastian Ludwig received travel compensation from Edwards Lifesciences Inc. Hermann Reichenspurner received travel compensation and lecture remunerations from Edwards Lifesciences Inc. and Medtronic Inc. Lenard Conradi is a proctor and consultant for Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific. Moritz Seiffert reports personal fees and non-financial support from Abbott Vascular, personal fees from Abiomed, personal fees from AstraZeneca, personal fees from Bayer Healthcare, personal fees from Boehringer Ingelheim, grants, personal fees and non-financial support from Boston Scientific, personal fees from Bristol-Myers Squibb, personal fees and non-financial support from Edwards Lifesciences, grants and personal fees from Philips, personal fees from Medtronic, personal fees from Amgen, personal fees from Shockwave Medical, personal fees from Daichii Sankyo, personal fees from Pfizer, personal fees from Siemens Healthineers, and personal fees from Inari Medical. Andreas Schafer received travel compensation from Edwards Lifesciences Inc. and lecture fees from Abbott. All other authors declared no conflict of interest. EDAT- 2023/02/16 06:00 MHDA- 2023/05/08 10:17 PMCR- 2023/02/15 CRDT- 2023/02/15 23:23 PHST- 2022/10/28 00:00 [received] PHST- 2023/01/30 00:00 [accepted] PHST- 2023/05/08 10:17 [medline] PHST- 2023/02/16 06:00 [pubmed] PHST- 2023/02/15 23:23 [entrez] PHST- 2023/02/15 00:00 [pmc-release] AID - 10.1007/s00392-023-02166-8 [pii] AID - 2166 [pii] AID - 10.1007/s00392-023-02166-8 [doi] PST - ppublish SO - Clin Res Cardiol. 2023 May;112(5):691-701. doi: 10.1007/s00392-023-02166-8. Epub 2023 Feb 15. PMID- 36769593 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230214 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 3 DP - 2023 Jan 26 TI - Procedural Outcomes of a Self-Expanding Transcatheter Heart Valve in Patients with Porcelain Aorta. LID - 10.3390/jcm12030945 [doi] LID - 945 AB - BACKGROUND: Severe calcification of the ascending aorta increases the peri-operative risk for neurological complications in patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) seems to be an optimal treatment option in these patients. However, the impact of the extent of aortic calcification on procedural and neurological outcomes during TAVI is unclear. METHODS: Data from 3010 patients with severe native aortic valve stenosis treated with ACURATE neo/neo2 from May 2012 to July 2022 were evaluated and matched by 2-to-1 nearest-neighbor matching to identify one patient with porcelain aorta (PA) (n = 492) compared with two patients without PA (n = 984). PA was additionally subdivided into circumferential (classic PA) (n = 89; 3.0%) and non-circumferential (partial PA) (n = 403; 13.4%) calcification. We compared outcomes according to VARC-3 criteria among patients with and without PA and identified predictors for occurrence of stroke in the overall population. RESULTS: Technical success (88.5% vs. 87.4%, p = 0.589) and device success at 30 days (82.3% vs. 81.5%, p = 0.755) after transcatheter ACURATE neo/neo2 implantation according to VARC-3 definition was high and did not differ between non-calcified aortas or PA. The rate of in-hospital complications according to VARC-3-definitions was low in both groups. Rates of all stroke (3.2% (n = 31) vs. 2.6% (n = 13), p = 0.705) or transitory ischemic attacks (1.1% vs. 1.2%, p = 1.000) did not differ significantly. Thirty-day all-cause mortality did not differ (3.0% vs. 3.2%, RR 1.1; p = 0.775). Overall device migration/embolization (OR 5.0 [2.10;11.87]), severe bleeding (OR 1.79 [1.11;2.89]), and major structural cardiac complications (OR 3.37 [1.32;8.57]) were identified as independent predictors for in-hospital stroke in a multivariate analysis after implantation of ACURATE neo/neo2. CONCLUSION: A porcelain aorta does not increase the risk of neurological complications after transfemoral ACURATE neo/neo2 implantation. Based on these findings, transfemoral ACURATE neo/neo2 implantation is safe in these particularly vulnerable patients. FAU - Eckel, Clemens AU - Eckel C AUID- ORCID: 0000-0002-8853-8096 AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - Department of Cardiology, University of Oldenburg, 26129 Oldenburg, Germany. FAU - Blumenstein, Johannes AU - Blumenstein J AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - Department of Cardiology, University of Oldenburg, 26129 Oldenburg, Germany. FAU - Grothusen, Christina AU - Grothusen C AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - Department of Cardiovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, 24118 Kiel, Germany. FAU - Tiyerili, Vedat AU - Tiyerili V AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. AD - Department of Cardiology, University of Bonn, 53113 Bonn, Germany. FAU - Elsasser, Albrecht AU - Elsasser A AD - Department of Cardiology, University of Oldenburg, 26129 Oldenburg, Germany. FAU - Dohmen, Guido AU - Dohmen G AUID- ORCID: 0000-0001-6577-7898 AD - Department of Cardiac Surgery, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Zeckzer, Anna AU - Zeckzer A AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Gaede, Luise AU - Gaede L AD - Department of Cardiology, University Hospital of Erlangen, 91054 Erlangen, Germany. FAU - Choi, Yeong-Hoon AU - Choi YH AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Charitos, Efstratios I AU - Charitos EI AUID- ORCID: 0000-0003-0284-8200 AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany. FAU - Renker, Matthias AU - Renker M AUID- ORCID: 0000-0002-4756-5397 AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. LA - eng PT - Journal Article DEP - 20230126 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9917710 OTO - NOTNLM OT - ACURATE OT - TAVI OT - THV OT - porcelain aorta OT - self-expanding OT - stroke COIS- The authors declare no conflict of interest. EDAT- 2023/02/12 06:00 MHDA- 2023/02/12 06:01 PMCR- 2023/01/26 CRDT- 2023/02/11 01:27 PHST- 2022/12/16 00:00 [received] PHST- 2023/01/07 00:00 [revised] PHST- 2023/01/22 00:00 [accepted] PHST- 2023/02/11 01:27 [entrez] PHST- 2023/02/12 06:00 [pubmed] PHST- 2023/02/12 06:01 [medline] PHST- 2023/01/26 00:00 [pmc-release] AID - jcm12030945 [pii] AID - jcm-12-00945 [pii] AID - 10.3390/jcm12030945 [doi] PST - epublish SO - J Clin Med. 2023 Jan 26;12(3):945. doi: 10.3390/jcm12030945. PMID- 36758861 OWN - NLM STAT- MEDLINE DCOM- 20230307 LR - 20230627 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 376 DP - 2023 Apr 1 TI - Quantification of physical activity with prospective activity tracking after transfemoral aortic valve replacement. PG - 100-107 LID - S0167-5273(23)00168-7 [pii] LID - 10.1016/j.ijcard.2023.01.085 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a well-established, safe and effective therapy for severe symptomatic aortic stenosis (AS). The aim of this study was to objectively quantify improvement of physical activity after TAVR, with consideration of different low-gradient AS subtypes. METHODS AND RESULTS: All patients undergoing TAVR for severe AS were screened. Participants received a wearable activity tracker (Fitbit(R)) at hospital discharge following TAVR and 6 months thereafter. The difference of median daily steps was defined as surrogate outcome for physical activity. For analysis, patients were grouped into high-gradient (HG) AS (dPmean >/=40 mmHg), classical low-flow low-gradient (LFLG) AS (dPmean <40 mmHg, EF <50%), paradoxical LFLG-AS (dPmean <40 mmHg, EF >/=50%, SVi /=50%, SVi >35 ml/m2) according to mean transvalvular pressure gradient (dPmean), stroke volume index (SVi) and left-ventricular ejection fraction (LVEF). RESULTS AND CONCLUSIONS: The analysis is based on 230 patients. The median daily step count was 4409 [IQR 2581-7487] after hospital discharge and 5326 [IQR 3045-8668] 6 months thereafter. Median difference of daily steps was ∆529 [IQR -702-2152]). Patients with HG-AS and paradoxical LFLG-AS showed a significant improvement of daily steps (∆951 [IQR -378-2323], p <0.001 and (∆1392 [IQR -609-4444], p = 0.02, respectively). Patients with classical LFLG-AS showed no statistically relevant improvement of daily steps (∆192 [IQR -687-770], p = 0.79). Patients with NFLG-AS showed a numerical decline in daily steps without statistical significance (∆-300 [IQR -1334-1406], p = 0.67). This first prospective study of this sample size shows significant improvement of physical activity after TAVR with an objective and reproducible method. This was mainly driven by an improvement in patients with HG-AS and paradoxical LFLG-AS. CI - Copyright (c) 2023 Elsevier B.V. All rights reserved. FAU - Haum, Magda AU - Haum M AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Humpfer, Fabian AU - Humpfer F AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Steffen, Julius AU - Steffen J AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Fischer, Julius AU - Fischer J AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Stocker, Thomas J AU - Stocker TJ AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Sadoni, Sebastian AU - Sadoni S AD - Herzchirurgische Klinik und Poliklinik, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Theiss, Hans AU - Theiss H AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Braun, Daniel AU - Braun D AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Orban, Martin AU - Orban M AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Rizas, Konstantinos AU - Rizas K AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Massberg, Steffen AU - Massberg S AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Hausleiter, Jorg AU - Hausleiter J AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany; German Centre for Cardiovascular Research (DZHK), partner site Munich, Germany. FAU - Deseive, Simon AU - Deseive S AD - Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, LMU Munchen, Marchioninistr. 15, 81377 Munich, Germany. Electronic address: simon.deseive@med.uni-muenchen.de. LA - eng PT - Journal Article DEP - 20230208 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Humans MH - Aortic Valve/surgery MH - Prospective Studies MH - Stroke Volume MH - Ventricular Function, Left MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Exercise MH - Treatment Outcome MH - Severity of Illness Index OTO - NOTNLM OT - Activity tracking OT - Aortic stenosis OT - Improvement of mobility OT - TAVR COIS- Declaration of Competing Interest JS received speaker honoraria from AstraZeneca. MO received speaker honoraria and travel compensations from Abbott Medical, AstraZeneca, Abiomed, Bayer vital, BIOTRONIK, Bristol-Myers Squibb, CytoSorbents, Daiichi Sankyo Germany, Edwards Lifesciences Services, and Sedana Medical. JH received research support Abbott Vascular and Edwards Lifesciences. DB received speaker honoraria from Abbott Vascular. SD received speaker honoraria from AstraZeneca. Other authors have no conflicts of interest to declare. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. EDAT- 2023/02/10 06:00 MHDA- 2023/03/08 06:00 CRDT- 2023/02/09 19:27 PHST- 2022/10/26 00:00 [received] PHST- 2023/01/11 00:00 [revised] PHST- 2023/01/31 00:00 [accepted] PHST- 2023/02/10 06:00 [pubmed] PHST- 2023/03/08 06:00 [medline] PHST- 2023/02/09 19:27 [entrez] AID - S0167-5273(23)00168-7 [pii] AID - 10.1016/j.ijcard.2023.01.085 [doi] PST - ppublish SO - Int J Cardiol. 2023 Apr 1;376:100-107. doi: 10.1016/j.ijcard.2023.01.085. Epub 2023 Feb 8. PMID- 36731250 OWN - NLM STAT- MEDLINE DCOM- 20230314 LR - 20230426 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 192 DP - 2023 Apr 1 TI - Intermediate Follow-Up of Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve Implantation in Patients With Small Aortic Annuli. PG - 31-38 LID - S0002-9149(23)00009-7 [pii] LID - 10.1016/j.amjcard.2023.01.009 [doi] AB - The clinical impact of prosthesis-patient mismatch (PPM) in patients with small aortic annuli who underwent transcatheter aortic valve (AV) implantation with either balloon-expandable (BE) or self-expanding (SE) valves remains controversial. We assessed in-hospital and intermediate clinical outcomes in 573 patients with transfemoral transcatheter AV implantation with a small AV annulus, defined as an AV annulus area mild aortic insufficiency were similar. All-cause mortality for the 2 cohorts was similar, with an overall mean (95% confidence interval) survival time of 61.2 months (57.8 to 64.5; p = 0.98). There were no significant survival differences between combined patients with BE and SE with no, moderate, or severe PPM, with an overall mean (95% confidence interval) survival time of 32.5 (30.5 to 34.5) months combining valve types (p = 0.23). In conclusion, despite an increased incidence of PPM with higher mean AV gradients that persist on late echocardiography in the BE cohort, patients with BE and SE with small aortic annuli have similar clinical outcomes at intermediate follow-up. Moderate and severe PPM had no impact on survival at a mean follow-up of 32.5 months. CI - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Mosleh, Wassim AU - Mosleh W AD - Department of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. FAU - Memon, Sarfaraz AU - Memon S AD - Departments of Cardiology and. FAU - Hoover, Nicole E AU - Hoover NE AD - Departments of Cardiology and. FAU - Mather, Jeff F AU - Mather JF AD - Department of Research Administration, Hartford Hospital, Hartford, Connecticut. FAU - Hagberg, Robert C AU - Hagberg RC AD - Cardiac Surgery, Hartford Healthcare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Azemi, Talhat AU - Azemi T AD - Departments of Cardiology and. FAU - Sadiq, Immad R AU - Sadiq IR AD - Departments of Cardiology and. FAU - Haider, Jawad AU - Haider J AD - Departments of Cardiology and. FAU - McMahon, Sean R AU - McMahon SR AD - Departments of Cardiology and. FAU - Hashim, Sabet AU - Hashim S AD - Cardiac Surgery, Hartford Healthcare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - McKay, Raymond G AU - McKay RG AD - Departments of Cardiology and. Electronic address: Raymond.mckay@hhchealth.org. LA - eng PT - Journal Article DEP - 20230131 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Follow-Up Studies MH - Stroke Volume MH - *Heart Valve Prosthesis/adverse effects MH - Treatment Outcome MH - Prosthesis Design MH - Hemodynamics MH - Ventricular Function, Left MH - Aortic Valve/surgery COIS- Disclosures The authors have no conflicts of interest to declare. EDAT- 2023/02/03 06:00 MHDA- 2023/03/15 06:00 CRDT- 2023/02/02 18:08 PHST- 2022/10/28 00:00 [received] PHST- 2022/12/16 00:00 [revised] PHST- 2023/01/03 00:00 [accepted] PHST- 2023/02/03 06:00 [pubmed] PHST- 2023/03/15 06:00 [medline] PHST- 2023/02/02 18:08 [entrez] AID - S0002-9149(23)00009-7 [pii] AID - 10.1016/j.amjcard.2023.01.009 [doi] PST - ppublish SO - Am J Cardiol. 2023 Apr 1;192:31-38. doi: 10.1016/j.amjcard.2023.01.009. Epub 2023 Jan 31. PMID- 36713753 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230202 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 2 IP - 7 DP - 2022 Dec TI - Outcome of Nonagenarians Undergoing Transfemoral Transcatheter Aortic Valve Replacement: A Nationwide Registry Analysis From Japan. PG - 856-864 LID - 10.1016/j.jacasi.2022.08.007 [doi] AB - BACKGROUND: Nonagenarians are a growing age group in patients undergoing transcatheter aortic valve replacement (TAVR); however, the appropriate use of TAVR in this population remains discussed because of their limited life expectancy and worse outcome reported. OBJECTIVES: The authors aimed to evaluate clinical characteristics and the prognostic impact of nonagenarians. METHODS: We analyzed consecutive patients undergoing transfemoral TAVR and were registered in the nationwide registry for TAVR in Japan (Japanese Transcatheter Valvular Therapies registry) between 2013 and 2018. The rate of 30-day and 1-year mortality and composite adverse event, comprising all-cause death, all stroke, and life-threatening/major bleeding, were assessed. RESULTS: Of the 15,028 registered patients during the study period, 2,215 (14.7%) were nonagenarians. Although the nonagenarians were less likely to have comorbid conditions (eg, diabetes mellitus and malignancy) than patients aged <90 y, they had a higher Society of Thoracic Surgeons risk score (8.8% vs 5.6%), mainly owing to their advanced age. The procedural characteristics were identical between 2 groups. The rate of 30-day mortality and composite endpoint was similar, whereas 1-year mortality and composite adverse events were increased among nonagenarians (10.3% vs 6.8% and 13.5% vs 9.2%, respectively), and nonagenarians were independently associated with these endpoints (HR: 1.21; 95% CI: 1.03-1.42; P = 0.023; HR: 1.24; 95% CI: 1.07-1.42; P = 0.004). CONCLUSIONS: Of the 15,028 TAVR procedures performed in Japan between 2013 and 2018, 14.7% were performed in nonagenarians. These patients were carefully selected by a multidisciplinary heart team and showed 21% and 24% increase of 1-year mortality and composite adverse outcome. CI - (c) 2022 The Authors. FAU - Higuchi, Ryosuke AU - Higuchi R AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Kumamaru, Hiraku AU - Kumamaru H AD - Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. FAU - Kohsaka, Shun AU - Kohsaka S AD - Department of Cardiology, Keio University, Tokyo, Japan. FAU - Saji, Mike AU - Saji M AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Takamisawa, Itaru AU - Takamisawa I AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Nanasato, Mamoru AU - Nanasato M AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Shimokawa, Tomoki AU - Shimokawa T AD - Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. FAU - Shimizu, Hideyuki AU - Shimizu H AD - Department of Cardiovascular Surgery, Keio University, Tokyo, Japan. FAU - Takayama, Morimasa AU - Takayama M AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20221129 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC9876954 OTO - NOTNLM OT - J-TVT registry OT - Japan OT - TAVR OT - TAVR, transcatheter aortic valve replacement OT - elderly COIS- Dr Kumamaru is affiliated with the department of Healthcare Quality Assessment, which is a social collaboration department supported by National Clinical Database, Johnson & Johnson K.K., and Nipro Corporation. Dr Kohsaka has received unrestricted grants from Daiichi Sankyo and Novartis and lecture fees from Bayer, Bristol-Myers Squibb, and Pfizer outside of the submitted work. Dr Takamisawa is a technical proctor of Edwards Lifesciences and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/01/31 06:00 MHDA- 2023/01/31 06:01 PMCR- 2022/11/29 CRDT- 2023/01/30 04:18 PHST- 2022/03/21 00:00 [received] PHST- 2022/07/27 00:00 [revised] PHST- 2022/08/08 00:00 [accepted] PHST- 2023/01/30 04:18 [entrez] PHST- 2023/01/31 06:00 [pubmed] PHST- 2023/01/31 06:01 [medline] PHST- 2022/11/29 00:00 [pmc-release] AID - S2772-3747(22)00220-4 [pii] AID - 10.1016/j.jacasi.2022.08.007 [doi] PST - epublish SO - JACC Asia. 2022 Nov 29;2(7):856-864. doi: 10.1016/j.jacasi.2022.08.007. eCollection 2022 Dec. PMID- 36709496 OWN - NLM STAT- MEDLINE DCOM- 20230301 LR - 20230301 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 101 IP - 3 DP - 2023 Feb TI - Iliofemoral artery predilation prior to transfemoral transcatheter aortic valve implantation in patients with aortic valve stenosis and advanced peripheral artery disease. PG - 628-638 LID - 10.1002/ccd.30576 [doi] AB - OBJECTIVES: To investigate the feasibility and safety of percutaneous transluminal angioplasty (PTA) of the iliofemoral arteries (IFA) before transfemoral transcatheter aortic valve implantation (Tf-TAVI) in patients with advanced peripheral artery disease (PAD). BACKGROUND: Although Tf-TAVI represents the access of choice, alternative vascular access routes are preferred for patients displaying advanced PAD. PTA of the IFA represents a less invasive option, broadening the spectrum of patients eligible for Tf-TAVI. METHODS: All patients requiring PTA of the IFA before Tf-TAVI, between 2012 and 2021, were included. Primary efficacy endpoint was the rate of successful transcatheter heart valve (THV) delivery and implantation. Primary safety endpoint was the rate of PTA and access-site-related vascular complications, procedural- and in-hospital complications. RESULTS: Among 2726 Tf-TAVI procedures, 59 patients required IFA predilation. Successful THV delivery and implantation was achieved in 57 (96.6%) patients, respectively. Sheath placement was achieved in 59 (100%) patients with only one minor dissection and no major vascular complications following iliofemoral PTA. Regarding access site complications, two (3.4%) vessel perforations and one (1.7%) vessel rupture were observed, with eight (13.5%) patients requiring unplanned endovascular interventions. There was one intraprocedural death due to THV-induced vessel laceration, while in-hospital all-cause mortality was 8.5% in the present high-risk patient cohort. CONCLUSIONS: Predilation of IFA is safe and effective in patients with advanced PAD. Careful preprocedural planning is paramount in improving procedural safety and efficacy. This strategy has the potential to broaden the spectrum of patients eligible for Tf-TAVI. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Alvarez-Covarrubias, Hector A AU - Alvarez-Covarrubias HA AUID- ORCID: 0000-0003-0505-9530 AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - Hospital de Cardiologia, Centro Medico Nacional Siglo XXI, IMSS, Cd. de Mexico, Mexico City, Mexico. FAU - Joner, Michael AU - Joner M AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Cassese, Salvatore AU - Cassese S AUID- ORCID: 0000-0002-8668-4313 AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Warmbrunn, Mairead AU - Warmbrunn M AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Lutz, Jannik AU - Lutz J AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Trenkwalder, Teresa AU - Trenkwalder T AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Seguchi, Masaru AU - Seguchi M AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Aytekin, Alp AU - Aytekin A AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Presch, Antonia AU - Presch A AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Pellegrini, Constanza AU - Pellegrini C AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Rheude, Tobias AU - Rheude T AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Patrick Mayr, N AU - Patrick Mayr N AUID- ORCID: 0000-0002-3549-3007 AD - Institut fur Anasthesiologie, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. FAU - Kufner, Sebastian AU - Kufner S AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Schunkert, Heribert AU - Schunkert H AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AUID- ORCID: 0000-0003-4341-891X AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AUID- ORCID: 0000-0002-0728-2819 AD - Department of Cardiology, Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany. AD - DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. LA - eng PT - Journal Article DEP - 20230129 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - Femoral Artery/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Aortic Valve/diagnostic imaging/surgery MH - *Peripheral Arterial Disease/diagnostic imaging/therapy/complications OTO - NOTNLM OT - percutaneous transluminal angioplasty OT - peripheral artery disease OT - transcatheter aortic valve implantation OT - transfemoral access EDAT- 2023/01/30 06:00 MHDA- 2023/03/03 06:00 CRDT- 2023/01/29 14:09 PHST- 2022/10/23 00:00 [revised] PHST- 2022/05/31 00:00 [received] PHST- 2023/01/15 00:00 [accepted] PHST- 2023/01/30 06:00 [pubmed] PHST- 2023/03/03 06:00 [medline] PHST- 2023/01/29 14:09 [entrez] AID - 10.1002/ccd.30576 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Feb;101(3):628-638. doi: 10.1002/ccd.30576. Epub 2023 Jan 29. PMID- 36705606 OWN - NLM STAT- MEDLINE DCOM- 20230310 LR - 20250722 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 35 IP - 3 DP - 2023 Mar TI - Neurovascular Outcomes in Relation With Carotid Artery Stenosis in Patients Undergoing Transcatheter Aortic Valve Implantation. PG - E136-E142 LID - JIC20230126-1 [pii] AB - INTRODUCTION: Data regarding the prevalence of carotid artery stenosis (CAS) in patients undergoing transcatheter aortic valve implantation (TAVI) are scarce. Whether CAS, especially severe or bilateral, is a predictor of worse prognosis after TAVI is unknown. We aimed to address these questions. METHODS: We included all patients who underwent TAVI between 2018 and 2021. Using pre-TAVI carotid Doppler ultrasound, atherosclerosis of the right and left carotid internal arteries was assessed. CAS was defined as moderate (50%-69% stenosis, peak systolic velocity of 125-230 cm/sec) or severe (>/=70% stenosis, peak systolic velocity of >230 cm/sec). When both carotid arteries presented with >/=50% stenosis, CAS was defined as bilateral. Endpoints included the 30-day incidence of stroke or transient ischemic attack (TIA), 30-day all-cause mortality, and periprocedural complications. RESULTS: Among 448 patients, 56 (12.5%) had CAS, of which 15 had bilateral and 15 had severe CAS. Patients with CAS were more often men and had higher rates of peripheral artery disease, coronary artery disease, and previous percutaneous coronary intervention. There was no association between CAS and 30-day stroke or TIA (adjusted hazard ratio [aHR], 2.55; 95% confidence interval [CI], 0.73-8.91; P=.14), even when considering severe CAS only. However, a significant association was found between bilateral CAS and 30-day stroke or TIA (aHR, 8.399; 95% CI, 1.603-44.000; P=.01). No association between CAS and 30-day mortality or periprocedural complications was found. CONCLUSIONS: CAS is common among TAVI patients. While CAS as a whole was not a predictor of neurovascular complications, the subgroup of bilateral CAS was associated with an increased risk of stroke. FAU - Oestreicher, Simon AU - Oestreicher S FAU - Vella, Agnese AU - Vella A FAU - Muller, Olivier AU - Muller O FAU - Kirsch, Matthias AU - Kirsch M FAU - Eeckhout, Eric AU - Eeckhout E FAU - Fournier, Stephane AU - Fournier S FAU - Monney, Pierre AU - Monney P FAU - Roux, Olivier AU - Roux O FAU - Roguelov, Christan AU - Roguelov C FAU - Zhang, Philippe AU - Zhang P FAU - Abraham, Paul AU - Abraham P FAU - Ferlay, Clemence AU - Ferlay C FAU - Antiochos, Panagiotis AU - Antiochos P FAU - Lu, Henri AU - Lu H AD - Service of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1010 Lausanne, CH. henri.lu@chuv.ch. LA - eng PT - Journal Article DEP - 20230126 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Male MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Carotid Stenosis/complications/diagnosis/surgery MH - *Ischemic Attack, Transient/diagnosis/epidemiology/etiology MH - Constriction, Pathologic/etiology MH - *Aortic Valve Stenosis/diagnosis/surgery/complications MH - Treatment Outcome MH - Risk Factors MH - *Stroke/epidemiology/etiology MH - Aortic Valve OTO - NOTNLM OT - aortic valve stenosis OT - carotid artery stenosis OT - stroke OT - transcatheter aortic valve replacement OT - transcatheter aortic valve implantation EDAT- 2023/01/28 06:00 MHDA- 2023/03/11 06:00 CRDT- 2023/01/27 10:22 PHST- 2023/01/28 06:00 [pubmed] PHST- 2023/03/11 06:00 [medline] PHST- 2023/01/27 10:22 [entrez] AID - JIC20230126-1 [pii] AID - 10.25270/jic/22.00321 [doi] PST - ppublish SO - J Invasive Cardiol. 2023 Mar;35(3):E136-E142. doi: 10.25270/jic/22.00321. Epub 2023 Jan 26. PMID- 36681530 OWN - NLM STAT- MEDLINE DCOM- 20230501 LR - 20230503 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 50 DP - 2023 May TI - Clinical Outcome of Transcatheter Aortic Valve Replacement With TriGUARD 3 Cerebral Embolic Protection Device. PG - 8-12 LID - S1553-8389(23)00010-6 [pii] LID - 10.1016/j.carrev.2023.01.008 [doi] AB - OBJECTIVE: Periprocedural stroke during transcatheter aortic valve replacement (TAVR) is a highly feared adverse event. The TriGUARD 3 cerebral embolic protection device (CEPD) may have the potential benefit of reduction of embolic events, but it still remains unclear whether it reduces the incidence of periprocedural stroke or transient ischemic attack (TIA). We aimed to investigate whether the latest TriGUARD 3 CEPD reduces the incidence of clinically overt stroke within 72 h or at discharge after TAVR. METHODS: In this prospective single-center study 117 patients (mean age 80.3 years, 53.8 % male) were included from July 2020 to December 2021. RESULTS: The primary efficacy endpoint of this study, periprocedural clinically overt stroke or TIA, within 72 h or at discharge after TAVR with the TriGUARD 3 CEPD occurred in 1/117 pts (0.8 %). Secondary endpoints (device related issues such as life-threatening or disabling bleeding, acute kidney injury, major vascular complications) were reported in 4/117 pts (3.4 %). CONCLUSIONS: This study suggests that the use of the latest TriGUARD 3 CEPD in transfemoral TAVR seems to be associated with a low rate of clinically overt stroke and a low rate of device related adverse events, reflecting "real world" TAVR practice. However these results should be hypothesis generating and confirmed in a large RCT. CI - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Daal, Sayonara M AU - Daal SM AD - Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Cardiac Surgery, Haga Teaching Hospitals, The Hague, the Netherlands. Electronic address: sayonara.daal@hotmail.com. FAU - Jimenez-Rodriguez, Gian M J AU - Jimenez-Rodriguez GMJ AD - Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: gianma21@hotmail.com. FAU - Voskuil, Michiel AU - Voskuil M AD - Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: mvoskuil@umcutrecht.nl. FAU - Kraaijeveld, Adriaan O AU - Kraaijeveld AO AD - Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: a.o.kraaijeveld-3@umcutrecht.nl. FAU - Dessing, Thomas C AU - Dessing TC AD - Department of Cardiothoracic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: t.c.dessing@umcutrecht.nl. FAU - Ramjankhan, Faiz Z AU - Ramjankhan FZ AD - Department of Cardiothoracic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: f.ramjankhan@umcutrecht.nl. FAU - Mokhles, Mostafa M AU - Mokhles MM AD - Department of Cardiothoracic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: m.m.mokhles@umcutrecht.nl. FAU - Stella, Pieter R AU - Stella PR AD - Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: pieter.stella@gmail.com. LA - eng PT - Journal Article DEP - 20230116 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Male MH - Aged, 80 and over MH - Female MH - *Transcatheter Aortic Valve Replacement MH - *Ischemic Attack, Transient/etiology/prevention & control MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Prospective Studies MH - Risk Factors MH - Treatment Outcome MH - Time Factors MH - *Intracranial Embolism/diagnostic imaging/etiology/prevention & control MH - *Stroke/etiology/prevention & control/epidemiology MH - *Embolic Protection Devices MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - Cerebral embolic protection device OT - Stroke prevention OT - Transcatheter aortic valve replacement OT - TriGUARD 3 COIS- Conflict of interest PS serves on advisory board Keystone Heart, AK received consultancy fees for Boston Scientific, all other authors declare no conflict of interest. EDAT- 2023/01/22 06:00 MHDA- 2023/05/01 06:42 CRDT- 2023/01/21 22:00 PHST- 2022/08/08 00:00 [received] PHST- 2023/01/11 00:00 [revised] PHST- 2023/01/11 00:00 [accepted] PHST- 2023/05/01 06:42 [medline] PHST- 2023/01/22 06:00 [pubmed] PHST- 2023/01/21 22:00 [entrez] AID - S1553-8389(23)00010-6 [pii] AID - 10.1016/j.carrev.2023.01.008 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2023 May;50:8-12. doi: 10.1016/j.carrev.2023.01.008. Epub 2023 Jan 16. PMID- 36680500 OWN - NLM STAT- MEDLINE DCOM- 20240521 LR - 20241024 IS - 1545-1550 (Electronic) IS - 1526-6028 (Linking) VI - 31 IP - 3 DP - 2024 Jun TI - Endovascular Technique for Ascending Aorta Repair Based on TEVAR and TAVI Procedures. PG - 360-365 LID - 10.1177/15266028221148383 [doi] AB - PURPOSE: Ascending aorta (AAo) acute pathology still has an open-surgery indication with a high mortality rate associated to cardiopulmonary bypass and circulatory arrest. In these cases, the endovascular aortic approach could be an excellent option. The aim of the present study is to detail an optimized technique for the endovascular treatment of AAo diseases, based on thoracic endovascular aortic repair (TEVAR) and transcatheter aortic valve implantation (TAVI) procedures. TECHNIQUE: The procedure implies the usual preparation for TEVAR and TAVI implants. A transient pacemaker lead is necessary to deliver the prosthesis under "rapid pacing." As in the TAVI technique, a final high-support guidewire is placed at the left ventricle. The proximal landing zone is the sinotubular junction (zone 0B). Transesophageal echocardiography is essential to ensure aortic valve function and patency in coronary arteries during the delivery. To assess a potential occlusion of the brachiocephalic artery, a guidewire is positioned in the descending aorta from the axillary artery. Finally, a noncovered stent is implanted to stabilize the AAo prosthesis. CONCLUSION: The technique presented here can standardize a safe and reproducible procedure to endovascular repair of AAo diseases. However, new devices specifically designed for the AAo could facilitate the transcatheter approach. CLINICAL IMPACT: Ascending aorta acute pathology still has an open-surgery indication with high mortality rate associated to cardiopulmonary bypass and circulatory arrest. Moreover, near 30% of patients are not considered suitable for surgery because of age, critical situation or the presence of severe comorbidities. The present study provides a detailed and optimized technique for the endovascular treatment of ascending aorta disease, based on TEVAR and TAVI procedures. FAU - Garrido, Jose M AU - Garrido JM AUID- ORCID: 0000-0002-2096-4371 AD - Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain. AD - Department of Cardiovascular Surgery, Virgen de las Nieves University Hospital, Granada, Spain. AD - Department of Surgery and Surgical Specialties, School of Medicine, University of Granada, Granada, Spain. FAU - Ferreiro-Marzal, Andrea AU - Ferreiro-Marzal A AD - Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain. AD - Department of Cardiovascular Surgery, Virgen de las Nieves University Hospital, Granada, Spain. FAU - Esteban-Molina, Maria AU - Esteban-Molina M AD - Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain. AD - Department of Cardiovascular Surgery, Virgen de las Nieves University Hospital, Granada, Spain. FAU - Rodriguez-Morata, Alejandro AU - Rodriguez-Morata A AD - Department of Angiology and Vascular Surgery, Quironsalud Malaga Hospital, Malaga, Spain. FAU - Rodriguez-Serrano, Fernando AU - Rodriguez-Serrano F AD - Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain. AD - Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, Granada, Spain. LA - eng PT - Journal Article DEP - 20230121 PL - United States TA - J Endovasc Ther JT - Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists JID - 100896915 SB - IM MH - Humans MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/instrumentation/adverse effects MH - *Blood Vessel Prosthesis Implantation/instrumentation/adverse effects MH - *Endovascular Procedures/instrumentation/adverse effects MH - *Blood Vessel Prosthesis MH - *Aortic Diseases/diagnostic imaging/surgery/physiopathology MH - Stents MH - Prosthesis Design MH - Aortography MH - Heart Valve Prosthesis MH - Endovascular Aneurysm Repair OTO - NOTNLM OT - ascending aorta OT - endovascular repair OT - type A aortic dissection COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2023/01/22 06:00 MHDA- 2024/05/21 12:45 CRDT- 2023/01/21 07:02 PHST- 2024/05/21 12:45 [medline] PHST- 2023/01/22 06:00 [pubmed] PHST- 2023/01/21 07:02 [entrez] AID - 10.1177/15266028221148383 [doi] PST - ppublish SO - J Endovasc Ther. 2024 Jun;31(3):360-365. doi: 10.1177/15266028221148383. Epub 2023 Jan 21. PMID- 36669982 OWN - NLM STAT- MEDLINE DCOM- 20230303 LR - 20230314 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 4 DP - 2023 Feb 27 TI - Predictable Deployment of Suture-Based Vascular Closure Device Before Transfemoral Transcatheter Aortic Valve Replacement. PG - 485-486 LID - S1936-8798(22)02223-3 [pii] LID - 10.1016/j.jcin.2022.11.021 [doi] FAU - Leone, Pier Pasquale AU - Leone PP AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Ludwig, Sebastian AU - Ludwig S AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. FAU - Sehatbakhsh, Samineh AU - Sehatbakhsh S AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Assafin, Manaf AU - Assafin M AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Chau, Mei AU - Chau M AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Spring, Alexander AU - Spring A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Montesino, Jesus AU - Montesino J AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Doolittle, James AU - Doolittle J AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Granada, Juan F AU - Granada JF AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: alatib@gmail.com. LA - eng PT - Journal Article DEP - 20230118 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Vascular Closure Devices MH - Treatment Outcome MH - *Heart Valve Prosthesis Implantation MH - *Aortic Valve Stenosis/surgery MH - Sutures MH - Aortic Valve/surgery MH - Femoral Artery/surgery MH - Risk Factors OTO - NOTNLM OT - TAVR OT - transfemoral OT - ultrasound OT - vascular closure device OT - vascular complication COIS- Funding Support and Author Disclosures Dr Latib serves on the advisory boards of Medtronic, Boston Scientific, and Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/01/21 06:00 MHDA- 2023/03/04 06:00 CRDT- 2023/01/20 22:02 PHST- 2022/10/06 00:00 [received] PHST- 2022/11/07 00:00 [revised] PHST- 2022/11/15 00:00 [accepted] PHST- 2023/01/21 06:00 [pubmed] PHST- 2023/03/04 06:00 [medline] PHST- 2023/01/20 22:02 [entrez] AID - S1936-8798(22)02223-3 [pii] AID - 10.1016/j.jcin.2022.11.021 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Feb 27;16(4):485-486. doi: 10.1016/j.jcin.2022.11.021. Epub 2023 Jan 18. PMID- 36669981 OWN - NLM STAT- MEDLINE DCOM- 20230303 LR - 20230314 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 16 IP - 4 DP - 2023 Feb 27 TI - The Bending of a Frame in a Balloon-Expandable Valve During Transcatheter Aortic Valve Replacement. PG - 492-495 LID - S1936-8798(22)02240-3 [pii] LID - 10.1016/j.jcin.2022.11.029 [doi] FAU - Takahashi, Kotaro AU - Takahashi K AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. Electronic address: kotaka331@gmail.com. FAU - Ikuta, Akihiro AU - Ikuta A AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Ohya, Masanobu AU - Ohya M AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Nakano, Jyota AU - Nakano J AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Komiya, Tatsuhiko AU - Komiya T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Fuku, Yasushi AU - Fuku Y AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. LA - eng PT - Journal Article DEP - 20230118 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Prosthesis Design MH - *Balloon Valvuloplasty OTO - NOTNLM OT - alternative access OT - critical patient OT - femoral access OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/01/21 06:00 MHDA- 2023/03/04 06:00 CRDT- 2023/01/20 22:02 PHST- 2022/10/31 00:00 [received] PHST- 2022/11/15 00:00 [revised] PHST- 2022/11/22 00:00 [accepted] PHST- 2023/01/21 06:00 [pubmed] PHST- 2023/03/04 06:00 [medline] PHST- 2023/01/20 22:02 [entrez] AID - S1936-8798(22)02240-3 [pii] AID - 10.1016/j.jcin.2022.11.029 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Feb 27;16(4):492-495. doi: 10.1016/j.jcin.2022.11.029. Epub 2023 Jan 18. PMID- 36649387 OWN - NLM STAT- MEDLINE DCOM- 20230119 LR - 20230213 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 16 IP - 1 DP - 2023 Jan TI - Temporal Trends and Contemporary Outcomes After Transcatheter Aortic Valve Replacement With Evolut PRO/PRO+ Self-Expanding Valves: Insights From the NEOPRO/NEOPRO-2 Registries. PG - e012538 LID - 10.1161/CIRCINTERVENTIONS.122.012538 [doi] AB - BACKGROUND: In recent years, transcatheter aortic valve replacement (TAVR) techniques and technology have continuously improved. Data regarding the impact of these advancements on outcomes in large real-world settings are still limited. The aim of this study was to investigate temporal trends and assess contemporary outcomes after TAVR with Evolut PRO/PRO+ supra-annular self-expanding valves. METHODS: This study included patients enrolled in the multicenter NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) and NEOPRO-2 (A Multicenter Comparison of ACURATE NEO2 Versus Evolut PRO/PRO+ Transcatheter Heart Valves 2) registries who underwent transfemoral TAVR with Evolut PRO/PRO+. Procedural dates (August 2017 through November 2021) were stratified in quartiles (Q) and used to investigate temporal trends in TAVR outcomes. Predischarge, 30-day Valve Academic Research Consortium-3 defined, and 1-year outcomes were evaluated. RESULTS: In total, 1616 patients from 28 centers were included. Over time, patients had lower Society of Thoracic Surgeon-Predicted Risk of Mortality score (Q1-4, 4.1% [2.8-6.3%], 3.7% [2.6-5.3%], 3.3% [2.4-4.9%], 2.9% [2.2-4.3%]; P<0.001) and more moderate or heavy valve calcification (Q1-4, 80%, 80%, 82%, 88%; P=0.038). Overall Valve Academic Research Consortium-3 technical success was 94.1%, with 30-day and 1-year all-cause mortality of 2.4% and 10%, respectively. Throughout the study period, procedures were associated with higher rates of 30-day device success (Q1-4, 81.2%, 82.2%, 82.0%, 88.0%; Cochran-Armitage P=0.023) and early safety (Q1-4, 66.8%, 67.5%, 74.0%, 77.6%; Cochran-Armitage P<0.001), with fewer permanent pacemaker implantations (Q1-4: 15.3%, 20.0%, 12.1%, 11.6%; Cochran-Armitage P=0.023) and residual mild or greater paravalvular leaks (Q1-4, 50.4%, 42.1%, 36.5%, 35.8%; Cochran-Armitage P<0.001). CONCLUSIONS: TAVR with Evolut PRO/PRO+ self-expanding valve is safe and effective. Despite the treatment of heavier calcified anatomies, procedural outcomes are improving over time with less need for pacemaker implantation and less significant paravalvular leaks. FAU - Scotti, Andrea AU - Scotti A AUID- ORCID: 0000-0003-4731-4384 AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.S., A.L.). FAU - Baggio, Sara AU - Baggio S AUID- ORCID: 0000-0002-2442-9982 AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy (S.B., B.R., A.C., A.M.). AD - IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy (S.B., B.R., A.C., A.M.). FAU - Pagnesi, Matteo AU - Pagnesi M AD - Cardiothoracic Department, ASST Spedali Civili di Brescia University of Brescia, Italy (M.P., M.A., M. Massussi). AD - Department of Medical Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (M.P., M.A., M. Massussi). FAU - Barbanti, Marco AU - Barbanti M AUID- ORCID: 0000-0002-4903-5437 AD - Department of Cardiology, C.A.S.T. Policlinico G. Rodolico, Catania, Italy (M.B., G.C.). FAU - Adamo, Marianna AU - Adamo M AD - Cardiothoracic Department, ASST Spedali Civili di Brescia University of Brescia, Italy (M.P., M.A., M. Massussi). AD - Department of Medical Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (M.P., M.A., M. Massussi). FAU - Eitan, Amnon AU - Eitan A AUID- ORCID: 0000-0002-6710-9057 AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel (A.E.). FAU - Estevez-Loureiro, Rodrigo AU - Estevez-Loureiro R AUID- ORCID: 0000-0001-5841-5514 AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain (R.E.-L., R.A.). FAU - Veulemans, Verena AU - Veulemans V AUID- ORCID: 0000-0002-2744-2154 AD - Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Dusseldorf, Germany (V.V., T.Z.). FAU - Toggweiler, Stefan AU - Toggweiler S AUID- ORCID: 0000-0002-7860-0298 AD - Heart Center Lucerne, Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland (S.T.). FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, Galway University Hospitals, Ireland (D.M., M.L.). FAU - De Marco, Federico AU - De Marco F AUID- ORCID: 0000-0003-3554-6938 AD - Centro Cardiologico Monzino IRCCS, Milan, Italy (F.D.M.). FAU - Giannini, Francesco AU - Giannini F AUID- ORCID: 0000-0002-0517-1410 AD - Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy (F.G., L.D.I.). FAU - Ferlini, Marco AU - Ferlini M AUID- ORCID: 0000-0002-5554-3577 AD - Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (M.F., G.L.). FAU - Naber, Christoph K AU - Naber CK AD - Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Germany (C.K.N., A.W.). FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy (A.B., D.M.). FAU - Schofer, Joachim AU - Schofer J AD - Department for Percutaneous Treatment of Structural Heart Disease, Albertinen Heart Center, Hamburg, Germany (J.S.). AD - MVZ Department Structural Heart Disease, Asklepios St Georg Clinic, Hamburg, Germany (J.S.). FAU - Rottbauer, Wolfgang AU - Rottbauer W AD - Department of Internal Medicine II, University Hospital Ulm, Germany (W.R., S.W.). FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AUID- ORCID: 0000-0002-2732-1205 AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands (N.M.V.M., F.Z.). FAU - Khogali, Saib AU - Khogali S AD - Heart and Lung Center, New Cross Hospital, Wolverhampton, UK (S.K.). FAU - Taramasso, Maurizio AU - Taramasso M AD - Division of Cardiothoracic Surgery, HerzZentrum Hirslanden Zurich, Switzerland (M.T., M.S.). FAU - Pilgrim, Thomas AU - Pilgrim T AUID- ORCID: 0000-0001-8721-4068 AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland (T.P.). FAU - Sinning, Jan-Malte AU - Sinning JM AD - Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Germany (J.-M.S., A. Sedaghat). FAU - Zweiker, David AU - Zweiker D AUID- ORCID: 0000-0002-7479-7767 AD - Division of Cardiology, Medical University of Graz, Austria (D.Z., A. Schmidt). FAU - Montorfano, Matteo AU - Montorfano M AUID- ORCID: 0000-0001-9732-9459 AD - Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (M. Montorfano). FAU - Van der Heyden, Jan A S AU - Van der Heyden JAS AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands (J.A.S.V.d.H., J.B.). AD - Interventional Cardiology Unit, AZ Sint-Jan Hospital, Bruges, Belgium (J.A.S.V.d.H.). FAU - Brugaletta, Salvatore AU - Brugaletta S AUID- ORCID: 0000-0001-5845-1435 AD - Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain (S.B., A.R.). FAU - Ielasi, Alfonso AU - Ielasi A AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy (A.I.). FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology and Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany (C.W.H., W.-K.K.). FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark (M.V., L.S.). FAU - Costa, Giuliano AU - Costa G AUID- ORCID: 0000-0003-3770-8988 AD - Department of Cardiology, C.A.S.T. Policlinico G. Rodolico, Catania, Italy (M.B., G.C.). FAU - Massussi, Mauro AU - Massussi M AUID- ORCID: 0000-0003-0895-440X AD - Cardiothoracic Department, ASST Spedali Civili di Brescia University of Brescia, Italy (M.P., M.A., M. Massussi). AD - Department of Medical Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (M.P., M.A., M. Massussi). FAU - Alarcon, Robert AU - Alarcon R AUID- ORCID: 0000-0003-2389-4812 AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain (R.E.-L., R.A.). FAU - Zeus, Tobias AU - Zeus T AUID- ORCID: 0000-0002-4517-0068 AD - Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Dusseldorf, Germany (V.V., T.Z.). FAU - Lunardi, Mattia AU - Lunardi M AUID- ORCID: 0000-0001-8344-6048 AD - Department of Cardiology, Galway University Hospitals, Ireland (D.M., M.L.). FAU - Testa, Luca AU - Testa L AUID- ORCID: 0000-0003-4687-3686 AD - Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy (L.T.). FAU - Di Ienno, Luca AU - Di Ienno L AD - Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy (F.G., L.D.I.). FAU - Lanzillo, Giuseppe AU - Lanzillo G AD - Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (M.F., G.L.). FAU - Wolf, Alexander AU - Wolf A AD - Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Germany (C.K.N., A.W.). FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy (A.B., D.M.). FAU - Ziviello, Francesca AU - Ziviello F AD - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands (N.M.V.M., F.Z.). FAU - Saccocci, Matteo AU - Saccocci M AUID- ORCID: 0000-0002-0843-9240 AD - Division of Cardiothoracic Surgery, HerzZentrum Hirslanden Zurich, Switzerland (M.T., M.S.). FAU - Windecker, Stephan AU - Windecker S AUID- ORCID: 0000-0003-2653-6762 AD - Department of Internal Medicine II, University Hospital Ulm, Germany (W.R., S.W.). FAU - Sedaghat, Alexander AU - Sedaghat A AUID- ORCID: 0000-0001-7015-1056 AD - Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Germany (J.-M.S., A. Sedaghat). FAU - Schmidt, Albrecht AU - Schmidt A AD - Division of Cardiology, Medical University of Graz, Austria (D.Z., A. Schmidt). FAU - Brouwer, Jorn AU - Brouwer J AUID- ORCID: 0000-0002-7815-1031 AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands (J.A.S.V.d.H., J.B.). FAU - Regueiro, Ander AU - Regueiro A AD - Clinic Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain (S.B., A.R.). FAU - Reimers, Bernhard AU - Reimers B AUID- ORCID: 0000-0002-9890-5582 AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy (S.B., B.R., A.C., A.M.). AD - IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy (S.B., B.R., A.C., A.M.). FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - Department of Cardiology and Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany (C.W.H., W.-K.K.). FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark (M.V., L.S.). FAU - Colombo, Antonio AU - Colombo A AUID- ORCID: 0000-0002-2940-2455 AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy (S.B., B.R., A.C., A.M.). AD - IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy (S.B., B.R., A.C., A.M.). FAU - Mangieri, Antonio AU - Mangieri A AUID- ORCID: 0000-0002-3239-4046 AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy (S.B., B.R., A.C., A.M.). AD - IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy (S.B., B.R., A.C., A.M.). FAU - Latib, Azeem AU - Latib A AUID- ORCID: 0000-0001-9035-343X AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.S., A.L.). CN - NEOPRO and NEOPRO-2 Investigatorsdouble dagger LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230117 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Heart Valve Prosthesis MH - Time Factors MH - Treatment Outcome MH - Registries MH - Prosthesis Design MH - Risk Factors OTO - NOTNLM OT - aortic stenosis OT - bioprosthesis OT - heart valve prosthesis OT - pacemaker OT - transcatheter aortic valve replacement OT - treatment outcome EDAT- 2023/01/18 06:00 MHDA- 2023/01/20 06:00 CRDT- 2023/01/17 14:03 PHST- 2023/01/17 14:03 [entrez] PHST- 2023/01/18 06:00 [pubmed] PHST- 2023/01/20 06:00 [medline] AID - 10.1161/CIRCINTERVENTIONS.122.012538 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2023 Jan;16(1):e012538. doi: 10.1161/CIRCINTERVENTIONS.122.012538. Epub 2023 Jan 17. PMID- 36640966 OWN - NLM STAT- MEDLINE DCOM- 20230315 LR - 20230626 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 377 DP - 2023 Apr 15 TI - Reducing cardiac tamponade caused by temporary pacemaker perforation in transcatheter aortic valve replacement. PG - 26-32 LID - S0167-5273(23)00047-5 [pii] LID - 10.1016/j.ijcard.2023.01.015 [doi] AB - BACKGROUND: Cardiac tamponade caused by temporary right ventricular (RV) pacemaker perforation is a rare but serious complication in transcatheter aortic valve replacement (TAVR). AIMS: To study the incidence of temporary pacemaker related cardiac tamponade in TAVR, and the relation to the type of pacemaker lead used in periprocedural temporary transvenous pacing. METHODS: A single center registry of transfemoral TAVRs in 2014-2020. Main inclusion criterion was peri-operative use of a temporary RV pacing lead. Main exclusion criteria were a preoperatively implanted permanent pacemaker or the exclusive use of left ventricular guidewire pacing. Incident cardiac tamponade was classified as pacemaker lead related, or other. Patients were grouped according to type of temporary RV pacing wire. RESULTS: 810 patients were included (age 80.5 +/- 7.3 [mean +/- standard deviation], female 319, 39.4%). Of these, 566 (69.9%) received a standard RV temporary pacing wire (RV-TPW), and 244 (30.1%) received temporary RV pacing through a permanent, passive pacemaker lead (RV-TPPL). In total, 18 (2.2%) events of cardiac tamponade occurred, 12 (67%) were pacemaker lead related. All pacemaker lead-related cardiac tamponades occurred in the group who received a standard RV-TPW and none in the group who received RV-TPPL (n = 12 [2.1%] vs. n = 0 [0%], p = 0.022). No difference in cardiac tamponade due to other causes was seen between the groups (p = 0.82). CONCLUSIONS: The use of soft-tip RV-TPPL was associated with a lower risk of pacemaker related cardiac tamponade in TAVR. When perioperative pacing is indicated, temporary RV-TPPL may contribute to a significant reduction of cardiac tamponade in TAVR. CI - Copyright (c) 2023 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Feldt, Kari AU - Feldt K AD - Department of Medicine, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. Electronic address: kari.feldt@ki.se. FAU - Dalen, Magnus AU - Dalen M AD - Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Cardiothoracic Surgery, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Meduri, Christopher U AU - Meduri CU AD - Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Kastengren, Mikael AU - Kastengren M AD - Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 76 Stockholm, Sweden. FAU - Bager, Jessica AU - Bager J AD - Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Hornsten, Jonas AU - Hornsten J AD - Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Omar, Aninda AU - Omar A AD - Department of Cardiothoracic Surgery, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Ruck, Andreas AU - Ruck A AD - Department of Medicine, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Saleh, Nawzad AU - Saleh N AD - Department of Medicine, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Linder, Rickard AU - Linder R AD - Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. FAU - Settergren, Magnus AU - Settergren M AD - Department of Medicine, Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. LA - eng PT - Journal Article DEP - 20230111 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM CIN - Int J Cardiol. 2023 Apr 15;377:42-43. doi: 10.1016/j.ijcard.2023.01.022. PMID: 36682690 MH - Humans MH - Female MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Cardiac Tamponade/diagnosis/epidemiology/etiology MH - Treatment Outcome MH - *Pacemaker, Artificial/adverse effects MH - Cardiac Pacing, Artificial MH - *Aortic Valve Stenosis/surgery MH - Risk Factors MH - Aortic Valve/surgery OTO - NOTNLM OT - Cardiac tamponade OT - Conduction abnormalities OT - Femoral OT - Miscellaneous OT - TAVI OT - Temporary pacing COIS- Declaration of Competing Interest Dr. Feldt has received consulting/speaker fees from Abbott Vascular, Astra Zeneca, Anteris Technologies and Alleviant Medical. Dr. Dalen, Dr. Kastengren, Dr. Hornsten, and Dr. Omar report no relationships that could be construed as a conflict of interest. Dr. Ruck has served as a proctor for Boston Scientific and has received consulting fees from Medtronic and Edwards. Dr. Meduri has received consulting fees from Boston Scientific, Abbott Vascular, Cardiovalve, Vdyne, Alleviant and Anteris Technologies. Dr. Saleh and Dr. Linder report no relationships that could be construed as a conflict of interest. Dr. Settergren has served as a proctor for Boston Scientific, Abbott Vascular and has received consulting fees from Medtronic, Anteris Technologies, Holistic Medical, Cardiomech and Teleflex. EDAT- 2023/01/15 06:00 MHDA- 2023/03/16 06:00 CRDT- 2023/01/14 19:26 PHST- 2022/10/09 00:00 [received] PHST- 2022/12/15 00:00 [revised] PHST- 2023/01/08 00:00 [accepted] PHST- 2023/01/15 06:00 [pubmed] PHST- 2023/03/16 06:00 [medline] PHST- 2023/01/14 19:26 [entrez] AID - S0167-5273(23)00047-5 [pii] AID - 10.1016/j.ijcard.2023.01.015 [doi] PST - ppublish SO - Int J Cardiol. 2023 Apr 15;377:26-32. doi: 10.1016/j.ijcard.2023.01.015. Epub 2023 Jan 11. PMID- 36640840 OWN - NLM STAT- MEDLINE DCOM- 20230303 LR - 20240913 IS - 2213-3763 (Electronic) IS - 0019-4832 (Print) IS - 0019-4832 (Linking) VI - 75 IP - 1 DP - 2023 Jan-Feb TI - Clinical outcomes of MANTA vs suture-based vascular closure devices after transcatheter aortic valve replacement: An updated meta-analysis. PG - 59-67 LID - S0019-4832(23)00007-X [pii] LID - 10.1016/j.ihj.2023.01.007 [doi] AB - OBJECTIVE: A recently published randomized control trial showed different results with suture-based vascular closure device (VCD) than plug-based VCD in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). The learning curve for MANTA device is steep, while the learning curve for suture based VCD is shallow as the devices are quite different. In this meta-analysis, we have compared suture-based (ProGlide and Prostar XL) vs plug-based VCDs (MANTA). METHODS: We performed a meta-analysis of all published studies (using PubMed/Medline and Cochrane databases) reporting the clinical outcome of plug-based vs suture-based VCDs in transfemoral TAVR patients. RESULTS: We included nine studies with a total of 2865 patients (plug-based n = 1631, suture-based n = 1234). There was no significant difference in primary outcome of all bleeding when using plug-based as opposed to suture-based VCDs (RR 1.14 [0.62-2.06] I(2) = 72%). There was no significant difference in the incidence of secondary outcomes between two groups including major life threatening bleeding (RR 1.16 [0.38-3.58] I(2) = 65%), major vascular complications (RR 0.84 [0.35-2.00] I(2) = 55%), minor vascular complications (RR 1.05 [0.56-1.95] I(2) = 42%), pseudo aneurysm (RR 1.84 [0.11-29.98] I(2) = 44%), stenosis-dissection (RR 0.98 [0.66-1.47] I(2) = 0%), VCD failure (RR 1.71 [0.96-3.04] I(2) = 0%), and blood transfusion (RR 1.01 [0.38-2.71], I(2) = 61%). CONCLUSION: Large bore arteriotomy closure with plug-based VCD was not superior to suture-based VCDs in this transfemoral TAVR population. There was very frequent use of secondary VCDs in suture-based VCD group which is not practical when using MANTA. Additional high-powered studies are required to determine the safety and efficacy of MANTA device. CI - Copyright (c) 2023 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved. FAU - Doshi, Rajkumar AU - Doshi R AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. Electronic address: raj20490@gmail.com. FAU - Vasudev, Rahul AU - Vasudev R AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Guragai, Nirmal AU - Guragai N AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Patel, Kunal Nitinkumar AU - Patel KN AD - Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, NJ, USA. FAU - Kumar, Ashish AU - Kumar A AD - Department of Internal Medicine Cleveland Clinic Akron General, Akron, OH, USA. FAU - Majmundar, Monil AU - Majmundar M AD - Department of Cardiology, University of Kansas Medical Center, Kansas City, KS, USA. FAU - Doshi, Preet AU - Doshi P AD - Department of Medicine, MS Ramaiah Medical College, Bengaluru, India. FAU - Patel, Prem AU - Patel P AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Shah, Kalpesh AU - Shah K AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Santana, Melvin AU - Santana M AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Roman, Sherif AU - Roman S AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Vallabhajosyula, Saraschandra AU - Vallabhajosyula S AD - Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA. FAU - Virk, Hartaj AU - Virk H AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Bikkina, Mahesh AU - Bikkina M AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. FAU - Shamoon, Fayez AU - Shamoon F AD - Department of Cardiology, St Joseph University Medical Center, Paterson, NJ, USA. LA - eng PT - Journal Article PT - Meta-Analysis DEP - 20230111 PL - India TA - Indian Heart J JT - Indian heart journal JID - 0374675 SB - IM MH - Humans MH - *Vascular Closure Devices MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - Femoral Artery/surgery MH - *Aortic Valve Stenosis/surgery MH - Sutures MH - Aortic Valve/surgery MH - Hemostatic Techniques PMC - PMC9986740 OTO - NOTNLM OT - Bleeding OT - Blood transfusion OT - Device failure OT - Transcatheter aortic valve replacement OT - Vascular closure device OT - Vascular complications COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/01/15 06:00 MHDA- 2023/03/04 06:00 PMCR- 2023/01/01 CRDT- 2023/01/14 19:24 PHST- 2022/08/26 00:00 [received] PHST- 2023/01/08 00:00 [revised] PHST- 2023/01/09 00:00 [accepted] PHST- 2023/01/15 06:00 [pubmed] PHST- 2023/03/04 06:00 [medline] PHST- 2023/01/14 19:24 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - S0019-4832(23)00007-X [pii] AID - 10.1016/j.ihj.2023.01.007 [doi] PST - ppublish SO - Indian Heart J. 2023 Jan-Feb;75(1):59-67. doi: 10.1016/j.ihj.2023.01.007. Epub 2023 Jan 11. PMID- 36615187 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230111 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 1 DP - 2023 Jan 3 TI - Transcatheter Aortic Valve Replacement for Bicuspid vs. Tricuspid Aortic Stenosis among Patients at Low Surgical Risk in China: From the Multicenter National NTCVR Database. LID - 10.3390/jcm12010387 [doi] LID - 387 AB - BACKGROUND: This study aims to compare the outcomes of transcatheter aortic valve replacement (TAVR) with self-expandable valves for bicuspid aortic valve (BAV) vs. tricuspid aortic valve (TAV) stenosis patients who are at low surgical risk. METHODS: Participants were enrolled from 36 centers in China between January 2017 and December 2021. The primary endpoint event was all-cause mortality and all stroke at 30 days. RESULTS: Among 389 patients at low surgical risk that underwent TAVR, 229 patients were BAV stenosis (mean age, 72.9 years; 65.1% men). There was no significant difference in the rate of all-cause death between two populations at 30 days. However, the rate of all stroke was significantly higher in the BAV group at 30 days (3.3% vs. 0%; odds ratio (OR), 0.97 (95% confidence interval (CI), 0.94 to 0.99); p = 0.044). By multivariate logistic regression analysis, trans-carotid access was associated with a higher all stroke rate at 30 days (OR, 29.20 (95% CI, 3.97 to 215.1); p = 0.001). CONCLUSIONS: In this national registry-based study, patients treated for BAV vs. TAV stenosis had no significant difference in all-cause mortality at 30 days, but trans-carotid access was associated with a higher all stroke rate after TAVR at 30 days. FAU - Hong, Nanchao AU - Hong N AD - Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, 180 Fenglin Road, Shanghai 200032, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai 200032, China. FAU - Pan, Wenzhi AU - Pan W AD - Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, 180 Fenglin Road, Shanghai 200032, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai 200032, China. FAU - Liu, Xianbao AU - Liu X AUID- ORCID: 0000-0003-1556-9198 AD - Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Zhou, Daxin AU - Zhou D AD - Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, 180 Fenglin Road, Shanghai 200032, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai 200032, China. FAU - Wang, Jianan AU - Wang J AD - Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Ge, Junbo AU - Ge J AD - Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, 180 Fenglin Road, Shanghai 200032, China. AD - National Clinical Research Center for Interventional Medicine, Shanghai 200032, China. LA - eng GR - 2020YFC2008100/National Key R & D Program of China/ GR - 22YF1443400，19DZ1930202/Shanghai Municipal Committee of Science and Technology/ GR - 2021M700822/fellowship of China Postdoctoral Science Foundation/ PT - Journal Article DEP - 20230103 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9821306 OTO - NOTNLM OT - bicuspid aortic stenosis OT - low surgical risk OT - trans-carotid access OT - transcatheter aortic valve replacement COIS- The authors declare that they have no conflict of interest. EDAT- 2023/01/09 06:00 MHDA- 2023/01/09 06:01 PMCR- 2023/01/03 CRDT- 2023/01/08 01:32 PHST- 2022/11/28 00:00 [received] PHST- 2022/12/27 00:00 [revised] PHST- 2023/01/01 00:00 [accepted] PHST- 2023/01/08 01:32 [entrez] PHST- 2023/01/09 06:00 [pubmed] PHST- 2023/01/09 06:01 [medline] PHST- 2023/01/03 00:00 [pmc-release] AID - jcm12010387 [pii] AID - jcm-12-00387 [pii] AID - 10.3390/jcm12010387 [doi] PST - epublish SO - J Clin Med. 2023 Jan 3;12(1):387. doi: 10.3390/jcm12010387. PMID- 36615142 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230308 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 1 DP - 2023 Jan 1 TI - Technical Success after Transcatheter Aortic Valve Replacement for Bicuspid versus Tricuspid Aortic Stenosis. LID - 10.3390/jcm12010343 [doi] LID - 343 AB - Background: Comparative data of the Valve Academic Research Consortium (VARC-3)-defined technical success between bicuspid versus tricuspid aortic stenosis (AS) remain lacking. Aims: We sought to compare the technical success and other clinical outcomes between patients with bicuspid and tricuspid AS receiving transcatheter aortic valve replacement. Methods: A registration-based analysis was performed for 402 patients (211 and 191 cases of bicuspid and tricuspid AS, respectively). The primary outcome was VARC-3-defined technical success. Additional analysis was performed to assess outcomes for up to one year between the two groups. Results: Bicuspid AS patients tended to be younger (74 years vs. 77 years; p < 0.001) with a lower Society of Thoracic Surgeons score (4.4% vs. 5.4%; p = 0.003). Bicuspid AS patients showed a lower prevalence of hypertension and peripheral vascular diseases. Technical failure was encountered in 17.7% of these patients, driven primarily by the high incidence of second valve implantation. The technical success rates were comparable between the bicuspid and tricuspid AS groups (82.5% vs. 82.2%, p = 0.944). Chronic kidney disease (CKD) and larger sinotubular junctional diameter (STJ) were identified as predictors of technical failure, whereas CKD, impaired left ventricular ejection fraction (LVEF), along with larger STJ, were predictors of cardiac technical failure. Technical failure was associated with an increased risk of all-cause mortality at 30 days and 1 year, as evidenced by the Cox multivariable analysis. Conclusions: No significant differences were observed in the technical success rates and most clinical outcomes between the bicuspid and tricuspid AS groups. Technical failure conferred an increased risk for both 30-day and 1-year all-cause mortalities. FAU - Dai, Hanyi AU - Dai H AUID- ORCID: 0000-0002-7782-891X AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Fan, Jiaqi AU - Fan J AUID- ORCID: 0000-0002-1909-9026 AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - He, Yuxin AU - He Y AUID- ORCID: 0000-0001-9110-9244 AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Chen, Jun AU - Chen J AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Zhou, Dao AU - Zhou D AUID- ORCID: 0000-0001-7815-9490 AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Yidilisi, Abuduwufuer AU - Yidilisi A AUID- ORCID: 0000-0001-8733-3585 AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Qi, Xinrui AU - Qi X AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Li, Ranxi AU - Li R AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Liu, Xianbao AU - Liu X AUID- ORCID: 0000-0003-1556-9198 AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. LA - eng GR - 2019YFA0110400/National Key R&D Program of China/ GR - 81870292/The National Natural Science Foundation of China/ GR - 81570233/The National Natural Science Foundation of China/ GR - 81770252/The National Natural Science Foundation of China/ GR - 82200552/The National Natural Science Foundation of China/ GR - 2021C03097/Zhejiang Province Science and Technology Department Key R&D Program/ GR - 2022C03063/Zhejiang Province Science and Technology Department Key R&D Program/ GR - JBZX-202001/Zhejiang Research Center of Cardiovascular Diagnosis and Treatment Technology/ GR - 2020KY569/Zhejiang Provincial Medical Scientific and Technological Project/ GR - LQ21H020005/Natural Science Foundation of Zhejiang Province of China/ PT - Journal Article DEP - 20230101 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9821499 OTO - NOTNLM OT - bicuspid aortic stenosis OT - self-expanding valve OT - technical success OT - transcatheter aortic valve replacement OT - transfemoral approach COIS- All authors declare that there is no conflict of interest relevant of the submitted work. EDAT- 2023/01/09 06:00 MHDA- 2023/01/09 06:01 PMCR- 2023/01/01 CRDT- 2023/01/08 01:32 PHST- 2022/11/23 00:00 [received] PHST- 2022/12/23 00:00 [revised] PHST- 2022/12/29 00:00 [accepted] PHST- 2023/01/08 01:32 [entrez] PHST- 2023/01/09 06:00 [pubmed] PHST- 2023/01/09 06:01 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - jcm12010343 [pii] AID - jcm-12-00343 [pii] AID - 10.3390/jcm12010343 [doi] PST - epublish SO - J Clin Med. 2023 Jan 1;12(1):343. doi: 10.3390/jcm12010343. PMID- 36594529 OWN - NLM STAT- MEDLINE DCOM- 20230503 LR - 20230503 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 81 IP - 4 DP - 2023 TI - Nationwide experience with transcarotid transcatheter aortic valve implantation: Insights from the POL-CAROTID registry. PG - 373-380 LID - 10.33963/KP.a2022.0288 [doi] AB - BACKGROUND: The carotid artery is an alternative access route for transcatheter aortic valve implantation (TAVI), especially useful in patients unsuitable for traditional access routes including transfemoral (TF), subclavian, transapical, and aortic. AIMS: To investigate the feasibility and safety of transcarotid (TC) access for TAVI in comparison to the TF approach in a multicenter setting. METHODS: A total of 41 patients, treated between December 2014 and December 2018, were retrospectively reported to the Polish Registry of Common Carotid Artery Access for TAVI (POL-CAROTID). The median follow-up time was 619 (365-944) days, and Valve Academic Research Consortium-2 (VARC-2) definitions were applied. Clinical outcomes were compared with 41 propensity-matched TF-TAVI patients. RESULTS: The mean (standard deviation [SD]) patients' age was 78.0 (7.2) years, and 29 patients (70.7%) were men. Prohibitive iliofemoral anatomy and/or obesity (46.3%) and/or the presence of a stent graft in the abdominal aorta (31.7%) were the most common indications for TC-TAVI. Device success for TC-TAVI was comparable with the matched TF-TAVI group (90.2% vs. 95.3%, respectively, P = 0.396), and no periprocedural mortality was observed. Moreover, early safety was similar between the two groups (92.7% vs. 95.3%, respectively, log-rank P = 0.658) with only 1 case of non-disabling stroke during the first month after TC-TAVI. Consequently, no cerebrovascular events were observed in the mid-term, and the clinical efficacy of TC-TAVI corresponded well with TF-TAVI (90.2% vs. 92.7%, respectively, log-rank P = 0.716). A total of 4 (9.8%) deaths were noted in the TC-TAVI cohort in comparison to 3 (7.3%) in the TF-TAVI group. CONCLUSIONS: The results of the study indicated that the first cohort of Polish patients with implantations of second-generation transcarotid transcatheter heart valves had a similar prognosis to TF-TAVI with regard to safety and feasibility. TC access may be considered an optimal alternative for patients in whom the TF approach is precluded. FAU - Wilimski, Radoslaw AU - Wilimski R AD - Department of Cardiac Surgery, Medical University of Warsaw, Warszawa, Poland. rwilimski@gmail.com. FAU - Huczek, Zenon AU - Huczek Z AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Grodecki, Kajetan AU - Grodecki K AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Kochman, Janusz AU - Kochman J AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Rymuza, Bartosz AU - Rymuza B AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Wojakowski, Wojciech AU - Wojakowski W AD - Division of Cardiology and Structural Heart Diseases Medical University of Silesia, Katowice, Poland. FAU - Hudziak, Damian AU - Hudziak D AD - Division of Cardiology and Structural Heart Diseases Medical University of Silesia, Katowice, Poland. FAU - Jagielak, Dariusz AU - Jagielak D AD - Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland. FAU - Sacha, Jerzy AU - Sacha J AD - Department of Cardiology, University Hospital, Faculty of Natural Sciences and Technology, University of Opole, Opole, Poland. AD - Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland. FAU - Grygier, Marek AU - Grygier M AD - 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Walczak, Andrzej AU - Walczak A AD - Department of Cardiac Surgery, Medical University of Lodz, Lodz, Poland. FAU - Hendzel, Piotr AU - Hendzel P AD - Department of Cardiac Surgery, Medical University of Warsaw, Warszawa, Poland. FAU - Cichon, Romuald AU - Cichon R AD - Department of Cardiac Surgery, Medical University of Zielona Gora, Poland. FAU - Grabowski, Marcin AU - Grabowski M AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Kusmierczyk, Mariusz AU - Kusmierczyk M AD - Department of Cardiac Surgery, Medical University of Warsaw, Warszawa, Poland. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230103 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM MH - Male MH - Humans MH - Aged MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - Carotid Arteries MH - Aortic Valve/surgery MH - Treatment Outcome MH - Registries OTO - NOTNLM OT - aortic stenosis OT - transcarotid access OT - transcatheter aortic valve implantation EDAT- 2023/01/04 06:00 MHDA- 2023/05/03 06:42 CRDT- 2023/01/03 06:42 PHST- 2022/10/07 00:00 [received] PHST- 2022/10/07 00:00 [accepted] PHST- 2023/05/03 06:42 [medline] PHST- 2023/01/04 06:00 [pubmed] PHST- 2023/01/03 06:42 [entrez] AID - VM/OJS/J/92204 [pii] AID - 10.33963/KP.a2022.0288 [doi] PST - ppublish SO - Kardiol Pol. 2023;81(4):373-380. doi: 10.33963/KP.a2022.0288. Epub 2023 Jan 3. PMID- 36573607 OWN - NLM STAT- MEDLINE DCOM- 20230306 LR - 20230317 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 81 IP - 2 DP - 2023 TI - Transcarotid access for transcatheter aortic valve implantation with a Navitor device. PG - 205-206 LID - 10.33963/KP.a2023.0007 [doi] FAU - Trebacz, Jaroslaw AU - Trebacz J AD - Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland. FAU - Sobczynski, Robert AU - Sobczynski R AD - Department of Cardiac Surgery and Transplantation, John Paul II Hospital, Krakow, Poland. FAU - Konstanty-Kalandyk, Janusz AU - Konstanty-Kalandyk J AD - Department of Cardiac Surgery and Transplantation, John Paul II Hospital, Krakow, Poland. AD - Department of Cardiac Surgery and Transplantation, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Krakow, Poland. FAU - Musial, Robert AU - Musial R AD - Department of Intensive Medical Care, John Paul II Hospital, Krakow, Poland. FAU - Stapor, Maciej AU - Stapor M AD - Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland. FAU - Okarski, Michal AU - Okarski M AD - Student Scientific Group of Modern Cardiac Therapy at the Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Mroz, Krystian AU - Mroz K AD - Student Scientific Group of Modern Cardiac Therapy at the Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Kapelak, Boguslaw AU - Kapelak B AD - Department of Cardiac Surgery and Transplantation, John Paul II Hospital, Krakow, Poland. AD - Department of Cardiac Surgery and Transplantation, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Krakow, Poland. FAU - Legutko, Jacek AU - Legutko J AD - Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland. FAU - Kleczynski, Pawel AU - Kleczynski P AD - Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland. kleczu@interia.pl. AD - Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland. kleczu@interia.pl. LA - eng PT - Journal Article DEP - 20221227 PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Aortic Valve/surgery MH - Carotid Arteries MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis EDAT- 2022/12/28 06:00 MHDA- 2023/03/07 06:00 CRDT- 2022/12/27 07:03 PHST- 2022/12/14 00:00 [received] PHST- 2022/12/14 00:00 [accepted] PHST- 2022/12/28 06:00 [pubmed] PHST- 2023/03/07 06:00 [medline] PHST- 2022/12/27 07:03 [entrez] AID - VM/OJS/J/93220 [pii] AID - 10.33963/KP.a2023.0007 [doi] PST - ppublish SO - Kardiol Pol. 2023;81(2):205-206. doi: 10.33963/KP.a2023.0007. Epub 2022 Dec 27. PMID- 36561055 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221227 IS - 1671-5411 (Print) IS - 1671-5411 (Linking) VI - 19 IP - 11 DP - 2022 Nov 28 TI - Systemic inflammatory markers in elderly patients undergoing transcatheter aortic valve replacement. PG - 811-821 LID - 10.11909/j.issn.1671-5411.2022.11.009 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) provokes an early injury response, partially represented by dynamic changes in inflammatory markers. TAVR greatly benefits the elderly and we aimed to determine whether increased inflammatory markers post-TAVR in octagenerians were different than their younger counterparts and whether it was associated with adverse clinical outcomes. METHODS: Patients with severe symptomatic aortic stenosis who underwent transfemoral TAVR from January 2010 to December 2021 were enrolled. Total white blood cells (WBC) count and subpopulation dynamics were evaluated. RESULTS: Five-hundred and seven patients were finally included in the study, 65% of these patients were 80 or more years old (54% female, median age 84 [82-87]) years, with severe symptomatic aortic stenosis. In patients aged above 80 years (patients >/= 80), we noticed significant kinetic changes in the WBC and their differential cellular subpopulations (P < 0.0001) between admission and early days post-procedure. This was evident by a significant increase in total WBC (median 7.1 to 9.4) and absolute neutrophil count (median 4.7 to 7.4), neutrophil-lymphocyte (NL) ratio (median 2.82 to 7.21), and a meaningful decrease in absolute lymphocyte count (median 1.5 to 1.0). Implantation of self-expandable valves (SEVs) was associated with a more pronounced inflammatory response than balloon-expandable valves (BEVs). Higher WBC and neutrophil counts were associated with higher mortality and major vascular complications at 30 days, in addition, higher neutrophil counts and NL ratios were found to be correlated to arrhythmia at 30 days with P values of 0.04 and 0.028, respectively. CONCLUSION: This is the first description of a differential age-related inflammatory response in patients after TAVR, which shows an association between inflammatory markers post procedure and clinical outcome. Nevertheless, survival rates were similar in the elderly population and in younger patients, despite the presence of comorbid conditions. CI - (c) 2022 JGC All rights reserved; www.jgc301.com. FAU - Khadija, Haitham Abu AU - Khadija HA AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Welt, Mechael AU - Welt M AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Gendelman, Gera AU - Gendelman G AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Hamode, Ahamd AU - Hamode A AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Poles, Lion AU - Poles L AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Jonas, Michael AU - Jonas M AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Jaber, Mustafa AU - Jaber M AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Sella, Gal AU - Sella G AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Ayyad, Omar AU - Ayyad O AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Tshori, Sagi AU - Tshori S AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - Blatt, Alex AU - Blatt A AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. FAU - George, Jacob AU - George J AD - Kaplan Heart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel. LA - eng PT - Journal Article PL - China TA - J Geriatr Cardiol JT - Journal of geriatric cardiology : JGC JID - 101237881 PMC - PMC9748265 EDAT- 2022/12/24 06:00 MHDA- 2022/12/24 06:01 PMCR- 2022/11/28 CRDT- 2022/12/23 02:16 PHST- 2022/12/23 02:16 [entrez] PHST- 2022/12/24 06:00 [pubmed] PHST- 2022/12/24 06:01 [medline] PHST- 2022/11/28 00:00 [pmc-release] AID - jgc-19-11-811 [pii] AID - 10.11909/j.issn.1671-5411.2022.11.009 [doi] PST - ppublish SO - J Geriatr Cardiol. 2022 Nov 28;19(11):811-821. doi: 10.11909/j.issn.1671-5411.2022.11.009. PMID- 36547419 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240909 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 9 IP - 12 DP - 2022 Nov 28 TI - Ten-Year Experience with Transapical and Direct Transaortic Transcatheter Aortic Valve Replacement to Address Patients with Aortic Stenosis and Peripheral Vascular Disease. LID - 10.3390/jcdd9120422 [doi] LID - 422 AB - Objective: Transcatheter aortic valve replacement (TAVR) through alternative access routes is indicated in patients with severe aortic valve stenosis and diseased peripheral arteries. We analysed and compared the outcome of patients undergoing transapical (TA) and direct transaortic (TAO) TAVR procedures. Methods: Preoperative characteristics, procedural details, and thirty-day outcome of patients undergoing transapical (TA-TAVR group) and direct transaortic (TAO-TAVR group) TAVR procedures were prospectively collected and retrospectively analysed. Results: From March 2012 to March 2022, 81 TA and 82 TAO-TAVR (total: 163 cases) were performed with balloon-expanding (n = 120; 73.6%) and self-expandable (n = 43; 26.4%) valves. The mean age was 79.7 +/- 6.2 and 81.9 +/- 6.7 years for the TA- and TAO-TAVR groups, respectively (p = 0.032). Females were more represented in the TAO-TAVR group (56% vs. 32%; p = 0.003) while TA-TAVR patients showed a higher prevalence of previous vascular surgery (20% vs. 6%; p = 0.01), previous cardiac surgery (51% vs. 3.6%; p < 0.001), and porcelain aorta (22% vs. 5%; p = 0.001). The mean ejection fraction was 49.0 +/- 14.6% (TA) and 53.5 +/- 12.2% (TAO) (p = 0.035) while mean gradients were 35.6 +/- 13.2 mmHg (TA) and 40.4 +/- 16.1 mmHg (TAO) (p = 0.045). The median EuroSCORE-II was 5.0% (IQR: 3.0-11.0) and 3.9% (IQR: 2.5-5.4) for the TA- and TAO-TAVR groups, respectively (p = 0.005). The procedural time was shorter for TA procedures (97 min (IQR: 882-118) vs. 102 min (IQR: 88-129); p = 0.133). Mortality at day 30 was 6% in both groups (p = 1.000); the permanent pacemaker implantation rate was similar (8.6% vs. 9.7%; p = 1.000), and hospital stay was shorter for the TAO group (8 days (IQR: 6-11) vs. 10 days (IQR: 7-13); p = 0.025). Conclusions: Our results show that transapical and direct transaortic TAVR in high-risk patients with diseased peripheral arteries provide satisfactory clinical results with similar thirty-day outcomes. FAU - Ferrari, Enrico AU - Ferrari E AUID- ORCID: 0000-0002-2837-3242 AD - Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. AD - Biomedical Faculty, University of Italian Switzerland (USI), 6900 Lugano, Switzerland. AD - School of Medicine, University of Zurich, 8006 Zurich, Switzerland. FAU - Pozzoli, Alberto AU - Pozzoli A AUID- ORCID: 0000-0002-1184-7210 AD - Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. FAU - Klersy, Catherine AU - Klersy C AUID- ORCID: 0000-0003-0314-8548 AD - Clinical Epidemiology & Biostatistics, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy. FAU - Toto, Francesca AU - Toto F AUID- ORCID: 0000-0002-8489-3234 AD - Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. FAU - Torre, Tiziano AU - Torre T AUID- ORCID: 0000-0002-8706-8563 AD - Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. FAU - Cassina, Tiziano AU - Cassina T AUID- ORCID: 0000-0001-9700-1584 AD - Biomedical Faculty, University of Italian Switzerland (USI), 6900 Lugano, Switzerland. AD - Cardiac Anaesthesia, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. FAU - Pedrazzini, Giovanni AU - Pedrazzini G AD - Biomedical Faculty, University of Italian Switzerland (USI), 6900 Lugano, Switzerland. AD - Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. FAU - Demertzis, Stefanos AU - Demertzis S AD - Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland. AD - Biomedical Faculty, University of Italian Switzerland (USI), 6900 Lugano, Switzerland. LA - eng PT - Journal Article DEP - 20221128 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC9783693 OTO - NOTNLM OT - aortic valve stenosis OT - direct transaortic access OT - transapical access OT - transcatheter aortic valve replacement COIS- Dr. Enrico Ferrari is a consultant for Edwards Lifesciences and received educational and research grants from Edwards Lifesciences and Medistim. Other authors have no conflicts of interest. EDAT- 2022/12/23 06:00 MHDA- 2022/12/23 06:01 PMCR- 2022/11/28 CRDT- 2022/12/22 10:53 PHST- 2022/10/03 00:00 [received] PHST- 2022/11/22 00:00 [revised] PHST- 2022/11/26 00:00 [accepted] PHST- 2022/12/22 10:53 [entrez] PHST- 2022/12/23 06:00 [pubmed] PHST- 2022/12/23 06:01 [medline] PHST- 2022/11/28 00:00 [pmc-release] AID - jcdd9120422 [pii] AID - jcdd-09-00422 [pii] AID - 10.3390/jcdd9120422 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2022 Nov 28;9(12):422. doi: 10.3390/jcdd9120422. PMID- 36543453 OWN - NLM STAT- MEDLINE DCOM- 20221223 LR - 20230109 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 15 IP - 24 DP - 2022 Dec 26 TI - Subclavian Artery Access for Transcatheter Aortic Valve Replacement in a Right Aortic Arch. PG - 2573-2574 LID - S1936-8798(22)01578-3 [pii] LID - 10.1016/j.jcin.2022.08.028 [doi] FAU - Hohri, Yu AU - Hohri Y AD - Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: hohri.kpum5@gmail.com. FAU - Zen, Kan AU - Zen K AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Kawajiri, Hidetake AU - Kawajiri H AD - Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Matoba, Satoaki AU - Matoba S AD - Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Yaku, Hitoshi AU - Yaku H AD - Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. LA - eng PT - Journal Article DEP - 20221130 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - Subclavian Artery/diagnostic imaging/surgery MH - Aorta, Thoracic/diagnostic imaging/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Cardiovascular Abnormalities/surgery OTO - NOTNLM OT - Kommerell diverticulum OT - right aortic arch OT - right subclavian artery approach OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2022/12/22 06:00 MHDA- 2022/12/24 06:00 CRDT- 2022/12/21 20:56 PHST- 2022/08/07 00:00 [received] PHST- 2022/08/16 00:00 [accepted] PHST- 2022/12/21 20:56 [entrez] PHST- 2022/12/22 06:00 [pubmed] PHST- 2022/12/24 06:00 [medline] AID - S1936-8798(22)01578-3 [pii] AID - 10.1016/j.jcin.2022.08.028 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2022 Dec 26;15(24):2573-2574. doi: 10.1016/j.jcin.2022.08.028. Epub 2022 Nov 30. PMID- 36538975 OWN - NLM STAT- MEDLINE DCOM- 20230331 LR - 20230331 IS - 2241-5955 (Electronic) IS - 1109-9666 (Linking) VI - 70 DP - 2023 Mar-Apr TI - Transcatheter aortic valve implantation with different self-expanding devices-a propensity score-matched multicenter comparison. PG - 1-9 LID - S1109-9666(22)00180-4 [pii] LID - 10.1016/j.hjc.2022.12.006 [doi] AB - OBJECTIVE: Several supra-annular self-expanding transcatheter systems are commercially available for transcatheter aortic valve implantation (TAVI). Comparative data in large-scale multicenter studies are scant. METHODS: This study included a total of 5175 patients with severe aortic stenosis undergoing TAVI with the ACURATE neo (n = 1095), Evolut R (n = 3365), or Evolut PRO (n = 715) by a transfemoral approach at five high-volume centers. Propensity score matching resulted in 654 triplets. Outcomes are reported according to the Valve Academic Research Consortium-3 (VARC-3) consensus. RESULTS: Moderate or severe paravalvular regurgitation (PVR) occurred significantly more often in the ACURATE neo group (5.2%) than in the Evolut R (1.8%) and Evolut PRO (3.3%) groups (p = 0.003). The rates of major vascular-/access-related complications (4.6%, 3.8%, and 5.0%; p = 0.56), type 3 or 4 bleeding (3.2%, 2.1%, and 4.1%; p = 0.12), and 30-day mortality (2.4%, 2.6%, and 3.7%; p = 0.40) were comparable. The rate of new permanent pacemaker implantation (PPI) was significantly lower in the ACURATE neo group (9.5%, 17.6%, and 16.8%; p < 0.001). Independent predictors for 2-year survival were a Society of Thoracic Surgeons (STS) risk score >/=5%, diabetes mellitus, a glomerular filtration rate <30 ml/min, baseline mean transvalvular gradient 0.99). No significant differences were observed in aortic valve mean gradient and Doppler velocity index at 1 year. However, the S3U group had a larger increase in mean gradient from implantation to 1 year (median +4.70 vs. +1.63 mmHg, p < 0.001). CONCLUSIONS: S3U and S3 carried similarly favorable clinical event risks. Nonetheless, S3U was associated with less frequent mild PVL but a larger increase in transprosthetic gradient. Further studies are needed to determine the prognostic impact of these hemodynamic differences. CI - (c) 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Isogai, Toshiaki AU - Isogai T AUID- ORCID: 0000-0002-2172-6447 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Agrawal, Ankit AU - Agrawal A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Shekhar, Shashank AU - Shekhar S AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Spilias, Nikolaos AU - Spilias N AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Hodges, Kevin AU - Hodges K AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Yun, James J AU - Yun JJ AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Reed, Grant W AU - Reed GW AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AUID- ORCID: 0000-0001-6048-7955 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. LA - eng GR - Jennifer and Robert McNeil/ PT - Journal Article DEP - 20221213 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM OTO - NOTNLM OT - SAPIEN 3 Ultra OT - balloon-expandable valve OT - hemodynamics OT - paravalvular leakage OT - transcatheter aortic valve replacement EDAT- 2022/12/14 06:00 MHDA- 2022/12/14 06:01 CRDT- 2022/12/13 07:03 PHST- 2022/11/11 00:00 [received] PHST- 2022/11/24 00:00 [accepted] PHST- 2022/12/14 06:01 [medline] PHST- 2022/12/14 06:00 [pubmed] PHST- 2022/12/13 07:03 [entrez] AID - 10.1002/ccd.30515 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Feb;101(2):417-430. doi: 10.1002/ccd.30515. Epub 2022 Dec 13. PMID- 36471671 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240908 IS - 2352-9067 (Print) IS - 2352-9067 (Electronic) IS - 2352-9067 (Linking) VI - 43 DP - 2022 Dec TI - Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis. PG - 101156 LID - 10.1016/j.ijcha.2022.101156 [doi] LID - 101156 AB - Femoral access is the gold standard for transcatheter aortic valve replacement (TAVR). Safe alternative access, that represents about 15 % of TAVR cases, remains important for patients without adequate transfemoral access. We aimed to perform a systematic review and meta-analysis of studies comparing transfemoral (TF) access versus transsubclavian or transaxillary (TSc/TAx) access in patients undergoing TAVR. We searched PubMed, Cochrane CENTRAL Register, EMBASE, Web of Science, Google Scholar and ClinicalTrials.gov (inception through May 24, 2022) for studies comparing (TF) to (TSc/TAx) access for TAVR. A total of 21 studies with 75,995 unique patients who underwent TAVR (73,203 transfemoral and 2,792 TSc/TAx) were included in the analysis. There was no difference in the risk of in-hospital and 30-day all-cause mortality between the two groups (RR 0.64, 95 % CI 0.36-1.13, P = 0.12) and (RR 0.95, 95 % CI 0.64-1.41, P = 0.81), while 1-year mortality was significantly lower in the TF TAVR group (RR 0.79, 95 % CI 0.67-0.93, P = 0.005). No significant differences in major bleeding (RR 0.82, 95 % CI 0.65-1.03, P = 0.09), major vascular complications (RR 1.14, 95 % CI 0.75-1.72, P = 0.53), and stroke (RR 0.66, 95 % CI 0.42-1.02, P = 0.06) were observed. In patients undergoing TAVR, TF access is associated with significantly lower 1-year mortality compared to TSc/TAx access without differences in major bleeding, major vascular complications and stroke. While TF is the preferred approach for TAVR, TSc/TAx is a safe alternative approach. Future studies should confirm these findings, preferably in a randomized setting. CI - (c) 2022 The Authors. FAU - Abusnina, Waiel AU - Abusnina W AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. FAU - Machanahalli Balakrishna, Akshay AU - Machanahalli Balakrishna A AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. FAU - Ismayl, Mahmoud AU - Ismayl M AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. FAU - Latif, Azka AU - Latif A AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. FAU - Reda Mostafa, Mostafa AU - Reda Mostafa M AD - Rochester Regional Health/Unity Hospital, Rochester, NY, USA. FAU - Al-Abdouh, Ahmad AU - Al-Abdouh A AD - Department of Medicine, University of Kentucky, Lexington, KY, USA. FAU - Junaid Ahsan, Muhammad AU - Junaid Ahsan M AD - Division of Cardiovascular Medicine, Iowa Heart Center, Des Moines, IA, USA. FAU - Radaideh, Qais AU - Radaideh Q AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. FAU - Haddad, Toufik M AU - Haddad TM AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. FAU - Goldsweig, Andrew M AU - Goldsweig AM AD - Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA. FAU - Ben-Dor, Itsik AU - Ben-Dor I AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA. FAU - Mamas, Mamas A AU - Mamas MA AD - Keele Cardiovascular Research Group, Keele University, UK. FAU - Dahal, Khagendra AU - Dahal K AD - Division of Cardiology, Creighton University School of Medicine, NE, USA. LA - eng PT - Journal Article PT - Review DEP - 20221201 PL - Ireland TA - Int J Cardiol Heart Vasc JT - International journal of cardiology. Heart & vasculature JID - 101649525 PMC - PMC9718962 OTO - NOTNLM OT - AKI, Acute Kidney Injury OT - AS, Aortic Stenosis OT - Access site OT - Axillary access OT - CI, Confidence Interval OT - Femoral access OT - MI, Myocardial Infarction OT - RR, Risk Ratio OT - Subclavian access OT - TAVI OT - TAVR OT - TAVR, Transcatheter Aortic Valve Replacement OT - TAx, Transaxillary OT - TC, Transcarotid OT - TF, Transfemoral OT - TSc, Transsubclavian COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/12/07 06:00 MHDA- 2022/12/07 06:01 PMCR- 2022/12/01 CRDT- 2022/12/06 01:43 PHST- 2022/08/23 00:00 [received] PHST- 2022/11/20 00:00 [revised] PHST- 2022/11/22 00:00 [accepted] PHST- 2022/12/06 01:43 [entrez] PHST- 2022/12/07 06:00 [pubmed] PHST- 2022/12/07 06:01 [medline] PHST- 2022/12/01 00:00 [pmc-release] AID - S2352-9067(22)00205-6 [pii] AID - 101156 [pii] AID - 10.1016/j.ijcha.2022.101156 [doi] PST - epublish SO - Int J Cardiol Heart Vasc. 2022 Dec 1;43:101156. doi: 10.1016/j.ijcha.2022.101156. eCollection 2022 Dec. PMID- 36463532 OWN - NLM STAT- MEDLINE DCOM- 20230329 LR - 20261010 IS - 1438-8359 (Electronic) IS - 0913-8668 (Linking) VI - 37 IP - 2 DP - 2023 Apr TI - Effect of remimazolam on the incidence of delirium after transcatheter aortic valve implantation under general anesthesia: a retrospective exploratory study. PG - 210-218 LID - 10.1007/s00540-022-03148-2 [doi] AB - PURPOSE: Delirium after transcatheter aortic valve implantation (TAVI) should be prevented because it is associated with worse patient outcomes. Perioperative administration of benzodiazepines is a risk factor for postoperative delirium; however, the association between remimazolam, a newer ultrashort-acting benzodiazepine for general anesthesia, and postoperative delirium remains unclear. This study aimed to evaluate whether remimazolam administration during TAVI under general anesthesia affected the incidence of postoperative delirium. METHODS: This single-center retrospective study recruited all adult patients who underwent transfemoral TAVI (TF-TAVI) under general anesthesia between March 2020 and May 2022. Patients were divided into the remimazolam (R) and propofol (P) groups according to the sedative used for anesthesia. In the R group, all patients received flumazenil after surgery. The primary endpoint was the incidence of delirium within 3 days after surgery. Factors associated with delirium after TF-TAVI were examined by multiple logistic regression analysis. RESULTS: Ninety-eight patients were included in the final analysis (R group, n = 40; P group, n = 58). The incidence of postoperative delirium was significantly lower in the R group than in the P group (8% vs. 26%, p = 0.032). Multiple logistic regression analysis revealed that remimazolam (odds ratio 0.17, 95% CI 0.04-0.80, p = 0.024) was independently associated with the incidence of postoperative delirium, even after adjustment for age, sex, preoperative cognitive function, history of stroke, and TF-TAVI approach. CONCLUSION: Remimazolam may benefit TF-TAVI in terms of postoperative delirium; however, its usefulness must be further evaluated in extensive prospective studies. CI - (c) 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists. FAU - Kaneko, Shohei AU - Kaneko S AUID- ORCID: 0000-0002-0156-4559 AD - Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. s-kaneko@nagasaki-u.ac.jp. FAU - Morimoto, Takayuki AU - Morimoto T AD - Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. FAU - Ichinomiya, Taiga AU - Ichinomiya T AD - Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. FAU - Murata, Hiroaki AU - Murata H AD - Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. FAU - Yoshitomi, Osamu AU - Yoshitomi O AD - Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. FAU - Hara, Tetsuya AU - Hara T AD - Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. LA - eng PT - Journal Article DEP - 20221204 PL - Japan TA - J Anesth JT - Journal of anesthesia JID - 8905667 RN - 7V4A8U16MB (remimazolam) RN - 12794-10-4 (Benzodiazepines) SB - IM CIN - J Anesth. 2023 Apr;37(2):321-322. doi: 10.1007/s00540-022-03157-1. PMID: 36562814 CIN - J Anesth. 2023 Apr;37(2):323-324. doi: 10.1007/s00540-023-03167-7. PMID: 36670281 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Retrospective Studies MH - *Emergence Delirium/epidemiology/prevention & control/complications MH - Prospective Studies MH - Incidence MH - Postoperative Complications/epidemiology/etiology MH - *Aortic Valve Stenosis/surgery MH - Anesthesia, General/adverse effects MH - Benzodiazepines MH - Aortic Valve/surgery OTO - NOTNLM OT - Aortic stenosis OT - Postoperative delirium OT - Remimazolam OT - Transcatheter aortic valve implantation EDAT- 2022/12/05 06:00 MHDA- 2023/03/29 06:05 CRDT- 2022/12/04 14:28 PHST- 2022/06/22 00:00 [received] PHST- 2022/11/27 00:00 [accepted] PHST- 2023/03/29 06:05 [medline] PHST- 2022/12/05 06:00 [pubmed] PHST- 2022/12/04 14:28 [entrez] AID - 10.1007/s00540-022-03148-2 [pii] AID - 10.1007/s00540-022-03148-2 [doi] PST - ppublish SO - J Anesth. 2023 Apr;37(2):210-218. doi: 10.1007/s00540-022-03148-2. Epub 2022 Dec 4. PMID- 36460902 OWN - NLM STAT- MEDLINE DCOM- 20230206 LR - 20230206 IS - 1720-8319 (Electronic) IS - 1594-0667 (Linking) VI - 35 IP - 2 DP - 2023 Feb TI - A new trend to reduce adverse events in patients undergoing transcatheter aortic valve implantation: cusp overlap technique: a cross sectional study. PG - 375-385 LID - 10.1007/s40520-022-02307-5 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is currently the treatment of choice for the majority of patients at moderate or high surgical risk. However, some complications occur frequently with this procedure. In this study, we aimed to assess whether the cusp-overlap view (COP) technique may be associated with a reduced incidence of some of these complications compared with the classical three-cusp view (TCV) technique. METHODS: In this single-center, retrospective study we investigated; technical success, postprocedural permanent pacemaker implantation (PPMI), new-onset stroke, pericardial tamponade, arrhythmia development, acute renal failure, major bleeding, major vascular complications, procedure-related coronary obstruction, new-onset left bundle branch block (LBBB), paravalvular leak, peri-procedural myocardial infarction (MI), day of hospitalization, death, and major adverse cardiac and cerebrovascular events (MACCE) were determined as the clinical endpoints. RESULTS: A total of 281 consecutive patients who met the study criteria and underwent elective or emergency transfemoral TAVI using the self-expandable CoreValve Evolut valve were included. 176 consecutive patients implanted with the classical TCV technique and 105 consecutive patients implanted with the COP technique were compared. Compared with the TCV group, patients in the COP group had lower PPMI (3.8% vs. 10.8%, p = 0.039), in-hospital mortality (1.9% vs. 8.5%, p = 0.018), and 1-year death (4.8% versus 18.8%, p = 0.001), and MACCE rates (12.4% vs 31.3%, p < 0.001). CONCLUSION: The COP technique may help to reduce the conduction disturbances, PPMI requirement and complication rates that may develop following TAVI. In addition, it is an interesting result that it reduces mortality and MACCE rates in long-term follow-ups. CI - (c) 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG. FAU - Guzel, Tuncay AU - Guzel T AUID- ORCID: 0000-0001-8470-1928 AD - Department of Cardiology, Health Science University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey. drtuncayguzel@gmail.com. FAU - Demir, Muhammed AU - Demir M AUID- ORCID: 0000-0002-9049-7123 AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Aktan, Adem AU - Aktan A AUID- ORCID: 0000-0003-0505-9784 AD - Department of Cardiology, Mardin Training and Research Hospital, Mardin, Turkey. FAU - Arik, Baran AU - Arik B AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Argun, Lokman AU - Argun L AUID- ORCID: 0000-0001-6453-9310 AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Ildirimli, Kamran AU - Ildirimli K AUID- ORCID: 0000-0001-6608-871X AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Sutcu, Mihriban AU - Sutcu M AUID- ORCID: 0000-0001-8664-0428 AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Arslan, Bayram AU - Arslan B AUID- ORCID: 0000-0003-2984-9094 AD - Department of Cardiology, Ergani State Hospital, Diyarbakir, Turkey. FAU - Ozbek, Mehmet AU - Ozbek M AUID- ORCID: 0000-0003-2243-6190 AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Kilic, Raif AU - Kilic R AUID- ORCID: 0000-0002-8338-4948 AD - Department of Cardiology, Diyarlife Hospital, Diyarbakir, Turkey. FAU - Aslan, Burhan AU - Aslan B AUID- ORCID: 0000-0002-8994-7414 AD - Department of Cardiology, Health Science University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey. FAU - Gitmez, Mesut AU - Gitmez M AUID- ORCID: 0000-0003-1078-9095 AD - Department of Cardiology, Batman Training and Research Hospital, Batman, Turkey. FAU - Karacalilar, Mehmet AU - Karacalilar M AUID- ORCID: 0000-0002-3610-3621 AD - Department of Cardiovascular Surgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. FAU - Cakir, Cayan AU - Cakir C AUID- ORCID: 0000-0002-2110-3178 AD - Department of Cardiology, Bismil State Hospital, Diyarbakir, Turkey. FAU - Ertas, Faruk AU - Ertas F AUID- ORCID: 0000-0003-1860-6513 AD - Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. LA - eng PT - Journal Article DEP - 20221202 PL - Germany TA - Aging Clin Exp Res JT - Aging clinical and experimental research JID - 101132995 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/surgery MH - Cross-Sectional Studies MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Retrospective Studies MH - *Heart Valve Prosthesis/adverse effects MH - *Pacemaker, Artificial/adverse effects OTO - NOTNLM OT - Cusp-overlap view OT - Permanent pacemaker implantation OT - Self-expandable valve OT - Three-cusp view OT - Transcatheter aortic valve implantation EDAT- 2022/12/03 06:00 MHDA- 2023/02/07 06:00 CRDT- 2022/12/02 23:40 PHST- 2022/09/17 00:00 [received] PHST- 2022/11/15 00:00 [accepted] PHST- 2022/12/03 06:00 [pubmed] PHST- 2023/02/07 06:00 [medline] PHST- 2022/12/02 23:40 [entrez] AID - 10.1007/s40520-022-02307-5 [pii] AID - 10.1007/s40520-022-02307-5 [doi] PST - ppublish SO - Aging Clin Exp Res. 2023 Feb;35(2):375-385. doi: 10.1007/s40520-022-02307-5. Epub 2022 Dec 2. PMID- 36459131 OWN - NLM STAT- MEDLINE DCOM- 20230309 LR - 20230327 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 44 IP - 10 DP - 2023 Mar 7 TI - Transfemoral aortic valve implantation: procedural hospital volume and mortality in Germany. PG - 856-867 LID - 10.1093/eurheartj/ehac698 [doi] AB - AIMS: Studies assessing transfemoral transcatheter aortic valve implantation (TF-TAVI) showed lower rates of in-hospital mortality at high-volume hospitals and minimum caseloads were recommended to assure quality standards. METHODS AND RESULTS: All patients in the German mandatory quality assurance registry with elective or urgent TF-TAVI procedures in 2018 and 2019 at 81 and 82 hospitals, respectively, were analysed. Observed in-hospital mortality was adjusted to expected mortality by the German AKL-KATH score (O/E) as well as by the EuroScore II (O/E2). Hospital volume and O/E were correlated by regression analyses and volume quartiles. 18 763 patients (age: 81.1 +/- 1.0 years, mean EuroSCORE II: 6.9 +/- 1.8%) and 22 137 patients (mean age: 80.7 +/- 3.5 years, mean EuroSCORE II: 6.5 +/- 1.6%) were analysed in 2018 and 2019, respectively. The average observed in-hospital mortality was 2.57 +/- 1.83% and 2.36 +/- 1.60%, respectively. Unadjusted in-hospital mortality was significantly inversely related to hospital volume by linear regression in both years. After risk adjustment, the association between hospital volume and O/E was statistically significant in 2019 (R2 = 0.049; P = 0.046), but not in 2018 (R2 = 0.027; P = 0.14). The variance of O/E explained by the number of cases in 2019 was low (4.9%). Differences in O/E outcome between the first and the fourth quartile were not statistically significant in both years (1.10 +/- 1.02 vs. 0.82 +/- 0.46; P = 0.26 in 2018; 1.16 0 .97 vs. 0.74 +/- 0.39; P = 0.084 in 2019). Any chosen volume cut-off could not precisely differentiate between hospitals with not acceptable quality (>95th percentile O/E of all hospitals) and those with acceptable (O/E 12,000 patients undergoing transfemoral TAVI. We assessed baseline patient characteristics and clinical outcomes in patients with DM and without DM. Clinical outcomes were defined by the second valve academic research consortium. Propensity score matching was applied to minimize potential confounding. RESULTS: Of the 11,440 patients included, 31% (n = 3550) had DM and 69% (n = 7890) did not have DM. Diabetic patients were younger but had an overall worse cardiovascular risk profile than non-diabetic patients. All-cause mortality rates were comparable at 30 days (4.5% vs. 4.9%, RR 0.9, 95%CI 0.8-1.1, p = 0.43) and at one year (17.5% vs. 17.4%, RR 1.0, 95%CI 0.9-1.1, p = 0.86) in the unmatched population. Propensity score matching obtained 3281 patient-pairs. Also in the matched population, mortality rates were comparable at 30 days (4.7% vs. 4.3%, RR 1.1, 95%CI 0.9-1.4, p = 0.38) and one year (17.3% vs. 16.2%, RR 1.1, 95%CI 0.9-1.2, p = 0.37). Other clinical outcomes including stroke, major bleeding, myocardial infarction and permanent pacemaker implantation, were comparable between patients with DM and without DM. Insulin treated diabetics (n = 314) showed a trend to higher mortality compared with non-insulin treated diabetics (n = 701, Hazard Ratio 1.5, 95%CI 0.9-2.3, p = 0.08). EuroSCORE II was the most accurate risk score and underestimated 30-day mortality with an observed-expected ratio of 1.15 in DM patients, STS-PROM overestimated actual mortality with a ratio of 0.77 and Logistic EuroSCORE with 0.35. CONCLUSION: DM was not associated with mortality during the first year after TAVI. DM patients undergoing TAVI had low rates of mortality and other adverse clinical outcomes, comparable to non-DM TAVI patients. Our results underscore the safety of TAVI treatment in DM patients. TRIAL REGISTRATION: The study is registered at clinicaltrials.gov (NCT03588247). CI - (c) 2022. The Author(s). FAU - van Nieuwkerk, Astrid C AU - van Nieuwkerk AC AD - Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands. FAU - Santos, Raquel B AU - Santos RB AD - Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands. AD - Department of Cardiology, Servico Cardiologia, Centro Hospitalar Universitario do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. FAU - Mata, Roberto Blanco AU - Mata RB AD - Cardiologia Intervencionista, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain. FAU - Tchetche, Didier AU - Tchetche D AD - Clinique Pasteur, Toulouse, France. FAU - de Brito, Fabio S Jr AU - de Brito FS Jr AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, Policlinico-Vittorio Emanuele Hospital, University of Catania, Catania CT, Italy. FAU - Kornowski, Ran AU - Kornowski R AD - Cardiology Department, Rabin Medical Center, Petach Tikva, Israel. FAU - Latib, Azeem AU - Latib A AD - Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa. AD - Montefiore Medical Center, Department of Interventional Cardiology, New York, NY, USA. FAU - D'Onofrio, Augusto AU - D'Onofrio A AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. FAU - Ribichini, Flavio AU - Ribichini F AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Baan, Jan AU - Baan J AD - Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands. FAU - Oteo-Dominguez, Juan AU - Oteo-Dominguez J AD - Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla 1, 28222, Majadahonda, Madrid, Spain. FAU - Dumonteil, Nicolas AU - Dumonteil N AD - Clinique Pasteur, Toulouse, France. FAU - Abizaid, Alexandre AU - Abizaid A AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Sartori, Samantha AU - Sartori S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. FAU - D'Errigo, Paola AU - D'Errigo P AD - National Centre for Global Health - Instituto Superiore di Sanita, Rome, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Division of Cardiac Surgery, University of Padova, Padova, Italy. FAU - Lunardi, Mattia AU - Lunardi M AD - Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. FAU - Orvin, Katia AU - Orvin K AD - Cardiology Department, Rabin Medical Center, Petach Tikva, Israel. FAU - Pagnesi, Matteo AU - Pagnesi M AD - Institute of Cardiology, Department of Medical and Surgical specialties, Radiological sciences and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy. FAU - Ghattas, Angie AU - Ghattas A AD - Clinique Pasteur, Toulouse, France. FAU - Amat-Santos, Ignacio AU - Amat-Santos I AD - CIBERCV, Department of Cardiology, Hospital Clinico Universitario, Valladolid, Spain. FAU - Dangas, George AU - Dangas G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. FAU - Delewi, Ronak AU - Delewi R AD - Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands. r.delewi@amsterdamumc.nl. LA - eng SI - ClinicalTrials.gov/NCT03588247 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221116 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 SB - IM MH - Humans MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - *Diabetes Mellitus/diagnosis/epidemiology/etiology MH - Propensity Score MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Multicenter Studies as Topic MH - Registries PMC - PMC9670618 OTO - NOTNLM OT - Aortic valve stenosis OT - Bleeding OT - Diabetes mellitus OT - Insulin OT - Mortality OT - Stroke OT - TAVI OT - Transcatheter aortic valve replacement COIS- Dr. de Brito Jr is a proctor for Edwards Lifesciences and Medtronic. Dr. Amat-Santos is a proctor for Boston Scientific. Dr. Barbanti is consultant for Edwards Lifesciences, and received speaker honoraria from Medtronic and Biotronik. Dr. Latib is a consultant for Medtronic, and has received honoraria from Abbott Vascular. Dr. Baan receives an unrestricted research grant from Edwards Lifesciences. The remaining authors have no relevant disclosures. EDAT- 2022/11/18 06:00 MHDA- 2022/11/22 06:00 PMCR- 2022/11/16 CRDT- 2022/11/17 09:54 PHST- 2022/01/27 00:00 [received] PHST- 2022/09/18 00:00 [accepted] PHST- 2022/11/17 09:54 [entrez] PHST- 2022/11/18 06:00 [pubmed] PHST- 2022/11/22 06:00 [medline] PHST- 2022/11/16 00:00 [pmc-release] AID - 10.1186/s12933-022-01654-x [pii] AID - 1654 [pii] AID - 10.1186/s12933-022-01654-x [doi] PST - epublish SO - Cardiovasc Diabetol. 2022 Nov 16;21(1):246. doi: 10.1186/s12933-022-01654-x. PMID- 36378873 OWN - NLM STAT- MEDLINE DCOM- 20230105 LR - 20230111 IS - 1540-8191 (Electronic) IS - 0886-0440 (Linking) VI - 37 IP - 12 DP - 2022 Dec TI - Suprasternal transcatheter aortic valve replacement: Modified trocar-free technique. PG - 5663-5665 LID - 10.1111/jocs.17117 [doi] AB - BACKGROUND AND AIM OF STUDY: Transcatheter aortic valve replacement is established as the standard treatment for severe aortic stenosis. Many approaches have been described, including the suprasternal technique, an alternative for patients with unsuitable femoral arteries. We now describe a trocar-free technique for the Suprasternal approach. METHODS AND RESULTS: Under endotracheal anesthesia, an incision is made above the manubrium and dissection is carried down to the innominate artery with adequate exposure for cannulation. Access site is closed with purse-string suture. The Suprasternal approach has relatively few contraindications. CONCLUSION: Our trocar-free technique is a safe and easily reproducible technique for TAVRs in patients with poor femoral access. CI - (c) 2022 Wiley Periodicals LLC. FAU - de Oliveira, Guilherme C AU - de Oliveira GC AUID- ORCID: 0000-0003-4574-4516 AD - Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. FAU - Kessel, Julia AU - Kessel J AD - School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. FAU - Vavalle, John AU - Vavalle J AD - Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. FAU - Caranasos, Thomas AU - Caranasos T AD - Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. LA - eng PT - Journal Article DEP - 20221115 PL - United States TA - J Card Surg JT - Journal of cardiac surgery JID - 8908809 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Femoral Artery/surgery MH - Brachiocephalic Trunk/surgery MH - Aortic Valve/surgery MH - Treatment Outcome OTO - NOTNLM OT - aorta and great vessels OT - cardiovascular research OT - valve repair/replacement EDAT- 2022/11/16 06:00 MHDA- 2023/01/06 06:00 CRDT- 2022/11/15 14:43 PHST- 2022/10/17 00:00 [revised] PHST- 2022/04/24 00:00 [received] PHST- 2022/10/26 00:00 [accepted] PHST- 2022/11/16 06:00 [pubmed] PHST- 2023/01/06 06:00 [medline] PHST- 2022/11/15 14:43 [entrez] AID - 10.1111/jocs.17117 [doi] PST - ppublish SO - J Card Surg. 2022 Dec;37(12):5663-5665. doi: 10.1111/jocs.17117. Epub 2022 Nov 15. PMID- 36378620 OWN - NLM STAT- MEDLINE DCOM- 20230120 LR - 20230206 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 101 IP - 1 DP - 2023 Jan TI - Clinical and echocardiographic outcomes with new-onset left bundle branch block after SAPIEN-3 transcatheter aortic valve replacement. PG - 187-196 LID - 10.1002/ccd.30488 [doi] AB - BACKGROUND: New-onset left bundle branch block (LBBB) can develop after transcatheter aortic valve replacement (TAVR) resulting in worse outcomes. AIMS: Describe clinical and echocardiographic outcomes with new-onset LBBB after TAVR. METHODS: We included consecutive patients who underwent transfemoral-TAVR with SAPIEN-3 (S3) valve between April 2015 and December 2018. Exclusion criteria included pre-existing LBBB, right BBB, left anterior hemiblock, left posterior hemiblock, wide QRS >/= 120ms, prior permanent pacemaker (PPM), and nontransfemoral access. RESULTS: Among 612 patients, 11.4% developed new-onset LBBB upon discharge. The length of stay was longer with new-onset LBBB compared with no LBBB [3 (2-5) days versus 2 (1-3) days; p < 0.001]. New-onset LBBB was associated with higher rates of 30-day PPM requirement (18.6% vs. 5.4%; p < 0.001) and 1-year heart failure hospitalizations (10.7% vs. 4.4%; p = 0.033). There was no difference in 3-year mortality between both groups (30.9% vs. 30.6%; p = 0.829). Further, new-onset LBBB was associated with lower left ventricular ejection fraction (LVEF) at both 30 days (55.9 +/- 11.4% vs. 59.3 +/- 9%; p = 0.026) and 1 year (55 +/- 12% vs. 60.1 +/- 8.9%; p = 0.002). These changes were still present when we stratified patients according to baseline LVEF (>/=50% or <50%). New-onset LBBBs were associated with a higher 1-year LV end-diastolic volume index (51.4 +/- 18.6 vs. 46.4 +/- 15.1 ml/m(2) ; p = 0.036), and LV end-systolic volume index (23.2 +/- 14.1 vs. 18.9 +/- 9.7 ml/m(2) ; p = 0.009). Compared with resolved new-onset LBBB, persistent new-onset LBBB was associated with worse LVEF and higher PPM at 1 year. CONCLUSIONS: New-onset LBBB after S3 TAVR was associated with higher PPM requirement, worse LVEF, higher LV volumes, and increased heart failure hospitalizations, with no difference in mortality. CI - (c) 2022 Wiley Periodicals LLC. FAU - Sammour, Yasser M AU - Sammour YM AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Lak, Hassan AU - Lak H AUID- ORCID: 0000-0002-4778-5461 AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Chahine, Johnny AU - Chahine J AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Abushouk, Abdelrahman AU - Abushouk A AUID- ORCID: 0000-0003-1399-6487 AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Chawla, Sanchit AU - Chawla S AUID- ORCID: 0000-0002-1115-7324 AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Kadri, Amer AU - Kadri A AUID- ORCID: 0000-0003-3493-3389 AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Alkhalaileh, Feras AU - Alkhalaileh F AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Kumar, Sachin AU - Kumar S AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Ghimire, Bindesh AU - Ghimire B AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Svensson, Lars AU - Svensson L AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Popovic, Zoran AU - Popovic Z AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Tarakji, Khaldoun AU - Tarakji K AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Wazni, Oussama AU - Wazni O AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Reed, Grant W AU - Reed GW AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Yun, James AU - Yun J AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AUID- ORCID: 0000-0001-6048-7955 AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. LA - eng PT - Journal Article DEP - 20221115 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2023 Jan;101(1):197-198. doi: 10.1002/ccd.30543. PMID: 36655566 MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Bundle-Branch Block/diagnosis/etiology/therapy MH - Stroke Volume MH - Ventricular Function, Left MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome MH - Arrhythmias, Cardiac MH - Echocardiography MH - *Pacemaker, Artificial MH - *Heart Failure MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - LBBB OT - LVEF OT - TAVR OT - new-onset left bundle branch block OT - pacemaker EDAT- 2022/11/16 06:00 MHDA- 2023/01/21 06:00 CRDT- 2022/11/15 13:23 PHST- 2022/10/13 00:00 [revised] PHST- 2022/03/24 00:00 [received] PHST- 2022/10/30 00:00 [accepted] PHST- 2022/11/16 06:00 [pubmed] PHST- 2023/01/21 06:00 [medline] PHST- 2022/11/15 13:23 [entrez] AID - 10.1002/ccd.30488 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Jan;101(1):187-196. doi: 10.1002/ccd.30488. Epub 2022 Nov 15. PMID- 36362730 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221222 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 11 IP - 21 DP - 2022 Nov 2 TI - Cerebral Ischemic Lesions after Transcatheter Aortic Valve Implantation in Patients with Non-Calcific Aortic Stenosis. LID - 10.3390/jcm11216502 [doi] LID - 6502 AB - Evidence for transcatheter aortic valve implantation (TAVI) is scarce among patients with non-calcific aortic stenosis, and it is not known whether aortic valve calcification is associated with new cerebral ischemic lesions (CILs) that are detected by diffusion-weighted magnetic resonance imaging. So, our study enrolled 328 patients who underwent transfemoral TAVI using a self-expanding valve between December 2016 and June 2021 from the TORCH registry (NCT02803294). A total of 34 patients were finally confirmed as non-calcific AS and the remaining 294 patients were included in the calcific AS group. Incidence of new CILs (70.6% vs. 85.7%, p = 0.022), number of lesions (2.0 vs. 3.0, p = 0.010), and lesions volume (105.0 mm(3) vs. 200.0 mm(3), p = 0.047) was significantly lower in the non-calcific AS group. However, the maximum and average lesion volumes were comparable between two groups. Non-calcific AS was associated with lower risk for developing new CILs by univariate logistic regression analysis [Odds ratio (OR): 0.040, 95% confident interval (CI): 0.18-0.90, p = 0.026] and multivariate analysis (OR: 0.031, 95% CI: 0.13-0.76, p = 0.010). In summary, non-calcific AS patients had a lower risk of developing new cerebral ischemic infarction after TAVI compared to calcific AS patients. However, new ischemic lesions were still found in over 70% of patients. FAU - Liu, Xianbao AU - Liu X AUID- ORCID: 0000-0003-1556-9198 AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Zhou, Dao AU - Zhou D AUID- ORCID: 0000-0001-7815-9490 AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Fan, Jiaqi AU - Fan J AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Dai, Hanyi AU - Dai H AUID- ORCID: 0000-0002-7782-891X AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Zhu, Gangjie AU - Zhu G AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Chen, Jun AU - Chen J AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Guo, Yuchao AU - Guo Y AUID- ORCID: 0000-0002-8206-6323 AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Yidilisi, Abuduwufuer AU - Yidilisi A AUID- ORCID: 0000-0001-8733-3585 AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Zhu, Qifeng AU - Zhu Q AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - He, Yuxin AU - He Y AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Wei, Yanxia AU - Wei Y AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Liu, Qiong AU - Liu Q AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Qi, Xinrui AU - Qi X AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China. LA - eng GR - 2019YFA0110400/National Key R&D Program of China/ GR - 81870292/The National Natural Science Foundation of China/ GR - 81570233/The National Natural Science Foundation of China/ GR - 81770252/The National Natural Science Foundation of China/ GR - 2021C03097/Zhejiang Province Science and Technology Department Key R&D Program/ GR - 2018C03084/Zhejiang Province Science and Technology Department Key R&D Program/ GR - 2022C03063/Zhejiang Province Science and Technology Department Key R&D Program/ GR - JBZX-202001/Zhejiang Research Center of Cardiovascular Diagnosis and Treatment Technology/ PT - Journal Article DEP - 20221102 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9655232 OTO - NOTNLM OT - cerebral ischemic lesions OT - diffusion-weighted magnetic resonance imaging OT - non-calcific aortic stenosis OT - transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2022/11/12 06:00 MHDA- 2022/11/12 06:01 PMCR- 2022/11/02 CRDT- 2022/11/11 01:32 PHST- 2022/09/17 00:00 [received] PHST- 2022/10/26 00:00 [revised] PHST- 2022/10/31 00:00 [accepted] PHST- 2022/11/11 01:32 [entrez] PHST- 2022/11/12 06:00 [pubmed] PHST- 2022/11/12 06:01 [medline] PHST- 2022/11/02 00:00 [pmc-release] AID - jcm11216502 [pii] AID - jcm-11-06502 [pii] AID - 10.3390/jcm11216502 [doi] PST - epublish SO - J Clin Med. 2022 Nov 2;11(21):6502. doi: 10.3390/jcm11216502. PMID- 36348992 OWN - NLM STAT- MEDLINE DCOM- 20221110 LR - 20221110 IS - 1540-8183 (Electronic) IS - 0896-4327 (Print) IS - 0896-4327 (Linking) VI - 2022 DP - 2022 TI - Effect of TAVR Approach and Other Baseline Factors on the Incidence of Acute Kidney Injury: A Systematic Review and Meta-Analysis. PG - 3380605 LID - 10.1155/2022/3380605 [doi] LID - 3380605 AB - BACKGROUND: Acute kidney injury (AKI) is a well-known complication following a transcatheter aortic valve replacement (TAVR) and is associated with higher morbidity and mortality. OBJECTIVE: We aim to compare the risk of developing AKI after transfemoral (TF), transapical (TA), and transaortic (TAo) approaches following TAVR. METHODS: We searched Medline and EMBASE databases from January 2009 to January 2021. We included studies that evaluated the risk of AKI based on different TAVR approaches. After extracting each study's data, we calculated the risk ratio and 95% confidence intervals using RevMan software 5.4. Publication bias was assessed by the forest plot. RESULTS: Thirty-six (36) studies, consisting of 70,406 patients undergoing TAVR were included. Thirty-five studies compared TF to TA, and only seven investigations compared TF to TAo. AKI was documented in 4,857 out of 50,395 (9.6%) patients that underwent TF TAVR compared to 3,155 out of 19,721 (16%) patients who underwent TA-TAVR, with a risk ratio of 0.49 (95% CI, 0.36-0.66; p < 0.00001). Likewise, 273 patients developed AKI out of the 1,840 patients (14.8%) that underwent TF-TAVR in contrast to 67 patients out of the 421 patients (15.9%) that underwent TAo-TAVR, with a risk ratio of 0.51 (95% CI, 0.27-0.98; p = 0.04). There was no significant risk when we compared TA to TAo approaches, with a risk ratio of 0.89 (95% CI, 0.29-2.75; p = 0.84). CONCLUSION: The risk of post-TAVR AKI is significantly lower in patients who underwent TF-TAVR than those who underwent TA-TAVR or TAo-TAVR. CI - Copyright (c) 2022 Hossam Alzu'bi et al. FAU - Alzu'bi, Hossam AU - Alzu'bi H AUID- ORCID: 0000-0001-9315-5914 AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Rmilah, Anan Abu AU - Rmilah AA AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Haq, Ikram-Ui AU - Haq IU AD - Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Kheiri, Babikir AU - Kheiri B AD - Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA. FAU - Al-Abdouh, Ahmad AU - Al-Abdouh A AUID- ORCID: 0000-0002-2836-0687 AD - Department of Medicine, Ascension Saint Agnes Hospital, Baltimore, MD, USA. FAU - Hasan, Bashar AU - Hasan B AD - Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN, USA. FAU - Elsekaily, Omar AU - Elsekaily O AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Jaber, Suhaib AU - Jaber S AD - Department of Internal Medicine, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia. FAU - Qaisi, Ibraheem AU - Qaisi I AD - An-Najah National University School of Medicine, Nablus, State of Palestine. FAU - Yagmour, Asil AU - Yagmour A AD - Al Quds University School of Medicine, Hebron, State of Palestine. FAU - Dajani, Hamada AU - Dajani H AD - An-Najah National University School of Medicine, Nablus, State of Palestine. FAU - Ahmed, Azza AU - Ahmed A AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Ahmed Elhag AU - Ahmed Elhag AD - Department of Internal Medicine, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia. FAU - Kashani, Kianoush AU - Kashani K AD - Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA. FAU - Deshmukh, Abhishek AU - Deshmukh A AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20221027 PL - United States TA - J Interv Cardiol JT - Journal of interventional cardiology JID - 8907826 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Incidence MH - Femoral Artery/surgery MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome MH - *Acute Kidney Injury/epidemiology/etiology MH - Aortic Valve/surgery PMC - PMC9633203 COIS- The authors declare that they have no conflicts of interest. EDAT- 2022/11/10 06:00 MHDA- 2022/11/11 06:00 PMCR- 2022/10/27 CRDT- 2022/11/09 02:08 PHST- 2021/06/22 00:00 [received] PHST- 2022/07/29 00:00 [revised] PHST- 2022/08/10 00:00 [accepted] PHST- 2022/11/09 02:08 [entrez] PHST- 2022/11/10 06:00 [pubmed] PHST- 2022/11/11 06:00 [medline] PHST- 2022/10/27 00:00 [pmc-release] AID - 10.1155/2022/3380605 [doi] PST - epublish SO - J Interv Cardiol. 2022 Oct 27;2022:3380605. doi: 10.1155/2022/3380605. eCollection 2022. PMID- 36337882 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221108 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - The safety of early discharge following transfemoral transcatheter aortic valve replacement under general anesthesia. PG - 1022018 LID - 10.3389/fcvm.2022.1022018 [doi] LID - 1022018 AB - BACKGROUND: There is growing evidence of the safety of same-day discharge for low-risk conscious sedated TAVR patients. However, the evidence supporting the safety of early discharge following GA-TAVR with routine transesophageal echocardiography (TEE) is limited. AIMS: To assess the safety of early discharge following transcatheter aortic valve replacement (TAVR) using General Anesthesia (GA-TAVR) and identify predictors for patient selection. MATERIALS AND METHODS: We used data from 2,447 TEE-guided GA-TAVR patients performed at Cedars-Sinai between 2016 and 2021. Patients were categorized into three groups based on the discharge time from admission: 24 h, 24-48 h, and >48 h. Predictors for 30-day outcomes (cumulative adverse events and death) were validated on a matched cohort of 24 h vs. >24 h using the bootstrap model. RESULTS: The >48 h group had significantly worse baseline cardiovascular profile, higher surgical risk, low functional status, and higher procedural complications than the 24 h and the 24-48 h groups. The rate of 30-day outcomes was significantly lower in the 24 h than the >48 h but did not differ from the 24-48 h (11.3 vs. 15.5 vs. 11.7%, p = 0.003 and p = 0.71, respectively). Independent poor prognostic factors of 30-day outcomes had a high STS risk of >/=8 (OR 1.90, 95% CI 1.30-2.77, E-value = 3.2, P < 0.001), low left ventricle ejection fraction of <30% (OR 6.0, 95% CI 3.96-9.10, E-value = 11.5, P < 0.001), and life-threatening procedural complications (OR 2.65, 95% CI 1.20-5.89, E-value = 4.7, P = 0.04). Our formulated predictors showed a good discrimination ability for patient selection (AUC: 0.78, 95% CI 0.75-0.81). CONCLUSION: Discharge within 24 h following GA-TAVR using TEE is safe for selected patients using our proposed validated predictors. CI - Copyright (c) 2022 Koren, Patel, Kohan, Naami, Naami, Allison, Natanzon, Shechter, Nagasaka, Al Badri, Devanabanda, Nakamura, Cheng, Jilaihawi and Makkar. FAU - Koren, Ofir AU - Koren O AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. AD - Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel. FAU - Patel, Vivek AU - Patel V AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Kohan, Siamak AU - Kohan S AD - Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, United States. FAU - Naami, Robert AU - Naami R AD - Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States. FAU - Naami, Edmund AU - Naami E AD - School of Medicine, University of Illinois Chicago, Chicago, IL, United States. FAU - Allison, Zev AU - Allison Z AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Natanzon, Sharon Shalom AU - Natanzon SS AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Shechter, Alon AU - Shechter A AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. AD - Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - Nagasaka, Takashi AU - Nagasaka T AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. AD - Department of Cardiology, Gunma University Hospital, Gunma, Japan. FAU - Al Badri, Ahmed AU - Al Badri A AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Devanabanda, Arvind Reddy AU - Devanabanda AR AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Nakamura, Mamoo AU - Nakamura M AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Cheng, Wen AU - Cheng W AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. FAU - Jilaihawi, Hasan AU - Jilaihawi H AD - Heart Valve Center, NYU Langone Health, New York City, NY, United States. FAU - Makkar, Raj R AU - Makkar RR AD - Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States. LA - eng PT - Journal Article DEP - 20221021 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9634245 OTO - NOTNLM OT - conscious sedation OT - early discharge OT - general anesthesia OT - length of stay OT - mortality OT - predictors OT - safety discharge OT - transcatheter aortic valve replacement COIS- RM received grant support from Edwards Lifesciences Corporation; consulted for Abbott Vascular, Cordis, and Medtronic; and holds equity in Entourage Medical. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/11/08 06:00 MHDA- 2022/11/08 06:01 PMCR- 2022/01/01 CRDT- 2022/11/07 04:18 PHST- 2022/08/18 00:00 [received] PHST- 2022/10/04 00:00 [accepted] PHST- 2022/11/07 04:18 [entrez] PHST- 2022/11/08 06:00 [pubmed] PHST- 2022/11/08 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.1022018 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Oct 21;9:1022018. doi: 10.3389/fcvm.2022.1022018. eCollection 2022. PMID- 36332499 OWN - NLM STAT- MEDLINE DCOM- 20221206 LR - 20230213 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 186 DP - 2023 Jan 1 TI - Predictors of 1-Year Mortality in Men Versus Women Undergoing Transfemoral Transcatheter Aortic Valve Implantation. PG - 1-4 LID - S0002-9149(22)01109-2 [pii] LID - 10.1016/j.amjcard.2022.10.018 [doi] AB - Although gender-related disparities in intermediate-term outcomes have been reported after transcatheter aortic valve implantation (TAVI), disparate predictors of mortality in men and women who underwent TAVI have not been well studied. This prospective institutional registry study included 297 consecutive patients (153 men, 144 women) who underwent transfemoral TAVI from December 2015 to June 2018 at an academic tertiary medical center. Baseline and clinical characteristics, procedural data, and clinical outcomes at 1 year were recorded. Mortality rates at 1 year were 11.1% and 20.3% in women and men, respectively (p = 0.033). Risk-adjusted mortality was significantly higher in men who underwent TAVI than in women (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.24 to 4.87, p = 0.010). Gender-specific risk-adjusted predictors of 1-year mortality post-TAVI included the presence of atrial fibrillation (OR 4.20, 95% CI 1.31 to 13.46, p = 0.016) and peripheral artery disease (OR 4.64, 95% CI 1.04 to 20.71, p = 0.044) in women and presence of chronic obstructive pulmonary disease (OR 3.14, 95% CI 1.13 to 8.72, p = 0.029), higher serum creatinine (OR 1.57, 95% CI 1.15 to 2.15, p = 0.004), and lower body mass index (OR 0.88, 95% CI 0.80 to 0.97, p = 0.008) in men. In this prospective institutional registry of adults who underwent TAVI, risk-adjusted 1-year mortality is significantly lower in women, and disparate predictors of risk-adjusted 1-year mortality exist in men and women. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Novotny, Samantha AU - Novotny S AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Kort, Smadar AU - Kort S AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Tannous, Henry AU - Tannous H AD - Department of Surgery, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Pyo, Robert AU - Pyo R AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Gracia, Ely AU - Gracia E AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Wang, Ting-Yu AU - Wang TY AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Callahan, Susan AU - Callahan S AD - Department of Surgery, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Skopicki, Hal AU - Skopicki H AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Bilfinger, Thomas AU - Bilfinger T AD - Department of Surgery, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. FAU - Parikh, Puja B AU - Parikh PB AD - Department of Medicine, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, New York. Electronic address: puja.parikh@stonybrookmedicine.edu. LA - eng PT - Journal Article DEP - 20221102 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Male MH - Humans MH - Female MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis MH - Aortic Valve/surgery MH - Prospective Studies MH - Risk Factors MH - Severity of Illness Index MH - Treatment Outcome COIS- Disclosures The authors have no conflicts of interest to declare. EDAT- 2022/11/05 06:00 MHDA- 2022/12/07 06:00 CRDT- 2022/11/04 19:25 PHST- 2022/04/28 00:00 [received] PHST- 2022/08/30 00:00 [revised] PHST- 2022/10/08 00:00 [accepted] PHST- 2022/11/05 06:00 [pubmed] PHST- 2022/12/07 06:00 [medline] PHST- 2022/11/04 19:25 [entrez] AID - S0002-9149(22)01109-2 [pii] AID - 10.1016/j.amjcard.2022.10.018 [doi] PST - ppublish SO - Am J Cardiol. 2023 Jan 1;186:1-4. doi: 10.1016/j.amjcard.2022.10.018. Epub 2022 Nov 2. PMID- 36331961 OWN - NLM STAT- MEDLINE DCOM- 20230323 LR - 20230327 IS - 1537-6591 (Electronic) IS - 1058-4838 (Linking) VI - 76 IP - 6 DP - 2023 Mar 21 TI - Incidence, Clinical Characteristics, and Impact of Absent Echocardiographic Signs in Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation. PG - 1003-1012 LID - 10.1093/cid/ciac872 [doi] AB - BACKGROUND: Echocardiography is the primary imaging modality for diagnosis of infective endocarditis (IE) in prosthetic valve endocarditis (PVE) including IE after transcatheter aortic valve implantation (TAVI). This study aimed to evaluate the characteristics and clinical outcomes of patients with absent compared with evident echocardiographic signs of TAVI-IE. METHODS: Patients with definite TAVI-IE derived from the Infectious Endocarditis after TAVI International Registry were investigated comparing those with absent and evident echocardiographic signs of IE defined as vegetation, abscess, pseudo-aneurysm, intracardiac fistula, or valvular perforation or aneurysm. RESULTS: Among 578 patients, 87 (15.1%) and 491 (84.9%) had absent (IE-neg) and evident (IE-pos) echocardiographic signs of IE, respectively. IE-neg were more often treated via a transfemoral access with a self-expanding device and had higher rates of peri-interventional complications (eg, stroke, major vascular complications) during the TAVI procedure (P < .05 for all). IE-neg had higher rates of IE caused by Staphylococcus aureus (33.7% vs 23.2%; P = .038) and enterococci (37.2% vs 23.8%; P = .009) but lower rates of coagulase-negative staphylococci (4.7% vs 20.0%, P = .001). IE-neg was associated with the same dismal prognosis for in-hospital mortality in a multivariate binary regression analysis (odds ratio: 1.51; 95% confidence interval [CI]: .55-4.12) as well as a for 1-year mortality in Cox regression analysis (hazard ratio: 1.10; 95% CI: .67-1.80). CONCLUSIONS: Even with negative echocardiographic imaging, patients who have undergone TAVI and presenting with positive blood cultures and symptoms of infection are a high-risk patient group having a reasonable suspicion of IE and the need for an early treatment initiation. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Mangner, Norman AU - Mangner N AUID- ORCID: 0000-0003-0793-7923 AD - Herzzentrum Dresden, Technische Universitat Dresden, Dresden, Germany. FAU - Panagides, Vassili AU - Panagides V AUID- ORCID: 0000-0002-0012-1289 AD - Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Del Val, David AU - Del Val D AD - Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AUID- ORCID: 0000-0002-9596-558X AD - Heart Center, Leipzig University, Leipzig, Germany. AD - Heart Center, Segeberger Kliniken, Bad Segeberg, Germany. FAU - Crusius, Lisa AU - Crusius L AD - Herzzentrum Dresden, Technische Universitat Dresden, Dresden, Germany. FAU - Durand, Eric AU - Durand E AD - Department of Cardiology, Normandie University, UNIROUEN, INSERM U1096, Rouen, France. FAU - Ihlemann, Nikolaj AU - Ihlemann N AD - Righospitalet, Copenhagen, Denmark. FAU - Urena, Marina AU - Urena M AD - Bichat Hopital, Paris, France. FAU - Pellegrini, Costanza AU - Pellegrini C AD - Augustinum Klinik Munchen, Munich, Germany. FAU - Giannini, Francesco AU - Giannini F AD - Ospedale San Raffaele, Milan, Italy. AD - Maria Cecilia Hospital, GVM Care and Research, Cotignola RA, Italy. FAU - Gasior, Tomasz AU - Gasior T AD - Herzzentrum Dresden, Technische Universitat Dresden, Dresden, Germany. FAU - Wojakowski, Wojtek AU - Wojakowski W AD - Medical University of Silesia, Katowice, Poland. FAU - Landt, Martin AU - Landt M AD - Heart Center, Segeberger Kliniken, Bad Segeberg, Germany. FAU - Auffret, Vincent AU - Auffret V AD - University of Rennes, CHU Rennes, Inserm, LTSI-UMR1099, Rennes, France. FAU - Sinning, Jan-Malte AU - Sinning JM AD - Heart Center Bonn, Bonn, Germany. FAU - Cheema, Asim N AU - Cheema AN AD - St Michaels Hospital, Toronto, Ontario, Canada. AD - Southlake Hospital, Newmarket, Ontario, Canada. FAU - Nombela-Franco, Luis AU - Nombela-Franco L AUID- ORCID: 0000-0003-3438-8907 AD - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. FAU - Chamandi, Chekrallah AU - Chamandi C AD - Hopital Europeen Georges-Pompidou, Paris, France. FAU - Campelo-Parada, Francisco AU - Campelo-Parada F AUID- ORCID: 0000-0003-1821-0658 AD - Hopital Rangueil, Toulouse, France. FAU - Munoz-Garcia, Erika AU - Munoz-Garcia E AD - Hospital Universitario Virgen de la Victoria, Malaga, Spain. FAU - Herrmann, Howard C AU - Herrmann HC AD - Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Testa, Luca AU - Testa L AUID- ORCID: 0000-0003-4687-3686 AD - IRCCS Pol. San Donato, Milan, Italy. FAU - Kim, Won-Keun AU - Kim WK AUID- ORCID: 0000-0002-0799-7478 AD - Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany. FAU - Eltchaninoff, Helene AU - Eltchaninoff H AD - Department of Cardiology, Normandie University, UNIROUEN, INSERM U1096, Rouen, France. FAU - Sondergaard, Lars AU - Sondergaard L AD - Righospitalet, Copenhagen, Denmark. FAU - Himbert, Dominique AU - Himbert D AD - Bichat Hopital, Paris, France. FAU - Husser, Oliver AU - Husser O AD - Augustinum Klinik Munchen, Munich, Germany. FAU - Latib, Azeem AU - Latib A AD - Ospedale San Raffaele, Milan, Italy. FAU - Le Breton, Herve AU - Le Breton H AD - University of Rennes, CHU Rennes, Inserm, LTSI-UMR1099, Rennes, France. FAU - Servoz, Clement AU - Servoz C AD - Hopital Rangueil, Toulouse, France. FAU - Gervais, Philippe AU - Gervais P AD - Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Cote, Melanie AU - Cote M AD - Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Thiele, Holger AU - Thiele H AUID- ORCID: 0000-0002-0169-998X AD - Heart Center, Leipzig University, Leipzig, Germany. FAU - Holzhey, David AU - Holzhey D AD - Heart Center, Leipzig University, Leipzig, Germany. FAU - Linke, Axel AU - Linke A AD - Herzzentrum Dresden, Technische Universitat Dresden, Dresden, Germany. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AUID- ORCID: 0000-0001-8237-7095 AD - Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. AD - Clinic Barcelona, Barcelona, Spain. LA - eng PT - Journal Article PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 SB - IM MH - Humans MH - *Endocarditis, Bacterial/diagnostic imaging/epidemiology/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Incidence MH - Risk Factors MH - *Prosthesis-Related Infections/diagnostic imaging/epidemiology/etiology MH - *Heart Valve Prosthesis MH - *Endocarditis/diagnostic imaging/epidemiology MH - Echocardiography OTO - NOTNLM OT - Duke criteria OT - TAVI OT - TEE OT - imaging OT - infective endocarditis COIS- Potential conflicts of interest. N. M. reports personal fees from Edwards Lifesciences (payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events), Medtronic (payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events), Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, Bayer, Abbott (payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events), Abiomed, and Boston Scientific (consulting and payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events), outside the submitted work. J. R.-C. has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific. V. P. received research grants from Boston Scientific, Medtronic, and Microport. A. L. reports personal fees from Medtronic, Abbott, Edwards Lifesciences, Boston Scientific, AstraZeneca, Novartis, Pfizer, Abiomed, Bayer, and Boehringer, outside the submitted work. H. C. H. has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. H. L. B. reports lecture fees from Edwards Lifesciences, outside the submitted work. J.-M. S. reports speaker's honoraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. W.-K. K. reports proctor/speaker's fees/advisory board participation from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Meril Life Sciences, and ShockWave Medical, outside the submitted work. L. S. has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic, and SMT. O. H. reports personal fees from Boston Scientific and payments from Abbott. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. EDAT- 2022/11/05 06:00 MHDA- 2023/03/24 06:00 CRDT- 2022/11/04 13:35 PHST- 2022/07/28 00:00 [received] PHST- 2022/11/05 06:00 [pubmed] PHST- 2023/03/24 06:00 [medline] PHST- 2022/11/04 13:35 [entrez] AID - 6801102 [pii] AID - 10.1093/cid/ciac872 [doi] PST - ppublish SO - Clin Infect Dis. 2023 Mar 21;76(6):1003-1012. doi: 10.1093/cid/ciac872. PMID- 36328866 OWN - NLM STAT- MEDLINE DCOM- 20230110 LR - 20230207 IS - 2174-2030 (Electronic) IS - 0870-2551 (Linking) VI - 42 IP - 1 DP - 2023 Jan TI - How accurate are manufacturers' recommendations in determining ineligibility for transfemoral transcatheter aortic valve implantation? PG - 31-38 LID - S0870-2551(22)00369-9 [pii] LID - 10.1016/j.repc.2021.09.019 [doi] AB - INTRODUCTION: Up to one-third of patients indicated for transcatheter aortic valve implantation (TAVI) may be unsuitable for transfemoral TAVI (TF-TAVI) according to manufacturers' recommendations and numerous professional societies. OBJECTIVE: This study aimed to investigate the predictive value of manufacturers' guidelines for major vascular access site complications using the Perclose ProGlide device. METHODS: Among 208 patients undergoing TF-TAVI, 144 patients (69.2%) were deemed eligible for TF-TAVI according to the manufacturer's instructions. A minimal lumen diameter (MLD) of the femoral artery below the manufacturer's specified limits and/or the presence of circumferential calcification were the reasons for ineligibility. Calcium score (CS), sheath-to-femoral artery ratio (SFAR) and MLD were estimated from computed tomography imaging. Vascular complications (VCs) (defined according to VARC-2 criteria) were retrospectively compared. RESULTS: Patients in the ineligible group had higher SFAR (1.13+/-0.15 vs. 0.88+/-0.107, p<0.001) and CS (1.66+/-0.99 vs. 1.24+/-0.73; p=0.003), and significantly lower MLD (7.72+/-1.03 vs. 6.31+/-0.96 mm; p<0.001) compared to the eligible group. Major (6.3% vs. 12.3%, p=0.13) and minor VCs (10.4% vs. 15.6%, p=0.29) were similar in the eligible and ineligible groups. The ineligible group had higher rates of rupture (0.7% vs. 6.3%; p=0.03). SFAR was the only independent predictor of major VCs (OR 469.1, 95% CI 4.95-44466.57, p=0.008). CONCLUSION: The TAVI team should not decide whether the patient is suitable for a femoral approach based solely on the manufacturer's criteria, and should incorporate additional factors that could be predictive of major VCs. CI - Copyright (c) 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier Espana, S.L.U. All rights reserved. FAU - Cakal, Beytullah AU - Cakal B AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. Electronic address: bcakal@hotmail.com. FAU - Cakal, Sinem AU - Cakal S AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey; Haseki Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey. FAU - Karaca, Oguz AU - Karaca O AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. FAU - Yilmaz, Filiz Kizilirmak AU - Yilmaz FK AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. FAU - Gunes, Haci Murat AU - Gunes HM AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. FAU - Yildirim, Arzu AU - Yildirim A AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. FAU - Guler, Yeliz AU - Guler Y AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. FAU - Ozcan, Ozgur Ulas AU - Ozcan OU AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. FAU - Boztosun, Bilal AU - Boztosun B AD - Istanbul Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. LA - eng LA - por PT - Journal Article DEP - 20221031 PL - Portugal TA - Rev Port Cardiol JT - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JID - 8710716 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - Retrospective Studies MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - *Vascular Diseases/etiology MH - Femoral Artery/surgery MH - Aortic Valve/surgery OTO - NOTNLM OT - Acesso vascular OT - Aortic valve disease OT - Complications OT - Complicacoes OT - Doenca valvular aortica OT - Implantacao valvular aortica percutanea OT - Transcatheter aortic valve implantation OT - Vascular access EDAT- 2022/11/04 06:00 MHDA- 2023/01/11 06:00 CRDT- 2022/11/03 23:04 PHST- 2021/03/25 00:00 [received] PHST- 2021/07/20 00:00 [revised] PHST- 2021/09/05 00:00 [accepted] PHST- 2022/11/04 06:00 [pubmed] PHST- 2023/01/11 06:00 [medline] PHST- 2022/11/03 23:04 [entrez] AID - S0870-2551(22)00369-9 [pii] AID - 10.1016/j.repc.2021.09.019 [doi] PST - ppublish SO - Rev Port Cardiol. 2023 Jan;42(1):31-38. doi: 10.1016/j.repc.2021.09.019. Epub 2022 Oct 31. PMID- 36326198 OWN - NLM STAT- MEDLINE DCOM- 20230117 LR - 20230117 IS - 1784-973X (Electronic) IS - 0001-5385 (Linking) VI - 77 IP - 10 DP - 2022 Dec TI - Trends and outcomes in transcatheter aortic valve implantation in Belgium: a 13-year single centre experience. PG - 960-969 LID - 10.1080/00015385.2022.2130444 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted as an alternative to surgery in severe aortic stenosis treatment, even in low-intermediate risk. The aim of this study is to retrospectively report our single-centre 13-year TAVI experience with emphasis on learning curve, referral indication and trends in outcomes over time. METHODS: We included 361 consecutive patients who underwent TAVI from January 2008 to December 2020, grouped according to similar per-year volume of procedures: G1 (2008-2014), G2 (2015-2017) and G3 (2018-2020). RESULTS: The number of procedures increased (group size: 59 vs. 106 vs. 196). No major differences were observed in STS-PROM and EuroSCORE-II between groups, despite TAVI in patients with prior surgical revascularisation was mainly performed in G1. Trans-femoral approach raised from 80.8 to 93.4%, while the most common alternative access was trans-subclavian. The pre-dilation rate was higher in G1 with lower prosthesis post-dilation rate. The length of hospital stay decreased in time by 30%. At 30 days a reduction in all-cause mortality, vascular complications, bleedings and para-valvular leak combined with higher rate of permanent pacing were observed over the groups. At 1-year there was no difference in all-cause mortality but over 30% reduction in cardiovascular death (8.5 vs. 7.5 vs. 5.6%). CONCLUSIONS: Favourable trends were observed across the groups, with an improvement in periprocedural outcomes and cardiovascular mortality at 1-year. These improvements could depend on increased expertise because mortality reduction was noted only after reaching a significant procedure volume. A trend towards lower risk patients selection was present in our cohort, as previously described worldwide. FAU - Bezzeccheri, Andrea AU - Bezzeccheri A AUID- ORCID: 0000-0002-7207-8953 AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. AD - Department of Experimental Medicine, University of Rome 'Tor Vergata', Rome, Italy. FAU - Vermeersch, Paul AU - Vermeersch P AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Verheye, Stefan AU - Verheye S AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Wilgenhof, Adriaan AU - Wilgenhof A AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Willemen, Yannick AU - Willemen Y AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Vescovo, Giovanni Maria AU - Vescovo GM AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Scott, Benjamin AU - Scott B AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Convens, Carl AU - Convens C AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Zivelonghi, Carlo AU - Zivelonghi C AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. FAU - Agostoni, Pierfrancesco AU - Agostoni P AD - HartCentrum, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium. LA - eng PT - Journal Article DEP - 20221103 PL - England TA - Acta Cardiol JT - Acta cardiologica JID - 0370570 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Belgium/epidemiology MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Heart Valve Prosthesis Implantation/methods OTO - NOTNLM OT - Transcatheter aortic valve implantation OT - VARC-3 OT - learning curve OT - outcomes EDAT- 2022/11/04 06:00 MHDA- 2023/01/18 06:00 CRDT- 2022/11/03 08:33 PHST- 2022/11/04 06:00 [pubmed] PHST- 2023/01/18 06:00 [medline] PHST- 2022/11/03 08:33 [entrez] AID - 10.1080/00015385.2022.2130444 [doi] PST - ppublish SO - Acta Cardiol. 2022 Dec;77(10):960-969. doi: 10.1080/00015385.2022.2130444. Epub 2022 Nov 3. PMID- 36326070 OWN - NLM STAT- MEDLINE DCOM- 20221116 LR - 20221222 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 11 IP - 22 DP - 2022 Nov 15 TI - Role of Changing Procedural Characteristics Versus Changing Risk Profile in Age-Based Trends of Outcomes in Patients With Transfemoral Transcatheter Aortic Valve Replacement From 2012 to 2018: A Nationwide Analysis. PG - e026812 LID - 10.1161/JAHA.122.026812 [doi] LID - e026812 AB - Background The trends in outcomes in patients who undergo transcatheter aortic valve replacement are well described in the literature. Some of these trends are driven by the decreasing risk profile of patients because of changing indications for transcatheter aortic valve replacement. We aimed to evaluate these trends in different age groups and quantify how much of these trends are driven by changes in procedural characteristics. Methods and Results Using the National Inpatient Sample from 2012 to 2018, we identified 204 230 adult patients who underwent transfemoral aortic valve replacement. The study's primary objective was to evaluate the changes in age-based trends in in-hospital mortality driven by changes in procedural characteristics over time. The secondary objectives were to evaluate similar trends in cardiac and noncardiac complications and resource use. Univariate and multivariate linear and logistic regression were used to obtain effect sizes. From 2012 to 2018, in-hospital mortality decreased from 1.8% to 0.79% in the age group 18 to 64 years, from 3.8% to 1.6% in the age group 65 to 80 years, and from 5.3% to 1.5% in the age group >80 years (P trend<0.01 for all age groups); these trends remained statistically significant on adjusted analysis except in patients aged 18 to 64 years. The other outcomes also showed variable trends over time. Length of stay, cost, and early discharge rates improved even after adjusting for comorbidities, which is likely attributable to improvement in procedural characteristics. Conclusions The changes in outcomes related to transcatheter aortic valve replacement are partly driven by changing patient risk profiles over time, but procedural characteristics have likely contributed to these trends in all age groups. FAU - Ashraf, Muddasir AU - Ashraf M AUID- ORCID: 0000-0001-9710-7610 AD - Aurora Cardiovascular and Thoracic Services Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health Milwaukee WI. FAU - Carnahan, Ryan M AU - Carnahan RM AUID- ORCID: 0000-0002-7478-4739 AD - Department of Epidemiology The University of Iowa College of Public Health Iowa City IA. LA - eng PT - Journal Article DEP - 20221103 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Humans MH - Adult MH - Infant, Newborn MH - Infant MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis MH - Risk Factors MH - Treatment Outcome MH - Time Factors MH - Aortic Valve/surgery MH - Postoperative Complications PMC - PMC9750063 OTO - NOTNLM OT - TAVR OT - procedural characteristics OT - transcatheter aortic valve replacement OT - trends EDAT- 2022/11/04 06:00 MHDA- 2022/11/18 06:00 PMCR- 2022/11/15 CRDT- 2022/11/03 06:43 PHST- 2022/11/04 06:00 [pubmed] PHST- 2022/11/18 06:00 [medline] PHST- 2022/11/03 06:43 [entrez] PHST- 2022/11/15 00:00 [pmc-release] AID - JAH37944 [pii] AID - 10.1161/JAHA.122.026812 [doi] PST - ppublish SO - J Am Heart Assoc. 2022 Nov 15;11(22):e026812. doi: 10.1161/JAHA.122.026812. Epub 2022 Nov 3. PMID- 36321613 OWN - NLM STAT- MEDLINE DCOM- 20221219 LR - 20230103 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 100 IP - 7 DP - 2022 Dec TI - Feasibility of transcaval access TAVI in morbidly obese patients: A single-center experience. PG - 1302-1306 LID - 10.1002/ccd.30465 [doi] AB - OBJECTIVES: We report a single-center experience in utilizing the transcaval-access transcatheter aortic valve implantation (TAVI) as an alternative approach in morbidly obese patients. BACKGROUND: Morbidly obese patients present frequently for TAVI. Transfemoral arterial access TAVI in these patients is technically challenging due to deep arterial access, resulting in a higher risk of vascular complications. Transcaval access TAVI is increasingly used in patients with prohibitive iliofemoral arterial access. METHODS: We used the transcaval approach for eight morbidly obese patients who had otherwise technically feasible femoral arterial access. This technique provides an alternative arterial access point that potentially circumvents some of the challenges relating to femoral arterial access. RESULTS: We report eight morbidly obese patients with a mean body mass index of 42.3 +/- 6.2 kg/m(2) who underwent transcaval access TAVI at our center (mean EuroScore II 2.47 +/- 1.83%). The patient mean age was 70.3 +/- 9.8 years; six were female. All eight patients underwent a successful and uncomplicated procedure. The median time to discharge was 2 days and all patients were alive at 30 days. CONCLUSIONS: Transcaval access TAVI is a feasible alternative for morbidly obese patients and may reduce vascular complications. Further data are required to evaluate the safety of this approach. CI - (c) 2022 Wiley Periodicals LLC. FAU - Michail, Michael AU - Michail M AUID- ORCID: 0000-0001-5553-3144 AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. FAU - Cockburn, James AU - Cockburn J AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. FAU - Tanseco, Kristoffer Vincent P AU - Tanseco KVP AUID- ORCID: 0000-0002-6137-7392 AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. FAU - Arunothayaraj, Sandeep AU - Arunothayaraj S AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. FAU - Hill, Andrew AU - Hill A AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. FAU - Trivedi, Uday AU - Trivedi U AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. FAU - Hildick-Smith, David AU - Hildick-Smith D AD - Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK. LA - eng PT - Journal Article DEP - 20221102 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Female MH - Middle Aged MH - Aged MH - Aged, 80 and over MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Aortic Valve Stenosis/complications/diagnostic imaging/surgery MH - Feasibility Studies MH - *Obesity, Morbid/complications/diagnosis MH - Treatment Outcome MH - Aortic Valve/diagnostic imaging/surgery MH - Femoral Artery/diagnostic imaging OTO - NOTNLM OT - TAVI OT - TAVR OT - alternative access OT - obesity EDAT- 2022/11/03 06:00 MHDA- 2022/12/20 06:00 CRDT- 2022/11/02 07:02 PHST- 2022/08/06 00:00 [revised] PHST- 2022/03/24 00:00 [received] PHST- 2022/10/08 00:00 [accepted] PHST- 2022/11/03 06:00 [pubmed] PHST- 2022/12/20 06:00 [medline] PHST- 2022/11/02 07:02 [entrez] AID - 10.1002/ccd.30465 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2022 Dec;100(7):1302-1306. doi: 10.1002/ccd.30465. Epub 2022 Nov 2. PMID- 36318599 OWN - NLM STAT- MEDLINE DCOM- 20221104 LR - 20221104 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 9 IP - 2 DP - 2022 Sep TI - Risk and protective factors for atrial fibrillation after cardiac surgery and valvular interventions: an umbrella review of meta-analyses. LID - 10.1136/openhrt-2022-002074 [doi] LID - e002074 AB - OBJECTIVE: Postoperative atrial fibrillation (POAF) is a common complication affecting approximately one-third of patients after cardiac surgery and valvular interventions. This umbrella review systematically appraises the epidemiological credibility of published meta-analyses of both observational and randomised controlled trials (RCT) to assess the risk and protective factors of POAF. METHODS: Three databases were searched up to June 2021. According to established criteria, evidence of association was rated as convincing, highly suggestive, suggestive, weak or not significant concerning observational studies and as high, moderate, low or very low regarding RCTs. RESULTS: We identified 47 studies (reporting 61 associations), 13 referring to observational studies and 34 to RCTs. Only the transfemoral transcatheter aortic valve replacement (TAVR) approach was associated with the prevention of POAF and was supported by convincing evidence from meta-analyses of observational data. Two other associations provided highly suggestive evidence, including preoperative hypertension and neutrophil/lymphocyte ratio. Three associations between protective factors and POAF presented a high level of evidence in meta-analyses, including RCTs. These associations included atrial and biatrial pacing and performing a posterior pericardiotomy. Nineteen associations were supported by moderate evidence, including use of drugs such as amiodarone, b-blockers, glucocorticoids and statins and the performance of TAVR compared with surgical aortic valve replacement. CONCLUSIONS: Our study provides evidence confirming the protective role of amiodarone, b-blockers, atrial pacing and posterior pericardiotomy against POAF as well as highlights the risk of untreated hypertension. Further research is needed to assess the potential role of statins, glucocorticoids and colchicine in the prevention of POAF. PROSPERO REGISTRATION NUMBER: CRD42021268268. CI - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Charitakis, Emmanouil AU - Charitakis E AUID- ORCID: 0000-0002-2514-5324 AD - Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden emmanouil.charitakis@liu.se. FAU - Tsartsalis, Dimitrios AU - Tsartsalis D AD - Department of Emergency Medicine, Hippokration Hospital, Athens, Greece. AD - First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece. FAU - Korela, Dafni AU - Korela D AD - Department of Cardiology, Venizeleio General Hospital, Heraklion, Greece. FAU - Stratinaki, Maria AU - Stratinaki M AD - Department of Cardiology, Venizeleio General Hospital, Heraklion, Greece. FAU - Vanky, Farkas AU - Vanky F AD - Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. FAU - Charitos, Efstratios I AU - Charitos EI AD - Department of Cardiac Surgery, Kerckhoff Hospital, Bad Nauheim, Hessen, Germany. FAU - Alfredsson, Joakim AU - Alfredsson J AD - Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. FAU - Karlsson, Lars O AU - Karlsson LO AD - Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. FAU - Foukarakis, Emmanouil AU - Foukarakis E AD - Department of Cardiology, Venizeleio General Hospital, Heraklion, Greece. FAU - Aggeli, Constantina AU - Aggeli C AD - First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece. FAU - Tsioufis, Costas AU - Tsioufis C AD - First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece. FAU - Walfridsson, Hakan AU - Walfridsson H AD - Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. FAU - Dragioti, Elena AU - Dragioti E AD - Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Systematic Review PL - England TA - Open Heart JT - Open heart JID - 101631219 RN - N3RQ532IUT (Amiodarone) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Humans MH - Amiodarone MH - *Atrial Fibrillation MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors MH - Hypertension MH - Meta-Analysis as Topic MH - Protective Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects PMC - PMC9454044 OTO - NOTNLM OT - Atrial Fibrillation OT - Cardiac Surgical Procedures OT - Meta-Analysis OT - Risk Factors OT - Transcatheter Aortic Valve Replacement COIS- Competing interests: None declared. EDAT- 2022/11/02 06:00 MHDA- 2022/11/04 06:00 PMCR- 2022/09/07 CRDT- 2022/11/01 13:43 PHST- 2022/06/20 00:00 [received] PHST- 2022/08/16 00:00 [accepted] PHST- 2022/11/01 13:43 [entrez] PHST- 2022/11/02 06:00 [pubmed] PHST- 2022/11/04 06:00 [medline] PHST- 2022/09/07 00:00 [pmc-release] AID - openhrt-2022-002074 [pii] AID - 10.1136/openhrt-2022-002074 [doi] PST - ppublish SO - Open Heart. 2022 Sep;9(2):e002074. doi: 10.1136/openhrt-2022-002074. PMID- 36317571 OWN - NLM STAT- MEDLINE DCOM- 20221102 LR - 20221102 IS - 2972-4066 (Electronic) IS - 0304-4602 (Linking) VI - 51 IP - 10 DP - 2022 Oct TI - Impact of aortic annular size and valve type on haemodynamics and clinical outcomes after transcatheter aortic valve implantation. PG - 605-618 LID - 10.47102/annals-acadmedsg.2022167 [doi] AB - INTRODUCTION: Data on patients with small aortic annuli (SAA) undergoing transcatheter aortic valve implantation (TAVI) are limited. We aim to describe the impact of aortic annular size, particularly SAA and TAVI valve type on valve haemodynamics, durability and clinical outcomes. METHOD: All patients in National Heart Centre Singapore who underwent transfemoral TAVI for severe symptomatic native aortic stenosis from July 2012 to December 2019 were included. Outcome measures include valve haemodynamics, prosthesis-patient mismatch (PPM), structural valve degeneration (SVD) and mortality. RESULTS: A total of 244 patients were included. The mean Society of Thoracic Surgeons score was 6.22+/-6.08, with 52.5% patients with small aortic annulus (<23mm), 33.2% patients with medium aortic annulus (23-26mm) and 14.3% patients with large aortic annulus (>26mm). There were more patients with self-expanding valve (SEV) (65.2%) versus balloon-expandable valve (BEV) (34.8%). There were no significant differences in indexed aortic valve area (iAVA), mean pressure gradient (MPG), PPM, SVD or mortality across all aortic annular sizes. However, specific to the SAA group, patients with SEV had larger iAVA (SEV 1.19+/-0.35cm2/m2 vs BEV 0.88+/-0.15cm2/m2, P<0.01) and lower MPG (SEV 9.25+/-4.88 mmHg vs BEV 14.17+/-4.75 mmHg, P<0.01) at 1 year, without differences in PPM or mortality. Aortic annular size, TAVI valve type and PPM did not predict overall mortality up to 7 years. There was no significant difference in SVD between aortic annular sizes up to 5 years. CONCLUSION: Valve haemodynamics and durability were similar across the different aortic annular sizes. In the SAA group, SEV had better haemodynamics than BEV at 1 year, but no differences in PPM or mortality. There were no significant differences in mortality between aortic annular sizes, TAVI valve types or PPM. FAU - Koh, Samuel Ji Quan AU - Koh SJQ AD - Department of Cardiology, National Heart Centre Singapore, Singapore. FAU - Yap, Jonathan AU - Yap J FAU - Jiang, Yilin AU - Jiang Y FAU - Tay, Julian Cheong Kiat AU - Tay JCK FAU - Quah, Kevin Kien Hong AU - Quah KKH FAU - Thiagarajan, Nishanth AU - Thiagarajan N FAU - Tan, Swee Yaw AU - Tan SY FAU - Amanullah, Mohammed Rizwan AU - Amanullah MR FAU - Lim, Soo Teik AU - Lim ST FAU - Aziz, Zameer Abdul AU - Aziz ZA FAU - Govindasamy, Sivaraj AU - Govindasamy S FAU - Chao, Victor Tar Toong AU - Chao VTT FAU - Ewe, See Hooi AU - Ewe SH FAU - Ho, Kay Woon AU - Ho KW LA - eng PT - Journal Article PL - Singapore TA - Ann Acad Med Singap JT - Annals of the Academy of Medicine, Singapore JID - 7503289 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Heart Valve Prosthesis MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/surgery MH - Prosthesis Design MH - Postoperative Complications/epidemiology/surgery MH - Treatment Outcome MH - Hemodynamics EDAT- 2022/11/02 06:00 MHDA- 2022/11/03 06:00 CRDT- 2022/11/01 05:53 PHST- 2022/11/01 05:53 [entrez] PHST- 2022/11/02 06:00 [pubmed] PHST- 2022/11/03 06:00 [medline] AID - 10.47102/annals-acadmedsg.2022167 [doi] PST - ppublish SO - Ann Acad Med Singap. 2022 Oct;51(10):605-618. doi: 10.47102/annals-acadmedsg.2022167. PMID- 36317114 OWN - NLM STAT- MEDLINE DCOM- 20221102 LR - 20260127 IS - 2314-6141 (Electronic) IS - 2314-6133 (Print) VI - 2022 DP - 2022 TI - Remimazolam Requires Less Vasopressor Support during Induction and Maintenance of General Anesthesia in Patients with Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Analysis from a Single Center. PG - 6386606 LID - 10.1155/2022/6386606 [doi] LID - 6386606 AB - INTRODUCTION: We compared the hemodynamics during general anesthesia with remimazolam and conventional anesthetics in patients with severe aortic stenosis (AS). METHODS: This was a retrospective single-center analysis. We reviewed the records of 42 patients who underwent transcatheter aortic valve implantation with a transfemoral artery approach under general anesthesia from January to December 2020. Patients were divided into three groups based on the general anesthetic used for (induction/maintenance) remimazolam/remimazolam (Group R/R), propofol/sevoflurane (Group P/S), and midazolam/propofol (Group M/P). Vasopressor use (ephedrine, phenylephrine, and noradrenaline) was compared among the groups. RESULTS: The number of patients in each group was 15 (Group R/R), 13 (Group P/S), and 14 (Group M/P), with no significant difference in background characteristics and intraoperative vital signs. For anesthesia induction, doses of ephedrine and phenylephrine used were significantly lower in Group R/R (ephedrine [mg]: Group R/R 2 [0-4] vs. Group P/S 8 [8-12], P < 0.001, Group R/R vs. Group M/P 5 [0-15], P = 0.39; phenylephrine (mg): Group R/R 0 [0-0.08] vs. Group P/S 0.15 [0.10-0.20], P = 0.03, Group M/P 0.21 [0.04-0.40], P = 0.08). For anesthesia maintenance, the noradrenaline dose used was low in the Group R/R (noradrenaline [mug/kg/min]: Group R/R 0.019 [0.015-0.039], Group P/S 0.042 [0.035-0.045], P = 0.02, Group M/P 0.048 [0.040-0.059], P < 0.01). CONCLUSION: In patients with severe AS, induction and maintenance of anesthesia with remimazolam resulted in less overall vasopressor use than conventional general anesthetics. CI - Copyright (c) 2022 Hirotsugu Miyoshi et al. FAU - Miyoshi, Hirotsugu AU - Miyoshi H AUID- ORCID: 0000-0002-1375-5344 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Watanabe, Tomoyuki AU - Watanabe T AUID- ORCID: 0000-0002-6492-0741 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Kido, Kenshiro AU - Kido K AUID- ORCID: 0000-0002-4449-1695 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Kamiya, Satoshi AU - Kamiya S AUID- ORCID: 0000-0001-9827-1404 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Otsuki, Sachiko AU - Otsuki S AUID- ORCID: 0000-0003-4771-9867 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Narasaki, Soshi AU - Narasaki S AUID- ORCID: 0000-0002-9838-078X AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Toyota, Yukari AU - Toyota Y AUID- ORCID: 0000-0002-9903-0415 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Kondo, Takashi AU - Kondo T AUID- ORCID: 0000-0001-9182-0394 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Horikawa, Yousuke T AU - Horikawa YT AUID- ORCID: 0000-0002-3421-3608 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. AD - Department of Pediatrics, Sharp Rees-Stealy Medical Group, San Diego, California, USA. FAU - Saeki, Noboru AU - Saeki N AUID- ORCID: 0000-0002-1967-0878 AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. FAU - Tsutsumi, Yasuo M AU - Tsutsumi YM AUID- ORCID: 0000-0002-1997-082X AD - Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan. LA - eng PT - Journal Article DEP - 20221022 PL - United States TA - Biomed Res Int JT - BioMed research international JID - 101600173 RN - YI7VU623SF (Propofol) RN - GN83C131XS (Ephedrine) RN - 0 (Anesthetics, General) RN - 1WS297W6MV (Phenylephrine) RN - X4W3ENH1CV (Norepinephrine) RN - 7V4A8U16MB (remimazolam) RN - 12794-10-4 (Benzodiazepines) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Propofol/therapeutic use MH - Retrospective Studies MH - Ephedrine MH - Anesthesia, General/methods MH - *Anesthetics, General MH - *Aortic Valve Stenosis/drug therapy/surgery MH - Phenylephrine/therapeutic use MH - Norepinephrine/therapeutic use MH - Aortic Valve/surgery MH - Benzodiazepines PMC - PMC9617702 COIS- The authors declare that there are no conflicts of interest regarding the publication of this article. EDAT- 2022/11/02 06:00 MHDA- 2022/11/03 06:00 PMCR- 2022/10/22 CRDT- 2022/11/01 01:47 PHST- 2022/08/07 00:00 [received] PHST- 2022/09/10 00:00 [revised] PHST- 2022/09/29 00:00 [accepted] PHST- 2022/11/01 01:47 [entrez] PHST- 2022/11/02 06:00 [pubmed] PHST- 2022/11/03 06:00 [medline] PHST- 2022/10/22 00:00 [pmc-release] AID - 10.1155/2022/6386606 [doi] PST - epublish SO - Biomed Res Int. 2022 Oct 22;2022:6386606. doi: 10.1155/2022/6386606. eCollection 2022. PMID- 36277778 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221025 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Predictors and neurological consequences of periprocedural cerebrovascular events following transcatheter aortic valve implantation with self-expanding valves. PG - 951943 LID - 10.3389/fcvm.2022.951943 [doi] LID - 951943 AB - AIMS: To evaluate the patient- and procedure-related predictors of transcatheter aortic-valve implantation (TAVI)-associated ischemic brain lesions and to assess the effect of silent cerebral ischemic lesions (SCIL) on neurocognitive function. METHODS AND RESULTS: We investigated 113 consecutive patients with severe aortic stenosis who underwent brain magnetic resonance imaging (MRI) within a week following TAVI. To assess periprocedural cerebral ischemic lesions, diffusion-weighted MRI was utilized. We used multivariate linear regression to identify the independent predictors of TAVI-related ischemic lesion volume (ILV) and periprocedural stroke. Neurocognitive evaluation was performed before and following TAVI at 6-month and one-year follow-up. Following TAVI, a total of 944 new cerebral ischemic lesions were detected in 104 patients (92%). The median ILV was 257 mul (interquartile range [IQR]:97.1-718.8mul) with a median lesion number of 6/patient [IQR:2-10]. The majority of ischemic lesions were clinically silent (95%), while 5% of the lesions induced a stroke, which was confirmed by MRI. Predilatation (beta = 1.13[95%CI:0.32-1.93], p = 0.01) and the number of valve positioning attempts during implantation (beta = 0.28[95%CI:0.06-0.50], p = 0.02) increased the log-transformed total ILV. Predilatation (OR = 12.04[95%CI:1.46-99.07], p = 0.02) and alternative access routes (OR = 7.84[95%CI:1.01-61.07], p = 0.02) were associated with stroke after adjustments for comorbidities and periprocedural factors. The presence of SCILs were not associated with a change in neurocognitive function that remained stable during the one-year follow-up. CONCLUSION: While periprocedural ischemic lesions are frequent, most of them are clinically silent and might not impact the patients' neurocognitive function. The number of valve positioning attempts, predilatation, and alternative access routes should be taken into consideration during TAVI to reduce the ILV and risk for stroke. CI - Copyright (c) 2022 Suhai, Varga, Szilveszter, Nagy-Vecsey, Apor, Nagy, Kolossvary, Karady, Bartykowszki, Molnar, Jermendy, Panajotu, Maurovich-Horvat and Merkely. FAU - Suhai, Ferenc Imre AU - Suhai FI AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Varga, Andrea AU - Varga A AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Szilveszter, Balint AU - Szilveszter B AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Nagy-Vecsey, Milan AU - Nagy-Vecsey M AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Apor, Astrid AU - Apor A AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Nagy, Aniko Ilona AU - Nagy AI AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. AD - Department of Medicine, Karolinska Institute, Stockholm, Sweden. FAU - Kolossvary, Marton AU - Kolossvary M AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. AD - Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. FAU - Karady, Julia AU - Karady J AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. AD - Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. FAU - Bartykowszki, Andrea AU - Bartykowszki A AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Molnar, Levente AU - Molnar L AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Jermendy, Adam L AU - Jermendy AL AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Panajotu, Alexisz AU - Panajotu A AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. FAU - Maurovich-Horvat, Pal AU - Maurovich-Horvat P AD - Medical Imaging Center, Semmelweis University, Budapest, Hungary. FAU - Merkely, Bela AU - Merkely B AD - Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary. LA - eng PT - Journal Article DEP - 20221005 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9581280 OTO - NOTNLM OT - cardiac CT angiography (CTA) OT - cerebral embolism OT - magnetic resonance imaging OT - stroke OT - transcatheter aortic valve implantation COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/10/25 06:00 MHDA- 2022/10/25 06:01 PMCR- 2022/01/01 CRDT- 2022/10/24 04:38 PHST- 2022/05/24 00:00 [received] PHST- 2022/09/09 00:00 [accepted] PHST- 2022/10/24 04:38 [entrez] PHST- 2022/10/25 06:00 [pubmed] PHST- 2022/10/25 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.951943 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Oct 5;9:951943. doi: 10.3389/fcvm.2022.951943. eCollection 2022. PMID- 36276673 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260518 IS - 2666-2507 (Electronic) IS - 2666-2507 (Linking) VI - 15 DP - 2022 Oct TI - Transfemoral versus transcarotid access for transcatheter aortic valve replacement. PG - 46-53 LID - 10.1016/j.xjtc.2022.05.019 [doi] AB - OBJECTIVES: To compare the outcomes after transcatheter aortic valve replacement (TAVR) through a transfemoral (TF) and transcarotid (TC) access at our institution. METHODS: From January 2014 to January 2020, 62 TC-TAVR and 449 TF-TAVR were performed using 2 prosthesis devices (Edwards SAPIEN 3, n = 369; Medtronic Evolut R, n = 142). Propensity score matching was used to adjust for imbalance in the baseline characteristics of the study groups. RESULTS: Propensity score matching provided 62 matched pairs with comparable operative risk (mean European System for Cardiac Operative Risk Evaluation II, TC-TAVR 7.6% vs TF-TAVR 6.6%, P = .17). Thirty-day mortality (4.8% vs 3.2%, P = 1.00) and 2-year mortality (11.3% vs 12.9%, P = .64) after TC-TAVR were comparable with TF-TAVR. Strokes were numerically more frequent after TC-TAVR compared with TF-TAVR (3.2% vs 0%, P = .23), but the difference did not reach statistical significance. TF-TAVR was associated with a significantly greater risk of permanent pacemaker implantation (29.0% vs 12.9%, P = .04) compared with TC-TAVR. Other complications were not frequent and were similarly distributed between the matched groups. CONCLUSIONS: TC access for TAVR was associated with satisfactory results compared to the femoral access. TC-TAVR could be considered a valid and safe alternative to TF-TAVR when femoral access is contraindicated. CI - (c) 2022 The Authors. Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery. FAU - Olivier, Maud-Emmanuelle AU - Olivier ME AD - Department of Thoracic and Cardio-Vascular Surgery, Robert Debre University Hospital, Reims, France. AD - University of Reims Champagne-Ardenne, Reims, France. FAU - Di Cesare, Alessandro AU - Di Cesare A AD - Department of Thoracic and Cardio-Vascular Surgery, Robert Debre University Hospital, Reims, France. AD - University of Reims Champagne-Ardenne, Reims, France. FAU - Poncet, Anne AU - Poncet A AD - Department of Thoracic and Cardio-Vascular Surgery, Robert Debre University Hospital, Reims, France. AD - University of Reims Champagne-Ardenne, Reims, France. FAU - Brasselet, Camille AU - Brasselet C AD - Department of Cardiology, Polyclinique of Bezannes, Reims, France. FAU - Metz, Damien AU - Metz D AD - University of Reims Champagne-Ardenne, Reims, France. AD - Department of Cardiology, Robert Debr, Reims, France. FAU - Biancari, Fausto AU - Biancari F AD - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. AD - Research Unit of Surgery, Anesthesiology and Critical Care, University of Oulu, Oulu, Finland. AD - Department of Surgery, University of Turku, Turku, Finland. FAU - Ruggieri, Vito Giovanni AU - Ruggieri VG AD - Department of Thoracic and Cardio-Vascular Surgery, Robert Debre University Hospital, Reims, France. AD - University of Reims Champagne-Ardenne, Reims, France. CN - Reims Heart Team Group LA - eng PT - Journal Article DEP - 20220720 PL - United States TA - JTCVS Tech JT - JTCVS techniques JID - 101768546 PMC - PMC9579710 OTO - NOTNLM OT - EuroSCORE II, European System for Cardiac Operative Risk Evaluation II OT - Fr, French OT - TAVI OT - TAVR OT - TAVR, transcatheter aortic valve replacement OT - TC, transcarotid OT - TF, transfemoral OT - aortic stenosis OT - carotid artery OT - transcatheter aortic valve replacement FIR - Faroux, Laurent IR - Faroux L FIR - Muccio, Salvatore IR - Muccio S FIR - Torossian, Pierre-Frederic IR - Torossian PF FIR - Duval, Sebastien IR - Duval S FIR - Liu, Li IR - Liu L FIR - Durand, Emmanuelle IR - Durand E FIR - Tassan, Sophie IR - Tassan S FIR - Heroguelle, Virginie IR - Heroguelle V EDAT- 2022/10/25 06:00 MHDA- 2022/10/25 06:01 PMCR- 2022/07/20 CRDT- 2022/10/24 04:19 PHST- 2020/10/20 00:00 [received] PHST- 2022/02/09 00:00 [revised] PHST- 2022/03/03 00:00 [accepted] PHST- 2022/10/24 04:19 [entrez] PHST- 2022/10/25 06:00 [pubmed] PHST- 2022/10/25 06:01 [medline] PHST- 2022/07/20 00:00 [pmc-release] AID - S2666-2507(22)00372-8 [pii] AID - 10.1016/j.xjtc.2022.05.019 [doi] PST - epublish SO - JTCVS Tech. 2022 Jul 20;15:46-53. doi: 10.1016/j.xjtc.2022.05.019. eCollection 2022 Oct. PMID- 36272953 OWN - NLM STAT- MEDLINE DCOM- 20230306 LR - 20230306 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 32 IP - 2 DP - 2023 Feb TI - Dedicated Next Day Discharge Post Minimalist TAVI: The Tasmanian Experience. PG - 232-239 LID - S1443-9506(22)01104-0 [pii] LID - 10.1016/j.hlc.2022.09.011 [doi] AB - OBJECTIVES: To assess the safety, feasibility and independent predictors of next day discharge (NDD) in patients undergoing minimalist transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) in a real-world Australian population. METHODS: This single centre study reviewed 135 consecutive patients who underwent minimalist transfemoral TAVI from June 2020 to February 2022. Baseline demographics, procedural characteristic and outcomes were obtained. All patients were assessed by the local protocol for NDD. Patients were then divided into two groups: those who achieved next day discharge (NDD) and those requiring >1 overnight hospital stay. Univariate, bivariate and stepwise multivariate logistic regression modelling was used to identify the predictors of successful next day discharge. RESULTS: The mean age of the cohort was 82.9+/-5.7 years with 62.3% patients male, the average STS score was 4.1+/-2.4. All 135 patients underwent a successful transfemoral TAVI procedure, with 131 (97%) receiving a balloon-expandable valve. Ninety-seven (97) (71.9%) patients achieved NDD. Thirty (30)-day outcomes were excellent with a 30-day mortality of 0.7%, transient ischaemic attack/cardiovascular accident (TIA/CVA) 1.5%, major vascular complication 1.5% and 11.4% need for permanent pacemaker (PPM). In patients not achieving NDD, the average length of stay (LOS) was 3.0 days. Baseline characteristics demonstrated pre-existing first degree atrioventricular (AV) block and right bundle branch block (RBBB) as statistically significant negative predictors of NDD on univariate analysis. Next day discharge was achievable in only 50% of patients who suffered any minor or major procedural complication (15/30). Stepwise multivariate logistic regression modelling demonstrated female gender (OR 3.094, 95% CI 1.141-8.391, p=0.026), smaller aortic valve area (AVA) (OR 48.265, 95% CI 2.269-102.6, p=0.013), the presence of diabetes mellitus (OR 0.594, 95% CI 0.356-0.991, p=0.046) and a longer procedure time (OR 0.960, 95% CI 0.935-0.986, p=0.002) as statistically significant negative predictors of NDD. In addition, there was no difference in 30-day readmission rates between the NDD and non-NDD cohort (7.2% vs 10.5%, p=0.386). CONCLUSION: Next day discharge is safe and feasible in almost three quarters of patients undergoing minimalist TAVI for severe AS in a predominantly balloon expandable valve cohort, with a very low rate of 30-day readmission. NDD provides advantages for hospital efficiency and improved cost-effectiveness. Female gender, smaller AVA, the presence of diabetes mellitus and a longer procedure time were independent negative predictors of successful NDD. CI - Copyright (c) 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Eaves, Scott AU - Eaves S AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. Electronic address: scott.eaves@ths.tas.gov.au. FAU - Lees, Conor AU - Lees C AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Jin, David AU - Jin D AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Rayner, Clare AU - Rayner C AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Paleri, Sarang AU - Paleri S AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Rowe, Stephanie AU - Rowe S AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Lee, John AU - Lee J AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Hayat, Umair AU - Hayat U AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia. FAU - Adams, Heath AU - Adams H AD - Department of Cardiology, Royal Hobart Hospital, Hobart, Tas, Australia; Menzies Research Institute, University of Tasmania, Hobart, Tas, Australia. LA - eng PT - Journal Article DEP - 20221020 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/methods MH - Aortic Valve/surgery MH - *Heart Valve Prosthesis/adverse effects MH - *Aortic Valve Stenosis/diagnosis/surgery/complications MH - Patient Discharge MH - Treatment Outcome MH - Australia MH - *Atrioventricular Block MH - *Pacemaker, Artificial/adverse effects MH - Risk Factors OTO - NOTNLM OT - Cost-effectiveness OT - Length of stay OT - Severe aortic stenosis OT - Transcatheter aortic valve implantation EDAT- 2022/10/23 06:00 MHDA- 2023/03/07 06:00 CRDT- 2022/10/22 22:07 PHST- 2022/07/11 00:00 [received] PHST- 2022/08/22 00:00 [revised] PHST- 2022/09/14 00:00 [accepted] PHST- 2022/10/23 06:00 [pubmed] PHST- 2023/03/07 06:00 [medline] PHST- 2022/10/22 22:07 [entrez] AID - S1443-9506(22)01104-0 [pii] AID - 10.1016/j.hlc.2022.09.011 [doi] PST - ppublish SO - Heart Lung Circ. 2023 Feb;32(2):232-239. doi: 10.1016/j.hlc.2022.09.011. Epub 2022 Oct 20. PMID- 36269884 OWN - NLM STAT- MEDLINE DCOM- 20221025 LR - 20221202 IS - 1526-6702 (Electronic) IS - 0730-2347 (Print) IS - 0730-2347 (Linking) VI - 49 IP - 5 DP - 2022 Sep 1 TI - Comparison of MANTA vs ProGlide Vascular Closure Device and 30-Day Outcomes in Transfemoral Transcatheter Aortic Valve Implantation. LID - 10.14503/THIJ-21-7650 [doi] LID - e217650 AB - BACKGROUND: Vascular complications (VCs) after transfemoral transcatheter aortic valve implantation (TAVI) have an increased mortality risk, and vascular closure device (VCD) use is mandatory. The percutaneous MANTA VCD (Teleflex) is a novel collagen-based technology for closure of large-bore arteriotomies. We compared the MANTA VCD with the suture-based ProGlide VCD (Abbott Vascular). METHODS: A retrospective review was performed on all consecutive patients who underwent transfemoral TAVI in our center from January 1, 2015, to February 28, 2021, and 30-day outcomes were recorded. Major adverse cardiovascular events (MACE) were cardiac death, disabling stroke, and/or major VCs. Access site-related VCs were VCs related to the access site vessel from which the transcatheter valve was introduced and advanced. RESULTS: The MANTA VCD was used in 99 patients and the ProGlide in 224. There was 4.0% MACE in the MANTA group and 4.9% in the ProGlide group (P = .999). Overall VCs were 10.1% vs 7.6%, major VCs were 3.0% vs 2.2%, and minor VCs 7.1% vs 5.4%(P = .753). Access site-related VCs were 5.1% vs 5.8% in the (P = .999), and periprocedural vascular surgical intervention was needed in 6.1% of the MANTA group vs 2.2% of the ProGlide group (P = .099). CONCLUSION: There was no significant difference in MACE, mortality, cardiovascular mortality, VCs, access site-related VCs, periprocedural vascular surgical interventions, bleeding, or transfusion rate between the 2 groups. The MANTA VCD group had more periprocedural vascular surgical interventions which did not reach statistical significance. CI - (c) 2022 by the Texas Heart(R) Institute, Houston. FAU - Eftychiou, Christos AU - Eftychiou C AD - Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Eteocleous, Nicolaos AU - Eteocleous N AD - Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Mitsis, Andreas AU - Mitsis A AD - Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Zittis, Ioannis AU - Zittis I AD - Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Papadopoulos, Kyriacos AU - Papadopoulos K AD - Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Petrou, Andria AU - Petrou A AD - Anesthesiology Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Adamou, Maria AU - Adamou M AD - Blood Bank Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Kounnos, Christos AU - Kounnos C AD - Vascular Surgery Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Bekos, Christos AU - Bekos C AD - Vascular Surgery Department, Nicosia General Hospital, Nicosia, Cyprus. FAU - Avraamides, Panayiotis AU - Avraamides P AD - Cardiology Department, Nicosia General Hospital, Nicosia, Cyprus. LA - eng PT - Journal Article PL - United States TA - Tex Heart Inst J JT - Texas Heart Institute journal JID - 8214622 RN - 9007-34-5 (Collagen) SB - IM MH - Humans MH - *Vascular Closure Devices/adverse effects MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/diagnosis/surgery/etiology MH - Femoral Artery/surgery MH - Treatment Outcome MH - Collagen MH - Aortic Valve/diagnostic imaging/surgery PMC - PMC9632403 OTO - NOTNLM OT - TAVI OT - aortic valve disease OT - vascular closure device OT - vascular complications COIS- Conflict of Interest Disclosures: None EDAT- 2022/10/22 06:00 MHDA- 2022/10/26 06:00 PMCR- 2022/09/01 CRDT- 2022/10/21 15:23 PHST- 2022/10/21 15:23 [entrez] PHST- 2022/10/22 06:00 [pubmed] PHST- 2022/10/26 06:00 [medline] PHST- 2022/09/01 00:00 [pmc-release] AID - 487726 [pii] AID - 10.14503/THIJ-21-7650 [doi] PST - ppublish SO - Tex Heart Inst J. 2022 Sep 1;49(5):e217650. doi: 10.14503/THIJ-21-7650. PMID- 36269158 OWN - NLM STAT- MEDLINE DCOM- 20221110 LR - 20260127 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 34 IP - 11 DP - 2022 Nov TI - Comparison of the Acurate Neo Vs Neo2 Transcatheter Heart Valves. PG - E804-E810 LID - JIC20221021-1 [pii] AB - BACKGROUND: Few data exist on immediate outcomes of the next-generation Acurate neo2 prosthesis (Boston Scientific), which is distinguished by an active sealing mechanism. We sought to determine procedural outcomes of transfemoral transcatheter aortic valve replacement using the neo2 in comparison with its predecessor, the Acurate neo. METHODS: In this retrospective analysis, consecutive neo2 and neo cases were compared from 2 high-volume centers. The primary outcome of interest was the rate of relevant paravalvular regurgitation (PVR), defined as PVR >/= moderate, or valve-in-valve and/or surgical aortic valve replacement for PVR >/= moderate. Secondary outcomes of interest were assessed according to Valve Academic Research Consortium (VARC)-3 criteria. Logistic regression analysis was used to identify predictors of relevant PVR. RESULTS: A total of 810 neo2 and 2055 neo cases comprised the study cohort. The rate of relevant PVR was significantly lower in the neo2 group (2.7% vs 4.5%; P=.04). The technical success rate was numerically higher in the neo2 group (91.5% vs 89.3%; P=.10) and the rate of device success at 30 days was significantly higher (86.5% vs 82.9%; P=.02). In the neo group, a greater amount of aortic valve calcification (AVC), the presence of eccentric AVC, less oversizing, and a higher sinotubular junction annulus index were predictors of relevant PVR, whereas in the neo2 population only the presence of eccentric AVC, less oversizing, and a higher sinotubular junction annulus index was predictive. CONCLUSION: The neo2 valve shows superior outcomes over the neo valve, with a lower burden of PVR and a higher device success rate at 30 days. FAU - Kim, Won-Keun AU - Kim WK AD - Kerckhoff Heart Center, Department of Cardiology, Benekestrasse 2-8, 61231 Bad Nauheim Germany. w.kim@kerckhoff-klinik.de. FAU - Eckel, Clemens AU - Eckel C FAU - Renker, Matthias AU - Renker M FAU - Grothusen, Christina AU - Grothusen C FAU - Tiyerili, Vedat AU - Tiyerili V FAU - Soetemann, Dagmar AU - Soetemann D FAU - Choi, Yeong-Hoon AU - Choi YH FAU - Hamm, Christian W AU - Hamm CW FAU - Mollmann, Helge AU - Mollmann H FAU - Charitos, Efstratios I AU - Charitos EI FAU - Blumenstein, Johannes AU - Blumenstein J LA - eng PT - Comparative Study PT - Journal Article DEP - 20221021 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - Aortic Valve, Calcification of SB - IM MH - Humans MH - Aortic Valve/surgery/pathology MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - Calcinosis OTO - NOTNLM OT - TAVR OT - paravalvular leak OT - transcatheter heart valve OT - Acurate OT - self-expanding EDAT- 2022/10/22 06:00 MHDA- 2022/11/04 06:00 CRDT- 2022/10/21 10:12 PHST- 2022/10/22 06:00 [pubmed] PHST- 2022/11/04 06:00 [medline] PHST- 2022/10/21 10:12 [entrez] AID - JIC20221021-1 [pii] AID - 10.25270/jic/22.00139 [doi] PST - ppublish SO - J Invasive Cardiol. 2022 Nov;34(11):E804-E810. doi: 10.25270/jic/22.00139. Epub 2022 Oct 21. PMID- 36267505 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231002 IS - 0377-1237 (Print) IS - 2213-4743 (Electronic) IS - 0377-1237 (Linking) VI - 78 IP - 4 DP - 2022 Oct TI - Transcatheter aortic valve replacement in the developing world: Lessons learnt and its implications for practice. PG - 387-393 LID - 10.1016/j.mjafi.2022.01.010 [doi] AB - BACKRGROUND: Transcatheter aortic valve replacement (TAVR) has become an accepted modality of treatment in intermediate and high surgical risk patients of symptomatic severe calcific aortic stenosis (AS). We herein report Indian data of 84 intermediate and high-risk patients who underwent TAVR at two Armed Forces cardiac centres. METHODS: Most of the patients underwent TAVR in cardiac catheterization lab by percutaneous transfemoral approach, under conscious sedation. Patients were followed up and echocardiographic parameters were assessed after six months of procedure. RESULTS: Total of 84 intermediate and high-risk patients underwent TAVR between Jan 2017 and June 2021. Mean age of population was 71.5 +/- 8.4 years; 28.5% of patients had bicuspid aortic valve and Mean STS score was 6.34 +/- 2.08. Majority (92.8%) patients underwent the procedure under conscious sedation. Self-expanding valves were used in 72.6% and balloon expandable in 27.4% of patients. Predilatation was done in 64% patients while 13% cases underwent post dilatation. Procedural mortality was 2.3%. Rate of permanent pacemaker implantation was 4.9%. Ischemic stroke occurred in 1.1% of patents. There was no case of severe paravalvular leak. Emergency surgical aortic valve replacement was done in 2.4% patients. Procedural success in this study was 97.6%. All-cause mortality was 9.5% at 6 months. CONCLUSIONS: TAVR is an effective treatment modality in intermediate and high-risk Indian patients with severe aortic stenosis. Patients with bicuspid or previous bio prosthetic aortic valves also have a good outcome post TAVR. CI - (c) 2022 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd. FAU - Datta, Rajat AU - Datta R AD - Director General Armed Forces Medical Services, O/o DGAFMS, Defence Offices Complex, A Block, Africa Avenue, New Delhi, India. FAU - Bharadwaj, Prashant AU - Bharadwaj P AD - Director General Medical Services (Air), Air HQ, West Block 6, RK Puram, New Delhi, India. FAU - Aggarwal, Naveen AU - Aggarwal N AD - Director (Cardiologist), Max Superspecialty Hospital, Phase 6, Mohali, Punjab, India. FAU - Keshavamurthy, G AU - Keshavamurthy G AD - Consultant (Cardiology), Army Hospital (R&R), Delhi Cantt, India. FAU - Sharma, Prafull AU - Sharma P AD - Senior Advisor (Medicine) & Cardiologist, Military Hospital Jalandhar, India. FAU - Bajaj, Nitin AU - Bajaj N AD - Senior Advisor (Medicine) & Cardiologist, Army Institute of Cardio Thoracic Sciences, Pune, India. FAU - Bohra, Vijay AU - Bohra V AD - Classified Specialist (Medicine) & Cardiologist, Command Hospital (CC), Lucknow, India. FAU - Guleria, V S AU - Guleria VS AD - Classified Specialist (Medicine) & Cardiologist, Army Hospital (R&R), Delhi Cantt, India. FAU - Singh, Balbir AU - Singh B AD - Classified Specialist (Medicine) & Cardiologist, 7 Air Force Hospital, Kanpur, India. LA - eng PT - Journal Article DEP - 20220201 PL - India TA - Med J Armed Forces India JT - Medical journal, Armed Forces India JID - 7602492 PMC - PMC9577349 OTO - NOTNLM OT - Armed Forces experience OT - Lessons learnt OT - Transcatheter aortic valve replacement COIS- The authors have none to declare. EDAT- 2022/10/22 06:00 MHDA- 2022/10/22 06:01 PMCR- 2023/10/01 CRDT- 2022/10/21 02:54 PHST- 2022/01/15 00:00 [received] PHST- 2022/01/24 00:00 [accepted] PHST- 2022/10/21 02:54 [entrez] PHST- 2022/10/22 06:00 [pubmed] PHST- 2022/10/22 06:01 [medline] PHST- 2023/10/01 00:00 [pmc-release] AID - S0377-1237(22)00010-7 [pii] AID - 10.1016/j.mjafi.2022.01.010 [doi] PST - ppublish SO - Med J Armed Forces India. 2022 Oct;78(4):387-393. doi: 10.1016/j.mjafi.2022.01.010. Epub 2022 Feb 1. PMID- 36262460 OWN - NLM STAT- MEDLINE DCOM- 20221021 LR - 20240905 IS - 1540-8183 (Electronic) IS - 0896-4327 (Print) IS - 0896-4327 (Linking) VI - 2022 DP - 2022 TI - Declining Trend of Transapical Access for Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis. PG - 5688026 LID - 10.1155/2022/5688026 [doi] LID - 5688026 AB - INTRODUCTION: The last decade has witnessed major evolution and shifts in the use of transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Included among the shifts has been the advent of alternative access sites for TAVR. Consequently, transapical access (TA) has become significantly less common. This study analyzes in detail the trend of TA access for TAVR over the course of 7 years. METHODS: The national inpatient sample database was reviewed from 2011-2017 and patients with AS were identified by using validated ICD 9-CM and ICD 10-CM codes. Patients who underwent TAVR through TA access were classified as TA-TAVR, and any procedure other than TA access was classified as non-TA-TAVR. We compared the yearly trends of TA-TAVR to those of non-TA-TAVR as the primary outcome. RESULTS: A total of 3,693,231 patients were identified with a diagnosis of AS. 129,821 patients underwent TAVR, of which 10,158 (7.8%) underwent TA-TAVR and 119,663 (92.2%) underwent non-TA-TAVR. After peaking in 2013 at 27.7%, the volume of TA-TAVR declined to 1.92% in 2017 (p < 0.0001). Non-TA-TAVR started in 2013 at 72.2% and consistently increased to 98.1% in 2017. In-patient mortality decreased from a peak of 5.53% in 2014 to 3.18 in 2017 (p=0.6) in the TA-TAVR group and from a peak of 4.51% in 2013 to 1.24% in 2017 (p=0.0001) in the non-TA-TAVR group. CONCLUSION: This study highlights a steady decline in TA access for TAVR, higher inpatient mortality, increased length of stay, and higher costs compared to non-TA-TAVR. CI - Copyright (c) 2022 Sumit Sohal et al. FAU - Sohal, Sumit AU - Sohal S AUID- ORCID: 0000-0002-0176-258X AD - Division of Cardiovascular Diseases, Department of Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112, USA. FAU - Mehta, Harsh AU - Mehta H AD - Division of Cardiovascular Diseases, Department of Medicine, University of Kansas Medical Centre, 3901 Rainbow Boulevard, Kansas, KS 66160, USA. FAU - Kurpad, Krishna AU - Kurpad K AD - Department of Medicine, RWJ-BH Saint Barnabas Medical Center, 94 Old Short Hills Rd, Livingston, NJ 07039, USA. FAU - Mathai, Sheetal Vasundara AU - Mathai SV AD - Department of Medicine, NYC Health+Hospitals/Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY 10461, USA. FAU - Tayal, Rajiv AU - Tayal R AD - Division of Cardiovascular Diseases, Department of Medicine, Valley Health System, 1200 East Ridgewood Avenue West Wing, Suite 301, Ridgewood, NJ 07450, USA. FAU - Visveswaran, Gautam K AU - Visveswaran GK AD - Division of Cardiovascular Diseases, Department of Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112, USA. FAU - Wasty, Najam AU - Wasty N AD - Division of Cardiovascular Diseases, Department of Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112, USA. FAU - Waxman, Sergio AU - Waxman S AD - Division of Cardiovascular Diseases, Department of Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112, USA. FAU - Cohen, Marc AU - Cohen M AD - Division of Cardiovascular Diseases, Department of Medicine, RWJ-BH Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112, USA. LA - eng PT - Journal Article DEP - 20220919 PL - United States TA - J Interv Cardiol JT - Journal of interventional cardiology JID - 8907826 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Risk Factors MH - Treatment Outcome MH - Time Factors MH - *Aortic Valve Stenosis/diagnosis PMC - PMC9553752 COIS- RT reports speaker fee from Abbott and Medtronic and speaker and proctor fee from Edwards Lifesciences. RT was also on the advisory panel of Edwards Lifesciences in 2020. GKV reports consulting fee from Edwards LifeSciences. The remaining authors declare that they have no conflicts of interest pertaining to this article. EDAT- 2022/10/21 06:00 MHDA- 2022/10/22 06:00 PMCR- 2022/09/19 CRDT- 2022/10/20 02:35 PHST- 2022/05/31 00:00 [received] PHST- 2022/08/31 00:00 [accepted] PHST- 2022/10/20 02:35 [entrez] PHST- 2022/10/21 06:00 [pubmed] PHST- 2022/10/22 06:00 [medline] PHST- 2022/09/19 00:00 [pmc-release] AID - 10.1155/2022/5688026 [doi] PST - epublish SO - J Interv Cardiol. 2022 Sep 19;2022:5688026. doi: 10.1155/2022/5688026. eCollection 2022. PMID- 36261572 OWN - NLM STAT- MEDLINE DCOM- 20221021 LR - 20230111 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 12 IP - 1 DP - 2022 Oct 19 TI - Hospital intervention volume affects outcomes of emergency transcatheter aortic valve implantations in Germany. PG - 17483 LID - 10.1038/s41598-022-20336-y [doi] LID - 17483 AB - The literature has shown an inverse volume-outcome relationship for transcatheter aortic valve implantation (TAVI). However, little is known about emergency admissions in Germany. Using German national electronic health records, we identified all isolated balloon-expandable and self-expanding transfemoral TAVI in 2018. The focus was on those patients with emergency admission. 17,295 patients were treated with TAVI, including 1682 emergency cases. 49.2% of the emergency admissions were female, the mean age was 81.2 years and the logistic EuroSCORE was 23.3%. The percentage of emergency cases was higher in lower volume than in higher volume centers (p < 0.001): In detail, centers performing < 50 TAVI showed an emergency admission rate of ~ 15%, those with > 200 TAVI a rate of ~ 11%. After propensity score adjustment, analyzing the outcomes for an increase in volume per 10 emergency admissions, higher volume centers showed significantly better outcomes regarding in-hospital mortality (OR = 0.872, p = 0.043), major bleeding (OR = 0.772, p = 0.001), stroke (OR = 0.816, p = 0.044), mechanical ventilation > 48 h (OR = 0.749, p = 0.001), length of hospital stay (risk adjusted difference in days of hospitalization per 10 emergency admissions: - 1.01 days, p < 0.001), and reimbursement (risk adjusted difference in reimbursement per 10 emergency admissions: -euro314.89, p < 0.001). Results were not significant for acute kidney injury (OR = 0.951, p = 0.104), postoperative delirium (OR = 0.975, p = 0.480), and permanent pacemaker implantation (OR = 1.010, p = 0.732). In conclusion, regarding transfemoral TAVI, the percentage of emergency cases was higher in lower volume centers in Germany. However, higher volume centers show significantly better outcomes for in-hospital mortality and complication rates as well as resource utilization parameters. CI - (c) 2022. The Author(s). FAU - Oettinger, Vera AU - Oettinger V AUID- ORCID: 0000-0003-4460-2102 AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. vera.oettinger@uniklinik-freiburg.de. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany. vera.oettinger@uniklinik-freiburg.de. FAU - Heidenreich, Adrian AU - Heidenreich A AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany. AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany. FAU - Bode, Christoph AU - Bode C AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Duerschmied, Daniel AU - Duerschmied D AD - Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. AD - European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. FAU - Stachon, Peter AU - Stachon P AD - Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221019 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Humans MH - Female MH - Aged, 80 and over MH - Male MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis MH - Treatment Outcome MH - Germany/epidemiology MH - Hospital Mortality MH - Hospitals MH - Postoperative Complications/etiology MH - Risk Factors PMC - PMC9581927 COIS- The authors declare no competing interests. EDAT- 2022/10/20 06:00 MHDA- 2022/10/22 06:00 PMCR- 2022/10/19 CRDT- 2022/10/19 23:30 PHST- 2021/12/27 00:00 [received] PHST- 2022/09/12 00:00 [accepted] PHST- 2022/10/19 23:30 [entrez] PHST- 2022/10/20 06:00 [pubmed] PHST- 2022/10/22 06:00 [medline] PHST- 2022/10/19 00:00 [pmc-release] AID - 10.1038/s41598-022-20336-y [pii] AID - 20336 [pii] AID - 10.1038/s41598-022-20336-y [doi] PST - epublish SO - Sci Rep. 2022 Oct 19;12(1):17483. doi: 10.1038/s41598-022-20336-y. PMID- 36256698 OWN - NLM STAT- MEDLINE DCOM- 20221024 LR - 20230108 IS - 1941-7632 (Electronic) IS - 1941-7640 (Print) IS - 1941-7640 (Linking) VI - 15 IP - 10 DP - 2022 Oct TI - Economics of Minimalist Transcatheter Aortic Valve Replacement: Results From the 3M-TAVR Economic Study. PG - e012168 LID - 10.1161/CIRCINTERVENTIONS.122.012168 [doi] AB - BACKGROUND: The 3M-TAVR trial (3M-Transcatheter Aortic Valve Replacement) demonstrated the feasibility and safety of next-day hospital discharge after transfemoral TAVR with implementation of a minimalist pathway. However, the economic impact of this approach is unknown. Therefore, we evaluated costs for patients undergoing minimalist TAVR compared with conventional TAVR. METHODS: We used propensity matching to compare resource utilization and costs (from a US health care system perspective) for patients in the 3M-TAVR trial with those for transfemoral TAVR patients enrolled in the contemporaneous S3i trial (PARTNER SAPIEN-3 Intermediate Risk). Procedural costs were estimated using measured resource utilization for both groups. For the S3i group, all other costs through 30-day follow-up were assessed by linkage with Medicare claims; for 3M, these costs were assessed using regression models derived from S3i cost and resource utilization data. RESULTS: After 1:1 propensity matching, 351 pairs were included in our study (mean age 82, mean Society of Thoracic Surgery risk score 5.3%). There were no differences in death, stroke, or rehospitalization between the 3M-TAVR and S3i groups through 30-day follow-up. Index hospitalization costs were $10 843/patient lower in the 3M-TAVR cohort, driven by reductions in procedure duration, anesthesia costs, and length of stay. Between discharge and 30 days, costs were similar for the 2 groups such that cumulative 30-day costs were $11 305/patient lower in the 3M-TAVR cohort compared with the S3i cohort ($49 425 versus $60 729, 95% CI for difference $9378 to $13 138; P<0.001). CONCLUSIONS: Compared with conventional transfemoral TAVR, use of a minimalist pathway in intermediate-risk patients was associated with similar clinical outcomes and substantial in-hospital cost savings, which were sustained through 30 days. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02287662. FAU - Butala, Neel M AU - Butala NM AUID- ORCID: 0000-0001-6937-4041 AD - Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (N.M.B.). FAU - Wood, David A AU - Wood DA AUID- ORCID: 0000-0001-5117-2353 AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Li, Haiyan AU - Li H AD - St Luke's Mid-America Heart Institute, Kansas City, MO (H.L., K.C., E.A.M.). FAU - Chinnakondepalli, Khaja AU - Chinnakondepalli K AD - St Luke's Mid-America Heart Institute, Kansas City, MO (H.L., K.C., E.A.M.). FAU - Lauck, Sandra B AU - Lauck SB AUID- ORCID: 0000-0002-0181-559X AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Sathananthan, Janarthanan AU - Sathananthan J AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Cairns, John A AU - Cairns JA AUID- ORCID: 0000-0001-8875-8841 AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Magnuson, Elizabeth A AU - Magnuson EA AUID- ORCID: 0000-0002-8631-6211 AD - St Luke's Mid-America Heart Institute, Kansas City, MO (H.L., K.C., E.A.M.). FAU - Barker, Madeleine AU - Barker M AUID- ORCID: 0000-0002-1334-5943 AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Webb, John G AU - Webb JG AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Welsh, Robert AU - Welsh R AUID- ORCID: 0000-0003-2613-9142 AD - Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (R.W.). FAU - Cheung, Anson AU - Cheung A AUID- ORCID: 0000-0003-1466-2788 AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Ye, Jian AU - Ye J AUID- ORCID: 0000-0003-1939-7573 AD - Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (D.A.W., S.B.L., J.S., J.A.C., M.B., J.G.W., A.C., J.Y.). FAU - Velianou, James L AU - Velianou JL AUID- ORCID: 0000-0003-0204-3701 AD - Division of Cardiology, Department of Medicine, Hamilton Health Sciences, McMaster University, Ontario, Canada (J.L.V.). FAU - Wijeysundera, Harindra C AU - Wijeysundera HC AUID- ORCID: 0000-0001-8464-1080 AD - Division of Cardiology, Department of Medicine, University of Toronto, Canada (H.C.W.). FAU - Asgar, Anita AU - Asgar A AUID- ORCID: 0000-0001-7308-2332 AD - Montreal Heart Institute, Quebec, Canada (A.A.). FAU - Kodali, Susheel AU - Kodali S AD - Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY (S.K.). FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, GA (V.H.T.). FAU - Cohen, David J AU - Cohen DJ AUID- ORCID: 0000-0001-9163-724X AD - Cardiovascular Research Foundation, New York, NY (D.J.C.). AD - St Francis Hospital and Heart Center, Roslyn, NY (D.J.C.). CN - 3M-TAVR Investigators LA - eng SI - ClinicalTrials.gov/NCT02287662 PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221018 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Aged MH - Aged, 80 and over MH - Humans MH - *Aortic Valve Stenosis/surgery MH - Medicare/economics MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome MH - United States PMC - PMC9575578 OTO - NOTNLM OT - Medicare OT - costs and cost analysis OT - hospital OT - hospitalization OT - length of stay OT - transcatheter aortic valve replacement EDAT- 2022/10/19 06:00 MHDA- 2022/10/21 06:00 PMCR- 2022/10/17 CRDT- 2022/10/18 14:09 PHST- 2022/10/18 14:09 [entrez] PHST- 2022/10/19 06:00 [pubmed] PHST- 2022/10/21 06:00 [medline] PHST- 2022/10/17 00:00 [pmc-release] AID - 10.1161/CIRCINTERVENTIONS.122.012168 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2022 Oct;15(10):e012168. doi: 10.1161/CIRCINTERVENTIONS.122.012168. Epub 2022 Oct 18. PMID- 36247444 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221019 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Transcatheter aortic valve replacement in patients with quadricuspid aortic valve in a single center. PG - 1011466 LID - 10.3389/fcvm.2022.1011466 [doi] LID - 1011466 AB - BACKGROUND: Quadricuspid aortic valve (QAV) is a rare congenital malformation that can present with aortic regurgitation or aortic stenosis (AS)), requiring surgical treatment. Transcatheter aortic valve replacement (TAVR) is an alternative treatment for older patients and its prognosis for QAV therapy remains challenging. We sought to examine our early experience with TAVR in patients with QAV. MATERIALS AND METHODS: Prospectively collected data were retrospectively reviewed in patients with QAV undergoing TAVR in our institution. RESULTS: Five patients with QAV and AR or AS were treated with TAVR between January 2016 and January 2022. The mean age was 73.8 years (range 69-82 years), and the median Society of Thoracic Surgeons score was 7.51% (range 2.668-18.138%). Two patients had type B and three had either type A, D, or F according to the Hurwitz and Roberts classification for QAV. Four patients with pure aortic regurgitation underwent transapical TAVR using the J-Valve system, and the patient with severe AS underwent transfemoral TAVR using the Venus-A system. Procedural success was achieved in all five patients. Trivial paravalvular leak was only detected in one case after the procedure, and one patient received a permanent pacemaker due to high-degree atrioventricular block three days later. The median follow-up period was 18 (12-56) months. After discharge, no deaths occurred during the 1 year follow-up. All patients improved by >/=1 New York Heart Association functional class at 30 days; four patients were in functional class /= 65 years and diagnosed with severe pure AR as defined by the Echocardiographic Core Laboratory will be consecutively enrolled for further multidetector computed tomography (MDCT) scanning and multiplanar analyses. Based on a new anatomical classification and dual anchoring theory, patients will be classified into 4 types according to the level of the anchoring area. Types 1, 2 and 3 (at least 2 anchoring areas) will undergo the TAVR procedure with a domestic Chinese self-expanding valve (VitaFlow Valve, MicroPort, Shanghai, China), whereas type 4 (0 or 1 anchoring area) patients will be considered unsuitable for TAVR and will receive medical treatment. Our goal is to recruit 100 patients to account for 10% missing data or loss of patients to follow-up. Procedural, 30-day, 6-month and 12-month outcomes will be assessed according to Valve Academic Research Consortium-3 criteria. DISCUSSION: The AURORA study will establish a new AR anatomical classification based on dual anchoring theory through MDCT multiplanar measurement and assess the safety and efficacy of TAVR guided by this new classification and strategy in AR patients. TRIAL REGISTRATION: This Study was registered at Chinses Clinical Trial Registry. The registration number: ChiCTR2200055415; The date of registration: 9, January 2022; The URL of the registration: http://www.chictr.org.cn/showproj.aspx?proj=141209 . CI - (c) 2022. The Author(s). FAU - Yao, Jing AU - Yao J AD - Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. FAU - Lu, Zhi-Nan AU - Lu ZN AD - Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. FAU - Modine, Thomas AU - Modine T AD - CHU de Bordeaux, Bordeaux, France. FAU - Jilaihawi, Hasan AU - Jilaihawi H AD - NYU Langone Health, New York, USA. FAU - Piazza, Nicolo AU - Piazza N AD - McGill University Health Center, Montreal and German Heart Centre, Munich, Germany. FAU - Tang, Yi-Da AU - Tang YD AD - Third Hospital of Peking University, Beijing, China. FAU - Xu, Ji-Zhe AU - Xu JZ AD - The First Hospital of Lanzhou University, Lanzhou, China. FAU - Peng, Xiao-Ping AU - Peng XP AD - Department of Cardiology, The First Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Wang, Hai-Ping AU - Wang HP AD - Qingdao Fuwai Cardiovascular Hospital, Qingdao, China. FAU - Li, Chuan-Bao AU - Li CB AD - Qilu Hospital of Shandong University, Jinan, China. FAU - Chen, Hui AU - Chen H AD - Beijing Friendship Hospital, Capital Medical University, Beijing, China. FAU - Liu, Chang-Fu AU - Liu CF AD - Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China. FAU - Jiang, Zheng-Ming AU - Jiang ZM AD - First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. FAU - Li, Jie AU - Li J AD - Guangdong Provincial People's Hospital, Guangzhou, China. FAU - Yu, Fei-Cheng AU - Yu FC AD - Sir Run Run Shaw Hospital (SRRSH), Affiliated with the Zhejiang University School of Medicine, Hangzhou, China. FAU - Han, Ke AU - Han K AD - The First Affiliated Hospital of Xi'an Jiao-Tong University, Xi'an, China. FAU - Wang, Sheng AU - Wang S AD - Fuwai Central China Cardiovascular Hospital, Zhengzhou, China. FAU - Huang, Hui AU - Huang H AD - Cardiovascular Institute, Heart Center, General Hospital of Ningxia Medical University, Yinchuan, China. FAU - Song, Guang-Yuan AU - Song GY AD - Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. songgy_fuwai@163.com. LA - eng SI - ChiCTR/ChiCTR2200055415 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20221015 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Insufficiency/diagnostic imaging/etiology/surgery MH - *Aortic Valve Stenosis/surgery MH - China MH - Cohort Studies MH - *Heart Valve Prosthesis MH - Humans MH - Prospective Studies MH - Prosthesis Design MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome PMC - PMC9571459 OTO - NOTNLM OT - Anatomical characteristics OT - Aortic regurgitation OT - Computed tomography OT - Transcatheter aortic valve replacement COIS- The authors declare that they have no competing interests. EDAT- 2022/10/16 06:00 MHDA- 2022/10/19 06:00 PMCR- 2022/10/15 CRDT- 2022/10/15 23:13 PHST- 2022/04/10 00:00 [received] PHST- 2022/10/05 00:00 [accepted] PHST- 2022/10/15 23:13 [entrez] PHST- 2022/10/16 06:00 [pubmed] PHST- 2022/10/19 06:00 [medline] PHST- 2022/10/15 00:00 [pmc-release] AID - 10.1186/s12872-022-02883-4 [pii] AID - 2883 [pii] AID - 10.1186/s12872-022-02883-4 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2022 Oct 15;22(1):445. doi: 10.1186/s12872-022-02883-4. PMID- 36239806 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20261010 IS - 1613-7671 (Electronic) IS - 0043-5325 (Linking) VI - 135 IP - 23-24 DP - 2023 Dec TI - Minimally invasive surgical aortic valve replacement versus transfemoral transcatheter aortic valve implantation in low-risk octogenarians : Observational, retrospective and single-center study. PG - 703-711 LID - 10.1007/s00508-022-02094-z [doi] AB - BACKGROUND: The aim of this study was to compare short-term and mid-term outcomes in low-risk octogenarian population treated with transfemoral transcatheter aortic valve implantation (tf-TAVI) or minimally invasive aortic valve replacement (mini-AVR) for severe aortic stenosis. METHODS: In this single-center, retrospective cohort study we gathered data on low-risk (Society of Thoracic Surgeons [STS] score < 4%) octogenarians before and after tf-TAVI and mini-AVR performed between January 2013 and May 2019; follow-up was completed in May 2022. Short-term outcomes were hospital length of stay, in-hospital all-cause mortality and other major postoperative outcomes. Mid-term clinical outcomes were 1‑year and 3‑year all-cause mortality. Propensity score-based matching was performed. RESULTS: In total 106 patients were matched, resulting in 53 pairs. In-hospital complications were similar between the matched groups of patients with the exception of mild and moderate paravalvular leak (mini-AVR vs. tf-TAVI: mild PVL: 3.8% vs. 45.3%, p < 0.001; moderate PVL: 0% vs. 3.8%, p = 0.4952) and of postprocedural acute kidney injury that was more frequent in mini-AVR group (mini-AVR vs. tf-TAVI: 22.6% vs. 5.7%; p = 0.023). Hospital length of stay (p = 0.239) and in-hospital mortality (p = 0.495) did not differ between groups. The 1-year and 3‑year all-cause mortality Kaplan-Meier estimates were similar between mini-AVR and tf-TAVI. CONCLUSION: In the present study on low-risk octogenarians, transfemoral TAVI and minimally invasive AVR showed comparable short-term and mid-term results. Both procedures are deemed safe and effective. Larger RCTs will be required to determine which low-risk patients will benefit most from TAVI. CI - (c) 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature. FAU - Kolar, Tadeja AU - Kolar T AUID- ORCID: 0000-0002-2839-7690 AD - Medical Faculty, University of Ljubljana, Ljubljana, Slovenia. tkolar17@gmail.com. AD - Department of cardiovascular surgery, University Clinical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia. tkolar17@gmail.com. FAU - Bunc, Matjaz AU - Bunc M AD - Department of cardiology, University Clinical Centre Ljubljana, Ljubljana, Slovenia. FAU - Jelenc, Matija AU - Jelenc M AD - Department of cardiovascular surgery, University Clinical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia. FAU - Terseglav, Simon AU - Terseglav S AD - Department of cardiology, University Clinical Centre Ljubljana, Ljubljana, Slovenia. FAU - Kotnik, Alesa AU - Kotnik A AD - Department of cardiovascular surgery, University Clinical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia. FAU - Lakic, Nikola AU - Lakic N AD - Department of cardiovascular surgery, University Clinical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia. LA - eng PT - Journal Article PT - Observational Study DEP - 20221014 PL - Austria TA - Wien Klin Wochenschr JT - Wiener klinische Wochenschrift JID - 21620870R SB - IM MH - Aged, 80 and over MH - Humans MH - Aortic Valve/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Octogenarians MH - Retrospective Studies MH - *Heart Valve Prosthesis Implantation/methods MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Risk Factors OTO - NOTNLM OT - Aortic stenosis OT - Low-risk OT - Minimally invasive AVR OT - Octogenarians OT - TAVI EDAT- 2022/10/15 06:00 MHDA- 2023/12/17 09:41 CRDT- 2022/10/14 11:15 PHST- 2022/08/10 00:00 [received] PHST- 2022/09/09 00:00 [accepted] PHST- 2023/12/17 09:41 [medline] PHST- 2022/10/15 06:00 [pubmed] PHST- 2022/10/14 11:15 [entrez] AID - 10.1007/s00508-022-02094-z [pii] AID - 10.1007/s00508-022-02094-z [doi] PST - ppublish SO - Wien Klin Wochenschr. 2023 Dec;135(23-24):703-711. doi: 10.1007/s00508-022-02094-z. Epub 2022 Oct 14. PMID- 36227011 OWN - NLM STAT- MEDLINE DCOM- 20221103 LR - 20250617 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 34 IP - 11 DP - 2022 Nov TI - A Novel Model to Predict 1-Year Mortality in Elective Transfemoral Aortic Valve Replacement: The TAVR-Risk Score. PG - E776-E783 LID - JIC20221013-1 [pii] AB - OBJECTIVES: We aimed to develop and validate an effective prediction model for 1-year mortality risk in elective transfemoral transcatheter aortic valve replacement (TAVR), ie, the TAVR-Risk (TARI) model. BACKGROUND: TAVR is the primary treatment for patients with symptomatic severe aortic valve stenosis; however, risk assessment tools for longer-term outcomes after TAVR remain scarce. METHODS: This retrospective cohort study used logistic regression to test univariate and multivariate associations. The German Aortic Valve Registry (GARY) was the derivation (n = 20,704) and the Swedish SWEDEHEART TAVR Registry (SWENTRY) was the validation cohort (n = 3982). The main outcome was the area under the curve (AUC) in the prediction of 1-year mortality. The final model included 12 parameters that were associated with 1-year mortality in a multivariate analysis. RESULTS: The TARI model (AUC, 0.66; 95% confidence interval [CI] 0.65-0.67) performed better as compared with the Society of Thoracic Surgeons (STS) score (AUC, 0.63; 95% CI, 0.62-0.64; P<.001) and logistic EuroSCORE I (AUC, 0.60; 95% CI, 0.59-0.61; P<.001) in the GARY derivation cohort, and discriminated the risk for 1-year mortality better than logistic EuroSCORE I in the SWENTRY validation cohort (AUC, 0.62; 95% CI, 0.60-0.64 vs AUC, 0.59; 95% CI, 0.57-0.61; P=.04). CONCLUSIONS: This novel TARI score provides a relatively easy-to-use risk model and offers a superior prediction for 1-year mortality in European TAVR patients. FAU - Jung, Christian AU - Jung C AD - Division of Cardiology, Pulmonology,and Vascular Medicine, University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany. christian.jung@med.uni-duesseldorf.de. FAU - Fujita, Buntaro AU - Fujita B FAU - Feldt, Kari AU - Feldt K FAU - Wernly, Bernhard AU - Wernly B FAU - Bruno, Raphael Romano AU - Bruno RR FAU - Wolff, Georg AU - Wolff G FAU - Zeus, Tobias AU - Zeus T FAU - Polzin, Amin AU - Polzin A FAU - Lichtenberg, Artur AU - Lichtenberg A FAU - Beyersdorf, Friedhelm AU - Beyersdorf F FAU - Bauer, Timm AU - Bauer T FAU - Bekeredjian, Raffi AU - Bekeredjian R FAU - Bleiziffer, Sabine AU - Bleiziffer S FAU - Beckmann, Andreas AU - Beckmann A FAU - Frerker, Christian AU - Frerker C FAU - Mollmann, Helge AU - Mollmann H FAU - Walther, Thomas AU - Walther T FAU - Gummert, Jan AU - Gummert J FAU - Zeiher, Andreas AU - Zeiher A FAU - Hamm, Christian AU - Hamm C FAU - Meduri, Christopher U AU - Meduri CU FAU - Settergren, Magnus AU - Settergren M FAU - Kelm, Malte AU - Kelm M FAU - Ensminger, Stephan AU - Ensminger S LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221013 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Aortic Valve/surgery MH - Retrospective Studies MH - *Aortic Valve Stenosis/surgery MH - Risk Factors MH - Risk Assessment MH - Treatment Outcome OTO - NOTNLM OT - aortic valve OT - intervention OT - TAVR OT - long-term OT - risk assessment EDAT- 2022/10/14 06:00 MHDA- 2022/11/04 06:00 CRDT- 2022/10/13 09:23 PHST- 2022/10/14 06:00 [pubmed] PHST- 2022/11/04 06:00 [medline] PHST- 2022/10/13 09:23 [entrez] AID - JIC20221013-1 [pii] AID - 10.25270/jic/22.00117 [doi] PST - ppublish SO - J Invasive Cardiol. 2022 Nov;34(11):E776-E783. doi: 10.25270/jic/22.00117. Epub 2022 Oct 13. PMID- 36219144 OWN - NLM STAT- MEDLINE DCOM- 20221110 LR - 20230404 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 23 IP - 12 DP - 2022 Dec 1 TI - Transcatheter aortic valve replacement with or without anesthesiologist: results from a high-volume single center. PG - 801-806 LID - 10.2459/JCM.0000000000001391 [doi] AB - AIMS: Local instead of general anesthesia has become the standard approach in many centers for transfemoral transcatheter aortic valve replacement (TAVR). New generation devices and an increase in operator skills had led to a drastic reduction in periprocedural complications, bringing in the adoption of a minimalist approach. In our study, we aimed to compare patients treated with TAVR under local anesthesia with or without the presence of an anesthesiologist on site (AOS). METHODS: We compare procedural aspects and results of patients treated with TAVR with an AOS against patients treated with TAVR with an anesthesiologist on call (AOC). From January 2019 to December 2020, all consecutive patients undergoing transfemoral TAVR with either the self-expandable Evolut (Medtronic, MN, USA) or balloon-expandable SAPIEN 3 (Edwards Lifesciences, CA, USA) were collected. RESULTS: Of 332 patients collected, 96 (29%) were treated with TAVR with AOS, while 236 (71%) were treated with TAVR with AOC. No differences in procedural time, fluoroscopy time and amount of contrast medium were observed. No procedural death and conversion to open-chest surgery was reported. The rate of stroke/transient ischemic attacks and major vascular complications was similar in the two groups. No patients in both groups required conversion to general anesthesia. Two patients (0.8%) in the AOC group required urgent intervention of the anesthesiologist. In the AOC group, there was a greater use of morphine (55.9% vs. 33.3%, P = 0.008), but with a lower dose for each patient (2.0 vs. 2.8 mg, P = 0.006). On the other hand, there was a lower use of other painkiller drugs (3.4% vs. 20.8%, P = 0.001). No difference in inotropic drugs use was observed. CONCLUSION: In patients at low or intermediate risk undergoing transfemoral TAVR, a safe procedure can be performed under local anesthesia without the presence of an anesthesiologist in the catheterization laboratory. CI - Copyright (c) 2022 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Angelillis, Marco AU - Angelillis M AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Stazzoni, Laura AU - Stazzoni L AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Costa, Giulia AU - Costa G AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Giannini, Cristina AU - Giannini C AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Primerano, Chiara AU - Primerano C AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Spontoni, Paolo AU - Spontoni P AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Pieroni, Andrea AU - Pieroni A AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Guarracino, Fabio AU - Guarracino F AD - Cardiothoracic and vascular Anaesthesiology and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Bertini, Pietro AU - Bertini P AD - Cardiothoracic and vascular Anaesthesiology and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Baldassarri, Rubia AU - Baldassarri R AD - Cardiothoracic and vascular Anaesthesiology and Intensive Care, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - De Carlo, Marco AU - De Carlo M AD - Catheterization laboratory, Cardiothoracic and Vascular Department. FAU - Petronio, Anna S AU - Petronio AS AD - Catheterization laboratory, Cardiothoracic and Vascular Department. LA - eng PT - Journal Article DEP - 20221007 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM CIN - J Cardiovasc Med (Hagerstown). 2022 Dec 1;23(12):807-808. doi: 10.2459/JCM.0000000000001392. PMID: 36349945 MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/etiology MH - *Heart Valve Prosthesis MH - Anesthesiologists MH - Prosthesis Design MH - Treatment Outcome MH - Fluoroscopy MH - Aortic Valve/diagnostic imaging/surgery EDAT- 2022/10/12 06:00 MHDA- 2022/11/11 06:00 CRDT- 2022/10/11 10:32 PHST- 2022/10/12 06:00 [pubmed] PHST- 2022/11/11 06:00 [medline] PHST- 2022/10/11 10:32 [entrez] AID - 01244665-202212000-00008 [pii] AID - 10.2459/JCM.0000000000001391 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2022 Dec 1;23(12):801-806. doi: 10.2459/JCM.0000000000001391. Epub 2022 Oct 7. PMID- 36217748 OWN - NLM STAT- MEDLINE DCOM- 20221219 LR - 20221221 IS - 1559-0879 (Electronic) IS - 1556-9845 (Linking) VI - 17 IP - 5 DP - 2022 Sep TI - Monitored Anesthesia Care Versus General Anesthesia for Transcatheter Aortic Valve Replacement. PG - 401-408 LID - 10.1177/15569845221124113 [doi] AB - OBJECTIVE: Monitored anesthesia care (MAC) has been increasingly used in lieu of general anesthesia (GA) for transcatheter aortic valve replacement (TAVR). We sought to compare outcomes and in-hospital costs between MAC and GA for TAVR at a Veterans Affairs Medical Center. METHODS: A single-center retrospective review was performed of 349 patients who underwent transfemoral TAVR (MAC, n = 244 vs GA, n = 105) from January 2014 to December 2019. Baseline patient characteristics, operating room (OR) time, intensive care unit (ICU) length of stay (LOS), and cost, total LOS, hospital cost, total cost, and complication rates were collected. Propensity matching was performed and resulted in 83 matched pairs. RESULTS: In the unmatched TAVR cohort, MAC TAVR was associated with reduced OR time (146 vs 198 min, P < 0.001), ICU LOS (1.4 vs 1.8 days, P < 0.001), total hospital LOS (3.4 vs 5.4 days, P < 0.001), and lower index total cost ($81,300 vs $85,400, P = 0.010). After propensity matching, MAC TAVR patients had reduced OR time (146 vs 196 min, P < 0.05), ICU LOS (1.2 vs 1.7 days, P = 0.006), total LOS (3.5 vs 5.1 days, P = 0.001), and 180-day mortality (2.4% vs 12%, P < 0.03). There was no difference in total hospitalization cost or total cost. CONCLUSIONS: In propensity-matched groups, TAVR utilizing MAC is associated with improved OR time efficiency, decreased LOS, and a reduction in 180-day mortality but no significant difference in cost. FAU - Holmes, Henry R AU - Holmes HR AUID- ORCID: 0000-0003-2495-5453 AD - Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, FL, USA. FAU - Falasa, Matheus AU - Falasa M AD - Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, FL, USA. FAU - Neal, Daniel AU - Neal D AD - Department of Surgery, University of Florida Health, Gainesville, FL, USA. FAU - Choi, Calvin Y AU - Choi CY AD - Division of Cardiology, Department of Medicine, University of Florida Health, Gainesville, FL, USA. AD - Division of Cardiology, Department of Medicine, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA. FAU - Park, Ki AU - Park K AD - Division of Cardiology, Department of Medicine, University of Florida Health, Gainesville, FL, USA. AD - Division of Cardiology, Department of Medicine, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA. FAU - Bavry, Anthony A AU - Bavry AA AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA. FAU - Freeman, Kirsten A AU - Freeman KA AUID- ORCID: 0000-0002-2669-4210 AD - Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, FL, USA. AD - Division of Thoracic and Cardiovascular Surgery, Department of Surgery, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA. FAU - Manning, Eddie W AU - Manning EW AD - Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, FL, USA. AD - Division of Thoracic and Cardiovascular Surgery, Department of Surgery, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA. FAU - Stinson, Wade W AU - Stinson WW AD - Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, FL, USA. AD - Division of Thoracic and Cardiovascular Surgery, Department of Surgery, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA. FAU - Jeng, Eric I AU - Jeng EI AD - Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, FL, USA. LA - eng PT - Journal Article DEP - 20221011 PL - United States TA - Innovations (Phila) JT - Innovations (Philadelphia, Pa.) JID - 101257528 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Anesthesia, General/methods MH - Length of Stay MH - Retrospective Studies MH - Risk Factors MH - Aortic Valve/surgery OTO - NOTNLM OT - cardiac anesthesia OT - cost analysis OT - endovascular procedures OT - quality improvement OT - transcatheter aortic valve replacement EDAT- 2022/10/12 06:00 MHDA- 2022/12/20 06:00 CRDT- 2022/10/11 03:13 PHST- 2022/10/12 06:00 [pubmed] PHST- 2022/12/20 06:00 [medline] PHST- 2022/10/11 03:13 [entrez] AID - 10.1177/15569845221124113 [doi] PST - ppublish SO - Innovations (Phila). 2022 Sep;17(5):401-408. doi: 10.1177/15569845221124113. Epub 2022 Oct 11. PMID- 36216605 OWN - NLM STAT- MEDLINE DCOM- 20221114 LR - 20221123 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 185 DP - 2022 Dec 15 TI - Transcarotid Versus Transfemoral Transcatheter Aortic Valve Replacement (from a Propensity-Matched Comparison). PG - 71-79 LID - S0002-9149(22)00962-6 [pii] LID - 10.1016/j.amjcard.2022.09.003 [doi] AB - Previous reports comparing transcarotid (TC) versus transfemoral (TF) approaches for patients undergoing transcatheter aortic valve replacement have had inconsistent conclusions. We compared in-hospital and 1-year clinical outcomes, changes in quality of life, and direct hospital costs for 138 TC versus 1,926 TF procedures. Propensity matching based on the Society of Thoracic Surgery Predicted Risk of Mortality was used to compare 130 patients who underwent TC with 813 patients who underwent TF. Matched TC versus TF cohorts did not differ with respect to in-hospital mortality (0.0% vs 1.4%, p = 0.380), stroke (2.3% vs 2.5%, p = 0.917), major vascular complications (0.8% vs 2.2%, p = 0.268), composite bleeding complications (4.6% vs 6.4%, p = 0.647), requirement for permanent pacemaker (14.6% vs 12.9%, p = 0.426), postoperative hospital length of stay (3.3 +/- 3.4 vs 3.1 +/- 3.3 days, p = 0.467), or direct hospital costs ($52,899 +/- 9,560 vs $50,464 +/- 10,997, p = 0.230). Similarly, at 1-year, patients who underwent TC versus patients who underwent TF did not differ with respect to all-cause mortality (7.6% vs 6.4%, p = 0.659), hospital readmission (20.0% vs 23.9%, p = 0.635), or quality of life as measured by the Kansas City Cardiomyopathy Questionnaire score (84.0 +/- 17.1 vs 88.4 +/- 13.9, p = 0.062). Patients who underwent TC and TF did not differ with respect to in-hospital complications, length of hospital stay, and direct hospital costs, as well as 1-year mortality, readmission, and quality of life. These data add to ongoing support for the TC approach as the optimal alternative access for patients with transcatheter aortic valve replacement deferred from a transfemoral approach. CI - Copyright (c) 2022 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Hoover, Nicole E AU - Hoover NE AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Ouranos, Hossein B AU - Ouranos HB AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Memon, Sarfaraz AU - Memon S AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Azemi, Talhat AU - Azemi T AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Piccirillo, Bryan J AU - Piccirillo BJ AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Sadiq, Immad R AU - Sadiq IR AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Rizvi, Asad A AU - Rizvi AA AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Haider, Jawad M AU - Haider JM AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Hagberg, Robert C AU - Hagberg RC AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Mather, Jeff F AU - Mather JF AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - Underhill, David J AU - Underhill DJ AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. FAU - McKay, Raymond G AU - McKay RG AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. Electronic address: Raymond.mckay@hhchealth.org. FAU - Cheema, Mohiuddin AU - Cheema M AD - Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut. LA - eng PT - Journal Article DEP - 20221008 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Quality of Life MH - Femoral Artery/surgery MH - Retrospective Studies MH - Treatment Outcome MH - Postoperative Complications/epidemiology/surgery MH - Aortic Valve/surgery MH - Risk Factors EDAT- 2022/10/11 06:00 MHDA- 2022/11/15 06:00 CRDT- 2022/10/10 22:03 PHST- 2022/06/15 00:00 [received] PHST- 2022/08/09 00:00 [revised] PHST- 2022/09/05 00:00 [accepted] PHST- 2022/10/11 06:00 [pubmed] PHST- 2022/11/15 06:00 [medline] PHST- 2022/10/10 22:03 [entrez] AID - S0002-9149(22)00962-6 [pii] AID - 10.1016/j.amjcard.2022.09.003 [doi] PST - ppublish SO - Am J Cardiol. 2022 Dec 15;185:71-79. doi: 10.1016/j.amjcard.2022.09.003. Epub 2022 Oct 8. PMID- 36210517 OWN - NLM STAT- MEDLINE DCOM- 20221229 LR - 20230103 IS - 2048-8734 (Electronic) IS - 2048-8726 (Linking) VI - 11 IP - 12 DP - 2022 Dec 27 TI - Emergency transcatheter aortic valve implantation for acute heart failure due to severe aortic stenosis in critically ill patients with or without cardiogenic shock. PG - 877-886 LID - 10.1093/ehjacc/zuac131 [doi] AB - AIMS: Severe aortic stenosis can cause acute heart failure and cardiogenic shock (CS). Transcatheter aortic valve implantation (TAVI) is the standard therapy for aortic stenosis in inoperable patients. However, its role in this setting is poorly evaluated. The study purpose was to explore clinical characteristics of these patients and to assess predictors of mortality. METHODS AND RESULTS: All 2930 patients undergoing transfemoral TAVI at our centre between 2013 and 2019 were screened for critically ill patients, receiving intensive care therapy and emergency TAVI. Selected patients were subdivided into two groups, according to the presence or absence of CS. Remaining patients undergoing elective TAVI served as a comparison. Primary outcome was 90-day mortality. Out of 179 critically ill patients, 47 fulfilled criteria of CS (shock group) and 132 did not despite a severe decompensation (no shock group). Shock patients were more often male and had higher Society of Thoracic Surgeons scores [15.6, interquartile range (8.0-32.1) vs. 5.5 (3.9-8.5), P < 0.01] compared with severely decompensated patients. Ninety-day mortality was: shock group, 42.6%, vs. no shock group, 15.9%, vs. elective group, 5.3% (P < 0.01). A landmark analysis from day 90 showed similar mortality (P = 0.29). Compared with elective patients, 30-day composite endpoint device failure was higher in critically ill groups [shock group, odds ratio, 2.86 (1.43-5.36), no shock group, odds ratio, 1.74 (1.09-2.69)]. Multivariable regression revealed mechanical ventilation, haemofiltration, elevated C-reactive protein or bilirubin, and hypotension before TAVI as 90-day mortality predictors. CONCLUSION: Ninety-day mortality after TAVI in critically ill patients is increased but survivors have similar outcomes as elective patients. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com. FAU - Steffen, Julius AU - Steffen J AUID- ORCID: 0000-0002-8807-7365 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. AD - German Centre for Cardiovascular Research (DZHK), Munich, Germany. FAU - Stocker, Angelika AU - Stocker A AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Scherer, Clemens AU - Scherer C AUID- ORCID: 0000-0003-2816-6793 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. AD - German Centre for Cardiovascular Research (DZHK), Munich, Germany. FAU - Haum, Magda AU - Haum M AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Fischer, Julius AU - Fischer J AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Doldi, Philipp M AU - Doldi PM AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. AD - German Centre for Cardiovascular Research (DZHK), Munich, Germany. FAU - Theiss, Hans AU - Theiss H AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Braun, Daniel AU - Braun D AUID- ORCID: 0000-0002-6355-3222 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Rizas, Konstantinos AU - Rizas K AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. AD - German Centre for Cardiovascular Research (DZHK), Munich, Germany. FAU - Peterss, Sven AU - Peterss S AUID- ORCID: 0000-0003-1880-152X AD - Departent of Heart Surgery, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Hausleiter, Jorg AU - Hausleiter J AUID- ORCID: 0000-0003-2909-7961 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. AD - German Centre for Cardiovascular Research (DZHK), Munich, Germany. FAU - Massberg, Steffen AU - Massberg S AUID- ORCID: 0000-0001-7387-3986 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. AD - German Centre for Cardiovascular Research (DZHK), Munich, Germany. FAU - Orban, Martin AU - Orban M AUID- ORCID: 0000-0001-9830-1941 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. FAU - Deseive, Simon AU - Deseive S AUID- ORCID: 0000-0001-8768-1184 AD - Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universitat Munchen, Marchioninistr. 15, 81377 Munich, Germany. LA - eng PT - Journal Article PL - England TA - Eur Heart J Acute Cardiovasc Care JT - European heart journal. Acute cardiovascular care JID - 101591369 SB - IM CIN - Eur Heart J Acute Cardiovasc Care. 2022 Dec 27;11(12):887-890. doi: 10.1093/ehjacc/zuac142. PMID: 36345728 MH - Humans MH - Male MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Shock, Cardiogenic/etiology/surgery MH - Critical Illness MH - Risk Factors MH - Treatment Outcome MH - *Heart Failure/etiology/surgery MH - *Aortic Valve Stenosis/complications/surgery OTO - NOTNLM OT - Acute heart failure OT - Aortic stenosis OT - Cardiogenic shock OT - Transcatheter aortic valve replacement COIS- Conflict of interest: J.S., C.S., and S.D. received speaker honoraria from AstraZeneca. D.B. received speaker honoraria from Abbott Vascular. J.H. received research support Abbott Vascular and Edwards Lifesciences. M.O. received speaker honoraria and travel compensations from Abbott Medical, AstraZeneca, Abiomed, Bayer vital, BIOTRONIK, Bristol-Myers Squibb, CytoSorbents, Daiichi Sankyo Germany, Edwards Lifesciences Services, and Sedana Medical. All other authors have no conflicts of interests to declare. EDAT- 2022/10/11 06:00 MHDA- 2022/12/30 06:00 CRDT- 2022/10/10 00:43 PHST- 2022/03/25 00:00 [received] PHST- 2022/08/29 00:00 [revised] PHST- 2022/10/07 00:00 [accepted] PHST- 2022/10/11 06:00 [pubmed] PHST- 2022/12/30 06:00 [medline] PHST- 2022/10/10 00:43 [entrez] AID - 6754622 [pii] AID - 10.1093/ehjacc/zuac131 [doi] PST - ppublish SO - Eur Heart J Acute Cardiovasc Care. 2022 Dec 27;11(12):877-886. doi: 10.1093/ehjacc/zuac131. PMID- 36205608 OWN - NLM STAT- MEDLINE DCOM- 20221020 LR - 20221109 IS - 1569-9285 (Electronic) IS - 1569-9293 (Print) IS - 1569-9285 (Linking) VI - 35 IP - 5 DP - 2022 Oct 10 TI - Use of virtual reality for procedural planning of transcatheter aortic valve replacement. LID - 10.1093/icvts/ivac248 [doi] LID - ivac248 AB - This study sought to evaluate the impact of virtual reality (VR) tools in procedural planning of transcatheter aortic valve replacement. A prospective study involving 11 patients referred for transcatheter aortic valve replacement was conducted. A multidetector computed tomography was used to acquire and segment the anatomy of the access route and landing zone. From the information obtained with the multidetector computed tomography in DICOM format, we built a virtual platform (VisuaMed, Techer Team, Valencia, Spain) that contains all the clinical information of the patients and a virtualized model of their anatomy. Wearing VR devices, the professional was able to 'walk inside' the anatomy in an interactive and immersive way. Decisions after the evaluation of routine clinical images were compared with those after experience with VR models and intraprocedural findings. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Ruyra, Xavier AU - Ruyra X AD - Cardiac Surgery Department, Quironsalud Teknon Heart Institute, Barcelona, Spain. FAU - Permanyer, Eduard AU - Permanyer E AUID- ORCID: 0000-0001-5810-8688 AD - Cardiac Surgery Department, Quironsalud Teknon Heart Institute, Barcelona, Spain. AD - Human Anatomy Department, Pompeu Fabra University, Barcelona, Spain. FAU - Huguet, Marina AU - Huguet M AD - Department of Diagnostic Imaging, Quironsalud Teknon Heart Institute, Barcelona, Spain. FAU - Maldonado, Giuliana AU - Maldonado G AD - Cardiology Department, Quironsalud Teknon Heart Institute, Barcelona, Spain. AD - Cardiology Department, Quironsalud Hospital General de Catalunya, Sant Cugat, Spain. LA - eng PT - Journal Article PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Aortic Valve/diagnostic imaging/surgery MH - Prospective Studies MH - Multidetector Computed Tomography/methods MH - *Virtual Reality MH - *Heart Valve Prosthesis MH - Treatment Outcome PMC - PMC9639804 OTO - NOTNLM OT - Imaging OT - Procedural planning OT - Transcatheter aortic valve replacement OT - Virtual reality EDAT- 2022/10/08 06:00 MHDA- 2022/10/21 06:00 PMCR- 2022/10/07 CRDT- 2022/10/07 10:07 PHST- 2021/10/27 00:00 [received] PHST- 2022/09/22 00:00 [revised] PHST- 2022/10/04 00:00 [accepted] PHST- 2022/10/08 06:00 [pubmed] PHST- 2022/10/21 06:00 [medline] PHST- 2022/10/07 10:07 [entrez] PHST- 2022/10/07 00:00 [pmc-release] AID - 6751790 [pii] AID - ivac248 [pii] AID - 10.1093/icvts/ivac248 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2022 Oct 10;35(5):ivac248. doi: 10.1093/icvts/ivac248. PMID- 36201243 OWN - NLM STAT- MEDLINE DCOM- 20221010 LR - 20221011 IS - 1538-4683 (Electronic) IS - 1061-5377 (Linking) VI - 30 IP - 6 DP - 2022 Nov-Dec 01 TI - Transcatheter Aortic Valve Replacement for Severe Symptomatic Aortic Stenosis in Rheumatic Heart Disease: A Systematic Review. PG - 318-323 LID - 10.1097/CRD.0000000000000425 [doi] AB - Transcatheter aortic valve replacement (TAVR) is well-established for severe symptomatic aortic stenosis (AS), but its use in rheumatic heart disease (RHD) has been limited. We systematically review the use of TAVR for severe symptomatic AS in RHD. Pubmed, Embase, and Scopus were searched for TAVR for symptomatic severe AS and proven or suspected RHD. Procedure characteristics, efficacy, and safety endpoints were collected and all definitions were based on the Valve Academic Research Consortium-2 (VARC-2) criteria. We included 3 case series and 12 case reports, with a total of 43 patients. Mean age was 76 years, 75% were female, and 85% had NYHA class III-IV symptoms. Follow up ranged from 1 to 29 months. Patients were moderate to high risk, with Society of Thoracic Surgery score ranging from 6.1% to 17.6%. The approach was transfemoral in 30 (83%) cases. Procedural success occurred in 37 (86%) patients. Of the 7 patients with periprocedural complications, 4 had valve dislodgement, 1 deployment failure, 1 unplanned cardiopulmonary bypass, and 1 moderate aortic regurgitation. Paravalvular leak was reported in 5 (11.6%) patients. Only 1 patient had heart block requiring pacemaker. Among 13 studies (23 patients), 30-day mortality was 0%. One case series with 19 patients had a 30-day, 1-year, 2-year, and 5-year mortality of 5%, 11%, 31%, and 48%, respectively. TAVR appears feasible for selected patients with rheumatic severe AS, albeit our results indicate a 14% incidence of device failure. Future randomized clinical trials may clarify the role of TAVR in this group. CI - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved. FAU - Fernandes, Amanda D F AU - Fernandes ADF AD - From the Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL. FAU - Fernandes, Gilson C AU - Fernandes GC AD - Division of Cardiology, University of Miami/ Jackson Memorial Hospital, Miami, FL. FAU - Grant, Jelani AU - Grant J AD - From the Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL. FAU - Knijnik, Leonardo AU - Knijnik L AD - From the Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL. FAU - Cardoso, Rhanderson AU - Cardoso R AD - Division of Cardiology, Brigham and Women's Hospital, Boston, MA. FAU - Cohen, Mauricio G AU - Cohen MG AD - Division of Cardiology, University of Miami, Miami, FL. FAU - Ferreira, Alexandre C AU - Ferreira AC AD - Division of Cardiology, Jackson Memorial Hospital, Miami, FL. FAU - Alfonso, Carlos E AU - Alfonso CE AD - Division of Cardiology, University of Miami, Miami, FL. LA - eng PT - Journal Article PT - Systematic Review DEP - 20211018 PL - United States TA - Cardiol Rev JT - Cardiology in review JID - 9304686 SB - IM MH - Aged MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Female MH - *Heart Valve Prosthesis MH - Humans MH - Male MH - *Rheumatic Heart Disease/complications/surgery MH - Risk Factors MH - Severity of Illness Index MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome COIS- Disclosure: The authors declare no funding and conflict of interest. EDAT- 2022/10/07 06:00 MHDA- 2022/10/12 06:00 CRDT- 2022/10/06 11:53 PHST- 2022/10/06 11:53 [entrez] PHST- 2022/10/07 06:00 [pubmed] PHST- 2022/10/12 06:00 [medline] AID - 00045415-202211000-00008 [pii] AID - 10.1097/CRD.0000000000000425 [doi] PST - ppublish SO - Cardiol Rev. 2022 Nov-Dec 01;30(6):318-323. doi: 10.1097/CRD.0000000000000425. Epub 2021 Oct 18. PMID- 36192198 OWN - NLM STAT- MEDLINE DCOM- 20221101 LR - 20221122 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 184 DP - 2022 Dec 1 TI - Feasibility of Sentinel Cerebral Embolic Protection Device Deployment During Transfemoral Transcatheter Aortic Valve Replacement. PG - 157-159 LID - S0002-9149(22)00961-4 [pii] LID - 10.1016/j.amjcard.2022.09.002 [doi] FAU - Isogai, Toshiaki AU - Isogai T AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Vanguru, Husitha Reddy AU - Vanguru HR AD - Cerebrovascular Center, Neurological Institute. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Agrawal, Ankit AU - Agrawal A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Spilias, Nikolaos AU - Spilias N AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Shekhar, Shashank AU - Shekhar S AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Saad, Anas M AU - Saad AM AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Verma, Beni Rai AU - Verma BR AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Reed, Grant W AU - Reed GW AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Popovic, Zoran B AU - Popovic ZB AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. FAU - Unai, Shinya AU - Unai S AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Yun, James J AU - Yun JJ AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Uchino, Ken AU - Uchino K AD - Cerebrovascular Center, Neurological Institute. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute. Electronic address: kapadis@ccf.org. LA - eng PT - Journal Article DEP - 20221001 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Feasibility Studies MH - *Embolic Protection Devices MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Aortic Valve/surgery MH - *Intracranial Embolism/etiology/prevention & control MH - Risk Factors MH - Prosthesis Design EDAT- 2022/10/04 06:00 MHDA- 2022/11/02 06:00 CRDT- 2022/10/03 22:03 PHST- 2022/08/03 00:00 [received] PHST- 2022/08/17 00:00 [revised] PHST- 2022/09/02 00:00 [accepted] PHST- 2022/10/04 06:00 [pubmed] PHST- 2022/11/02 06:00 [medline] PHST- 2022/10/03 22:03 [entrez] AID - S0002-9149(22)00961-4 [pii] AID - 10.1016/j.amjcard.2022.09.002 [doi] PST - ppublish SO - Am J Cardiol. 2022 Dec 1;184:157-159. doi: 10.1016/j.amjcard.2022.09.002. Epub 2022 Oct 1. PMID- 36184682 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221007 IS - 2363-9024 (Electronic) IS - 2363-9024 (Linking) VI - 8 IP - 1 DP - 2022 Oct 3 TI - Transcatheter aortic valve implantation under lower activated clotting time in a patient with hemorrhagic gastric cancer: a case report. PG - 77 LID - 10.1186/s40981-022-00566-9 [doi] LID - 77 AB - BACKGROUND: Perioperative management of transcatheter aortic valve implantation (TAVI) in patients with a high risk of bleeding requires careful consideration. CASE PRESENTATION: A 74-year-old man complained of chest pain and was admitted to our hospital. Close examination revealed severe aortic stenosis (AS) and hemorrhagic gastric cancer. Hemorrhage from gastric cancer was controlled using endoscopic hemostasis. While both gastric cancer and AS required surgery, we decided to perform transfemoral transcatheter aortic valve implantation (TAVI) under monitored anesthesia. To reduce bleeding from gastric cancer, we carefully adjusted the heparin dose to maintain the activated clotting time (ACT) between 180 and 200 s. TAVI with a balloon-expandable valve was completed without thrombotic complications. Laparoscopic distal gastrectomy was performed on the 6th day after TAVI. CONCLUSIONS: We report the successful management of TAVI in a patient with hemorrhagic gastric cancer. In TAVI for patients with hemorrhagic diseases, careful consideration of antithrombotic therapy is required. CI - (c) 2022. The Author(s). FAU - Mitsuta, Yuki AU - Mitsuta Y AD - Department of Anesthesiology, Kumamoto University Hospital, Kumamoto, 860-8556, Japan. FAU - Oyoshi, Takafumi AU - Oyoshi T AD - Department of Anesthesiology, Kumamoto University Hospital, Kumamoto, 860-8556, Japan. FAU - Nonaka, Takahiro AU - Nonaka T AD - Department of Anesthesiology, Kumamoto City Hospital, Kumamoto, Japan. FAU - Hirata, Naoyuki AU - Hirata N AUID- ORCID: 0000-0002-3776-8115 AD - Department of Anesthesiology, Kumamoto University Hospital, Kumamoto, 860-8556, Japan. naohirata@mac.com. LA - eng PT - Journal Article DEP - 20221003 PL - Germany TA - JA Clin Rep JT - JA clinical reports JID - 101682121 PMC - PMC9527264 OTO - NOTNLM OT - Activated clotting time OT - Aortic stenosis OT - Transcatheter aortic valve implantation COIS- The authors declare that they have no competing interests. EDAT- 2022/10/03 06:00 MHDA- 2022/10/03 06:01 PMCR- 2022/10/03 CRDT- 2022/10/02 23:20 PHST- 2022/08/08 00:00 [received] PHST- 2022/09/23 00:00 [accepted] PHST- 2022/09/22 00:00 [revised] PHST- 2022/10/02 23:20 [entrez] PHST- 2022/10/03 06:00 [pubmed] PHST- 2022/10/03 06:01 [medline] PHST- 2022/10/03 00:00 [pmc-release] AID - 10.1186/s40981-022-00566-9 [pii] AID - 566 [pii] AID - 10.1186/s40981-022-00566-9 [doi] PST - epublish SO - JA Clin Rep. 2022 Oct 3;8(1):77. doi: 10.1186/s40981-022-00566-9. PMID- 36184556 OWN - NLM STAT- MEDLINE DCOM- 20221028 LR - 20250121 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 86 IP - 11 DP - 2022 Oct 25 TI - Efficacy of a Protective Sheet for Reducing Ocular Radiation Exposure During Transcatheter Aortic Valve Implantation. PG - 1764-1768 LID - 10.1253/circj.CJ-22-0400 [doi] AB - BACKGROUND: The use of hybrid operating rooms (HOR) for transcatheter aortic valve implantation (TAVI) has increased, so radiation exposure during procedures that use X-ray fluoroscopy is a fundamental problem not only for patients but also for surgeons and interventional cardiologists, increasing the risk of cataracts among operators. We investigated the efficacy of leaded glasses and protective sheets for ocular radiation protection. METHODS AND RESULTS: Between January 2020 and February 2021 we enrolled 54 TAVI procedures using the transfemoral approach. The subjects were divided into a curtain protection group (Group C, n=20), glass protection group (Group G, n=17), and sheet protection group (Group S, n=17). The cumulative dose (CD) of the operators showed a decreasing trend in Group S compared with the other two groups. The CD normalized by dose area product (CD/DAP) of the operators was significantly reduced in Group S compared with Group C. However, Group G showed no significant difference compared with Group C. Regarding the distribution of CD/DAP, Group S had a significantly lower distribution than that in groups C and G. CONCLUSIONS: Protective sheets provide more stable radiation protection than conventional curtains or leaded glasses. FAU - Yokota, Junki AU - Yokota J AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. FAU - Kuratani, Toru AU - Kuratani T AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. FAU - Shimamura, Kazuo AU - Shimamura K AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. FAU - Maeda, Koichi AU - Maeda K AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. FAU - Kawamura, Ai AU - Kawamura A AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. FAU - Yamashita, Kizuku AU - Yamashita K AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. FAU - Mizote, Isamu AU - Mizote I AD - Department of Cardiology, Osaka University, Graduate School of Medicine. FAU - Nakamura, Daisuke AU - Nakamura D AD - Department of Cardiology, Osaka University, Graduate School of Medicine. FAU - Mukai, Takashi AU - Mukai T AD - Department of Cardiology, Osaka University, Graduate School of Medicine. FAU - Sakata, Yasushi AU - Sakata Y AD - Department of Cardiology, Osaka University, Graduate School of Medicine. FAU - Miyagawa, Shigeru AU - Miyagawa S AD - Department of Cardiovascular Surgery, Osaka University, Graduate School of Medicine. LA - eng PT - Journal Article DEP - 20220930 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Aortic Valve Stenosis/surgery MH - Radiation Dosage MH - Risk Factors MH - *Radiation Exposure/adverse effects/prevention & control MH - Fluoroscopy/adverse effects MH - Aortic Valve/surgery MH - Treatment Outcome OTO - NOTNLM OT - Eyes OT - Radiation exposure OT - Radiation protection OT - Transcatheter aortic valve implantation EDAT- 2022/10/03 06:00 MHDA- 2022/10/29 06:00 CRDT- 2022/10/02 22:20 PHST- 2022/10/03 06:00 [pubmed] PHST- 2022/10/29 06:00 [medline] PHST- 2022/10/02 22:20 [entrez] AID - 10.1253/circj.CJ-22-0400 [doi] PST - ppublish SO - Circ J. 2022 Oct 25;86(11):1764-1768. doi: 10.1253/circj.CJ-22-0400. Epub 2022 Sep 30. PMID- 36172929 OWN - NLM STAT- MEDLINE DCOM- 20221005 LR - 20221122 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 11 IP - 19 DP - 2022 Oct 4 TI - Sex-Specific Considerations in Degenerative Aortic Stenosis for Female-Tailored Transfemoral Aortic Valve Implantation Management. PG - e025944 LID - 10.1161/JAHA.121.025944 [doi] LID - e025944 AB - The impact of sex on pathophysiological processes, clinical presentation, treatment options, as well as outcomes of degenerative aortic stenosis remain poorly understood. Female patients are well represented in transfemoral aortic valve implantation (TAVI) trials and appear to derive favorable outcomes with TAVI. However, higher incidences of major bleeding, vascular complications, and stroke have been reported in women following TAVI. The anatomical characteristics and pathophysiological features of aortic stenosis in women might guide a tailored planning of the percutaneous approach. We highlight whether a sex-based TAVI management strategy might impact on clinical outcomes. This review aimed to evaluate the impact of sex from diagnosis to treatment of degenerative aortic stenosis, discussing the latest evidence on epidemiology, pathophysiology, clinical presentation, therapeutic options, and outcomes. Furthermore, we focused on technical sex-oriented considerations in TAVI including the preprocedural screening, device selection, implantation strategy, and postprocedural management. FAU - Masiero, Giulia AU - Masiero G AUID- ORCID: 0000-0003-4209-6824 AD - Department of Cardiac, Thoracic Vascular Science and Public Health, University of Padova Italy. FAU - Paradies, Valeria AU - Paradies V AD - Department of Cardiology Maasstad Hospital Rotterdam The Netherlands. FAU - Franzone, Anna AU - Franzone A AD - Department of Advanced Biomedical Sciences Federico II University of Naples Italy. FAU - Bellini, Barbara AU - Bellini B AD - Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute Milan Italy. FAU - De Biase, Chiara AU - De Biase C AD - Groupe CardioVasculaire Interventionnel Clinique Pasteur Toulouse France. FAU - Karam, Nicole AU - Karam N AUID- ORCID: 0000-0002-3861-6914 AD - Cardiology Department European Hospital Georges Pompidou Paris France. FAU - Sanguineti, Francesca AU - Sanguineti F AD - Institut Cardiovasculaire Paris Sud Hopital Prive Jacques CARTIER Massy France. FAU - Mamas, Mamas A AU - Mamas MA AUID- ORCID: 0000-0001-9241-8890 AD - Keele Cardiovascular Research Group School of Medicine, Keele University Stoke-on-Trent United Kingdom. AD - Department of Cardiology Royal Stoke University Hospital Stoke-on-Trent United Kingdom. AD - Department of Medicine Thomas Jefferson University Philadelphia PA. FAU - Eltchaninoff, Helene AU - Eltchaninoff H AD - Cardiology Department Rouen University Hospital Rouen France. FAU - Fraccaro, Chiara AU - Fraccaro C AUID- ORCID: 0000-0002-3972-4642 AD - Department of Cardiac, Thoracic Vascular Science and Public Health, University of Padova Italy. FAU - Castiglioni, Battistina AU - Castiglioni B AUID- ORCID: 0000-0003-4925-2877 AD - Cardiothoracovascular Department Ospedale di Circolo, ASST Sette Laghi Varese Italy. FAU - Attisano, Tiziana AU - Attisano T AD - Division of Interventional Cardiology Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi Salerno Italy. FAU - Esposito, Giovanni AU - Esposito G AUID- ORCID: 0000-0003-0565-7127 AD - Department of Advanced Biomedical Sciences Federico II University of Naples Italy. FAU - Chieffo, Alaide AU - Chieffo A AUID- ORCID: 0000-0002-3505-9112 AD - Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute Milan Italy. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20220929 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - Female MH - *Heart Valve Prosthesis Implantation MH - Humans MH - Male MH - *Stroke MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome PMC - PMC9673730 OTO - NOTNLM OT - aortic stenosis OT - clinical management OT - device selection OT - sex differences OT - transcatheter aortic valve implantation EDAT- 2022/09/30 06:00 MHDA- 2022/10/06 06:00 PMCR- 2022/10/04 CRDT- 2022/09/29 05:42 PHST- 2022/09/30 06:00 [pubmed] PHST- 2022/10/06 06:00 [medline] PHST- 2022/09/29 05:42 [entrez] PHST- 2022/10/04 00:00 [pmc-release] AID - JAH37758 [pii] AID - 10.1161/JAHA.121.025944 [doi] PST - ppublish SO - J Am Heart Assoc. 2022 Oct 4;11(19):e025944. doi: 10.1161/JAHA.121.025944. Epub 2022 Sep 29. PMID- 36148255 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220924 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 4 IP - 9 DP - 2022 Sep TI - Risk Factors for Hospital Readmission Post-Transcatheter Aortic Valve Implantation in the Contemporary Era: A Systematic Review. PG - 792-801 LID - 10.1016/j.cjco.2022.05.007 [doi] AB - BACKGROUND: Despite transcatheter aortic valve implantation (TAVI) becoming a widely accepted therapeutic option for the management of aortic stenosis, post-procedure readmission rates remain high. Rehospitalization is associated with negative patient outcomes, as well as increased healthcare costs, and has therefore been identified as an important target for quality improvement. Strategies to reduce the post-TAVI readmission rate are needed but require the identification of patients at high risk for rehospitalization. Our systematic review aims to identify predictors of post-procedure readmission in patients eligible for TAVI. METHODS: We conducted a comprehensive search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for the time period from 2015 to the present for articles evaluating risk factors for rehospitalization post-TAVI with a follow-up period of at least 30 days in adults age >/= 70 years with aortic stenosis. The quality of included studies was evaluated using the Newcastle-Ottawa Scale. We present the results as a qualitative narrative review. RESULTS: We identified 49 studies involving 828,528 patients. Post-TAVI readmission is frequent, and rates vary (14.9% to 54.3% at 1 year). The most-frequent predictors identified for both 30-day and 1-year post-TAVI readmission are atrial fibrillation, lung disease, renal disease, diabetes mellitus, in-hospital life-threatening bleeding, and non-femoral access. CONCLUSIONS: This systematic review identifies the most-common predictors for 30-day and 1-year readmission post-TAVI, including comorbidities and potentially modifiable procedural approaches and complications. These predictors can be used to identify patients at high-risk for readmission who are most likely to benefit from increased support and follow-up post-TAVI. CI - (c) 2022 The Authors. FAU - Patel, Raumil V AU - Patel RV AD - Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. AD - Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. FAU - Ravindran, Mithunan AU - Ravindran M AD - Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. FAU - Manoragavan, Ragavie AU - Manoragavan R AD - Division of Cardiology, Department of Medicine, Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. FAU - Sriharan, Abi AU - Sriharan A AD - Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. FAU - Wijeysundera, Harindra C AU - Wijeysundera HC AD - Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. AD - Division of Cardiology, Department of Medicine, Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. AD - Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada. AD - Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. LA - eng PT - Journal Article PT - Review DEP - 20220606 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC9486870 EDAT- 2022/09/24 06:00 MHDA- 2022/09/24 06:01 PMCR- 2022/06/06 CRDT- 2022/09/23 02:56 PHST- 2021/11/14 00:00 [received] PHST- 2022/05/31 00:00 [accepted] PHST- 2022/09/23 02:56 [entrez] PHST- 2022/09/24 06:00 [pubmed] PHST- 2022/09/24 06:01 [medline] PHST- 2022/06/06 00:00 [pmc-release] AID - S2589-790X(22)00105-6 [pii] AID - 10.1016/j.cjco.2022.05.007 [doi] PST - epublish SO - CJC Open. 2022 Jun 6;4(9):792-801. doi: 10.1016/j.cjco.2022.05.007. eCollection 2022 Sep. PMID- 36126131 OWN - NLM STAT- MEDLINE DCOM- 20220923 LR - 20221013 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 15 IP - 9 DP - 2022 Sep TI - Association Between Peripheral Versus Central Access for Alternative Access Transcatheter Aortic Valve Replacement and Mortality and Stroke: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. PG - e011756 LID - 10.1161/CIRCINTERVENTIONS.121.011756 [doi] AB - BACKGROUND: In some patients, the alternative access route for transcatheter aortic valve replacement (TAVR) is utilized because the conventional transfemoral approach is not felt to be either feasible or optimal. However, accurate prognostication of patient risks is not well established. This study examines the associations between peripheral (transsubclavian/transaxillary, and transcarotid) versus central access (transapical and transaortic) in alternative access TAVR and 30-day and 1-year end points of mortality and stroke for all valve platforms. METHODS: Using data from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry with linkage to Medicare claims, patients who underwent alternative access TAVR from June 1, 2015 to June 30, 2018 were identified. Adjusted and unadjusted Cox proportional hazards modeling were performed to determine the association between alternate access TAVR site and 30-day and 1-year end points of mortality and stroke. RESULTS: Of 7187 alternative access TAVR patients, 3725 (52%) had peripheral access and 3462 (48%) had central access. All-cause mortality was significantly lower in peripheral access versus central access group at in-hospital and 1 year (2.9% versus 6.3% and 20.3% versus 26.6%, respectively), but stroke rates were higher (5.0% versus 2.8% and 7.3% versus 5.5%, respectively; all P<0.001). These results persisted after 1-year adjustment (death adjusted hazard ratio, 0.72 [95% CI, 0.62-0.85] and stroke adjusted hazard ratio, 2.92 [95% CI, 2.21-3.85]). When broken down by individual subtypes, compared with transaxillary/subclavian access patients, transapical, and transaortic access patients had higher all-cause mortality but less stroke (P<0.05). CONCLUSIONS: In this real-world, contemporary, nationally representative benchmarking study of alternate access TAVR sites, peripheral access was associated with favorable mortality and morbidity outcomes compared with central access, at the expense of higher stroke. These findings may allow for accurate prognostication of risk for patient counseling and decision-making for the heart team with regard to alternative access TAVR. FAU - Kaneko, Tsuyoshi AU - Kaneko T AUID- ORCID: 0000-0001-6500-7471 AD - Division of Thoracic and Cardiac Surgery (T.K., S.H., F.Y.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - Hirji, Sameer A AU - Hirji SA AD - Division of Thoracic and Cardiac Surgery (T.K., S.H., F.Y.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - Yazdchi, Farhang AU - Yazdchi F AD - Division of Thoracic and Cardiac Surgery (T.K., S.H., F.Y.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - Sun, Yee-Ping AU - Sun YP AUID- ORCID: 0000-0003-1320-1875 AD - Division of Cardiovascular Medicine (Y.P.S., P.S., P.O.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - Nyman, Charles AU - Nyman C AD - Division of Cardiac Anesthesia (C.N., D.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - Shook, Douglas AU - Shook D AD - Division of Cardiac Anesthesia (C.N., D.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - Cohen, David J AU - Cohen DJ AUID- ORCID: 0000-0001-9163-724X AD - Cardiovascular Research Foundation, New York, NY (D.J.C.). AD - Duke Clinical Research Institute, Durham, NC (D.J.C.). FAU - Stebbins, Amanda AU - Stebbins A AUID- ORCID: 0000-0002-0808-9025 FAU - Zeitouni, Michel AU - Zeitouni M AUID- ORCID: 0000-0001-9562-3128 FAU - Vemulapalli, Sreekanth AU - Vemulapalli S AUID- ORCID: 0000-0003-1599-2957 FAU - Thourani, Vinod H AU - Thourani VH AD - Piedmont Heart Institute, Atlanta, GA (V.H.T.). FAU - Shah, Pinak B AU - Shah PB AUID- ORCID: 0000-0002-1642-7557 AD - Division of Cardiovascular Medicine (Y.P.S., P.S., P.O.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. FAU - O'Gara, Patrick AU - O'Gara P AUID- ORCID: 0000-0003-0601-1088 AD - Division of Cardiovascular Medicine (Y.P.S., P.S., P.O.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA. LA - eng PT - Journal Article DEP - 20220920 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Aged MH - *Aortic Valve Stenosis MH - *Cardiology MH - Humans MH - Medicare MH - Registries MH - *Stroke/etiology MH - *Surgeons MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - United States OTO - NOTNLM OT - Medicare OT - counseling OT - hospitals OT - morbidity OT - transcatheter aortic valve replacement EDAT- 2022/09/21 06:00 MHDA- 2022/09/24 06:00 CRDT- 2022/09/20 14:04 PHST- 2022/09/20 14:04 [entrez] PHST- 2022/09/21 06:00 [pubmed] PHST- 2022/09/24 06:00 [medline] AID - 10.1161/CIRCINTERVENTIONS.121.011756 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2022 Sep;15(9):e011756. doi: 10.1161/CIRCINTERVENTIONS.121.011756. Epub 2022 Sep 20. PMID- 36121924 OWN - NLM STAT- MEDLINE DCOM- 20221010 LR - 20250617 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 34 IP - 10 DP - 2022 Oct TI - Transcatheter Aortic Valve Replacement Through a Single Femoral Access: A Multicenter Experience. PG - E739-E742 LID - JIC20220916-1 [pii] AB - OBJECTIVES: During the past few years, physicians have optimized transcatheter aortic valve replacement and its periprocedural management, with the minimalist approach becoming popular. We aimed to further simplify the procedure using a single femoral access (the "all-in-one" technique). Here, we report a multicenter experience with TAVR with Acurate neo/neo2 transcatheter heart valves (Boston Scientific) through a single, large-bore, femoral sheath. METHODS: Patients underwent TAVR with the Acurate neo or neo2 through a single femoral access at 4 centers. The large sheath was used for both the delivery catheter and the pigtail used to visualize the aortic root. RESULTS: A total of 157 patients (59% women) with a mean age of 82 +/- 6 years underwent TAVR with the Acurate neo (n = 100) or the Acurate neo2 (n = 57). The procedure was successfully performed through a single large sheath in all patients. Median duration of hospitalization stay was 2 days (interquartile range, 1-3 days). On echocardiography before discharge, the mean gradient was 7 +/- 3 mm Hg and 7 patients (4.4%) had more than mild paravalvular leak. At 30 days, a major vascular complication had occurred in 2 patients (1.3%), 2 patients (1.3%) had suffered a stroke, and only 4 patients (2.5%) had required new permanent pacemaker implantation. A total of 3 patients (1.9%) had died. CONCLUSIONS: An all-in-one access technique allows safe implantation of Acurate neo and neo2 transcatheter heart valves, with low rates of periprocedural complications and favorable short-term outcomes. FAU - Toggweiler, Stefan AU - Toggweiler S FAU - Bagur, Rodrigo AU - Bagur R FAU - Agatiello, Carla Romina AU - Agatiello CR FAU - Giuliani, Carlos AU - Giuliani C FAU - Moccetti, Federico AU - Moccetti F FAU - Diamantouros, Pantelis AU - Diamantouros P FAU - Medina de Chazal, Horacio AU - Medina de Chazal H FAU - Seropian, Ignacio Miguel AU - Seropian IM FAU - Wolfrum, Mathias AU - Wolfrum M FAU - Sztejfman, Matias AU - Sztejfman M AD - Department of Cardiology, Sanatorio Guemes, Buenos Aires, Argentina. sztejfman@gmail.com. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20220916 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnosis/etiology/surgery MH - Female MH - *Heart Valve Prosthesis MH - Humans MH - Male MH - Prosthesis Design MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - aortic stenosis OT - complications OT - simplification OT - vascular EDAT- 2022/09/20 06:00 MHDA- 2022/10/12 06:00 CRDT- 2022/09/19 14:13 PHST- 2022/09/20 06:00 [pubmed] PHST- 2022/10/12 06:00 [medline] PHST- 2022/09/19 14:13 [entrez] AID - JIC20220916-1 [pii] AID - 10.25270/jic/22.00113 [doi] PST - ppublish SO - J Invasive Cardiol. 2022 Oct;34(10):E739-E742. doi: 10.25270/jic/22.00113. Epub 2022 Sep 16. PMID- 36121245 OWN - NLM STAT- MEDLINE DCOM- 20221215 LR - 20260127 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 15 IP - 23 DP - 2022 Dec 12 TI - Facilitated Transcaval Access by Shockwave Lithoplasty and Conscious Sedation for Transcatheter Aortic Valve Replacement. PG - e241-e244 LID - S1936-8798(22)01753-8 [pii] LID - 10.1016/j.jcin.2022.09.012 [doi] FAU - Baz Alonso, Jose Antonio AU - Baz Alonso JA AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain. Electronic address: https://twitter.com/jabazal. FAU - Jimenez-Diaz, Victor Alfonso AU - Jimenez-Diaz VA AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain. Electronic address: sooner_79@hotmail.com. FAU - Dominguez-Erquicia, Pablo AU - Dominguez-Erquicia P AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain. FAU - Puga, Luis AU - Puga L AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain. Electronic address: https://twitter.com/luispuga.cardio. FAU - Barreiro-Perez, Manuel AU - Barreiro-Perez M AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain. Electronic address: https://twitter.com/manuelbarreirop. FAU - Iniguez-Romo, Andres AU - Iniguez-Romo A AD - Cardiology Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group, Galicia Sur Health Research Institute (IISGS), Vigo, Spain. Electronic address: https://twitter.com/AndresIniguezR. LA - eng PT - Journal Article DEP - 20220916 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - Procedural Sedation OTO - NOTNLM OT - TAVR OT - conscious sedation OT - peripheral vascular disease OT - shockwave lithoplasty OT - transcatheter valve implantation/replacement OT - transcaval COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2022/09/20 06:00 MHDA- 2022/12/15 06:00 CRDT- 2022/09/19 09:04 PHST- 2022/08/28 00:00 [received] PHST- 2022/09/06 00:00 [revised] PHST- 2022/09/07 00:00 [accepted] PHST- 2022/09/20 06:00 [pubmed] PHST- 2022/12/15 06:00 [medline] PHST- 2022/09/19 09:04 [entrez] AID - S1936-8798(22)01753-8 [pii] AID - 10.1016/j.jcin.2022.09.012 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2022 Dec 12;15(23):e241-e244. doi: 10.1016/j.jcin.2022.09.012. Epub 2022 Sep 16. PMID- 36121242 OWN - NLM STAT- MEDLINE DCOM- 20221223 LR - 20230109 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 15 IP - 23 DP - 2022 Dec 12 TI - Transcatheter Aortic Valve Replacement With the Latest-Iteration Self-Expanding or Balloon-Expandable Valves: The Multicenter OPERA-TAVI Registry. PG - 2398-2407 LID - S1936-8798(22)01710-1 [pii] LID - 10.1016/j.jcin.2022.08.057 [doi] AB - BACKGROUND: The latest iterations of devices for transcatheter aortic valve replacement (TAVR) have brought refinements to further improve patient outcomes. OBJECTIVES: This study sought to compare early outcomes of patients undergoing TAVR with the self-expanding (SE) Evolut PRO/PRO+ (Medtronic, Inc) or balloon-expandable (BE) Sapien 3 ULTRA (Edwards Lifesciences) devices. METHODS: The OPERA-TAVI (Comparative Analysis of Evolut PRO vs Sapien 3 Ultra Valves for Transfemoral Transcatheter Aortic Valve Implantation) registry collected data from 14 high-volume centers worldwide on patients undergoing TAVR with SE or BE devices. After excluding patients who were not eligible for both devices, patients were compared using 1:1 propensity score matching. The primary efficacy and safety outcomes were Valve Academic Research Consortium-3 device success and early safety, respectively. RESULTS: Among 2,241 patients eligible for the present analysis, 683 pairs of patients were matched. The primary efficacy outcome did not differ between patients receiving SE or BE transcatheter aortic valves (SE: 87.4% vs BE: 85.9%; P = 0.47), but the BE device recipients showed a higher rate of the primary safety outcome (SE: 69.1% vs BE: 82.6%; P < 0.01). This finding was driven by the higher rates of permanent pacemaker implantation (SE: 17.9% vs BE: 10.1%; P < 0.01) and disabling stroke (SE: 2.3% vs BE: 0.7%; P = 0.03) in SE device recipients. On post-TAVR echocardiography, the rate of moderate to severe paravalvular regurgitation was similar between groups (SE: 3.2% vs BE: 2.3%; P = 0.41), whereas lower mean transvalvular gradients were observed in the SE cohort (median SE: 7.0 vs BE: 12.0 mm Hg; P < 0.01). CONCLUSIONS: The OPERA-TAVI registry showed that SE and BE devices had comparable Valve Academic Research Consortium-3 device success rates, but the BE device had a higher rate of early safety. The higher permanent pacemaker implantation and disabling stroke rates in SE device recipients drove this composite endpoint. CI - Copyright (c) 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Costa, Giuliano AU - Costa G AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Saia, Francesco AU - Saia F AD - Cardiovascular Department, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Garot, Philippe AU - Garot P AD - Institut Cardiovasculaire Paris Sud, Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Valvo, Roberto AU - Valvo R AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Gandolfo, Caterina AU - Gandolfo C AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy. FAU - Branca, Luca AU - Branca L AD - Spedali Civili, Brescia, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Santos, Ignacio Amat AU - Santos IA AD - Division of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, University Hospital, National University of Ireland Galway, Ireland. FAU - De Marco, Federico AU - De Marco F AD - Interventional Cardiology Department, Istituto di Ricovero e Cura a Carattere Scientifico Centro Cardiologico Monzino, Milan, Italy. FAU - De Backer, Ole AU - De Backer O AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Franco, Luis Nombela AU - Franco LN AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Akodad, Mariama AU - Akodad M AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Mazzapicchi, Alessandro AU - Mazzapicchi A AD - Cardiovascular Department, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Tomii, Daijiro AU - Tomii D AD - Bern University Hospital, Inselspital, Bern, Switzerland. FAU - Laforgia, Pietro AU - Laforgia P AD - Institut Cardiovasculaire Paris Sud, Hopital Jacques Cartier, Ramsay-Sante, Massy, France. FAU - Cannata, Stefano AU - Cannata S AD - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy. FAU - Fiorina, Claudia AU - Fiorina C AD - Spedali Civili, Brescia, Italy. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. FAU - Lunardi, Mattia AU - Lunardi M AD - Department of Cardiology, University Hospital, National University of Ireland Galway, Ireland. FAU - Poletti, Enrico AU - Poletti E AD - Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Italy. FAU - Mazzucca, Mattia AU - Mazzucca M AD - Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Italy. FAU - Quagliana, Angelo AU - Quagliana A AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Hennessey, Breda AU - Hennessey B AD - Hospital Clinico San Carlo, Madrid, Spain. FAU - Meier, David AU - Meier D AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Adamo, Marianna AU - Adamo M AD - Spedali Civili, Brescia, Italy. FAU - Sgroi, Carmelo AU - Sgroi C AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Reddavid, Claudia Maria AU - Reddavid CM AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Strazzieri, Orazio AU - Strazzieri O AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Motta, Silvia Crescenzia AU - Motta SC AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Frittitta, Valentina AU - Frittitta V AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Dipietro, Elena AU - Dipietro E AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Comis, Alessandro AU - Comis A AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Melfa, Chiara AU - Melfa C AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig, University of Leipzig, Leipzig, Germany. FAU - Webb, John G AU - Webb JG AD - Centre for Heart Valve Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Tamburino, Corrado AU - Tamburino C AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. FAU - Barbanti, Marco AU - Barbanti M AD - Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy. Electronic address: mbarbanti83@gmail.com. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20220916 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2022 Dec 12;15(23):2408-2411. doi: 10.1016/j.jcin.2022.09.014. PMID: 36121243 MH - Humans MH - *Heart Valve Prosthesis MH - *Stroke/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - Valve Academic Research Consortium-3 OT - balloon expandable OT - comparison OT - outcomes OT - self-expanding COIS- Funding Support and Author Disclosures Dr Pilgrim has received research grants to the institution from Biotronik, Boston Scientific, and Edwards Lifesciences; and has received speaker/consultancy fees from Medtronic, Boston Scientific, Biotronik, and HighLifeSAS. Dr Abdel-Wahab's institution has received speaker honoraria and/or consultancy fees on his behalf from Boston Scientific and Medtronic. Dr Garot has served as medical director and being a shareholder of CERC, a CRO dedicated to cardiovascular diseases; and has received speaker/consultancy fees from Abbott, Biosensors, Boston Scientific, Edwards Lifesciences, and General Electric HealthCare. Dr Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, and Abbott. Dr Mylotte is a consultant for Medtronic, Boston Scientific, and Microport. Dr De Backer has received institutional research grants and/or consulting fees from Abbott and Boston Scientific. Dr Akodad has received research funding from Medtronic, Biotronik, MUSE-Explore, Villa M, and Federation Francaise de Cardiologie. Dr Meier is supported by the Swiss National Science Foundation (grant P2LAP3_199561). Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic, and SMT. Dr Tamburino is consultant for Medtronic. Dr Barbanti is a consultant for Boston Scientific, Edwards Lifesciences, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2022/09/20 06:00 MHDA- 2022/12/15 06:00 CRDT- 2022/09/19 09:04 PHST- 2022/07/06 00:00 [received] PHST- 2022/08/25 00:00 [revised] PHST- 2022/08/30 00:00 [accepted] PHST- 2022/09/20 06:00 [pubmed] PHST- 2022/12/15 06:00 [medline] PHST- 2022/09/19 09:04 [entrez] AID - S1936-8798(22)01710-1 [pii] AID - 10.1016/j.jcin.2022.08.057 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2022 Dec 12;15(23):2398-2407. doi: 10.1016/j.jcin.2022.08.057. Epub 2022 Sep 16. PMID- 36121045 OWN - NLM STAT- MEDLINE DCOM- 20221007 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 387 IP - 14 DP - 2022 Oct 6 TI - Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement. PG - 1253-1263 LID - 10.1056/NEJMoa2204961 [doi] AB - BACKGROUND: Transcatheter aortic-valve replacement (TAVR) for the treatment of aortic stenosis can lead to embolization of debris. Capture of debris by devices that provide cerebral embolic protection (CEP) may reduce the risk of stroke. METHODS: We randomly assigned patients with aortic stenosis in a 1:1 ratio to undergo transfemoral TAVR with CEP (CEP group) or without CEP (control group). The primary end point was stroke within 72 hours after TAVR or before discharge (whichever came first) in the intention-to-treat population. Disabling stroke, death, transient ischemic attack, delirium, major or minor vascular complications at the CEP access site, and acute kidney injury were also assessed. A neurology professional examined all the patients at baseline and after TAVR. RESULTS: A total of 3000 patients across North America, Europe, and Australia underwent randomization; 1501 were assigned to the CEP group and 1499 to the control group. A CEP device was successfully deployed in 1406 of the 1489 patients (94.4%) in whom an attempt was made. The incidence of stroke within 72 hours after TAVR or before discharge did not differ significantly between the CEP group and the control group (2.3% vs. 2.9%; difference, -0.6 percentage points; 95% confidence interval, -1.7 to 0.5; P = 0.30). Disabling stroke occurred in 0.5% of the patients in the CEP group and in 1.3% of those in the control group. There were no substantial differences between the CEP group and the control group in the percentage of patients who died (0.5% vs. 0.3%); had a stroke, a transient ischemic attack, or delirium (3.1% vs. 3.7%); or had acute kidney injury (0.5% vs. 0.5%). One patient (0.1%) had a vascular complication at the CEP access site. CONCLUSIONS: Among patients with aortic stenosis undergoing transfemoral TAVR, the use of CEP did not have a significant effect on the incidence of periprocedural stroke, but on the basis of the 95% confidence interval around this outcome, the results may not rule out a benefit of CEP during TAVR. (Funded by Boston Scientific; PROTECTED TAVR ClinicalTrials.gov number, NCT04149535.). CI - Copyright (c) 2022 Massachusetts Medical Society. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Makkar, Raj AU - Makkar R AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Leon, Martin AU - Leon M AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Abdel-Wahab, Mohamed AU - Abdel-Wahab M AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Waggoner, Thomas AU - Waggoner T AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Massberg, Steffen AU - Massberg S AUID- ORCID: 0000-0001-7387-3986 AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Rottbauer, Wolfgang AU - Rottbauer W AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Horr, Samuel AU - Horr S AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Sondergaard, Lars AU - Sondergaard L AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Karha, Juhana AU - Karha J AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Gooley, Robert AU - Gooley R AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Satler, Lowell AU - Satler L AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Stoler, Robert C AU - Stoler RC AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Messe, Steven R AU - Messe SR AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Baron, Suzanne J AU - Baron SJ AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Seeger, Julia AU - Seeger J AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Kodali, Susheel AU - Kodali S AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Thourani, Vinod H AU - Thourani VH AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Harrington, Katherine AU - Harrington K AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Pocock, Stuart AU - Pocock S AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Modolo, Rodrigo AU - Modolo R AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Allocco, Dominic J AU - Allocco DJ AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Meredith, Ian T AU - Meredith IT AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). FAU - Linke, Axel AU - Linke A AD - From the Department of Cardiovascular Medicine (S.R.K.), Cleveland Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles (R. Makkar); Columbia Interventional Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.), Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and German Center for Cardiovascular Research (DZHK), Munich Heart Alliance, Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden (A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville (S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L. Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre, Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC (L. Satler); the Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington (S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) - both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the London School of Hygiene and Tropical Medicine, London (S.P.). CN - PROTECTED TAVR Investigators LA - eng SI - ClinicalTrials.gov/NCT04149535 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220917 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2022 Oct 6;387(14):1318-1319. doi: 10.1056/NEJMe2210185. PMID: 36121036 CIN - Catheter Cardiovasc Interv. 2022 Nov;100(5):821-822. doi: 10.1002/ccd.30452. PMID: 36378721 CIN - N Engl J Med. 2023 Feb 16;388(7):667. doi: 10.1056/NEJMc2215783. PMID: 36791172 CIN - N Engl J Med. 2023 Feb 16;388(7):667-668. doi: 10.1056/NEJMc2215783. PMID: 36791173 CIN - N Engl J Med. 2023 Feb 16;388(7):668. doi: 10.1056/NEJMc2215783. PMID: 36791174 CIN - N Engl J Med. 2023 Feb 16;388(7):668-669. doi: 10.1056/NEJMc2215783. PMID: 36791175 CIN - N Engl J Med. 2023 Feb 16;388(7):669. doi: 10.1056/NEJMc2215783. PMID: 36791176 MH - Acute Kidney Injury/etiology MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Delirium/etiology MH - *Embolic Protection Devices MH - Humans MH - *Intracranial Embolism/etiology/prevention & control MH - Ischemic Attack, Transient/etiology MH - *Prosthesis Implantation/instrumentation MH - Risk Factors MH - *Stroke/etiology/prevention & control MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome FIR - Makkar, Raj IR - Makkar R FIR - Alsabaawi, Khaled IR - Alsabaawi K FIR - Arakelyan, Artur IR - Arakelyan A FIR - Golwala, Keyur IR - Golwala K FIR - Jones, Kristyan IR - Jones K FIR - Harutyunyan, Izabela IR - Harutyunyan I FIR - Friedman, Michelle IR - Friedman M FIR - Robinson, Anna IR - Robinson A FIR - Eskenazi, Jonathan IR - Eskenazi J FIR - Altman, Karen IR - Altman K FIR - Chakravarty, Tarun IR - Chakravarty T FIR - Tiwana, Ripandeep IR - Tiwana R FIR - Salseth, Tracy IR - Salseth T FIR - Mody, Cyrus IR - Mody C FIR - Patel, Jigarkumar IR - Patel J FIR - Gheorghiu, Mitch IR - Gheorghiu M FIR - Cheng, Wen IR - Cheng W FIR - Nakamura, Mamoo IR - Nakamura M FIR - Wise, Quentin IR - Wise Q FIR - Mainea, Gabriella IR - Mainea G FIR - Abdel-Wahab, Mohamed IR - Abdel-Wahab M FIR - Rosch, Sebastian IR - Rosch S FIR - Koehler, Wolfgang IR - Koehler W FIR - Thiele, Holger IR - Thiele H FIR - Desch, Steffen IR - Desch S FIR - Wilde, Johannes IR - Wilde J FIR - Holzhey, David IR - Holzhey D FIR - Sandri, Marcus IR - Sandri M FIR - Kiefer, Philipp IR - Kiefer P FIR - Mueller, Annekatrin IR - Mueller A FIR - Leontyev, Sergey IR - Leontyev S FIR - Stockert, Anika IR - Stockert A FIR - Majunke, Nicolas IR - Majunke N FIR - Kirchhof, Eva IR - Kirchhof E FIR - Haidari, Salim IR - Haidari S FIR - Obradovic, Danilo IR - Obradovic D FIR - Krebs, Julia IR - Krebs J FIR - von Hofen-Hohloch, Judith IR - von Hofen-Hohloch J FIR - Fahr, Florian IR - Fahr F FIR - Lehmann, Sven IR - Lehmann S FIR - Noack, Thilo IR - Noack T FIR - Ottlinger, Jennifer IR - Ottlinger J FIR - Fricke, Christopher IR - Fricke C FIR - Hoelig, Silke IR - Hoelig S FIR - Kowalewski, Christopher IR - Kowalewski C FIR - Rotta Detto Loria, Johannes IR - Rotta Detto Loria J FIR - Raehder, Sandra IR - Raehder S FIR - Waggoner, Thomas IR - Waggoner T FIR - Thomas, William IR - Thomas W FIR - O'Brien, Stephanie IR - O'Brien S FIR - Strout, Mikayla IR - Strout M FIR - Sim, Yeeck IR - Sim Y FIR - Ehsan, Ariana IR - Ehsan A FIR - Tripathi, Siddhant IR - Tripathi S FIR - Marsh, Mary IR - Marsh M FIR - Castro, Samantha IR - Castro S FIR - Hwang, Soy Yeon IR - Hwang SY FIR - Soto, Edgardo IR - Soto E FIR - Koleilat, Shadi IR - Koleilat S FIR - Teeple, David IR - Teeple D FIR - Gheewala, Neil IR - Gheewala N FIR - Elias Calles, Natalia IR - Elias Calles N FIR - Massberg, Steffen IR - Massberg S FIR - Kaab, Stefan IR - Kaab S FIR - Loesch-Biffar, Anna IR - Loesch-Biffar A FIR - Dimitriadis, Konstantinos IR - Dimitriadis K FIR - Braun, Daniel IR - Braun D FIR - Theiss, Hans IR - Theiss H FIR - Burianek, Franziska IR - Burianek F FIR - Orban, Martin IR - Orban M FIR - Schulz, Martina IR - Schulz M FIR - Weckbach, Ludwig IR - Weckbach L FIR - Vogt, Janine IR - Vogt J FIR - Blum, Bernhard IR - Blum B FIR - Fischer, Julius IR - Fischer J FIR - Steffen, Julius IR - Steffen J FIR - Hohenleitner, Karin IR - Hohenleitner K FIR - Markov, Eva IR - Markov E FIR - Roden, Daniel IR - Roden D FIR - Mourouzis, Konstantinos IR - Mourouzis K FIR - Schmidbauer, Moritz IR - Schmidbauer M FIR - Raschidi, Zerkah IR - Raschidi Z FIR - Zadrozny, Magda IR - Zadrozny M FIR - Rottbauer, Wolfgang IR - Rottbauer W FIR - Birkemeyer, Ralf IR - Birkemeyer R FIR - Althaus, Katharina IR - Althaus K FIR - Karabulut, Serife IR - Karabulut S FIR - Liewald, Christian IR - Liewald C FIR - Gorki, Hagen IR - Gorki H FIR - Haberkorn, Barbara IR - Haberkorn B FIR - Reichart, Christine IR - Reichart C FIR - Otto, Markus IR - Otto M FIR - Buckert, Dominik IR - Buckert D FIR - Schajti-Gouda, Julia IR - Schajti-Gouda J FIR - Moerike, Johannes IR - Moerike J FIR - Smirnova, Olga IR - Smirnova O FIR - Gonska, Birgid IR - Gonska B FIR - Buck, Christoph IR - Buck C FIR - Horr, Samuel IR - Horr S FIR - Jarquin-Valdivia, Adrian IR - Jarquin-Valdivia A FIR - Leibell, Corey-Jeanne IR - Leibell CJ FIR - Patrylo, Morgan IR - Patrylo M FIR - Harper, Molly IR - Harper M FIR - Riddick, John IR - Riddick J FIR - Quillen, Drew IR - Quillen D FIR - Braker, Charita IR - Braker C FIR - Goodman, Andrew IR - Goodman A FIR - Hank, Hallie IR - Hank H FIR - Merkelz, Brenda IR - Merkelz B FIR - Shamsuddin, Abdullah IR - Shamsuddin A FIR - Sondergaard, Lars IR - Sondergaard L FIR - Skovgaard, Emilie IR - Skovgaard E FIR - De Backer, Ole IR - De Backer O FIR - Hansen, Klaus IR - Hansen K FIR - Hojgaard, Joan IR - Hojgaard J FIR - Bieliauskas, Gintautas IR - Bieliauskas G FIR - Elleby, Jeanett IR - Elleby J FIR - Laugesen, Cathrine IR - Laugesen C FIR - Jensen, Line IR - Jensen L FIR - 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Nicholas K FIR - Blakley, Karen IR - Blakley K FIR - Castaneda, Paige IR - Castaneda P FIR - Daniels, Amanda IR - Daniels A FIR - Li, Gloria IR - Li G FIR - Carpenter, Amanda IR - Carpenter A FIR - Moscona, John IR - Moscona J FIR - Jurek, Kristine IR - Jurek K FIR - Abraham, Renila IR - Abraham R FIR - Zidar, Francis IR - Zidar F FIR - Stewart, Kelly IR - Stewart K FIR - Gooley, Robert IR - Gooley R FIR - Mendoza, Aljan IR - Mendoza A FIR - Daniele, Loredana IR - Daniele L FIR - George, Anu IR - George A FIR - Perju-Dumbrava, Laura IR - Perju-Dumbrava L FIR - Tran, Anne IR - Tran A FIR - Nguyen, Kristy IR - Nguyen K FIR - Ramzy, John IR - Ramzy J FIR - Dowling, Cameron IR - Dowling C FIR - Rashid, Hashrul IR - Rashid H FIR - McCormick, Liam IR - McCormick L FIR - Lockwood, Siobhan IR - Lockwood S FIR - Akbari, Sam IR - Akbari S FIR - Austin, MaryAnne IR - Austin M FIR - Baldi, Mauro IR - Baldi M FIR - D'Mello, Andre IR - D'Mello A FIR - Vuong, Jason IR - Vuong J FIR - Pol, Derk IR - Pol D FIR - Nelson, Adam IR - Nelson A FIR - Satler, Lowell IR - Satler L FIR - Sterba, Samantha IR - Sterba S FIR - Collins, Erin IR - Collins E FIR - Baten, Ahmareen IR - Baten A FIR - Benn, Hadiya IR - Benn H FIR - Jackman, Caroline IR - Jackman C FIR - Laureno, Robert IR - Laureno R FIR - Waksman, Ron IR - Waksman R FIR - Griffin, Sandra IR - Griffin S FIR - Deville, Michelle IR - Deville M FIR - Lin, Mark IR - Lin M FIR - Whitman, Donna IR - Whitman D FIR - Ben-Dor, Itsik IR - Ben-Dor I FIR - Choi, Joseph IR - Choi J FIR - Rogers, Toby IR - Rogers T FIR - Malla, Prerna IR - Malla P FIR - Shaikh, Naima IR - Shaikh N FIR - Stoler, Robert IR - Stoler R FIR - Willcott, Leslie IR - Willcott L FIR - Mendez, Angela IR - Mendez A FIR - Olsin, Ashley IR - Olsin A FIR - Horton, Miles IR - Horton M FIR - Schafer, Paige IR - Schafer P FIR - Waters, Kim IR - Waters K FIR - Rafael-Yarihuaman, Aldo IR - Rafael-Yarihuaman A FIR - Hebeler, Robert IR - Hebeler R FIR - Henry, Carl IR - Henry C FIR - Vallabhan, Ravi IR - 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Morrill, Sydney IR - Morrill S FIR - Breunig, Jacqueline IR - Breunig J FIR - Lee, Amber IR - Lee A FIR - Pattle, Megan IR - Pattle M FIR - Dolan, Monica IR - Dolan M FIR - Barnhill, Natasha IR - Barnhill N FIR - Launchbury, Kelsey IR - Launchbury K FIR - Seyal, Shereen IR - Seyal S FIR - Foley, Jonathan IR - Foley J FIR - Weber, Stewart IR - Weber S FIR - Zahr, Firas IR - Zahr F FIR - Cameron, Kelsey IR - Cameron K FIR - Clark, Wayne IR - Clark W FIR - Song, Howard IR - Song H FIR - Folk, LilyAna IR - Folk L FIR - Kilmer, Zoe IR - Kilmer Z FIR - Chadderdon, Scott IR - Chadderdon S FIR - Bozorgchami, Hormozd IR - Bozorgchami H FIR - Lantz, Gurion IR - Lantz G FIR - Allaqaband, Suhail IR - Allaqaband S FIR - Pesch, Amy IR - Pesch A FIR - Warner, Danielle IR - Warner D FIR - Morawski, Elizabeth IR - Morawski E FIR - Anderson, Sara IR - Anderson S FIR - Bird, Tracy IR - Bird T FIR - Bajwa, Tanvir IR - Bajwa T FIR - Bennett, Michelle IR - Bennett M FIR - Eilers, Sarah IR - Eilers S FIR - Kresa, Jodi IR - Kresa J FIR - Biddick, Lindsay IR - Biddick L FIR - Yeomans, Christine IR - Yeomans C FIR - Burke, Dena IR - Burke D FIR - Khitha, Jayant IR - Khitha J FIR - DeGregorio, Joseph IR - DeGregorio J FIR - Arnofsky, Adam IR - Arnofsky A FIR - Hastings, Ramin IR - Hastings R FIR - Shaji, Elizabeth IR - Shaji E FIR - Levy, Kirk IR - Levy K FIR - Clark, Nathalia IR - Clark N FIR - Schwarcz, Aron IR - Schwarcz A FIR - Sosa, Beatriz IR - Sosa B FIR - Sullivan, Cara IR - Sullivan C FIR - Goldstein, Denise IR - Goldstein D FIR - Kidangan, Raena IR - Kidangan R FIR - Kukreja, Rahul IR - Kukreja R FIR - Badivuku, Hana IR - Badivuku H FIR - Feiler, Anna IR - Feiler A FIR - Chang, Sungrok IR - Chang S FIR - Cuisset, Thomas IR - Cuisset T FIR - Nouguerede, Emilie IR - Nouguerede E FIR - Perot, Charline IR - Perot C FIR - Ranjeva, Marie-Pierre IR - Ranjeva MP FIR - Fontaine, Marie-Elisabeth IR - Fontaine ME FIR - Laksiri, Nadia IR - Laksiri N FIR - Spychaj, Jean-Charles IR - Spychaj JC FIR - Deharo, Pierre IR - Deharo P FIR - Blondelon, Aurelie IR - Blondelon A FIR - Rey, Caroline IR - Rey C FIR - Robinet, Emmanuelle IR - Robinet E FIR - Horwitz, Phillip IR - Horwitz P FIR - Ollinger, Amy IR - Ollinger A FIR - Rossen, James IR - Rossen J FIR - Larson, Sharon IR - Larson S FIR - Shaban, Amir IR - Shaban A FIR - Panos, Anthony IR - Panos A FIR - Singhal, Arun IR - Singhal A FIR - Bashir, Mohammad IR - Bashir M FIR - Wagner, Nancy IR - Wagner N FIR - Panaich, Sidakpal IR - Panaich S FIR - Voss, Allison IR - Voss A FIR - Abbas, Samer IR - Abbas S FIR - Wolford, Vanessa IR - Wolford V FIR - Duncan, Nicole IR - Duncan N FIR - Badruddin, Aamir IR - Badruddin A FIR - O'Sullivan, Whitney IR - O'Sullivan W FIR - Clark, Stephany IR - Clark S FIR - Walsh, John IR - Walsh J FIR - Speicher, Zachary IR - Speicher Z FIR - Patel, Alok IR - Patel A FIR - Mosier, Sherry IR - Mosier S FIR - Lucas, Jagoda IR - Lucas J FIR - Biank, Jennifer IR - Biank J FIR - Schlotman, Joan IR - Schlotman J FIR - Chaudhry, Farrukh IR - Chaudhry F FIR - Gagne, Tera IR - Gagne T FIR - Patel, Amar IR - Patel A FIR - Twidt, Portia IR - Twidt P FIR - van den Brand, Katrina IR - van den Brand K FIR - Harden, Shavette IR - Harden S FIR - Ragland, Jeremy IR - Ragland J FIR - Slocum, Megan IR - Slocum M FIR - Owada, Kumiko IR - Owada K FIR - Horn, Christopher IR - Horn C FIR - Hormes, Joseph IR - Hormes J FIR - Holtzclaw, Holly IR - Holtzclaw H FIR - Patel, Ateet IR - Patel A FIR - Corrigan, Frank IR - Corrigan F FIR - Neese, Michele IR - Neese M FIR - Reitman, Arthur IR - Reitman A FIR - Eshcol, Javasheel IR - Eshcol J FIR - Carpenter, Kyle IR - Carpenter K FIR - Deepak, Bangalore IR - Deepak B FIR - Chew, Kenzie IR - Chew K FIR - Mandacina, Nicole IR - Mandacina N FIR - Dahlin, Joyce IR - Dahlin J FIR - Ahmed, Iftekhar IR - Ahmed I FIR - Bahr, Sherry IR - Bahr S FIR - Braklow, Jana IR - Braklow J FIR - Baldwin, Suzanne IR - Baldwin S FIR - Fulks, Elizabeth IR - Fulks E FIR - Potluri, Srinivasa IR - Potluri S FIR - Brinkman, William IR - Brinkman W FIR - Youngblood, Katrina IR - Youngblood K FIR - Nosnik, Pedro IR - Nosnik P FIR - Szerlip, Molly IR - Szerlip M FIR - Morgan, Michelle IR - Morgan M FIR - Campbell, Douglas IR - Campbell D FIR - Guerrero, Elyza IR - Guerrero E FIR - Harrington, Katherine IR - Harrington K FIR - Kell, Necole IR - Kell N FIR - Marin, Simona IR - Marin S FIR - Schaffer, Justin IR - Schaffer J FIR - Sauder, Rocio IR - Sauder R FIR - Harding, Raven IR - Harding R FIR - Thomas, Sibi IR - Thomas S FIR - Al-Azizi, Karim IR - Al-Azizi K FIR - Yaryura, Ricardo IR - Yaryura R FIR - Rotta, Francisco IR - Rotta F FIR - Wilson, Jeanette IR - Wilson J FIR - Little, Amy IR - Little A FIR - Brown, Kelly IR - Brown K FIR - Concha, Mauricio IR - Concha M FIR - Kersey, Austin IR - Kersey A FIR - Rodriguez, Roberto IR - Rodriguez R FIR - Jordan, Jennifer IR - Jordan J FIR - Scharadin, Tyler IR - Scharadin T FIR - Aggarwal, Sudhir IR - Aggarwal S FIR - Golden, Sasha IR - Golden S FIR - Goldman, Scott IR - Goldman S FIR - Skulski, Rosemarie IR - Skulski R FIR - Coady, Paul IR - Coady P FIR - Singh, Dharampreet IR - Singh D FIR - Thome, Lisa IR - Thome L FIR - Ramlawi, Basel IR - Ramlawi B FIR - Gnall, Eric IR - Gnall E FIR - Kar, Saibal IR - Kar S FIR - Fontana, Gregory IR - Fontana G FIR - Aachi, Venkat IR - Aachi V FIR - Cabral Aoki, Maria IR - Cabral Aoki M FIR - Dev, Vishva IR - Dev V FIR - Parker, Natalia IR - Parker N FIR - McKenna, Kelley IR - McKenna K FIR - Hall, Kelly IR - Hall K FIR - Taqi, Muhammad IR - Taqi M FIR - Arabyan, Mane IR - Arabyan M FIR - Papanicolaou, Cherry IR - Papanicolaou C FIR - Faraci, Philip IR - Faraci P FIR - Sodhi, Ajeet IR - Sodhi A FIR - Kleiman, Neal IR - Kleiman N FIR - Wiese, Jonathan IR - Wiese J FIR - Gaul, Abriana IR - Gaul A FIR - Whitham, Kiely IR - Whitham K FIR - White, Shannon IR - White S FIR - Grimes, Maranda IR - Grimes M FIR - Ganguly, Paulamy IR - Ganguly P FIR - Daniels, Adam IR - Daniels A FIR - Nelson, Sheryl IR - Nelson S FIR - Brisco, Annalise IR - Brisco A FIR - Gee, Danielle IR - Gee D FIR - Alanis, Iris IR - Alanis I FIR - Brinegar, Patricia IR - Brinegar P FIR - Green, LaShawna IR - Green L FIR - Green, Lisa IR - Green L FIR - Khan, Saba IR - Khan S FIR - Underwood, Carol IR - Underwood C FIR - Klein, Mary IR - Klein M FIR - Reables, Daphney IR - Reables D FIR - Del Pino, Maria IR - Del Pino M FIR - Gupta, Tanush IR - Gupta T FIR - Hinohara, Tanu Garg Tomoya IR - Hinohara TGT FIR - Reardon, Michael IR - Reardon M FIR - Reyes, Manuel IR - Reyes M FIR - Volpi, John IR - Volpi J FIR - Goel, Sachin IR - Goel S FIR - Wyler von Ballmoos, Moritz IR - Wyler von Ballmoos M FIR - Atkins, Marvin IR - Atkins M FIR - Castriota, Fausto IR - Castriota F FIR - Ciucci, Gabriele IR - Ciucci G FIR - Sbarzaglia, Paolo IR - Sbarzaglia P FIR - Toselli, Marco IR - Toselli M FIR - Nerla, Roberto IR - Nerla R FIR - Lunetto, Maria IR - Lunetto M FIR - Poon, Karl IR - Poon K FIR - Raffel, Owen IR - Raffel O FIR - Corbett, Joel IR - Corbett J FIR - Roxas, Maricel IR - Roxas M FIR - Beevors, Estelle IR - Beevors E FIR - Murdoch, Dale IR - Murdoch D FIR - Janoschka, Bo IR - Janoschka B FIR - Gopal, Karthikeyan IR - Gopal K FIR - Stibilj, Kathryn IR - Stibilj K FIR - Rymar, Irena IR - Rymar I FIR - Hlaing, Su Hnin IR - Hlaing SH FIR - Gericke, Christian IR - Gericke C FIR - Adusumalli, Srikanth IR - Adusumalli S FIR - Halim, Muthanna Abdul IR - Halim MA FIR - Spencer, Suzanne IR - Spencer S FIR - Mearns, Megan IR - Mearns M FIR - Agarwal, Himanshu IR - Agarwal H FIR - Butkus, Eddy IR - Butkus E FIR - Rasmussen, Lois IR - Rasmussen L FIR - Lapke, Barbara IR - Lapke B FIR - Kanmanthareddy, Arun IR - Kanmanthareddy A FIR - Kerrey, Lindsey IR - Kerrey L FIR - Amato, Lindsey IR - Amato L FIR - Mokashi, Suyog IR - Mokashi S FIR - Romsa, Melissa IR - Romsa M FIR - Caldera, Angel IR - Caldera A FIR - Bent, Nordelle IR - Bent N FIR - Collins, Jess IR - Collins J FIR - Gnezda, Samantha IR - Gnezda S FIR - Contreras, Jose Condado IR - Contreras JC FIR - Stone, Britt IR - Stone B FIR - Gonzalez, Rafael IR - Gonzalez R FIR - Sutton, Carmen IR - Sutton C FIR - Quezada, Theresa IR - Quezada T FIR - Divakaran, Vijay IR - Divakaran V FIR - McKay, Raymond IR - McKay R FIR - Cloutier, Jill IR - Cloutier J FIR - Sadiq, Immad IR - Sadiq I FIR - Piccirillo, Bryan IR - Piccirillo B FIR - Azemi, Talhat IR - Azemi T FIR - Hosley, Catherine IR - Hosley C FIR - Somerville, Dani IR - Somerville D FIR - Courtemanche, Caitlyn IR - Courtemanche C FIR - Cyr, Giselle IR - Cyr G FIR - Curtis, Lauren IR - Curtis L FIR - Hoover, Nicole IR - Hoover N FIR - Blum, Jennifer IR - Blum J FIR - Garcia, Christina IR - Garcia C FIR - Zhao, David IR - Zhao D FIR - Daniel, Kurt IR - Daniel K FIR - Ezzeddine, Mustapha IR - Ezzeddine M FIR - Pack, Angelina IR - Pack A FIR - McDaniel, Sharon IR - McDaniel S FIR - Blinson, Karen IR - Blinson K FIR - Gandhi, Sanjay IR - Gandhi S FIR - Applegate, Robert IR - Applegate R FIR - Sheets, Jennifer IR - Sheets J FIR - Owens, Owen IR - Owens O FIR - Ranasinghe, Tamra IR - Ranasinghe T FIR - Rathee, Ritu IR - Rathee R FIR - Bushnell, Cheryl IR - Bushnell C FIR - Davis, Donna IR - Davis D FIR - Belford, Peter IR - Belford P FIR - Jessup, Alicia IR - Jessup A FIR - Southard, Jeffrey IR - Southard J FIR - Cole, Codi IR - Cole C FIR - Kan, Karen IR - Kan K FIR - Stripe, Benjamin IR - Stripe B FIR - Demayo, Cherrie IR - Demayo C FIR - Keenan, Kevin IR - Keenan K FIR - Ng, Kwan IR - Ng K FIR - Yee, Alan IR - Yee A FIR - Nguyen, Ivy IR - Nguyen I FIR - Tuermer-Lee, Kaelyn IR - Tuermer-Lee K FIR - Wong, Garrett IR - Wong G FIR - Book, Kimberley IR - Book K FIR - Rutkin, Bruce IR - Rutkin B FIR - Stanton, Kayla IR - Stanton K FIR - McGowan, Kristine IR - McGowan K FIR - Katz, Jeffrey IR - Katz J FIR - Berg, Jacinda IR - Berg J FIR - Spielmann, Rex IR - Spielmann R FIR - Dorsey, Alyson IR - Dorsey A FIR - Annunziato, Samantha IR - Annunziato S FIR - Singh, Avneet IR - Singh A FIR - Schwartz, Erin IR - Schwartz E FIR - Drobinko, Eric IR - Drobinko E FIR - Agrawal, Nirav IR - Agrawal N FIR - Booth, Terri IR - Booth T FIR - Maurer, Gregory IR - Maurer G FIR - Boutis, Loukas IR - Boutis L FIR - Barker, Colin IR - Barker C FIR - Crook, Sherron IR - Crook S FIR - Adams, Kathy IR - Adams K FIR - Goel, Kashish IR - Goel K FIR - Peltier, Amanda IR - Peltier A FIR - Lowe, Melissa IR - Lowe M FIR - Kerrigan, Deborah IR - Kerrigan D FIR - Saybolt, Matthew IR - Saybolt M FIR - Kiss, Daniel IR - Kiss D FIR - Baqui, Huma IR - Baqui H FIR - Sedarous, Mary IR - Sedarous M FIR - Martino, Stephen IR - Martino S FIR - Deutsch, Alan IR - Deutsch A FIR - DeToro, Anne IR - DeToro A FIR - Argenzio, Lynda IR - Argenzio L FIR - Apolito, Renato IR - Apolito R FIR - Flynn, Brian IR - Flynn B FIR - Dejene, Brook IR - Dejene B FIR - Asgarian, Kourosh IR - Asgarian K FIR - Mohanty, Bibhu IR - Mohanty B FIR - Matar, Fadi IR - Matar F FIR - Castro, Diana IR - Castro D FIR - Noles, Aaron IR - Noles A FIR - Kasischke, Karl IR - Kasischke K FIR - Bozeman, Andrea IR - Bozeman A FIR - Beba, Kanita IR - Beba K FIR - Bezerra, Hiram IR - Bezerra H FIR - Tran, Nhi IR - Tran N FIR - Reid, Taylor IR - Reid T FIR - Burgin, William IR - Burgin W FIR - Brennan, Kathryn IR - Brennan K FIR - Shelley, Amanda IR - Shelley A FIR - Renati, Swetha IR - Renati S FIR - Schmidt, Tobias IR - Schmidt T FIR - Frerker, Christian IR - Frerker C FIR - Emmel, Eric IR - Emmel E FIR - Ensminger, Stephan IR - Ensminger S FIR - Eitel, Ingo IR - Eitel I FIR - Royl, Georg IR - Royl G FIR - Stiermaier, Thomas IR - Stiermaier T FIR - Schoenhoff, Katrin IR - Schoenhoff K FIR - Sikonczyk, Artur IR - Sikonczyk A FIR - Saraei, Roza IR - Saraei R FIR - Kurz, Thomas IR - Kurz T FIR - Reichert, Stefan IR - Reichert S FIR - Riebau, Susanne IR - Riebau S FIR - Al Desouki, Aya IR - Al Desouki A FIR - Yadav, Pradeep IR - Yadav P FIR - Rajagopal, Vivek IR - Rajagopal V FIR - Holt, Shelley IR - Holt S FIR - Underwood, Danielle IR - Underwood D FIR - James, Sherry IR - James S FIR - Lazarus, Joash IR - Lazarus J FIR - English, Jeffrey IR - English J FIR - Truss, Brittney IR - Truss B FIR - Davis, Ramona IR - Davis R FIR - Whyte, Denise IR - Whyte D FIR - Wang, Kimi IR - Wang K FIR - Seiden, Lawrence IR - Seiden L FIR - Meduri, Christopher IR - Meduri C FIR - Serbanescu, Andrei IR - Serbanescu A FIR - Gray, Kashaine IR - Gray K FIR - Kauten, James IR - Kauten J FIR - Tucker, Claire IR - Tucker C FIR - Vasa-Nicotera, Marjuca IR - Vasa-Nicotera M FIR - Dimitriadis, Zisis IR - Dimitriadis Z FIR - Walther, Thomas IR - Walther T FIR - Gruber, Katharina IR - Gruber K FIR - Mas, Silvia IR - Mas S FIR - Charisse, Daniel IR - Charisse D FIR - Schaefer, Jan-Hendrik IR - Schaefer JH FIR - Kurka, Natalia IR - Kurka N FIR - Seppelt, Philipp IR - Seppelt P FIR - Robbertz, Sandra IR - Robbertz S FIR - Wunderlich, Evelin IR - Wunderlich E FIR - Schwarzer, Claudia IR - Schwarzer C FIR - Mueller-Ardogan, Margret IR - Mueller-Ardogan M FIR - Smorta, Carmelo IR - Smorta C FIR - van Linden, Arnaud IR - van Linden A FIR - Fichtlscherer, Stephan IR - Fichtlscherer S FIR - Baron, Suzanne IR - Baron S FIR - Piemonte, Thomas IR - Piemonte T FIR - Pendleton, Judy IR - Pendleton J FIR - Kirk, Elizabeth IR - Kirk E FIR - Culbertson, Collin IR - Culbertson C FIR - Alsamarah, Ali IR - Alsamarah A FIR - Voetsch, Barbara IR - Voetsch B FIR - Sehgal, Siddharth IR - Sehgal S FIR - Gadey, Gautam IR - Gadey G FIR - Byrne, Jean IR - Byrne J FIR - Goswami, Nilesh IR - Goswami N FIR - El Hangouche, Nadia IR - El Hangouche N FIR - Goldstein, Jeffrey IR - Goldstein J FIR - Khoury, Naim IR - Khoury N FIR - Kitchener, Jacob IR - Kitchener J FIR - McHugh, Melissa IR - McHugh M FIR - Hudson, Stephanie IR - Hudson S FIR - Mather, Kelse IR - Mather K FIR - Tchetche, Didier IR - Tchetche D FIR - Dumonteil, Nicolas IR - Dumonteil N FIR - Petit, Frederic IR - Petit F FIR - Piquart, Aurelie IR - Piquart A FIR - Cottin, Marianne IR - Cottin M FIR - Viala, Frederique IR - Viala F FIR - Cho, Nam IR - Cho N FIR - Dhar, Gaurav IR - Dhar G FIR - Blaske, Lonna IR - Blaske L FIR - Boak, Jennifer IR - Boak J FIR - Wilson, Jacki IR - Wilson J FIR - Saleemi, Muhammad IR - Saleemi M FIR - Smith, Jamie IR - Smith J FIR - Gujrati, Yogesh IR - Gujrati Y FIR - Dreffs, Janelle IR - Dreffs J FIR - Nixon, Jessica IR - Nixon J FIR - Mitchell, Sandra IR - Mitchell S FIR - Nombela-Franco, Luis IR - Nombela-Franco L FIR - Jimenez Quevedo, Pilar IR - Jimenez Quevedo P FIR - Hennessey, Breda IR - Hennessey B FIR - Gomez-Escalonilla, Carlos IR - Gomez-Escalonilla C FIR - Simal, Patricia IR - Simal P FIR - Tirado, Gabriela IR - Tirado G FIR - Gonzalo, Nieves IR - Gonzalo N FIR - Fernandez Ortiz, Antonio IR - Fernandez Ortiz A FIR - Escaned, Javier IR - Escaned J FIR - Nunez, Ivan IR - Nunez I FIR - Aranzazu Ortega Pozzi, Maria IR - Aranzazu Ortega Pozzi M FIR - Bernardo Garcia, Esther IR - Bernardo Garcia E FIR - Marroquin, Luis IR - Marroquin L FIR - Schwartz, Richard IR - Schwartz R FIR - Tercynski, Mary IR - Tercynski M FIR - Varghese, Princy IR - Varghese P FIR - Bokhari, Matthew IR - Bokhari M FIR - Jin, Yuxuan IR - Jin Y FIR - Batteria, Melissa IR - Batteria M FIR - Alam, Shazia IR - Alam S FIR - Stepinowski, Kimberly IR - Stepinowski K FIR - Licata, Marina IR - Licata M FIR - Pocock, Stuart IR - Pocock S FIR - Faxon, David P IR - Faxon DP FIR - Rose, David Z IR - Rose DZ FIR - Babikian, Viken IR - Babikian V FIR - Gorman, Mark IR - Gorman M FIR - Leary, Megan IR - Leary M FIR - Kannam, Joseph IR - Kannam J FIR - Kimmelstiel, Carey IR - Kimmelstiel C FIR - Weaver, W Douglas IR - Weaver WD FIR - Anwaruddin, Saif IR - Anwaruddin S FIR - Gada, Hemal IR - Gada H FIR - Grubb, Kendra IR - Grubb K FIR - Kapadia, Samir IR - Kapadia S FIR - Kodali, Susheel IR - Kodali S FIR - Krishnaswamy, Amar IR - Krishnaswamy A FIR - Leon, Marty IR - Leon M FIR - Messe, Steven IR - Messe S FIR - Rinaldi, Michael IR - Rinaldi M FIR - Seeger, Julia IR - Seeger J FIR - Tchetche, Didier IR - Tchetche D FIR - Thourani, Vinod IR - Thourani V FIR - Van Mieghen, Nicholas IR - Van Mieghen N EDAT- 2022/09/20 06:00 MHDA- 2022/10/12 06:00 CRDT- 2022/09/19 06:52 PHST- 2022/09/20 06:00 [pubmed] PHST- 2022/10/12 06:00 [medline] PHST- 2022/09/19 06:52 [entrez] AID - 10.1056/NEJMoa2204961 [doi] PST - ppublish SO - N Engl J Med. 2022 Oct 6;387(14):1253-1263. doi: 10.1056/NEJMoa2204961. Epub 2022 Sep 17. PMID- 36116988 OWN - NLM STAT- MEDLINE DCOM- 20230307 LR - 20250530 IS - 1558-4623 (Electronic) IS - 0001-2998 (Linking) VI - 53 IP - 2 DP - 2023 Mar TI - (18)F-Sodium Fluoride PET/CT in Assessing Valvular Heart and Atherosclerotic Diseases. PG - 241-257 LID - S0001-2998(22)00075-7 [pii] LID - 10.1053/j.semnuclmed.2022.08.007 [doi] AB - Aortic valve stenosis is the most common valvular disease in Western countries, while atherosclerotic cardiovascular disease is the foremost cause of death and disability worldwide. Valve degeneration and atherosclerosis are mediated by inflammation and calcification and inevitably progress over time. Computed tomography can visualise the later stages of macroscopic calcification but fails to assess the early stages of microcalcification and cannot differentiate active from burnt out disease states. Molecular imaging has the ability to provide complementary information related to disease activity, which may allow us to detect disease early, to predict disease progression and to monitor preventive or therapeutic strategies for in both aortic stenosis and atherosclerosis. PET/CT is a non-invasive imaging technique that enables visualization of ongoing molecular processes within small structures, such as the coronary arteries or heart valves. (18)F-sodium fluoride ((18)F-NaF) binds hydroxyapatite deposits in the extracellular matrix, with preferential binding to newly developing deposits of microcalcification, which provides an assessment of calcification activity. In recent years, (18)F-NaF has attracted the attention of many research groups and has been evaluated in several pathological cardiovascular processes. Histologic validation of the (18)F-NaF PET signal in valvular disease and atherosclerosis has been reported in multiple independent studies. The selective high-affinity binding of (18)F-NaF to microscopic calcified deposits (beyond the resolution of muCT) has been demonstrated ex vivo, as well as its ability to distinguish between areas of macro- and active microcalcification. In addition, prospective clinical studies have shown that baseline (18)F-NaF uptake in patients with aortic stenosis and mitral annular calcification is correlated with subsequent calcium deposition and valvular dysfunction after a follow-up period of 2 years. In patients with surgical bioprosthetic aortic valves but without morphological criteria for prosthetic degeneration, increased (18)F-NaF uptake at baseline was associated with subsequent bioprosthetic degeneration over time. Similar data were obtained in a cohort of patients with transcatheter aortic valve implantation. Furthermore, several studies have confirmed the association of coronary (18)F-NaF uptake with adverse atherosclerotic plaque features, active disease and future disease progression. (18)F-NaF uptake is also associated with future fatal or nonfatal myocardial infarction in patients with established coronary artery disease. The link between (18)F-NaF uptake and active atherosclerotic disease has not only been demonstrated in the coronary arteries, but also in peripheral arterial disease, abdominal aortic aneurysms and carotid atherosclerosis. It can be assumed that (18)F-NaF PET/CT will strengthen the diagnostic toolbox of practitioners in the coming years. Indeed, there is a strong medical need to diagnose degenerative valvular disease and to detect active atherosclerotic disease states. Finally, the use of (18)F-NaF as a biomarker to monitor the efficacy of drug therapies in preventing these pathological processes is attractive. In this review, we consider the role of (18)F-NaF PET/CT imaging in cardiac valvular diseases and atherosclerosis. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - De Azevedo, David AU - De Azevedo D AD - Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, and IREC/CARD UCLouvain, Brussels, Belgium. Electronic address: david.vancraeynest@saintluc.uclouvain.be. FAU - Geers, Jolien AU - Geers J AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Chancellor's Building, Little France Crescent, Midlothian, Edinburgh, UK; Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. FAU - Gheysens, Olivier AU - Gheysens O AD - Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc and Institute of Clinical and Experimental Research (IREC), Universite catholique de Louvain (UCLouvain), Brussels, Belgium. FAU - Dweck, Marc AU - Dweck M AD - Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. FAU - Vancraeynest, David AU - Vancraeynest D AD - Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, and IREC/CARD UCLouvain, Brussels, Belgium. LA - eng GR - FS/14/78/31020/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20220916 PL - United States TA - Semin Nucl Med JT - Seminars in nuclear medicine JID - 1264464 RN - 8ZYQ1474W7 (Sodium Fluoride) RN - 0 (Radiopharmaceuticals) RN - 0 (Fluorine Radioisotopes) SB - IM MH - Humans MH - Positron Emission Tomography Computed Tomography/methods MH - Sodium Fluoride/metabolism MH - Prospective Studies MH - Radiopharmaceuticals/metabolism MH - *Atherosclerosis MH - *Plaque, Atherosclerotic/metabolism MH - *Calcinosis/metabolism MH - *Heart Valve Diseases MH - *Aortic Valve Stenosis MH - Disease Progression MH - Fluorine Radioisotopes EDAT- 2022/09/19 06:00 MHDA- 2023/03/08 06:00 CRDT- 2022/09/18 22:04 PHST- 2022/08/12 00:00 [received] PHST- 2022/08/22 00:00 [accepted] PHST- 2022/09/19 06:00 [pubmed] PHST- 2023/03/08 06:00 [medline] PHST- 2022/09/18 22:04 [entrez] AID - S0001-2998(22)00075-7 [pii] AID - 10.1053/j.semnuclmed.2022.08.007 [doi] PST - ppublish SO - Semin Nucl Med. 2023 Mar;53(2):241-257. doi: 10.1053/j.semnuclmed.2022.08.007. Epub 2022 Sep 16. PMID- 36114124 OWN - NLM STAT- MEDLINE DCOM- 20230124 LR - 20230203 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 47 DP - 2023 Feb TI - Early Hemodynamic Outcomes in Self-Expandable Valves: Comparison of ACURATE Neo Versus ACURATE Neo2. PG - 62-69 LID - S1553-8389(22)00758-8 [pii] LID - 10.1016/j.carrev.2022.08.029 [doi] AB - BACKGROUND: Comparisons of hemodynamic results between ACURATE Neo and ACURATE Neo 2, which have updated outer sealing skirts, are limited. This retrospective study aimed to demonstrate the differences in hemodynamic outcomes between the two transcatheter heart valves (THVs). METHODS: We included 449 patients who underwent transfemoral transcatheter aortic valve replacement (TAVR) with either ACURATE Neo2 (n = 100) or ACURATE Neo (n = 348) between January 2016 and November 2021. The primary endpoint was the incidence of moderate or severe paravalvular leakage (PVL). The mean aortic pressure gradient (APG), peak aortic velocity (AV), and early clinical outcomes were assessed as secondary outcomes. RESULTS: In the propensity-score matching comparison (94 pairs), there were no significant differences in the incidence of moderate or severe PVL (4.3 % in Neo2 group vs. 8.5 % in Neo group, p = 0.233), and peak AV and mean APG were significantly higher in Neo2 group (Peak AV: 2.1 +/- 0.4 vs. 1.9 +/- 0.5 m/s, p = 0.003; mean APG: 10.6 +/- 4.8 vs. 9.0 +/- 6.1 mmHg, p = 0.045). In the multivariate logistic regression analysis, the THV type (ACURATE Neo2) was not an independent predictor of moderate or severe PVL. CONCLUSION: The incidence of moderate or severe PVL did not significantly differ between TAVR with ACURATE Neo2 and ACURATE Neo; however, it was numerically lower in ACURATE Neo2. In contrast, the Neo2 group had a higher residual mean APG and peak AV. A larger study with long-term follow-up is warranted to assess the clinical relevance of these findings. CI - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Miyashita, Hirokazu AU - Miyashita H AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland; Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Moriyama, Noriaki AU - Moriyama N AD - Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Laine, Mika AU - Laine M AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. Electronic address: Mika.Laine@hus.fi. LA - eng PT - Journal Article DEP - 20220828 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Retrospective Studies MH - *Heart Valve Prosthesis MH - Prosthesis Design MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Hemodynamics OTO - NOTNLM OT - Aortic stenosis OT - Paravalvular leakage OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest Dr. Miyashita has no conflict of interest to disclose. Dr. Moriyama is a clinical proctor of Edwards Lifesciences (SAPIEN) and Boston Scientific (ACURATE Neo and LOTUS Edge). Dr. Laine reports consulting fees from Edwards Lifesciences, Boston Scientific, and Medtronics. EDAT- 2022/09/17 06:00 MHDA- 2023/01/25 06:00 CRDT- 2022/09/16 22:06 PHST- 2022/05/05 00:00 [received] PHST- 2022/08/16 00:00 [revised] PHST- 2022/08/23 00:00 [accepted] PHST- 2022/09/17 06:00 [pubmed] PHST- 2023/01/25 06:00 [medline] PHST- 2022/09/16 22:06 [entrez] AID - S1553-8389(22)00758-8 [pii] AID - 10.1016/j.carrev.2022.08.029 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2023 Feb;47:62-69. doi: 10.1016/j.carrev.2022.08.029. Epub 2022 Aug 28. PMID- 36097458 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220914 IS - 2666-5018 (Electronic) IS - 2666-5018 (Linking) VI - 3 IP - 4 DP - 2022 Aug TI - Predicting permanent pacemaker implantation following transcatheter aortic valve replacement: A contemporary meta-analysis of 981,168 patients. PG - 385-392 LID - 10.1016/j.hroo.2022.05.001 [doi] AB - BACKGROUND: Heart block requiring permanent pacemaker (PPM) implantation is a relatively frequent complication of transcatheter aortic valve replacement (TAVR). OBJECTIVE: The purpose of this study was to perform a contemporary meta-analysis to provide an updated assessment of clinically useful predictors of PPM implantation post-TAVR. METHODS: Medline and EMBASE searches were performed to include all studies reporting PPM post-TAVR between 2015 and 2020. Pertinent data were extracted from the studies for further analysis. RevMan was used to create forest plots and calculate risk ratios (RRs). RESULTS: We evaluated 41 variables from 239 studies with a total of 981,168 patients. From this cohort, 17.4% received a PPM following TAVR. Strong predictors for PPM implant were right bundle branch block (RBBB) (RR 3.12; P <.001) and bifascicular block (RR 2.40; P = .002). Intermediate factors were chronic kidney disease (CKD) (RR 1.53; P <.0001) and first-degree atrioventricular block (FDAVB) (RR 1.44; P <.001). Weak factors (RR 1-1.50; P <.05) were male gender, age >/=80 years, body mass index >/=25, diabetes mellitus (DM), atrial fibrillation (AF), and left anterior fascicular block (LAFB). These factors along with increased left ventricular outflow tract (LVOT) area (>435 mm(2)) and/or aortic annulus diameter (>24.4 mm) were incorporated to propose a new scoring system to stratify patients into high- and low-risk groups. CONCLUSION: Male gender, age >/=80 years, FDAVB, RBBB, AF, DM, CKD, Medtronic CoreValve, transfemoral TAVR, increased LVOT, and aortic annulus diameter were significant predictors of post-TAVR PPM implantation. Preprocedural assessment should consider these factors to guide clinical decision-making before TAVR. Validation of our scoring system is warranted. CI - (c) 2022 Heart Rhythm Society. Published by Elsevier Inc. FAU - Abu Rmilah, Anan A AU - Abu Rmilah AA AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Al-Zu'bi, Hossam AU - Al-Zu'bi H AD - Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Haq, Ikram-Ul AU - Haq IU AD - Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Yagmour, Asil H AU - Yagmour AH AD - Al Quds University School of Medicine, Palestine. FAU - Jaber, Suhaib A AU - Jaber SA AD - Department of Internal Medicine, Al Hamadi Hospital, Riyadh, Saudi Arabia. FAU - Alkurashi, Adham K AU - Alkurashi AK AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Qaisi, Ibraheem AU - Qaisi I AD - An-Najah National University School of Medicine, Palestine. FAU - Kowlgi, Gurukripa N AU - Kowlgi GN AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Cha, Yong-Mei AU - Cha YM AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Mulpuru, Siva AU - Mulpuru S AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. FAU - DeSimone, Christopher V AU - DeSimone CV AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. FAU - Deshmukh, Abhishek J AU - Deshmukh AJ AD - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. LA - eng PT - Journal Article DEP - 20220512 PL - United States TA - Heart Rhythm O2 JT - Heart rhythm O2 JID - 101768511 PMC - PMC9463692 OTO - NOTNLM OT - Atrioventricular block OT - Bundle branch block OT - Conduction disturbance OT - Pacemaker OT - Transcatheter aortic valve replacement EDAT- 2022/09/14 06:00 MHDA- 2022/09/14 06:01 PMCR- 2022/05/12 CRDT- 2022/09/13 01:44 PHST- 2022/09/13 01:44 [entrez] PHST- 2022/09/14 06:00 [pubmed] PHST- 2022/09/14 06:01 [medline] PHST- 2022/05/12 00:00 [pmc-release] AID - S2666-5018(22)00106-4 [pii] AID - 10.1016/j.hroo.2022.05.001 [doi] PST - epublish SO - Heart Rhythm O2. 2022 May 12;3(4):385-392. doi: 10.1016/j.hroo.2022.05.001. eCollection 2022 Aug. PMID- 36075653 OWN - NLM STAT- MEDLINE DCOM- 20220913 LR - 20250728 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 15 IP - 17 DP - 2022 Sep 12 TI - Cardiovalve Transfemoral Tricuspid Valve Replacement Assisted With CT-Fluoroscopy Fusion Imaging. PG - e197-e199 LID - S1936-8798(22)01186-4 [pii] LID - 10.1016/j.jcin.2022.06.023 [doi] FAU - Barreiro-Perez, Manuel AU - Barreiro-Perez M AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: manuelbarreiroperez@gmail.com. FAU - Estevez-Loureiro, Rodrigo AU - Estevez-Loureiro R AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: https://twitter.com/RodrigoEstvez1. FAU - Baz, Jose Antonio AU - Baz JA AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: https://twitter.com/jabazal. FAU - Pinon, Miguel A AU - Pinon MA AD - Cardiac Surgery Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: https://twitter.com/miguelpinon_73. FAU - Maisano, Francesco AU - Maisano F AD - Heart Valve Center, IRCCS Ospedale San Raffaele, Milano, Italy. Electronic address: https://twitter.com/drmaisano. FAU - Puga, Luis AU - Puga L AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: https://twitter.com/luispuga_cardio. FAU - Caneiro-Queija, Berenice AU - Caneiro-Queija B AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: https://twitter.com/b_caneiro. FAU - Iniguez-Romo, Andres AU - Iniguez-Romo A AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IISGS), Vigo, Pontevedra, Spain. Electronic address: https://twitter.com/AndresIniguezR. LA - eng PT - Journal Article DEP - 20220817 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Cardiac Catheterization MH - Fluoroscopy/methods MH - *Heart Valve Prosthesis MH - *Heart Valve Prosthesis Implantation/adverse effects/methods MH - Humans MH - Tomography, X-Ray Computed/methods MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - Tricuspid Valve/diagnostic imaging/surgery OTO - NOTNLM OT - fusion imaging OT - structural heart intervention OT - transcatheter tricuspid valve replacement COIS- Funding Support and Author Disclosures Dr Maisano is proctor for Cardiovalve Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2022/09/09 06:00 MHDA- 2022/09/14 06:00 CRDT- 2022/09/08 21:04 PHST- 2022/05/29 00:00 [received] PHST- 2022/06/08 00:00 [revised] PHST- 2022/06/14 00:00 [accepted] PHST- 2022/09/08 21:04 [entrez] PHST- 2022/09/09 06:00 [pubmed] PHST- 2022/09/14 06:00 [medline] AID - S1936-8798(22)01186-4 [pii] AID - 10.1016/j.jcin.2022.06.023 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2022 Sep 12;15(17):e197-e199. doi: 10.1016/j.jcin.2022.06.023. Epub 2022 Aug 17. PMID- 36062263 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220907 IS - 2673-3129 (Electronic) IS - 2673-3129 (Linking) VI - 4 DP - 2022 TI - Advances in technology and techniques for transcatheter aortic valve replacement with concomitant peripheral arterial disease. PG - 959249 LID - 10.3389/fmedt.2022.959249 [doi] LID - 959249 AB - Aortic stenosis (AS) is a prevalent disease affecting 3.7% of the adult population aged 65 or above. In the past, surgical aortic valve replacement (SAVR) was the only definitive therapy available for the treatment of severe AS. Owing to the invasive nature of open-heart surgery, patients with advanced age and frailty could not benefit from SAVR. The advent of transcatheter aortic valve replacement (TAVR) in the past decade has offered an alternative treatment option for patients with severe AS, particularly those who are deemed to have high surgical risks. Nevertheless, a large proportion of patients also have concomitant peripheral arterial disease (PAD), which increases the risk of peri-procedural vascular complication, and precludes the possibility of transfemoral TAVR owing to inadequate luminal size for delivery system deployment. In this review, the prevalence and outcome of TAVR patients with PAD will be discussed. Furthermore, novel technologies and techniques that enable TAVR to be safely performed using transfemoral or alternative access in patients with severe PAD will be reviewed. CI - Copyright (c) 2022 Wong, Chiu, Chan, Sze, Tam, Un, Lam and Tse. FAU - Wong, Chun-Ka AU - Wong CK AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Chiu, Alston Conrad Ho-On AU - Chiu ACH AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Chan, Kwong-Yue Eric AU - Chan KE AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Sze, Shu-Yue AU - Sze SY AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Tam, Frankie Chor-Cheung AU - Tam FC AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Un, Ka-Chun AU - Un KC AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Lam, Simon Cheung-Chi AU - Lam SC AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. FAU - Tse, Hung-Fat AU - Tse HF AD - Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. LA - eng PT - Journal Article PT - Review DEP - 20220818 PL - Switzerland TA - Front Med Technol JT - Frontiers in medical technology JID - 101772626 PMC - PMC9433652 OTO - NOTNLM OT - PAD - peripheral arterial disease OT - TAVR - transcatheter aortic valve replacement OT - aortic stenosis OT - percutaneous transluminal angioplasty OT - vascular closure device COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/09/06 06:00 MHDA- 2022/09/06 06:01 PMCR- 2022/08/18 CRDT- 2022/09/05 04:23 PHST- 2022/06/01 00:00 [received] PHST- 2022/07/19 00:00 [accepted] PHST- 2022/09/05 04:23 [entrez] PHST- 2022/09/06 06:00 [pubmed] PHST- 2022/09/06 06:01 [medline] PHST- 2022/08/18 00:00 [pmc-release] AID - 10.3389/fmedt.2022.959249 [doi] PST - epublish SO - Front Med Technol. 2022 Aug 18;4:959249. doi: 10.3389/fmedt.2022.959249. eCollection 2022. PMID- 36040688 OWN - NLM STAT- MEDLINE DCOM- 20221118 LR - 20230107 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 100 IP - 5 DP - 2022 Nov TI - Long term follow-up after balloon expandable covered stents implantation for management of transcatheter aortic valve replacement related vascular access complications. PG - 903-909 LID - 10.1002/ccd.30385 [doi] AB - OBJECTIVES: To report the experience of a high-volume center with balloon-expandable (BE) stents implantation to manage vascular complications after transcatheter aortic valve replacement (TAVR). BACKGROUND: Despite increased operator experience and better devices, vascular complications after TAVR are still a major issue and covered stent implantation is often required. METHODS: We retrospectively collected baseline and procedural data about 78 consecutive patients who underwent BE stent implantation to manage a vascular complication after transfemoral TAVR. Primary endpoints were technical success, incidence of new-onset claudication and need for vascular interventions during long-term follow-up. Secondary endpoints included length of hospitalization, in-hospital and 30-day mortality, and major postoperative complications. RESULTS: BE stents implantation to manage vascular complications after TAVR was successfully performed in 96.2% of the cases, with bailout surgery required in two cases. One patient suffered in-hospital death. Predischarge Doppler Ultrasound revealed no cases of in-stent occlusion or fracture. At a median follow-up of 429 days (interquartile range, 89-994 days), no cases of symptomatic leg ischemia were reported and only one patient experienced new-onset claudication. CONCLUSIONS: Our experience showed good periprocedural and long-term results of BE covered stent implantation to manage vascular complication after TAVR. Their great radial outward force may guarantee effective hemostasis without necessarily being associated with stent deformation/fracture resulting in restenosis or further interventions. More research is needed to define the role of BE covered stents in this setting. CI - (c) 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Maurina, Matteo AU - Maurina M AUID- ORCID: 0000-0003-3761-7605 AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Condello, Francesco AU - Condello F AUID- ORCID: 0000-0002-7830-4341 AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - IRCCS Humanitas Research Hospital, Milan, Italy. FAU - Sanz-Sanchez, Jorge AU - Sanz-Sanchez J AUID- ORCID: 0000-0003-4991-6549 AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Hospital Universitari i Politecnic La Fe, Cardiology, Valencia, Spain. AD - Centro de Investicacion Biomedica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Stefanini, Giulio Giuseppe AU - Stefanini GG AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Bongiovanni, Dario AU - Bongiovanni D AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Internal Medicine I, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany. FAU - Cozzi, Ottavia AU - Cozzi O AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Leone, Pier Pasquale AU - Leone PP AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Baggio, Sara AU - Baggio S AUID- ORCID: 0000-0002-2442-9982 AD - IRCCS Humanitas Research Hospital, Milan, Italy. AD - Department of Biomedical Sciences, Humanitas University, Milan, Italy. FAU - Gasparini, Gabriele AU - Gasparini G AUID- ORCID: 0000-0003-3653-9553 AD - IRCCS Humanitas Research Hospital, Milan, Italy. FAU - Pagnotta, Paolo AU - Pagnotta P AD - IRCCS Humanitas Research Hospital, Milan, Italy. FAU - Civilini, Efrem AU - Civilini E AD - Vascular Surgery, Humanitas Research Hospital IRCCS, Milan, Italy. FAU - Colombo, Antonio AU - Colombo A AD - IRCCS Humanitas Research Hospital, Milan, Italy. FAU - Reimers, Bernhard AU - Reimers B AD - IRCCS Humanitas Research Hospital, Milan, Italy. FAU - Regazzoli, Damiano AU - Regazzoli D AD - IRCCS Humanitas Research Hospital, Milan, Italy. LA - eng PT - Journal Article DEP - 20220830 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Follow-Up Studies MH - Retrospective Studies MH - Hospital Mortality MH - Femoral Artery/diagnostic imaging/surgery MH - Treatment Outcome MH - Stents MH - *Vascular Diseases/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Aortic Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis PMC - PMC9804753 OTO - NOTNLM OT - TAVR OT - Vascular complications OT - balloon expandable covered stent COIS- The authors declare no conflict of interest. EDAT- 2022/08/31 06:00 MHDA- 2022/11/19 06:00 PMCR- 2022/12/31 CRDT- 2022/08/30 11:26 PHST- 2022/07/18 00:00 [revised] PHST- 2022/01/14 00:00 [received] PHST- 2022/08/12 00:00 [accepted] PHST- 2022/08/31 06:00 [pubmed] PHST- 2022/11/19 06:00 [medline] PHST- 2022/08/30 11:26 [entrez] PHST- 2022/12/31 00:00 [pmc-release] AID - CCD30385 [pii] AID - 10.1002/ccd.30385 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2022 Nov;100(5):903-909. doi: 10.1002/ccd.30385. Epub 2022 Aug 30. PMID- 36033228 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220830 IS - 2223-3652 (Print) IS - 2223-3660 (Electronic) IS - 2223-3652 (Linking) VI - 12 IP - 4 DP - 2022 Aug TI - Machine learning models predict total charges and drivers of cost for transcatheter aortic valve replacement. PG - 464-474 LID - 10.21037/cdt-21-717 [doi] AB - BACKGROUND: Given the increasing healthcare costs, there is an interest in developing machine learning (ML) prediction models for estimating hospitalization charges. We use ML algorithms to predict hospitalization charges for patients undergoing transfemoral transcatheter aortic valve replacement (TF-TAVR) utilizing the National Inpatient Sample (NIS) database. METHODS: Patients who underwent TF-TAVR from 2012 to 2016 were included in the study. The primary outcome was total hospitalization charges. Study dataset was divided into 80% training and 20% testing sets. We used following ML regression algorithms: random forest, gradient boosting, k-nearest neighbors (KNN), multi-layer perceptron and linear regression. ML algorithms were built for for 3 stages: Stage 1, including variables that were known pre-procedurally (prior to TF-TAVR); Stage 2, including variables that were known post-procedurally; Stage 3, including length of stay (LOS) in addition to the stage 2 variables. RESULTS: A total of 18,793 hospitalization for TF-TAVR were analyzed. The mean and median adjusted hospitalization charges were $220,725.2 ($137,675.1) and $187,212.0 ($137,971.0-264,824.8) respectively. Random forest regression algorithm outperformed other ML algorithms at all stages with higher R(2) score and lower mean absolute error (MAE), root mean squared area (RMSE) and root mean squared logarithmic error (RMSLE) (Stage 1: MAE 79,979.11, R(2) 0.157; Stage 2: MAE 76,200.09, R(2) 0.256; Stage 3: MAE 69,350.09, R(2) 0.453). LOS was the most important predictor of hospitalization charges. CONCLUSIONS: We built ML algorithms that predict hospitalization charges with good accuracy in patients undergoing TF-TAVR at different stages of hospitalization and that can be used by healthcare providers to better understand the drivers of charges. CI - 2022 Cardiovascular Diagnosis and Therapy. All rights reserved. FAU - Bansal, Agam AU - Bansal A AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Garg, Chandan AU - Garg C AD - Department of Statistics, Columbia University, New York, NY, USA. FAU - Hariri, Essa AU - Hariri E AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Kassis, Nicholas AU - Kassis N AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Mentias, Amgad AU - Mentias A AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. LA - eng PT - Journal Article PL - China TA - Cardiovasc Diagn Ther JT - Cardiovascular diagnosis and therapy JID - 101601613 PMC - PMC9412209 OTO - NOTNLM OT - Transcatheter aortic valve replacement (TAVR) OT - hospitalization charges OT - machine learning (ML) COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-21-717/coif). The authors have no conflicts of interest to declare. EDAT- 2022/08/30 06:00 MHDA- 2022/08/30 06:01 PMCR- 2022/08/01 CRDT- 2022/08/29 04:51 PHST- 2021/11/11 00:00 [received] PHST- 2022/06/30 00:00 [accepted] PHST- 2022/08/29 04:51 [entrez] PHST- 2022/08/30 06:00 [pubmed] PHST- 2022/08/30 06:01 [medline] PHST- 2022/08/01 00:00 [pmc-release] AID - cdt-12-04-464 [pii] AID - 10.21037/cdt-21-717 [doi] PST - ppublish SO - Cardiovasc Diagn Ther. 2022 Aug;12(4):464-474. doi: 10.21037/cdt-21-717. PMID- 35991081 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220823 IS - 2424-810X (Electronic) IS - 2382-6533 (Print) IS - 2382-6533 (Linking) VI - 8 IP - 4 DP - 2022 Aug 29 TI - Modified transapical-transcatheter aortic valve implantation. PG - 299-301 AB - BACKGROUND AND AIM: Some transcatheter aortic valve implantation (TAVI) candidates present with ubiquitary arterial disease with massive calcification burden and stenoses in the whole arterial tree and cannot undergo any transvascular TAVI-approach. Moreover, a history of previous coronary surgery including LIMA-LITA in situ bypass grafting, previous carotid surgery or stenosis/occlusions, a concomitant porcelain aorta, Leriche syndrome, diverse other aortic diseases, arterial occlusions, or a chronic dialysis with arteriovenous shunt are common in such patients with end-stage peripheral artery disease, making even a minimal artery access impossible. For patients without arterial access or at very high risk for artery injury, we modified the transapical-TAVI method to ensure artery-no-touch-technique. We employed this technique in six patients without procedural and in-hospital complications. RELEVANCE FOR PATIENTS: A high-grade aortic stenosis is a serious disease. Untreated patients exhibit poor survival. Only surgery or TAVI is valid therapy concept for treatment. However, some patients can undergo neither surgery nor TAVI, because of an extensive surgical risk or inoperability, whereas at the same time, no arterial approaches are available due to extensive, end-stage panarteriopathy. For these high-specific patients, our modified, artery-no-touch-TA-TAVI is an appropriate method and can be safely used. CI - Copyright: (c) 2022 Author(s). FAU - Useini, Dritan AU - Useini D AD - Department of Cardiothoracic Surgery, Ruhr-University Hospital Bergmannsheil, Bochum, Germany. AD - Department of Cardiovascular Surgery, Herz-Kreislauf-Zentrum, Rotenburg a. d. Fulda, Germany. FAU - Strauch, Justus AU - Strauch J AD - Department of Cardiothoracic Surgery, Ruhr-University Hospital Bergmannsheil, Bochum, Germany. LA - eng PT - Journal Article DEP - 20220725 PL - Singapore TA - J Clin Transl Res JT - Journal of clinical and translational research JID - 101667205 PMC - PMC9389571 OTO - NOTNLM OT - end-stage panarteriopathy OT - modified OT - novelty OT - transapical-transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2022/08/23 06:00 MHDA- 2022/08/23 06:01 PMCR- 2022/07/25 CRDT- 2022/08/22 04:05 PHST- 2022/05/29 00:00 [received] PHST- 2022/06/11 00:00 [revised] PHST- 2022/07/07 00:00 [accepted] PHST- 2022/08/22 04:05 [entrez] PHST- 2022/08/23 06:00 [pubmed] PHST- 2022/08/23 06:01 [medline] PHST- 2022/07/25 00:00 [pmc-release] AID - jctres.08.202204.006 [pii] PST - epublish SO - J Clin Transl Res. 2022 Jul 25;8(4):299-301. eCollection 2022 Aug 29. PMID- 35985946 OWN - NLM STAT- MEDLINE DCOM- 20221129 LR - 20221129 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 31 IP - 11 DP - 2022 Nov TI - Using Intravascular Lithotripsy to Facilitate Transfemoral Arterial Access for Transcatheter Aortic Valve Implantation. PG - e135-e139 LID - S1443-9506(22)01041-1 [pii] LID - 10.1016/j.hlc.2022.07.016 [doi] AB - Peripheral vascular assessment is important in pre-procedural planning for transcatheter aortic valve implantation (TAVI). While alternative vascular access sites have been used in patients with hostile iliofemoral anatomy, femoral access has been established as the superior access method for procedural outcomes. Intravascular lithotripsy (IVL) can facilitate transfemoral access for TAVI in patients with calcific stenoses of the iliofemoral arteries. This How-To-Do-It article describes the procedural planning and methods for performing IVL in these patients. CI - Copyright (c) 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved. FAU - Kempton, Hannah AU - Kempton H AD - St Vincent's Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia. Electronic address: hannah.kempton2@svha.org.au. FAU - Roy, Andrew AU - Roy A AD - St Vincent's Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; University of Notre Dame, Sydney, NSW, Australia. FAU - Watson, Alasdair AU - Watson A AD - St Vincent's Hospital, Sydney, NSW, Australia; The Victor Chang Cardiac Research Institute, Sydney, NSW, Australia. FAU - Evans, David AU - Evans D AD - St Vincent's Hospital, Sydney, NSW, Australia. FAU - Muller, David AU - Muller D AD - St Vincent's Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; The Victor Chang Cardiac Research Institute, Sydney, NSW, Australia. FAU - Roy, David AU - Roy D AD - St Vincent's Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; University of Notre Dame, Sydney, NSW, Australia. LA - eng PT - Journal Article DEP - 20220817 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Treatment Outcome MH - Femoral Artery/surgery MH - *Lithotripsy MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - Aortic valve disease OT - Intravascular lithotripsy OT - Transcatheter aortic valve implantation OT - Transfemoral arterial access EDAT- 2022/08/20 06:00 MHDA- 2022/11/30 06:00 CRDT- 2022/08/19 22:07 PHST- 2022/04/05 00:00 [received] PHST- 2022/07/06 00:00 [revised] PHST- 2022/07/25 00:00 [accepted] PHST- 2022/08/20 06:00 [pubmed] PHST- 2022/11/30 06:00 [medline] PHST- 2022/08/19 22:07 [entrez] AID - S1443-9506(22)01041-1 [pii] AID - 10.1016/j.hlc.2022.07.016 [doi] PST - ppublish SO - Heart Lung Circ. 2022 Nov;31(11):e135-e139. doi: 10.1016/j.hlc.2022.07.016. Epub 2022 Aug 17. PMID- 35982200 OWN - NLM STAT- MEDLINE DCOM- 20220822 LR - 20250728 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 12 IP - 1 DP - 2022 Aug 18 TI - Manual compression versus MANTA device for access management after impella removal on the ICU. PG - 14060 LID - 10.1038/s41598-022-18184-x [doi] LID - 14060 AB - To compare the safety and efficacy of manual compression versus use of the MANTA closure device for access management after Impella removal on the intensive care unit (ICU). The number of patients treated with percutaneous left ventricular assist devices (pLVAD), namely Impella and ECMO, for complex cardiac procedures or shock, is growing. However, removal of pLVAD and large bore arteriotomy closure among such patients on the ICU remains challenging, since it is associated with a high risk for bleeding and vascular complications. Patients included in a prospective registry between 2017 and 2020 were analyzed. Bleeding and vascular access site complications were assessed and adjudicated according to VARC-2 criteria. We analyzed a cohort of 87 consecutive patients, who underwent access closure after Impella removal on ICU by using either the MANTA device or manual compression. The cohort s mean age was 66.1 +/- 10.7 years and 76 patients (87%) were recovering from CS. Mean support time was 40 h (interquartile range 24-69 h). MANTA was used in 31 patients (35.6%) and manual compression was applied in 56 patients (64.4%). Overall access related bleedings were significantly lower in the MANTA group (6.5% versus 39.3% (odds ratio (OR) 0.10, 95% CI 0.01-0.50; p = 0.001), and there was no significant difference in vascular complications between the two groups (p = 0.55). Our data suggests that the application of the MANTA device directly on the ICU is safe. In addition, it seems to reduce access related bleeding without increasing the risk of vascular complications. CI - (c) 2022. The Author(s). FAU - Cuculi, Florim AU - Cuculi F AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Burkart, Philipp AU - Burkart P AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Cioffi, Giacomo AU - Cioffi G AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Moccetti, Federico AU - Moccetti F AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Madanchi, Mehdi AU - Madanchi M AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Seiler, Thomas AU - Seiler T AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Hess, Stefanie AU - Hess S AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Wolfrum, Mathias AU - Wolfrum M AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Jeyarasa, Magiliny AU - Jeyarasa M AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. AD - Medical School, University of Zurich, Zurich, Switzerland. FAU - Meier, Sonja AU - Meier S AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Kuzmiakova, Silvia AU - Kuzmiakova S AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Hakimi, Maani AU - Hakimi M AD - Division of Vascular Surgery, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Seelos, Robert AU - Seelos R AD - Division of Vascular Surgery, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Kobza, Richard AU - Kobza R AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Attinger-Toller, Adrian AU - Attinger-Toller A AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. FAU - Bossard, Matthias AU - Bossard M AD - Cardiology Division, Heart Center Lucerne, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. matthias.bossard@luks.ch. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220818 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Aged MH - Femoral Artery/surgery MH - Hemorrhage/etiology/therapy MH - Humans MH - Intensive Care Units MH - Middle Aged MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Vascular Closure Devices/adverse effects PMC - PMC9388691 COIS- MB has received speaker fees from Abiomed. ST is a consultant for Teleflex, Shockwave, atHeart, Medira, VeoSource, a consultant and proctor for Boston Scientific, Medtronic and Biosensors, a proctor for Abbott vascular, has received institutional grant support from Boston Scientific and Fumedica and holds equity in Hi-D Imaging. RK has received institutional grant support from Abbott, Biotronik, Biosense Webster, Boston Scientific, Medtronic and SIS Medical. FC has received speaker fees and research grants from Abiomed, Abbott Vascular and SIS Medical. None of the other authors had any relevant competing interests. EDAT- 2022/08/19 06:00 MHDA- 2022/08/23 06:00 PMCR- 2022/08/18 CRDT- 2022/08/18 23:28 PHST- 2021/12/16 00:00 [received] PHST- 2022/08/08 00:00 [accepted] PHST- 2022/08/18 23:28 [entrez] PHST- 2022/08/19 06:00 [pubmed] PHST- 2022/08/23 06:00 [medline] PHST- 2022/08/18 00:00 [pmc-release] AID - 10.1038/s41598-022-18184-x [pii] AID - 18184 [pii] AID - 10.1038/s41598-022-18184-x [doi] PST - epublish SO - Sci Rep. 2022 Aug 18;12(1):14060. doi: 10.1038/s41598-022-18184-x. PMID- 35981853 OWN - NLM STAT- MEDLINE DCOM- 20220822 LR - 20250728 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 15 IP - 16 DP - 2022 Aug 22 TI - Modified Transcaval Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Without Preplanning Contrast CT: Step-by-Step Guide. PG - e181-e185 LID - S1936-8798(22)01066-4 [pii] LID - 10.1016/j.jcin.2022.05.033 [doi] FAU - Chiang, Michael AU - Chiang M AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. Electronic address: michaelcschiang@gmail.com. FAU - Gonzalez, Pedro E AU - Gonzalez PE AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - Basir, Mir Babar AU - Basir MB AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - O'Neill, Brian P AU - O'Neill BP AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - Lee, James AU - Lee J AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - Frisoli, Tiberio AU - Frisoli T AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - Wang, Dee Dee AU - Wang DD AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - O'Neill, William W AU - O'Neill WW AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. FAU - Villablanca, Pedro A AU - Villablanca PA AD - Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA. LA - eng PT - Journal Article DEP - 20220713 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - *Extracorporeal Membrane Oxygenation MH - Hospital Mortality MH - Humans MH - Shock, Cardiogenic MH - Tomography, X-Ray Computed MH - Treatment Outcome OTO - NOTNLM OT - ECMO OT - LAVA-ECMO OT - TAVI OT - TAVR OT - aortic insufficiency OT - cardiogenic shock OT - transcaval COIS- Funding Support and Author Disclosures Dr Basir is a consultant for Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, Saranas, and Zoll. Dr B. O'Neill is a consultant to and receives research support from Edwards Lifesciences. Dr Frisoli is a proctor for Edwards Lifesciences, Abbott, Boston Scientific, and Medtronic. Dr Wang is a consultant to Edwards Lifesciences, Abbott, Neochord, and Boston Scientific; and receives institutional research grant support from Boston Scientific. Dr W. O'Neill has served as a consultant for Abiomed, Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Vascular, and St. Jude Medical; and serves on the board of directors of Neovasc Inc. Dr Villablanca is a consultant for Edwards Lifesciences and Teleflex. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2022/08/19 06:00 MHDA- 2022/08/23 06:00 CRDT- 2022/08/18 21:04 PHST- 2022/05/01 00:00 [received] PHST- 2022/05/17 00:00 [revised] PHST- 2022/05/24 00:00 [accepted] PHST- 2022/08/18 21:04 [entrez] PHST- 2022/08/19 06:00 [pubmed] PHST- 2022/08/23 06:00 [medline] AID - S1936-8798(22)01066-4 [pii] AID - 10.1016/j.jcin.2022.05.033 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2022 Aug 22;15(16):e181-e185. doi: 10.1016/j.jcin.2022.05.033. Epub 2022 Jul 13. PMID- 35975016 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240902 IS - 1671-5411 (Print) IS - 1671-5411 (Linking) VI - 19 IP - 7 DP - 2022 Jul 28 TI - Transcarotid transcatheter aortic valve implantation with a novel balloon expandable Myval((R)) THV under the local anesthesia. PG - 562-564 LID - 10.11909/j.issn.1671-5411.2022.07.006 [doi] FAU - Ayhan, Huseyin AU - Ayhan H AD - Department of Cardiology, Medicana International Ankara Hospital, Atilim University, Ankara, Turkey. FAU - Karaduman, Bilge Duran AU - Karaduman BD AD - Department of Cardiology, Medicana International Ankara Hospital, Atilim University, Ankara, Turkey. FAU - Keles, Telat AU - Keles T AD - Department of Cardiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Uguz, Emrah AU - Uguz E AD - Department of Cardiovascular Surgery, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Boysan, Emre AU - Boysan E AD - Department of Cardiovascular Surgery, Medicana International Ankara Hospital, Ankara, Turkey. FAU - Bozkurt, Engin AU - Bozkurt E AD - Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey. LA - eng PT - Journal Article PL - China TA - J Geriatr Cardiol JT - Journal of geriatric cardiology : JGC JID - 101237881 PMC - PMC9361163 EDAT- 2022/08/18 06:00 MHDA- 2022/08/18 06:01 PMCR- 2022/07/28 CRDT- 2022/08/17 01:58 PHST- 2022/08/17 01:58 [entrez] PHST- 2022/08/18 06:00 [pubmed] PHST- 2022/08/18 06:01 [medline] PHST- 2022/07/28 00:00 [pmc-release] AID - jgc-19-7-562 [pii] AID - 10.11909/j.issn.1671-5411.2022.07.006 [doi] PST - ppublish SO - J Geriatr Cardiol. 2022 Jul 28;19(7):562-564. doi: 10.11909/j.issn.1671-5411.2022.07.006. PMID- 35974389 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240902 IS - 2055-0464 (Print) IS - 2055-0464 (Electronic) IS - 2055-0464 (Linking) VI - 9 IP - 1 DP - 2022 Aug 17 TI - A time-efficient protocol for transthoracic echocardiography during transfemoral transcatheter aortic valve implantation: early identification and effective management of intraprocedural complications. PG - 3 LID - 10.1186/s44156-022-00005-6 [doi] LID - 3 AB - Transfemoral transcatheter aortic valve implantation (TAVI) under conscious sedation is the most widely used method of implantation. Echocardiography is used to detect complications and to assess the implantation result. The aim of this paper is to provide a time-efficient protocol when transthoracic echocardiography (TTE) is used to guide TAVI procedures. CI - (c) 2022. The Author(s). FAU - Savvoulidis, Panagiotis AU - Savvoulidis P AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Moody, William E AU - Moody WE AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Steeds, Rick AU - Steeds R AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Ludman, Peter F AU - Ludman PF AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Bradley, Joseph R AU - Bradley JR AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Singh, Aldrin AU - Singh A AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Lawton, Ewa AU - Lawton E AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. FAU - Nadir, M Adnan AU - Nadir MA AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. FAU - Doshi, Sagar N AU - Doshi SN AD - Department of Cardiology, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK. Sagar.Doshi@uhb.nhs.uk. AD - Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. Sagar.Doshi@uhb.nhs.uk. LA - eng PT - Journal Article PT - Review DEP - 20220817 PL - England TA - Echo Res Pract JT - Echo research and practice JID - 101664713 PMC - PMC9382780 OTO - NOTNLM OT - Complications OT - Echocardiography guidance OT - Transcatheter aortic valve implantation COIS- Dr SN Doshi is a proctor for Edwards LifeSciences and has received speaker fees from Medtronic and Boston Scientific. The other authors have no disclosures. EDAT- 2022/08/17 06:00 MHDA- 2022/08/17 06:01 PMCR- 2022/08/17 CRDT- 2022/08/16 23:42 PHST- 2022/02/23 00:00 [received] PHST- 2022/05/28 00:00 [accepted] PHST- 2022/08/16 23:42 [entrez] PHST- 2022/08/17 06:00 [pubmed] PHST- 2022/08/17 06:01 [medline] PHST- 2022/08/17 00:00 [pmc-release] AID - 10.1186/s44156-022-00005-6 [pii] AID - 5 [pii] AID - 10.1186/s44156-022-00005-6 [doi] PST - epublish SO - Echo Res Pract. 2022 Aug 17;9(1):3. doi: 10.1186/s44156-022-00005-6. PMID- 35970699 OWN - NLM STAT- MEDLINE DCOM- 20230113 LR - 20250623 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 46 DP - 2023 Jan TI - Selection of Vascular Closure Devices in Transcatheter Aortic Valve Replacement: Systematic Review and Network Meta-Analysis. PG - 78-84 LID - S1553-8389(22)00709-6 [pii] LID - 10.1016/j.carrev.2022.08.011 [doi] AB - Various vascular closure devices (VCDs) are commonly used for percutaneous transcatheter aortic valve replacement (TAVR). However, superiority and safety profile among them remain unclear. We compared periprocedural complications among various VCDs in patients undergoing TAVR. PubMed and EMBASE were searched through January 2022 to identify clinical studies comparing any 2 VCDs of Prostar, Proglide and MANTA in patients who underwent TAVR. Studies using surgical cut-down or alternative access other than transfemoral approach were excluded. We analyzed the odds ratios (ORs) of vascular complications (VC), bleeding, acute kidney injury and all-cause mortality using a network meta-analysis. All outcomes were defined by Valve Academic Research Consortium 2 criteria. Two randomized controlled trials and 15 observational studies were identified, yielding a total of 11,344 patients including Prostar (n = 4499), Proglide (n = 5705), or MANTA group (n = 1140). The rates of major VC and life-threatening and major bleeding were significantly lower in Proglide compared to Prostar (OR [95 % CI] = 0.54 [0.32-0.89], 0.68 [0.52-0.90], and 0.49 [0.26-0.95], respectively). There was no significant difference in major VC and bleeding between Proglide and MANTA groups. Proglide was associated with a lower rate of acute kidney injury (0.56 [0.34-0.92]) and red blood cell transfusion (0.39 [0.16-0.98]) compared to Prostar. There was no significant difference in additional interventions and 30-day overall mortality among three groups. In this network meta-analysis of VCD in patients undergoing TAVR, MANTA and Proglide had comparable outcomes while Proglide appears superior to Prostar in terms of major VC and bleeding. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Sakata, Tomoki AU - Sakata T AD - Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, USA. FAU - Kuno, Toshiki AU - Kuno T AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA. Electronic address: tkuno@montefiore.org. FAU - Fujisaki, Tomohiro AU - Fujisaki T AD - Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside and West, New York, USA. FAU - Yokoyama, Yujiro AU - Yokoyama Y AD - Department of Surgery, St. Luke's University Health Network, PA, USA. FAU - Misumida, Naoki AU - Misumida N AD - Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, USA. FAU - Sugiura, Tadahisa AU - Sugiura T AD - Department of Cardiothoracic & Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA. FAU - Latib, Azeem AU - Latib A AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA. LA - eng PT - Journal Article PT - Network Meta-Analysis PT - Systematic Review DEP - 20220811 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Acute Kidney Injury MH - Aortic Valve/diagnostic imaging/surgery MH - Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Hemorrhage/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation MH - Treatment Outcome MH - *Vascular Closure Devices/adverse effects OTO - NOTNLM OT - Transcatheter aortic valve replacement OT - Vascular closure device COIS- Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tomoki Sakata reports a relationship with AbioMed Inc. that includes: funding grants. Azeem Latib reports a relationship with Medtronic Inc. that includes: consulting or advisory. Azeem Latib reports a relationship with Boston Scientific Corp that includes: consulting or advisory. Azeem Latib reports a relationship with Philips that includes: consulting or advisory. EDAT- 2022/08/16 06:00 MHDA- 2023/01/11 06:00 CRDT- 2022/08/15 22:06 PHST- 2022/08/06 00:00 [received] PHST- 2022/08/08 00:00 [accepted] PHST- 2022/08/16 06:00 [pubmed] PHST- 2023/01/11 06:00 [medline] PHST- 2022/08/15 22:06 [entrez] AID - S1553-8389(22)00709-6 [pii] AID - 10.1016/j.carrev.2022.08.011 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2023 Jan;46:78-84. doi: 10.1016/j.carrev.2022.08.011. Epub 2022 Aug 11. PMID- 35944788 OWN - NLM STAT- MEDLINE DCOM- 20221026 LR - 20221026 IS - 1532-2939 (Electronic) IS - 0195-6701 (Linking) VI - 129 DP - 2022 Nov TI - Prevalence of enterococcal groin colonization in patients undergoing cardiac interventions: challenging antimicrobial prophylaxis with cephalosporins in patients undergoing transcatheter aortic valve replacement. PG - 198-202 LID - S0195-6701(22)00242-0 [pii] LID - 10.1016/j.jhin.2022.07.020 [doi] AB - BACKGROUND: Cephalosporins are recommended for prophylaxis before transcatheter aortic valve replacement (TAVR). Infective endocarditis (IE) after TAVR is caused by enterococci in up to 30% of cases, particularly early after TAVR. Enterococcal colonization in the groin has been postulated as a source of infection, not only because prophylaxis does not cover enterococci but also because most TAVR procedures are performed by transfemoral access. There are few data analysing the groin microbiome to demonstrate the presence of enterococci. AIM: To assess the prevalence of enterococci in the groins of cardiological patients receiving transfemoral interventions. METHODS: This prospective cohort study was undertaken at University Hospital Basel, Switzerland between February and August 2020. Two skin swabs were taken from the groins of consecutive patients undergoing transfemoral cardiac interventions before the administration of antibiotic prophylaxis; for each patient, swabs were taken before and after groin disinfection. Swabs were analysed in the local microbiological laboratory following validated culture methods. FINDINGS: Of 290 included patients, 245 (84.5%) underwent coronary angiography, 31 (10.7%) underwent TAVR, eight (2.8%) underwent right heart catheterization, five (1.7%) underwent closure of patent foramen ovale, and one (0.3%) underwent a MitraClip procedure. Enterococci were detected before disinfection in 48 patients, enterococci were still cultured after disinfection in three patients, and enterococci were detected after disinfection alone (i.e. not detected before disinfection) in one patient. The prevalence of enterococci was 16.6% before disinfection and 1.4% after disinfection. Patients colonized with enterococci had a significantly higher body mass index and were more likely to be diabetic than uncolonized patients. CONCLUSION: Common enterococcal colonization of the groin, coupled with frequent isolation of enterococci from patients with TAVR-associated IE, provides strong evidence that the current recommendation of antimicrobial prophylaxis with cephalosporins before TAVR should be changed to antimicrobial prophylaxis with a compound that is active against enterococci. CI - Copyright (c) 2022 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. FAU - Widmer, D AU - Widmer D AD - Clarunis, University Hospital Basel, Basel, Switzerland. FAU - Widmer, A F AU - Widmer AF AD - Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Jeger, R AU - Jeger R AD - Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Dangel, M AU - Dangel M AD - Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Stortecky, S AU - Stortecky S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Frei, R AU - Frei R AD - Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Conen, A AU - Conen A AD - Department of Infectious Diseases and Infection Prevention, Kantonsspital Aarau, Aarau, Switzerland. Electronic address: anna.conen@ksa.ch. LA - eng PT - Journal Article DEP - 20220806 PL - England TA - J Hosp Infect JT - The Journal of hospital infection JID - 8007166 RN - 0 (Cephalosporins) RN - 0 (Anti-Bacterial Agents) RN - 0 (Anti-Infective Agents) SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Groin MH - Prevalence MH - Cephalosporins/therapeutic use MH - Prospective Studies MH - Treatment Outcome MH - *Endocarditis/epidemiology MH - Anti-Bacterial Agents/therapeutic use MH - *Anti-Infective Agents MH - Risk Factors OTO - NOTNLM OT - Cardiological OT - Colonization OT - Enterococci OT - Groin OT - Patients OT - TAVR EDAT- 2022/08/10 06:00 MHDA- 2022/10/27 06:00 CRDT- 2022/08/09 19:35 PHST- 2022/06/08 00:00 [received] PHST- 2022/07/17 00:00 [revised] PHST- 2022/07/25 00:00 [accepted] PHST- 2022/08/10 06:00 [pubmed] PHST- 2022/10/27 06:00 [medline] PHST- 2022/08/09 19:35 [entrez] AID - S0195-6701(22)00242-0 [pii] AID - 10.1016/j.jhin.2022.07.020 [doi] PST - ppublish SO - J Hosp Infect. 2022 Nov;129:198-202. doi: 10.1016/j.jhin.2022.07.020. Epub 2022 Aug 6. PMID- 35933223 OWN - NLM STAT- MEDLINE DCOM- 20220908 LR - 20221222 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 180 DP - 2022 Oct 1 TI - Ultrasound-Guided Versus Conventional MANTA Vascular Closure Device Deployment After Transcatheter Aortic Valve Implantation. PG - 116-123 LID - S0002-9149(22)00712-3 [pii] LID - 10.1016/j.amjcard.2022.06.046 [doi] AB - Despite the development of device technology and operators' experience, access site vascular complications (VCs) remain one of the major concerns after transcatheter aortic valve implantation (TAVI). MANTA (Teleflex, Wayne, Pennsylvania) is a large-bore vascular closure device (VCD) with promising incidence of VC. Previously, we demonstrated that the ultrasound-guided MANTA (US-MANTA) technique further improved the outcomes compared with conventional MANTA (C-MANTA) without ultrasound guidance. The present study was established to prove the effectiveness of the technique in a larger population. In this study, we included 1,150 patients (335 patients with C-MANTA and 815 with US-MANTA) who received MANTA after TAVI from April 2017 to September 2021. The primary endpoint was MANTA-related VC. Overall VC, VCD failure, and bleeding complications were also assessed based on the Valve Academic Research Consortium 3 criteria. MANTA-related VC occurred in 12.5% in the C-MANTA group and 6.8% in the US-MANTA group (p = 0.001). VCD failure rate were 7.5% and 3.9%, respectively (p = 0.012). Valve Academic Research Consortium 3 major and minor VC were more frequent in C-MANTA group (major: 7.8% vs 4.4%, p = 0.023; minor: 8.1% vs 4.4%, p = 0.022). Multivariate analysis revealed US-MANTA as the negative predictor of MANTA-related VC (odds ratio 0.57, 95% confidence interval 0.36 to 0.89, p = 0.013). However, subgroup analysis showed the efficacy of the US-MANTA technique was limited to the patients without severely calcified puncture site (P(interaction) = 0.048). In conclusion, the US-MANTA technique was an effective strategy to reduce VC after transfemoral TAVI compared with C-MANTA. CI - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Miyashita, Hirokazu AU - Miyashita H AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland; Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Moriyama, Noriaki AU - Moriyama N AD - Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Dahlbacka, Sebastian AU - Dahlbacka S AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. FAU - Vahasilta, Tommi AU - Vahasilta T AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. FAU - Vainikka, Tiina AU - Vainikka T AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. FAU - Jalanko, Mikko AU - Jalanko M AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. FAU - Viikila, Juho AU - Viikila J AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. FAU - Laine, Mika AU - Laine M AD - Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. Electronic address: Mika.Laine@hus.fi. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220804 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - Femoral Artery/surgery MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - Ultrasonography, Interventional MH - *Vascular Closure Devices EDAT- 2022/08/07 06:00 MHDA- 2022/09/09 06:00 CRDT- 2022/08/06 22:03 PHST- 2022/03/21 00:00 [received] PHST- 2022/06/01 00:00 [revised] PHST- 2022/06/08 00:00 [accepted] PHST- 2022/08/07 06:00 [pubmed] PHST- 2022/09/09 06:00 [medline] PHST- 2022/08/06 22:03 [entrez] AID - S0002-9149(22)00712-3 [pii] AID - 10.1016/j.amjcard.2022.06.046 [doi] PST - ppublish SO - Am J Cardiol. 2022 Oct 1;180:116-123. doi: 10.1016/j.amjcard.2022.06.046. Epub 2022 Aug 4. PMID- 35927712 OWN - NLM STAT- MEDLINE DCOM- 20220808 LR - 20250728 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 17 IP - 1 DP - 2022 Aug 4 TI - Comparison of outcomes of trans-subclavian versus trans-apical approaches in transcatheter aortic valve implantation. PG - 180 LID - 10.1186/s13019-022-01929-0 [doi] LID - 180 AB - BACKGROUND: Many patients are unsuitable for conventional femoral transcatheter aortic valve implantation (TAVI) but there is limited evidence as to which alternative approach has the best outcomes. We compared clinical outcomes in patients undergoing trans-subclavian (TS) or trans-apical (TA) TAVI. METHODS: This was a national retrospective observational study of patients undergoing surgical TAVI in Scotland between January 2013 and March 2020. The pre-operative patient characteristics, intraoperative details and post-operative outcomes were compared between TS and TA cohorts using data from the National Institute of Cardiovascular Outcomes Research (NICOR) registry. RESULTS: Among 1055 patients who underwent TAVI, TS or TA access was used in 50 (4.7%) and 90 (8.5%) patients respectively. Self-expanding Medtronic Evolut R valves were used in 84% of TS procedures, while balloon-expandable Edwards SAPIEN valves were used in all TA procedures. The TS group had a lower mean logistic EuroSCORE than the TA group (27.31 +/- 19.44% vs 34.92 +/- 19.61% p = 0.029). The TS approach was associated with a higher incidence of moderate postprocedural aortic regurgitation (12.5% vs 2.4%, p = 0.025). There was no significant difference in 30-day, 1-year or overall all-cause mortality. CONCLUSIONS: Both trans-subclavian and trans-apical access are viable approaches for patients requiring non-transfemoral TAVI. Differences in peri-procedural indices reflect the disparate patient populations and factors governing prosthesis choice, and short- and long-term mortality was similar. CI - (c) 2022. The Author(s). FAU - Tomala, Olaf AU - Tomala O AD - Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK. FAU - Zamvar, Vipin AU - Zamvar V AUID- ORCID: 0000-0003-2447-828X AD - Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK. zamvarv@hotmail.com. FAU - Bing, Rong AU - Bing R AD - Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, UK. FAU - Pessotto, Renzo AU - Pessotto R AD - Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK. FAU - Cruden, Nick AU - Cruden N AD - Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, UK. LA - eng PT - Journal Article PT - Observational Study DEP - 20220804 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis MH - Femoral Artery/surgery MH - Fluoroscopy MH - *Heart Valve Prosthesis MH - Humans MH - Prosthesis Design MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome PMC - PMC9354363 OTO - NOTNLM OT - Aortic stenosis OT - TAVR OT - Transcatheter aortic valve implantation OT - Vascular access COIS- The authors declare no conflicts of interest. EDAT- 2022/08/05 06:00 MHDA- 2022/08/09 06:00 PMCR- 2022/08/04 CRDT- 2022/08/04 23:48 PHST- 2022/02/22 00:00 [received] PHST- 2022/08/01 00:00 [accepted] PHST- 2022/08/04 23:48 [entrez] PHST- 2022/08/05 06:00 [pubmed] PHST- 2022/08/09 06:00 [medline] PHST- 2022/08/04 00:00 [pmc-release] AID - 10.1186/s13019-022-01929-0 [pii] AID - 1929 [pii] AID - 10.1186/s13019-022-01929-0 [doi] PST - epublish SO - J Cardiothorac Surg. 2022 Aug 4;17(1):180. doi: 10.1186/s13019-022-01929-0. PMID- 35924996 OWN - NLM STAT- MEDLINE DCOM- 20220907 LR - 20250728 IS - 1540-8191 (Electronic) IS - 0886-0440 (Linking) VI - 37 IP - 10 DP - 2022 Oct TI - The current practice of transcatheter aortic valve replacement in China. PG - 3168-3177 LID - 10.1111/jocs.16815 [doi] AB - OBJECTIVE: The purpose of this study is to summarize the current practice and experience of transcatheter aortic valve replacement in China. METHODS: The relevant articles were identified through computerized searches of the CNKI, WANFANG, VIP, and PubMed databases through February 1, 2022, using the search terms: "transcatheter aortic valve replacement," "transcatheter aortic valve implantation," "China." RESULTS: The database searches identified 22 articles, 2092 patients, 57.65% were male, with a mean age of 74.2 +/- 6.0 years, 71.51% of patients were classified by New York Heart Association as class Ⅲ/Ⅳ, Society of Thoracic Surgeons score 8.4 +/- 4.1, mean left ventricular ejection fraction 52.8 +/- 14.2%, mean transvalvular aortic pressure gradient 59.9 +/- 18.9 mmHg. The overall procedural success rate was 97.85%, and 2.15% of patients were converted to sternotomy, mainly due to transcatheter aortic bioprosthesis dislocation. The most common vascular access approach was transfemoral (1071 patients, 51.20%). General anesthesia (48.90%) was the commonly used anesthesia technique. The incidence of postprocedural complications was as follows: permanent pacemaker implantation (10.47%), bleeding events (8.60%), mild paravalvular leakage (17.73%), moderate and severe paravalvular leakage (4.16%), vascular complications (3.30%), stroke (1.43%), respectively. The overall periprocedural period and postprocedural 30-day mortality was 2.72%. CONCLUSIONS: Among patients undergoing transcatheter aortic valve replacement in China, device implantation success was achieved in 97.85% of cases. The most common vascular access approach was transfemoral. General anesthesia was the most commonly used anesthetic technique. Paravalvular leakage (458 patients, 21.89%) was the most common complication. CI - (c) 2022 Wiley Periodicals LLC. FAU - Xie, Chun-Mei AU - Xie CM AUID- ORCID: 0000-0001-8821-3198 AD - Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China. FAU - Yao, Yun-Tai AU - Yao YT AD - Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. LA - eng GR - None/ PT - Journal Article DEP - 20220804 PL - United States TA - J Card Surg JT - Journal of cardiac surgery JID - 8908809 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Female MH - *Heart Valve Prosthesis MH - Humans MH - Male MH - Prosthesis Design MH - Risk Factors MH - Stroke Volume MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - Ventricular Function, Left OTO - NOTNLM OT - China OT - anesthesia OT - complication OT - transcatheter aortic valve implantation OT - transcatheter aortic valve replacement EDAT- 2022/08/05 06:00 MHDA- 2022/09/08 06:00 CRDT- 2022/08/04 10:05 PHST- 2022/05/29 00:00 [revised] PHST- 2022/03/28 00:00 [received] PHST- 2022/06/19 00:00 [accepted] PHST- 2022/08/05 06:00 [pubmed] PHST- 2022/09/08 06:00 [medline] PHST- 2022/08/04 10:05 [entrez] AID - 10.1111/jocs.16815 [doi] PST - ppublish SO - J Card Surg. 2022 Oct;37(10):3168-3177. doi: 10.1111/jocs.16815. Epub 2022 Aug 4. PMID- 35923768 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220805 IS - 1756-1485 (Electronic) IS - 1756-1477 (Print) IS - 1756-1485 (Linking) VI - 17 DP - 2022 Jan TI - Transcatheter Aortic Valve Implantation for Severe Pure Aortic Regurgitation With Dedicated Devices. PG - e11 LID - 10.15420/icr.2021.19 [doi] LID - e11 AB - Aortic regurgitation (AR) is not the most common valvular disease; however, its prevalence increases with age, with more than 2% of those aged >70 years having at least moderate AR. Once symptoms related to AR develop, the prognosis becomes poor. Transcatheter aortic valve implantation for patients with pure severe AR and at prohibitive surgical risk is occasionally performed, but remains a clinical challenge due to absence of valvular calcium, large aortic root and increased stroke volume. These issues make the positioning and deployment of transcatheter aortic valve implantation devices unpredictable, with a tendency to prosthesis embolisation or malposition. To date, the only two dedicated transcatheter valves for AR are the J-Valve (JC Medical) and the JenaValve (JenaValve Technology). Both devices have been used successfully via the transapical approach. The transfemoral experience is limited to first-in-human publications and to a clinical trial dedicated to AR, for which the completion date is still pending. CI - Copyright (c) 2022, Radcliffe Cardiology. FAU - Costanzo, Pierluigi AU - Costanzo P AD - Division of Cardiology, St Michael's Hospital, University of Toronto Toronto, Canada. AD - Division of Cardiology, Royal Papworth Hospital Cambridge, UK. FAU - Bamborough, Paul AU - Bamborough P AD - Division of Cardiology, Royal Papworth Hospital Cambridge, UK. FAU - Peterson, Mark AU - Peterson M AD - Division of Cardiac Surgery, St Michael's Hospital, University of Toronto Toronto, Canada. FAU - Deva, Djeven J AU - Deva DJ AD - Department of Medical Imaging, St Michael's Hospital, University of Toronto Toronto, Canada. FAU - Ong, Geraldine AU - Ong G AD - Division of Cardiology, St Michael's Hospital, University of Toronto Toronto, Canada. FAU - Fam, Neil AU - Fam N AD - Division of Cardiology, St Michael's Hospital, University of Toronto Toronto, Canada. LA - eng PT - Journal Article PT - Review DEP - 20220721 PL - England TA - Interv Cardiol JT - Interventional cardiology (London, England) JID - 101559687 PMC - PMC9340575 OTO - NOTNLM OT - Aortic regurgitation OT - transcatheter aortic valve implantation OT - valvular disease COIS- Disclosure: The authors have no conflicts of interest to declare. EDAT- 2022/08/05 06:00 MHDA- 2022/08/05 06:01 PMCR- 2022/07/21 CRDT- 2022/08/04 02:24 PHST- 2021/06/10 00:00 [received] PHST- 2022/02/18 00:00 [accepted] PHST- 2022/08/04 02:24 [entrez] PHST- 2022/08/05 06:00 [pubmed] PHST- 2022/08/05 06:01 [medline] PHST- 2022/07/21 00:00 [pmc-release] AID - 10.15420/icr.2021.19 [doi] PST - epublish SO - Interv Cardiol. 2022 Jul 21;17:e11. doi: 10.15420/icr.2021.19. eCollection 2022 Jan. PMID- 35916117 OWN - NLM STAT- MEDLINE DCOM- 20221118 LR - 20230107 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 100 IP - 5 DP - 2022 Nov TI - Cerebral embolic protection and severity of stroke following transcatheter aortic valve replacement. PG - 810-820 LID - 10.1002/ccd.30340 [doi] AB - BACKGROUND: The cerebral embolic protection (CEP) device captures embolic debris during transcatheter aortic valve replacement (TAVR). However, the impact of CEP on stroke severity following TAVR remains unclear. Therefore, we aimed to examine whether CEP was associated with reduced severity of stroke following TAVR. METHODS: This was a retrospective cohort study of 2839 consecutive patients (mean age: 79.2 +/- 9.5 years, females: 41.5%) who underwent transfemoral TAVR at our institution between 2013 and 2020. We categorized patients into Sentinel CEP users and nonusers. Neuroimaging data were reviewed and the final diagnosis of a cerebrovascular event was adjudicated by a neurologist blinded to the CEP use or nonuse. We compared the incidence and severity (assessed by the National Institutes of Health Stroke Scale [NIHSS]) of stroke through 72 h post-TAVR or discharge between the two groups using stabilized inverse probability of treatment weighting (IPTW) of propensity scores. RESULTS: Of the eligible patients, 1802 (63.5%) received CEP during TAVR and 1037 (36.5%) did not. After adjustment for patient characteristics by stabilized IPTW, the rate of overall stroke was numerically lower in CEP users than in CEP nonusers, but the difference did not reach statistical significance (0.49% vs. 1.18%, p = 0.064). However, CEP users had significantly lower rates of moderate-or-severe stroke (NIHSS >/= 6: 0.11% vs. 0.69%, p = 0.013) and severe stroke (NIHSS >/= 15: 0% vs. 0.29%, p = 0.046). Stroke following CEP use (n = 8), compared with stroke following CEP nonuse (n = 15), tended to carry a lower NIHSS (median [IQR], 4.0 [2.0-7.0] vs. 7.0 [4.5-19.0], p = 0.087). Four (26.7%) out of 15 patients with stroke following CEP nonuse died within 30 days, with no death after stroke following CEP use. CONCLUSIONS: CEP use may be associated with attenuated severity of stroke despite no significant difference in overall stroke incidence compared with CEP nonuse. This finding is considered hypothesis-generating and needs to be confirmed in large prospective studies. CI - (c) 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Isogai, Toshiaki AU - Isogai T AUID- ORCID: 0000-0002-2172-6447 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Vanguru, Husitha Reddy AU - Vanguru HR AD - Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AUID- ORCID: 0000-0001-6048-7955 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Agrawal, Ankit AU - Agrawal A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Spilias, Nikolaos AU - Spilias N AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Shekhar, Shashank AU - Shekhar S AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Saad, Anas M AU - Saad AM AUID- ORCID: 0000-0003-0101-0131 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Verma, Beni Rai AU - Verma BR AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Reed, Grant W AU - Reed GW AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Popovic, Zoran B AU - Popovic ZB AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Unai, Shinya AU - Unai S AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Yun, James J AU - Yun JJ AD - Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Uchino, Ken AU - Uchino K AUID- ORCID: 0000-0001-9468-4172 AD - Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. LA - eng PT - Journal Article DEP - 20220802 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Female MH - Humans MH - Aged MH - Aged, 80 and over MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/complications MH - Prospective Studies MH - Retrospective Studies MH - Treatment Outcome MH - *Intracranial Embolism/diagnostic imaging/epidemiology/etiology MH - *Embolic Protection Devices MH - *Stroke/epidemiology/etiology/prevention & control MH - Aortic Valve/diagnostic imaging/surgery MH - Risk Factors PMC - PMC9805232 OTO - NOTNLM OT - cerebral embolic protection devices OT - stroke OT - transcatheter aortic valve replacement COIS- Dr. Samir R. Kapadia has served as the study principal investigator for the ongoing PROTECTED TAVR trial (NCT04149535). The remaining authors declare no conflict of interest. EDAT- 2022/08/03 06:00 MHDA- 2022/11/19 06:00 PMCR- 2022/12/31 CRDT- 2022/08/02 05:13 PHST- 2022/06/25 00:00 [received] PHST- 2022/07/04 00:00 [accepted] PHST- 2022/08/03 06:00 [pubmed] PHST- 2022/11/19 06:00 [medline] PHST- 2022/08/02 05:13 [entrez] PHST- 2022/12/31 00:00 [pmc-release] AID - CCD30340 [pii] AID - 10.1002/ccd.30340 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2022 Nov;100(5):810-820. doi: 10.1002/ccd.30340. Epub 2022 Aug 2. PMID- 35903846 OWN - NLM STAT- MEDLINE DCOM- 20221123 LR - 20240908 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 18 IP - 10 DP - 2022 Nov 18 TI - Dual ProGlide versus ProGlide and FemoSeal for vascular access haemostasis after transcatheter aortic valve implantation. PG - 812-819 LID - EIJ-D-22-00311 [pii] LID - 10.4244/EIJ-D-22-00311 [doi] AB - BACKGROUND: Large-bore arteriotomy for transcatheter aortic valve implantation (TAVI) requires percutaneous vascular closure devices, but real-world data comparing different closure strategies are limited. AIMS: We sought to compare a dual ProGlide strategy vs a combination of one ProGlide and one FemoSeal for vascular closure after TAVI. METHODS: We retrospectively analysed 874 propensity score-matched patients undergoing TAVI at the Munich University Hospital from August 2018 to October 2020. From August 2018 to August 2019, a dual ProGlide strategy was used for vascular closure. From October 2019 to October 2020, a combination of one ProGlide and one FemoSeal was used. The primary endpoint was defined as access-related major vascular complications or bleeding >/=Type 2 according to Valve Academic Research Consortium 3 criteria. RESULTS: Patients in the dual ProGlide group (n=437) had a higher incidence of the primary endpoint than patients treated with one ProGlide and one FemoSeal (n=437; 11.4% vs 3.0%; p<0.001). Furthermore, they had a higher rate of closure device failure (2.7% vs 0.9%; p=0.044) and more often required unplanned surgery or endovascular treatment (3.9% vs 0.9%; p=0.004). The incidence of death did not differ significantly between groups (3.4% vs 1.6%; p=0.08). CONCLUSIONS: A combined ProGlide and FemoSeal strategy might have the potential to reduce access-related vascular complications following TAVI. FAU - Gmeiner, Jonas M D AU - Gmeiner JMD AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Linnemann, Marie AU - Linnemann M AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Steffen, Julius AU - Steffen J AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Scherer, Clemens AU - Scherer C AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Orban, Martin AU - Orban M AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Theiss, Hans AU - Theiss H AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Mehilli, Julinda AU - Mehilli J AD - Medizinische Klinik I, Krankenhaus Landshut Achdorf, Landshut, Germany. FAU - Sadoni, Sebastian AU - Sadoni S AD - Herzchirurgische Klinik und Poliklinik, LMU Klinikum Munchen, Munich, Germany. FAU - Peterss, Sven AU - Peterss S AD - Herzchirurgische Klinik und Poliklinik, LMU Klinikum Munchen, Munich, Germany. FAU - Joskowiak, Dominik AU - Joskowiak D AD - Herzchirurgische Klinik und Poliklinik, LMU Klinikum Munchen, Munich, Germany. FAU - Hagl, Christian AU - Hagl C AD - Herzchirurgische Klinik und Poliklinik, LMU Klinikum Munchen, Munich, Germany. FAU - Tsilimparis, Nikolaos AU - Tsilimparis N AD - Abteilung fur Gefasschirurgie, LMU Klinikum Munchen, Munich, Germany. FAU - Curta, Adrian AU - Curta A AD - Klinik und Poliklinik fur Radiologie, LMU Klinikum Munchen, Munich, Germany. FAU - Maurus, Stefan AU - Maurus S AD - Klinik und Poliklinik fur Radiologie, LMU Klinikum Munchen, Munich, Germany. FAU - Doldi, Philipp M AU - Doldi PM AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Low, Kornelia AU - Low K AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Haum, Magda AU - Haum M AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Roden, Daniel AU - Roden D AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Hausleiter, Jorg AU - Hausleiter J AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. AD - Munich Heart Alliance, German Center for Cardiovascular Research (DZHK), Munich, Germany. FAU - Massberg, Steffen AU - Massberg S AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. AD - Munich Heart Alliance, German Center for Cardiovascular Research (DZHK), Munich, Germany. FAU - Rizas, Konstantinos AU - Rizas K AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Deseive, Simon AU - Deseive S AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. FAU - Braun, Daniel AU - Braun D AD - Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany. LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - Femoral Artery/surgery MH - Treatment Outcome MH - *Vascular Closure Devices/adverse effects MH - Hemostasis MH - Aortic Valve/diagnostic imaging/surgery MH - Hemostatic Techniques/adverse effects PMC - PMC9724847 COIS- M. Orban reports speaker honoraria from Abbott Medical, AstraZeneca, Abiomed, Bayer Vital, BIOTRONIK, Bristol-Myers Squibb, CytoSorbents, Daiichi Sankyo Deutschland, Edwards Lifesciences, and Sedana Medical; support for attending meetings from AstraZeneca; stocks from Abbott Laboratories, AbbVie, AstraZeneca, Bayer, Biontech, Bristol-Myers Squibb, Curevac, Draegerwerk, Fresenius Medical Care, Gilead Sciences, Inari Medical, Johnson&Johnson, Linde, Merck US, Moderna, NovoNordisk, Nuance Communications, Pfizer, Proctor&Gamble, Roche, SAP, Siemens Healthineers, and Zoom.D. Braun reports speaker honoraria from Abbott Vascular and Edwards Lifesciences.J. Hausleiter reports speaker honoraria and consulting fees from Abbott Vascular and Edwards Lifesciences. S. Deseive reports speaker honoraria from AstraZeneca. S. Peterss reports speaker honoraria from AstraZeneca. C. Scherer reports speaker honoraria from AstraZeneca. J. Mehilli reports institutional research grants from Boston Scientific and speaker honoraria from AstraZeneca, Pfizer, SIS Medical, Daiichi Sankyo. J. Steffen reports speaker honoraria from AstraZeneca and Travel support from theGerman Center for Cardiovascular Research (DZHK). The other authors have no conflicts of interest to declare. EDAT- 2022/07/30 06:00 MHDA- 2022/11/24 06:00 PMCR- 2023/11/18 CRDT- 2022/07/29 02:22 PHST- 2022/07/30 06:00 [pubmed] PHST- 2022/11/24 06:00 [medline] PHST- 2022/07/29 02:22 [entrez] PHST- 2023/11/18 00:00 [pmc-release] AID - EIJ-D-22-00311 [pii] AID - 10.4244/EIJ-D-22-00311 [doi] PST - ppublish SO - EuroIntervention. 2022 Nov 18;18(10):812-819. doi: 10.4244/EIJ-D-22-00311. PMID- 35895988 OWN - NLM STAT- MEDLINE DCOM- 20221110 LR - 20221122 IS - 1678-9741 (Electronic) IS - 0102-7638 (Print) IS - 0102-7638 (Linking) VI - 37 IP - 5 DP - 2022 Oct 8 TI - Tips and Tricks in Transaortic TAVR. PG - 765-768 LID - 10.21470/1678-9741-2021-0553 [doi] AB - Transfemoral transcatheter aortic valve replacement (TAVR) is currently the standard catheter-based treatment of severe aortic stenosis patients. Being the transfemoral route not feasible, other access sites could be chosen. Transaortic TAVR via either a J mini-sternotomy or a right anterolateral mini-thoracotomy is a good option for patients having tricky thoracoabdominal aorta. Some tips and tricks may help in getting a fast and safe transaortic procedure. FAU - Gennari, Marco AU - Gennari M AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. FAU - Trabattoni, Piero AU - Trabattoni P AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. FAU - Agrifoglio, Marco AU - Agrifoglio M AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. AD - Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Italy. FAU - Polvani, Gianluca AU - Polvani G AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. AD - Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Italy. FAU - Roberto, Maurizio AU - Roberto M AD - Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, Milan, Italy. LA - eng PT - Journal Article DEP - 20221008 PL - Brazil TA - Braz J Cardiovasc Surg JT - Brazilian journal of cardiovascular surgery JID - 101677045 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Treatment Outcome MH - Sternotomy MH - Thoracotomy MH - Aortic Valve/surgery MH - Risk Factors MH - *Heart Valve Prosthesis Implantation/methods PMC - PMC9670343 OTO - NOTNLM OT - Aortic Valve Stenosis OT - Aortic Valve Stenosis. OT - Sternotomy OT - Thoracotomy OT - Transcatheter Aortic Valve Replacement COIS- No conflict of interest. EDAT- 2022/07/28 06:00 MHDA- 2022/11/11 06:00 PMCR- 2022/09/01 CRDT- 2022/07/27 16:07 PHST- 2022/07/28 06:00 [pubmed] PHST- 2022/11/11 06:00 [medline] PHST- 2022/07/27 16:07 [entrez] PHST- 2022/09/01 00:00 [pmc-release] AID - 10.21470/1678-9741-2021-0553 [doi] PST - epublish SO - Braz J Cardiovasc Surg. 2022 Oct 8;37(5):765-768. doi: 10.21470/1678-9741-2021-0553. PMID- 35895046 OWN - NLM STAT- MEDLINE DCOM- 20220916 LR - 20230728 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 7 IP - 9 DP - 2022 Sep 1 TI - Association Between Early Left Ventricular Ejection Fraction Improvement After Transcatheter Aortic Valve Replacement and 5-Year Clinical Outcomes. PG - 934-944 LID - 10.1001/jamacardio.2022.2222 [doi] AB - IMPORTANCE: In patients with severe aortic stenosis and left ventricular ejection fraction (LVEF) less than 50%, early LVEF improvement after transcatheter aortic valve replacement (TAVR) is associated with improved 1-year mortality; however, its association with long-term clinical outcomes is not known. OBJECTIVE: To examine the association between early LVEF improvement after TAVR and 5-year outcomes. DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed patients enrolled in the Placement of Aortic Transcatheter Valves (PARTNER) 1, 2, and S3 trials and registries between July 2007 and April 2015. High- and intermediate-risk patients with baseline LVEF less than 50% who underwent transfemoral TAVR were included in the current study. Data were analyzed from August 2020 to May 2021. EXPOSURES: Early LVEF improvement, defined as increase of 10 percentage points or more at 30 days and also as a continuous variable (DeltaLVEF between baseline and 30 days). MAIN OUTCOMES AND MEASURES: All-cause death at 5 years. RESULTS: Among 659 included patients with LVEF less than 50%, 468 (71.0%) were male, and the mean (SD) age was 82.4 (7.7) years. LVEF improvement within 30 days following transfemoral TAVR occurred in 216 patients (32.8%) (mean [SD] DeltaLVEF, 16.4 [5.7%]). Prior myocardial infarction, diabetes, cancer, higher baseline LVEF, larger left ventricular end-diastolic diameter, and larger aortic valve area were independently associated with lower likelihood of LVEF improvement. Patients with vs without early LVEF improvement after TAVR had lower 5-year all-cause death (102 [50.0%; 95% CI, 43.3-57.1] vs 246 [58.4%; 95% CI, 53.6-63.2]; P = .04) and cardiac death (52 [29.5%; 95% CI, 23.2-37.1] vs 135 [38.1%; 95% CI, 33.1-43.6]; P = .05). In multivariable analyses, early improvement in LVEF (modeled as a continuous variable) was associated with lower 5-year all-cause death (adjusted hazard ratio per 5% increase in LVEF, 0.94 [95% CI, 0.88-1.00]; P = .04) and cardiac death (adjusted hazard ratio per 5% increase in LVEF, 0.90 [95% CI, 0.82-0.98]; P = .02) after TAVR. Restricted cubic spline analysis demonstrated a visual inflection point at DeltaLVEF of 10% beyond which there was a steep decline in all-cause mortality with increasing degree of LVEF improvement. There were no statistically significant differences in rehospitalization, New York Heart Association functional class, or Kansas City Cardiomyopathy Questionnaire Overall Summary score at 5 years in patients with vs without early LVEF improvement. In subgroup analysis, the association between early LVEF improvement and 5-year all-cause death was consistent regardless of the presence or absence of coronary artery disease or prior myocardial infarction. CONCLUSIONS AND RELEVANCE: In patients with severe aortic stenosis and LVEF less than 50%, 1 in 3 experience LVEF improvement within 1 month after TAVR. Early LVEF improvement is associated with lower 5-year all-cause and cardiac death. FAU - Kolte, Dhaval AU - Kolte D AD - Cardiology Division, Massachusetts General Hospital/Harvard Medical School, Boston. FAU - Bhardwaj, Bhaskar AU - Bhardwaj B AD - Division of Cardiovascular Medicine, University of Missouri, Columbia. FAU - Lu, Michael AU - Lu M AD - Edwards Lifesciences, Irvine, California. FAU - Alu, Maria C AU - Alu MC AD - Cardiovascular Research Foundation, New York, New York. AD - Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York. FAU - Passeri, Jonathan J AU - Passeri JJ AD - Cardiology Division, Massachusetts General Hospital/Harvard Medical School, Boston. FAU - Inglessis, Ignacio AU - Inglessis I AD - Cardiology Division, Massachusetts General Hospital/Harvard Medical School, Boston. FAU - Vlahakes, Gus J AU - Vlahakes GJ AD - Division of Cardiac Surgery, Massachusetts General Hospital/Harvard Medical School, Boston. FAU - Garcia, Santiago AU - Garcia S AD - Minneapolis Heart Institute Foundation, Minneapolis, Minnesota. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York, New York. AD - St. Francis Hospital and Heart Center, Roslyn, New York. FAU - Lindman, Brian R AU - Lindman BR AD - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. FAU - Kodali, Susheel AU - Kodali S AD - Cardiovascular Research Foundation, New York, New York. AD - Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York. FAU - Thourani, Vinod H AU - Thourani VH AD - Department of Cardiovascular Surgery, Piedmont Heart Institute, Atlanta, Georgia. FAU - Daubert, Melissa A AU - Daubert MA AD - Division of Cardiology and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. FAU - Douglas, Pamela S AU - Douglas PS AD - Division of Cardiology and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. FAU - Jaber, Wael AU - Jaber W AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Pibarot, Philippe AU - Pibarot P AD - Department of Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec-Universite Laval, Quebec City, Quebec, Canada. FAU - Clavel, Marie-Annick AU - Clavel MA AD - Department of Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec-Universite Laval, Quebec City, Quebec, Canada. FAU - Palacios, Igor F AU - Palacios IF AD - Cardiology Division, Massachusetts General Hospital/Harvard Medical School, Boston. FAU - Leon, Martin B AU - Leon MB AD - Cardiovascular Research Foundation, New York, New York. AD - Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York. FAU - Smith, Craig R AU - Smith CR AD - Cardiovascular Research Foundation, New York, New York. AD - Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York. FAU - Mack, Michael J AU - Mack MJ AD - Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, Texas. FAU - Elmariah, Sammy AU - Elmariah S AD - Cardiology Division, Massachusetts General Hospital/Harvard Medical School, Boston. LA - eng GR - K23 HL157612/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 SB - IM MH - Aged, 80 and over MH - *Aortic Valve Stenosis MH - Cohort Studies MH - Death MH - Female MH - Humans MH - Male MH - *Myocardial Infarction/surgery MH - Stroke Volume MH - *Transcatheter Aortic Valve Replacement MH - Ventricular Function, Left PMC - PMC9330296 COIS- Conflict of Interest Disclosures: Dr Kolte reported grants from the National Heart, Lung, and Blood Institute outside the submitted work. Dr Alu reported institutional research support from Edwards Lifesciences during the conduct of the study and from Abbott outside the submitted work. Dr Passeri reports grants and personal fees from Edwards Lifesciences and personal fees from Medtronic. Dr Garcia has received institutional research grants from Boston Scientific, Medtronic, Abbott Vascular, and Edwards Lifesciences; serves as a consultant to Abbott Vascular, Neochord, Medtronic, and Edwards Lifesciences; and serves as a proctor for Edwards Lifesciences. Dr Cohen has received research grant support from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific and has received consulting fees from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific. Dr Lindman has served on the scientific advisory board for Roche Diagnostics, received research grants from Edwards Lifesciences and Roche Diagnostics, and consulted for Medtronic outside the submitted work. Dr Kodali reported institutional research grants from Edwards Lifesciences, Medtronic, and Abbott; grants from Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Vascular, and Jenavalve; personal fees from Tricares, Triflo, Phillips, Admedus, and Dura Biotech, consulting fees from Abbott, Admedus, and Meril Lifesciences; equity from Biotrace Medical, MicroInterventional Devices, Thubrikar Aortic Valve Inc, Supira, Adona, Tioga, and X-Dot outside the submitted work. Dr Thourani has received grant support and consulting honoraria from Abbott Vascular, Allergen, Boston Scientific, Cryolife, Edwards Lifesciences, Gore Vascular, and Jenavalve. Dr Daubert reported institutional grant support from Edwards Lifesciences and consulting fees from Bayer. Dr Jaber has core laboratory contracts with Edwards Lifesciences through the Cleveland Clinic C5 with no personal compensation, consultant fees from Pfizer, and grants from Boston Scientific during the conduct of the study. Dr Pibarot reported institutional grants from Edwards Lifesciences during the conduct of the study and grants from Medtronic Contract and Pi-Cardia outside the submitted work. Dr Clavel reported grants from Edwards Lifesciences with no direct compensation and grants from Medtronic outside the submitted work. Dr Leon has received grant support, paid to his institution, from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific and advisory board fees from Medtronic, Abbott, Boston Scientific, Gore, and Meril Life Sciences. Dr Mack is the co-principal investigator of the trials supported by Edwards Lifesciences, Abbott, and Medtronic all uncompensated during the conduct of the study. Dr Elmariah reported grants from the American Heart Association, National Institutes of Health, Edwards Lifesciences, Medtronic, and Svelte Medical and has received consulting fees from Medtronic and AstraZeneca outside the submitted work. No other disclosures were reported. EDAT- 2022/07/28 06:00 MHDA- 2022/09/17 06:00 PMCR- 2023/07/27 CRDT- 2022/07/27 11:33 PHST- 2022/07/28 06:00 [pubmed] PHST- 2022/09/17 06:00 [medline] PHST- 2022/07/27 11:33 [entrez] PHST- 2023/07/27 00:00 [pmc-release] AID - 2794436 [pii] AID - hoi220038 [pii] AID - 10.1001/jamacardio.2022.2222 [doi] PST - ppublish SO - JAMA Cardiol. 2022 Sep 1;7(9):934-944. doi: 10.1001/jamacardio.2022.2222. PMID- 35887990 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220731 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 11 IP - 14 DP - 2022 Jul 21 TI - Multi-Center Comparison of Two Self-Expanding Transcatheter Heart Valves: A Propensity Matched Analysis. LID - 10.3390/jcm11144228 [doi] LID - 4228 AB - BACKGROUND: During the last years, several transcatheter aortic heart valves entered the clinical market and are commercially available. The prostheses differ regarding several technical and functional aspects. However, little is known regarding head-to-head comparative data of the ACURATE neo and the PORTICO valve prostheses. OBJECTIVES: The aim of this study was to compare two self-expanding transcatheter aortic heart valves (THV), the ACURATE neo and the PORTICO, with regard to in-hospital and 30-day outcomes, as well as early device failures. METHODS: A total of 1591 consecutive patients with severe native aortic valve stenosis from two centers were included in the analyses and matched by 1:1 nearest neighbor matching to identify one patient treated with PORTICO (n = 344) for each patient treated with ACURATE neo (n = 344). RESULTS: In-hospital complications were comparable between both valves, including any kind of stroke (ACURATE neo = 3.5% vs. PORTICO = 3.8%; p = 1.0), major vascular complications (ACURATE neo = 4.5% vs. PORTICO = 5.4%; p = 0.99) or life-threatening bleeding (ACURATE neo = 1% vs. PORTICO = 2%; p = 0.68). The rate of device failure defined by the VARC-2 criteria were comparable, including elevated gradients and moderate-to-severe paravalvular leakage (ACURATE neo = 7.3% vs. PORTICO = 7.6%; p = 1.0). However, the need for permanent pacemaker implantation (PPI) was significantly more frequent after the use of PORTICO THV (9.5% vs. 18.7%; p = 0.002). CONCLUSIONS: In this two-center case-matched comparison, short-term clinical and hemodynamic outcomes showed comparable results between PORTICO and ACURATE neo prostheses. However, PORTICO was associated with a significant higher incidence of PPI. FAU - Blumenstein, Johannes AU - Blumenstein J AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. AD - Medical School, Carl von Ossietzky University, 26111 Oldenburg, Germany. FAU - Eckel, Clemens AU - Eckel C AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. AD - Medical School, Carl von Ossietzky University, 26111 Oldenburg, Germany. FAU - Husser, Oliver AU - Husser O AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany. FAU - Renker, Matthias AU - Renker M AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Choi, Yeong-Hoon AU - Choi YH AD - Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany. AD - Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany. FAU - Al-Terki, Hani AU - Al-Terki H AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. FAU - Sotemann, Dagmar AU - Sotemann D AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. FAU - Korbi, Leon AU - Korbi L AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. FAU - Tiyerili, Vedat AU - Tiyerili V AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. FAU - Grothusen, Christina AU - Grothusen C AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. FAU - Gaede, Luise AU - Gaede L AD - Department of Medicine 2-Cardiology and Angiology, Friedrich-Alexander University, 91054 Erlangen, Germany. FAU - Dohmen, Guido AU - Dohmen G AUID- ORCID: 0000-0001-6577-7898 AD - Department of Cardiothoracic Surgery, St.-Johannes-Hospital, 11137 Dortmund, Germany. FAU - Mollmann, Helge AU - Mollmann H AD - Department of Internal Medicine I, St.-Johannes-Hospital, 44137 Dortmund, Germany. LA - eng PT - Journal Article DEP - 20220721 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9318122 OTO - NOTNLM OT - TAVR OT - aortic stenosis OT - balloon-expanding OT - self-expanding OT - transfemoral COIS- H.M.: Proctor fees and or speaker honoraria from Boston Scientific and Abott. W.-K.K.: Proctor fees and or speaker honoraria from Boston and Abott. J.B.: Proctor fees and or speaker honoraria from Boston Scientific and Abott. EDAT- 2022/07/28 06:00 MHDA- 2022/07/28 06:01 PMCR- 2022/07/21 CRDT- 2022/07/27 01:28 PHST- 2022/06/03 00:00 [received] PHST- 2022/07/14 00:00 [revised] PHST- 2022/07/18 00:00 [accepted] PHST- 2022/07/27 01:28 [entrez] PHST- 2022/07/28 06:00 [pubmed] PHST- 2022/07/28 06:01 [medline] PHST- 2022/07/21 00:00 [pmc-release] AID - jcm11144228 [pii] AID - jcm-11-04228 [pii] AID - 10.3390/jcm11144228 [doi] PST - epublish SO - J Clin Med. 2022 Jul 21;11(14):4228. doi: 10.3390/jcm11144228. PMID- 35887922 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220731 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 11 IP - 14 DP - 2022 Jul 18 TI - Transapical Transcatheter Aortic Valve Replacement: A Real-World Early and Mid-Term Outcome of a Third-Level Centre. LID - 10.3390/jcm11144158 [doi] LID - 4158 AB - BACKGROUND: Transapical transcatheter aortic valve replacement (TA-TAVR) is generally considered to be associated with higher morbidity compared with transfemoral-TAVR. However, TA-TAVR remains a feasible alternative for patients who are unsuitable for TF-TAVR. It has been shown that outcomes after TAVR are linked to the operator's expertise. Therefore, the purpose of this study is to report short- and mid-term outcomes after TA-TAVR performed by an expert Heart-Team of a third-level centre. METHODS: From 2015 to 2022, 154 consecutive patients underwent TA-TAVR. The outcomes were analysed according to the VARC-3 criteria. Kaplan-Meier curves were estimated for major clinical events at mid-term follow-up. RESULTS: The mean age of the population was 79.3 years and the STS risk-score of mortality was 4.2 +/- 3.6%. Periprocedural mortality was 1.9%. Acute kidney injury and prolonged ventilation occurred in 1.9%. Incidence of stroke was 0.6%. Pacemaker implantation rate was 1.9%. Freedom from cardiovascular mortality was 75.7%, and 60.2% at 3 and 5 years. Freedom from stroke was 92.3% and 88.9% at 3 and 5 years, respectively; freedom from endocarditis was 94.4% and 90.8% at 3 and 5 years, respectively. CONCLUSION: TA-TAVR may be considered a safe and effective alternative approach in patients unsuitable for TF-TAVR, especially when performed by a proficient Heart-Team. FAU - Francica, Alessandra AU - Francica A AUID- ORCID: 0000-0001-8674-3179 AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. FAU - Tonelli, Filippo AU - Tonelli F AUID- ORCID: 0000-0001-5362-9070 AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. FAU - Saran, Alberto AU - Saran A AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. FAU - Pesarini, Gabriele AU - Pesarini G AD - Department of Medicine, Division of Cardiology, University of Verona Medical School, 37126 Verona, Italy. FAU - Vendramin, Igor AU - Vendramin I AD - Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy. FAU - Tabbi, Rocco AU - Tabbi R AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. FAU - Rossetti, Cecilia AU - Rossetti C AUID- ORCID: 0000-0002-0279-4292 AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. FAU - Luciani, Giovanni Battista AU - Luciani GB AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. FAU - Ribichini, Flavio L AU - Ribichini FL AUID- ORCID: 0000-0002-6662-0304 AD - Department of Medicine, Division of Cardiology, University of Verona Medical School, 37126 Verona, Italy. FAU - Onorati, Francesco AU - Onorati F AD - Department of Surgery, Dentistry, Paediatrics, and Gynaecology, Division of Cardiac Surgery, University of Verona Medical School, 37126 Verona, Italy. LA - eng PT - Journal Article DEP - 20220718 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC9323015 OTO - NOTNLM OT - Heart-Team OT - severe aortic valve stenosis OT - transapical transchateter aortic valve replacement OT - transapical valve-in-valve implantation OT - transchateter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2022/07/28 06:00 MHDA- 2022/07/28 06:01 PMCR- 2022/07/18 CRDT- 2022/07/27 01:27 PHST- 2022/06/15 00:00 [received] PHST- 2022/07/09 00:00 [revised] PHST- 2022/07/15 00:00 [accepted] PHST- 2022/07/27 01:27 [entrez] PHST- 2022/07/28 06:00 [pubmed] PHST- 2022/07/28 06:01 [medline] PHST- 2022/07/18 00:00 [pmc-release] AID - jcm11144158 [pii] AID - jcm-11-04158 [pii] AID - 10.3390/jcm11144158 [doi] PST - epublish SO - J Clin Med. 2022 Jul 18;11(14):4158. doi: 10.3390/jcm11144158. PMID- 35886501 OWN - NLM STAT- MEDLINE DCOM- 20220728 LR - 20250728 IS - 1660-4601 (Electronic) IS - 1661-7827 (Print) IS - 1660-4601 (Linking) VI - 19 IP - 14 DP - 2022 Jul 16 TI - The Transaxillary Route as a Second Access Option in TAVI Procedures: Experience of a Single Centre. LID - 10.3390/ijerph19148649 [doi] LID - 8649 AB - Background: The aim of our study was to determine the feasibility and efficacy of transaxillary (TAX) TAVI in patients not eligible for the transfemoral route. Methods: This is a retrospective study of a single center. We analysed 262 patients treated with TAVI. In 17 patients (6.5%), the procedure was performed with the TAX approach. Procedural and hospital data, 30-day safety, and clinical efficacy were assessed and compared between the transfemoral and TAX groups. Results: In the TAX groups, we found a higher prevalence of men (p = 0.001), smokers (p = 0.033), and previous strokes (p = 0.02). The EUROSCORE II was higher in the TAX group (p = 0.014). The success rate of the device was 100%. TAX was associated with a longer procedure time (p = 0.001) and shorter median device time (p = 0.034) in minutes. Patients treated with TAX had a longer hospital stay (p = 0.005) and higher overall bleeding rate (p = 0.001). Peripheral neurological complications were more frequent with TAX (p = 0.001), which almost completely resolved by 30 days. Conclusions: TAX TAVI is safe and effective and should be considered as a second choice when transfemoral TAVI is not feasible due to severe comorbidities. FAU - Muscoli, Saverio AU - Muscoli S AUID- ORCID: 0000-0002-4037-7561 AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Cammalleri, Valeria AU - Cammalleri V AUID- ORCID: 0000-0001-5374-8125 AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. AD - Department of Cardiology, University Campus Biomedico of Rome, Via Alvaro del Portillo 200, 00133 Rome, Italy. FAU - Bonanni, Michela AU - Bonanni M AUID- ORCID: 0000-0001-8069-592X AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Prandi, Francesca Romana AU - Prandi FR AUID- ORCID: 0000-0003-1878-8871 AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Sanseviero, Angela AU - Sanseviero A AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Massaro, Gianluca AU - Massaro G AUID- ORCID: 0000-0003-3007-5313 AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Di Luozzo, Marco AU - Di Luozzo M AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Chiocchi, Marcello AU - Chiocchi M AD - Department of Radiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Ascoli Marchetti, Andrea AU - Ascoli Marchetti A AUID- ORCID: 0000-0001-9229-0495 AD - Department of Vascular Surgery, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Ippoliti, Arnaldo AU - Ippoliti A AD - Department of Vascular Surgery, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Zingaro, Alessia AU - Zingaro A AD - Department of Anesthesia, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. FAU - Ussia, Gian Paolo AU - Ussia GP AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. AD - Department of Cardiology, University Campus Biomedico of Rome, Via Alvaro del Portillo 200, 00133 Rome, Italy. FAU - Romeo, Francesco AU - Romeo F AD - Department of Cardiology, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. AD - Department of Cardiology, Faculty of Medicine, Unicamillus-Medical University of Rome, Via di Sant Alessandro 8, 00133 Rome, Italy. FAU - De Vico, Pasquale AU - De Vico P AD - Department of Anesthesia, Tor Vergata University of Rome, Viale Oxford 81, 00133 Rome, Italy. LA - eng PT - Journal Article DEP - 20220716 PL - Switzerland TA - Int J Environ Res Public Health JT - International journal of environmental research and public health JID - 101238455 SB - IM MH - *Aortic Valve Stenosis/therapy MH - Humans MH - Length of Stay MH - Male MH - Retrospective Studies MH - Treatment Outcome PMC - PMC9323695 OTO - NOTNLM OT - TAVI OT - aortic stenosis OT - deep sedation OT - transaxillary COIS- The authors declare no conflict of interest. EDAT- 2022/07/28 06:00 MHDA- 2022/07/29 06:00 PMCR- 2022/07/16 CRDT- 2022/07/27 01:20 PHST- 2022/05/25 00:00 [received] PHST- 2022/06/27 00:00 [revised] PHST- 2022/07/12 00:00 [accepted] PHST- 2022/07/27 01:20 [entrez] PHST- 2022/07/28 06:00 [pubmed] PHST- 2022/07/29 06:00 [medline] PHST- 2022/07/16 00:00 [pmc-release] AID - ijerph19148649 [pii] AID - ijerph-19-08649 [pii] AID - 10.3390/ijerph19148649 [doi] PST - epublish SO - Int J Environ Res Public Health. 2022 Jul 16;19(14):8649. doi: 10.3390/ijerph19148649. PMID- 35882612 OWN - NLM STAT- MEDLINE DCOM- 20221220 LR - 20230221 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 81 IP - 2 DP - 2023 Feb TI - Minimum-incision trans-subclavian transcatheter aortic valve replacement with regional anesthesia. PG - 131-137 LID - S0914-5087(22)00169-1 [pii] LID - 10.1016/j.jjcc.2022.07.006 [doi] AB - BACKGROUND: Minimum-incision trans-subclavian transcatheter aortic valve replacement (MITS-TAVR) is usually performed in patients who are contraindicated for transfemoral TAVR, under regional anesthesia (RA). This study aimed to evaluate the safety and efficacy of MITS-TAVR under RA compared to MITS-TAVR under general anesthesia (GA). METHODS: This single-center observational study included 44 consecutive patients who underwent MITS-TAVR under RA (RA group, n = 19) and GA (GA group, n = 25). RA was achieved using an ultrasound-guided nerve block. RESULTS: The rates of respiratory disease (RA vs. GA, 36.8 % vs. 4.0 %; p < 0.01) and dialysis (79.0 % vs. 0 %; p < 0.01) were significantly higher in the RA group. STS score was significantly higher in the RA group (RA vs. GA, 10.8 +/- 1.06 % vs. 7.87 +/- 0.93 %; p < 0.01). Both groups had a 100 % procedural success rate. The two groups showed comparable operation room stay times (RA vs. GA, 160 +/- 6.96 min vs. 148 +/- 5.90 min; p = 0.058). The mean rate of change in blood pressure, used as an index of hemodynamic stability, was significantly lower in the RA group (RA vs. GA, 19.0 +/- 3.4 % vs. 35.5 +/- 3.0 %; p < 0.01). No in-hospital deaths occurred in either group. One case of minor dissection occurred in the GA group (RA vs.GA, 0 % vs. 4.0 %, p = 0.378). The intensive care unit stay (RA vs. GA, 0.21 +/- 0.11 days vs. 1.24 +/- 0.10 days; p < 0.01) and hospital stay (RA vs. GA, 7.00 +/- 1.73 days vs. 12.2 +/- 1.44 days; p < 0.01) were significantly shorter in the RA group. CONCLUSIONS: MITS-TAVR under RA is safe and effective and might be a promising alternative approach. It could ensure intraoperative hemodynamic stability and shorten intensive care unit and hospital stays. CI - Copyright (c) 2022 Elsevier Ltd. All rights reserved. FAU - Domoto, Satoru AU - Domoto S AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: domoto.satoru@twmu.ac.jp. FAU - Nakazawa, Keisuke AU - Nakazawa K AD - Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Yamaguchi, Junichi AU - Yamaguchi J AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Hayakawa, Minako AU - Hayakawa M AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. FAU - Otsuki, Hisao AU - Otsuki H AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Inagaki, Yusuke AU - Inagaki Y AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Saito, Chihiro AU - Saito C AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Arashi, Hiroyuki AU - Arashi H AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Kogure, Tomohito AU - Kogure T AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Niinami, Hiroshi AU - Niinami H AD - Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. LA - eng PT - Journal Article PT - Observational Study DEP - 20220723 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - *Aortic Valve Stenosis/surgery MH - Retrospective Studies MH - Treatment Outcome MH - *Anesthesia, Conduction MH - Aortic Valve/surgery MH - Risk Factors OTO - NOTNLM OT - Regional anesthesia OT - Transcathether aortic valve replacement OT - Transsubclavian approach COIS- Declaration of competing interest Satoru Domoto serves as a proctor of Edwards and Medtronic. All other authors have no conflicts of interest. EDAT- 2022/07/27 06:00 MHDA- 2022/12/21 06:00 CRDT- 2022/07/26 22:03 PHST- 2022/04/29 00:00 [received] PHST- 2022/06/13 00:00 [revised] PHST- 2022/07/01 00:00 [accepted] PHST- 2022/07/27 06:00 [pubmed] PHST- 2022/12/21 06:00 [medline] PHST- 2022/07/26 22:03 [entrez] AID - S0914-5087(22)00169-1 [pii] AID - 10.1016/j.jjcc.2022.07.006 [doi] PST - ppublish SO - J Cardiol. 2023 Feb;81(2):131-137. doi: 10.1016/j.jjcc.2022.07.006. Epub 2022 Jul 23. PMID- 35865026 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220723 IS - 2589-790X (Electronic) IS - 2589-790X (Linking) VI - 4 IP - 7 DP - 2022 Jul TI - Iliofemoral Tortuosity Increases the Risk of Access-Site-Related Complications After Aortic Valve Implantation and Plug-Based Access-Site Closure. PG - 609-616 LID - 10.1016/j.cjco.2022.03.006 [doi] AB - BACKGROUND: Access-site-related complications are often related to high-risk anatomy and technical pitfalls and impair the outcomes of transfemoral aortic valve implantations (TAVIs). Calcification and tortuosity are widely recognized risk factors, and their impact on procedural planning is left to the implanting experts' discretion. To facilitate decision-making, we introduced a quantitative measure for iliofemoral tortuosity and assessed its predictive value for access-site-related vascular and bleeding complications. METHODS: We performed a single-centre prospective cohort study of consecutive, percutaneous transfemoral TAVI performed between April 2019 and March 2020. Medical history and all-cause mortality were extracted from the electronic patient files. Arterial anatomy and calcifications were evaluated using 3mensio Structural Heart software. The primary outcome was access-site-related vascular or bleeding complications. RESULTS: In this elderly, intermediate-risk population, we registered the primary outcome in 43 patients (39%), and major access-site complications in 10 patients (9.2%). Complete hemostasis was achieved in 77 patients (70.6%), by the application of the MANTA plug alone. In the group with access-site-related adverse events, compared with the group without, the tortuosity index was higher median (26% interquartile range [IQR 18%-33%] vs median 19% [IQR 13%-29%], respectively; P = 0.012), as was maximal angulation median (50 degrees [IQR 40 degrees -59 degrees ] vs median 43 degrees [IQR 36 degrees -51 degrees ], respectively; P = 0.026) were higher. Both variables had a significant effect on our primary outcome, with odds ratios (OR) of 3.1 (tortuosity, P = 0.005) and 2.6 (angulation, P = 0.020). The degree of angulation was a predictor of major complications too (odds ratio 7 [1.4-34.8]; P = 0.017). CONCLUSIONS: Steeper angles and greater arterial elongation increase the risk of vascular and bleeding complications after femoral TAVI with the utilization of a plug-based closure device. CI - (c) 2022 The Authors. FAU - Lux, Arpad AU - Lux A AD - Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands. AD - Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. FAU - Mullenberg, Lisa AU - Mullenberg L AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands. FAU - Veenstra, Leo F AU - Veenstra LF AD - Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands. FAU - Dohmen, Wim AU - Dohmen W AD - Business Information Management, Maastricht University Medical Center+, Maastricht, The Netherlands. FAU - Kats, Suzanne AU - Kats S AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands. FAU - Maesen, Bart AU - Maesen B AD - Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. AD - Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands. FAU - Van't Hof, Arnoud W J AU - Van't Hof AWJ AD - Department of Cardiology, Maastricht University Medical Center+, Maastricht, The Netherlands. AD - Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands. AD - Department of Cardiology, Zuyderland Medical Centrum, Heerlen, The Netherlands. LA - eng PT - Journal Article DEP - 20220319 PL - United States TA - CJC Open JT - CJC open JID - 101763635 PMC - PMC9294987 EDAT- 2022/07/23 06:00 MHDA- 2022/07/23 06:01 PMCR- 2022/03/19 CRDT- 2022/07/22 02:19 PHST- 2021/12/18 00:00 [received] PHST- 2022/03/15 00:00 [accepted] PHST- 2022/07/22 02:19 [entrez] PHST- 2022/07/23 06:00 [pubmed] PHST- 2022/07/23 06:01 [medline] PHST- 2022/03/19 00:00 [pmc-release] AID - S2589-790X(22)00054-3 [pii] AID - 10.1016/j.cjco.2022.03.006 [doi] PST - epublish SO - CJC Open. 2022 Mar 19;4(7):609-616. doi: 10.1016/j.cjco.2022.03.006. eCollection 2022 Jul. PMID- 35860884 OWN - NLM STAT- MEDLINE DCOM- 20220722 LR - 20250728 IS - 1308-4488 (Electronic) IS - 1016-5169 (Linking) VI - 50 IP - 5 DP - 2022 Jul TI - The Role of Prophylactic Ipsilateral Distal Femoral Artery Cannulation in Preventing Periprocedural Peripheral Complications During Transcatheter Aortic Valve Implantation. PG - 327-333 LID - 10.5543/tkda.2022.21276 [doi] AB - OBJECTIVE: Access site-related vascular complications are common complications of trans- catheter aortic valve replacement. In this study, we aimed to investigate the efficacy and safety of prophylactic cannulation of the ipsilateral distal femoral artery in the management of access site-related vascular complications. METHODS: One hundred sixty-four patients, who were evaluated by the Heart Team of our institution and found eligible for transcatheter aortic valve replacement procedure between January 2016 and August 2019, were included in this retrospective study. Patients were divided into two groups according to the management of peripheral complications. The antegrade crossover was used as bailout treatment in the first 70 patients. Prophylactic cannulation of the ipsilateral distal femoral artery was performed in the last 94 patients. These 2 groups were compared. RESULTS: Peripheral complications developed in 15 of the first 70 patients included in the study. The percutaneous intervention was unsuccessful in 4 of the patients who underwent bailout antegrade crossover. Peripheral complications developed in 14 of the last 94 patients in whom prophylactic cannulation of the ipsilateral distal femoral artery was performed, and all these patients were managed successfully with percutaneous intervention. CONCLUSION: Prophylactic cannulation of the ipsilateral distal femoral artery is a simple, effec- tive, and safe method in the management of access site-related vascular complications. FAU - Avci, Ilhan Ilker AU - Avci II AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Zeren, Gonul AU - Zeren G AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Sungur, Mustafa Azmi AU - Sungur MA AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Simsek, Baris AU - Simsek B AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Can, Fatma AU - Can F AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Yilmaz, Mehmet Fatih AU - Yilmaz MF AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Yilmaz, Sahin AU - Yilmaz S AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Anestezi ve Reanimasyon Bolumu, Istanbul, Turkiye. FAU - Gurkan, Ufuk AU - Gurkan U AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. FAU - Karabay, Can Yucel AU - Karabay CY AD - Dr. Siyami Ersek Egitim ve Arastirma Hastanesi, Kardiyoloji Bolumu, Istanbul, Turkiye. LA - eng PT - Journal Article PL - Turkey TA - Turk Kardiyol Dern Ars JT - Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir JID - 9426239 SB - IM MH - *Catheterization, Peripheral/adverse effects/methods MH - Femoral Artery/surgery MH - Humans MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods EDAT- 2022/07/22 06:00 MHDA- 2022/07/23 06:00 CRDT- 2022/07/21 03:02 PHST- 2022/07/21 03:02 [entrez] PHST- 2022/07/22 06:00 [pubmed] PHST- 2022/07/23 06:00 [medline] AID - 10.5543/tkda.2022.21276 [doi] PST - ppublish SO - Turk Kardiyol Dern Ars. 2022 Jul;50(5):327-333. doi: 10.5543/tkda.2022.21276. PMID- 39600837 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241128 IS - 1758-3896 (Electronic) IS - 1758-3896 (Print) IS - 1758-3896 (Linking) VI - 16 DP - 2022 TI - Transcatheter Versus Surgical Aortic Valve Replacement in Young, Low-risk Patients with Severe Aortic Stenosis. PG - e18 LID - 10.15420/usc.2022.08 [doi] LID - e18 AB - Aortic stenosis is a common form of acquired degenerative valvular disease associated with poor survival after the onset of symptoms. Treatment options for patients with aortic stenosis in addition to medical therapy include surgical aortic valve replacement (SAVR) with either tissue or mechanical valves, or transcatheter aortic valve replacement (TAVR) with either balloon-expandable or self-expanding valves via either transfemoral or alternative access routes. In this review, the authors discuss the current evidence and special considerations regarding the use of TAVR versus SAVR in the management of severe aortic stenosis in young (<65 years of age), low-risk patients, highlighting the history of aortic stenosis treatment, the current guidelines and recommendations, and important issues that remain to be addressed. Ultimately, until ongoing clinical trials with long-term follow-up data shed light on whether interventions for aortic stenosis can be broadened to a low-risk population, TAVR in young, low-risk patients should be undertaken with caution and with guidance from a multidisciplinary heart team. CI - Copyright (c) The Author(s), 2022. Published by Radcliffe Group Ltd. FAU - Nguyen, Quynh AU - Nguyen Q AD - Faculty of Medicine and Dentistry, University of Alberta Edmonton, Canada. FAU - Luc, Jessica Gy AU - Luc JG AD - Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia Vancouver, Canada. FAU - MacGillivray, Thomas E AU - MacGillivray TE AD - Division of Cardiac Surgery and Thoracic Transplantation Surgery, Houston Methodist DeBakey Heart and Vascular Center Houston, TX. FAU - Preventza, Ourania A AU - Preventza OA AD - Division of Cardiothoracic Surgery, Michael E DeBakey Department of Surgery, Baylor College of Medicine Houston, TX. AD - Department of Cardiovascular Surgery, Texas Heart Institute Houston, TX. LA - eng PT - Journal Article PT - Review DEP - 20220721 PL - England TA - US Cardiol JT - US cardiology JID - 101574791 PMC - PMC11588169 OTO - NOTNLM OT - Aortic stenosis OT - surgical aortic valve replacement OT - transcatheter aortic valve replacement COIS- Disclosure: OAP is a consultant for Terumo Aortic and WL Gore and Associates. All other authors have no conflicts of interest to declare. EDAT- 2022/07/21 00:00 MHDA- 2022/07/21 00:01 PMCR- 2022/07/21 CRDT- 2024/11/27 04:13 PHST- 2022/02/18 00:00 [received] PHST- 2022/04/13 00:00 [accepted] PHST- 2022/07/21 00:01 [medline] PHST- 2022/07/21 00:00 [pubmed] PHST- 2024/11/27 04:13 [entrez] PHST- 2022/07/21 00:00 [pmc-release] AID - 10.15420/usc.2022.08 [doi] PST - epublish SO - US Cardiol. 2022 Jul 21;16:e18. doi: 10.15420/usc.2022.08. eCollection 2022. PMID- 35852581 OWN - NLM STAT- MEDLINE DCOM- 20221124 LR - 20261010 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 111 IP - 12 DP - 2022 Dec TI - Predictive value of the Fibrosis-4 index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. PG - 1367-1376 LID - 10.1007/s00392-022-02055-6 [doi] AB - BACKGROUND: Liver dysfunction is associated with an increased risk of mortality after cardiac interventions. The Fibrosis-4 (FIB-4 index), a marker of hepatic fibrosis, has been associated with a worse prognosis in heart failure. The prognostic relevance of the index in patients undergoing transcatheter aortic valve replacement (TAVR) is unknown. The aim of this study was to evaluate the clinical implications associated with the FIB-4 index in patients undergoing TAVR. METHODS: Between May 2012 and June 2019, 941 patients undergoing TAVR were stratified into a low or high FIB-4 index group, based on a cutoff value that was determined according to a receiver operating characteristic curve predicting 1-year all-cause mortality. RESULTS: Patients with a high FIB-4 index (n = 480), based on the cutoff value of 1.82, showed higher rates of pulmonary hypertension (43.8% vs. 31.8%, p < 0.01), right-ventricular systolic dysfunction (29.5% vs. 19.2%, p < 0.01) and larger inferior vena cava diameter (1.6 +/- 0.6 cm vs. 1.3 +/- 0.6 cm, p < 0.01) than patients with a low FIB-4 index (n = 461). Furthermore, a high FIB-4 index was associated with a significantly higher cumulative 1-year all-cause mortality (17.5% vs. 10.2%, p < 0.01) and non-cardiovascular mortality (12.1% vs. 2.5%, p < 0.01), compared to a low FIB-4 index. Multivariable analysis revealed that a high FIB-4 index was independently associated with all-cause mortality (HR: 1.75 [95% CI: 1.18-2.59], p < 0.01). CONCLUSIONS: A high FIB-4 index is associated with right-sided heart overload and an increased risk of mortality in patients undergoing TAVR. The FIB-4 index may be useful as an additional predictor of outcomes in these patients. CI - (c) 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. FAU - Sudo, Mitsumasa AU - Sudo M AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. AD - Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. FAU - Shamekhi, Jasmin AU - Shamekhi J AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Sedaghat, Alexander AU - Sedaghat A AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Aksoy, Adem AU - Aksoy A AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Zietzer, Andreas AU - Zietzer A AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Tanaka, Tetsu AU - Tanaka T AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Wilde, Nihal AU - Wilde N AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Weber, Marcel AU - Weber M AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Sinning, Jan-Malte AU - Sinning JM AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Grube, Eberhard AU - Grube E AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Veulemans, Verena AU - Veulemans V AD - Division of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Dusseldorf, Dusseldorf, Germany. FAU - Adam, Matti AU - Adam M AD - Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany. FAU - Kelm, Malte AU - Kelm M AD - Division of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Dusseldorf, Dusseldorf, Germany. FAU - Baldus, Stephan AU - Baldus S AD - Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Zimmer, Sebastian AU - Zimmer S AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Tiyerili, Vedat AU - Tiyerili V AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. FAU - Al-Kassou, Baravan AU - Al-Kassou B AUID- ORCID: 0000-0003-2967-6613 AD - Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. baravan.al-kassou@ukbonn.de. LA - eng GR - 397484323 - TRR259/Deutsche Forschungsgemeinschaft/ PT - Journal Article DEP - 20220719 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/complications/diagnosis/surgery MH - Treatment Outcome MH - Prognosis MH - Severity of Illness Index MH - Fibrosis MH - Aortic Valve/surgery MH - Risk Factors OTO - NOTNLM OT - Aortic stenosis OT - FIB-4 index OT - Liver dysfunction OT - TAVR EDAT- 2022/07/20 06:00 MHDA- 2022/11/25 06:00 CRDT- 2022/07/19 11:14 PHST- 2022/01/22 00:00 [received] PHST- 2022/06/13 00:00 [accepted] PHST- 2022/07/20 06:00 [pubmed] PHST- 2022/11/25 06:00 [medline] PHST- 2022/07/19 11:14 [entrez] AID - 10.1007/s00392-022-02055-6 [pii] AID - 10.1007/s00392-022-02055-6 [doi] PST - ppublish SO - Clin Res Cardiol. 2022 Dec;111(12):1367-1376. doi: 10.1007/s00392-022-02055-6. Epub 2022 Jul 19. PMID- 35838644 OWN - NLM STAT- MEDLINE DCOM- 20220719 LR - 20221026 IS - 1526-6702 (Electronic) IS - 0730-2347 (Print) IS - 0730-2347 (Linking) VI - 49 IP - 4 DP - 2022 Jul 1 TI - Predictors and Prognostic Implications of Myocardial Injury After Transcatheter Aortic Valve Replacement. LID - 10.14503/THIJ-20-7380 [doi] LID - e207380 AB - Myocardial injury (MI) is not unusual after transcatheter aortic valve replacement (TAVR). To determine precipitating factors and prognostic outcomes of MI after TAVR, we retrospectively investigated relationships between MI after TAVR and aortic root dimensions, baseline patient characteristics, echocardiographic findings, and procedural features. Of 474 patients who underwent transfemoral TAVR for severe aortic stenosis in our tertiary center from June 2011 through June 2018, 188 (mean age, 77.7 +/- 7.7 yr; 96 women [51%]) met the study inclusion criteria. Patients were divided into postprocedural MI (PMI) (n=74) and no-PMI (n=114) groups, in accordance with high-sensitivity troponin T levels. We found that MI risk was associated with older age (odds ratio [OR]=1.054; 95% CI, 1.013-1.098; P=0.01), transcatheter heart valve type (OR=10.207; 95% CI, 2.861-36.463; P=0.001), distances from the aortic annulus to the right coronary artery ostium (OR=0.853; 95% CI, 0.731-0.995; P=0.04) and the left main coronary artery ostium (OR=0.747; 95% CI, 0.616-0.906; P=0.003), and baseline glomerular filtration rate (OR=0.985; 95% CI, 0.970-1.000; P=0.04). Moreover, the PMI group had a longer time to hospital discharge (P=0.001) and a higher permanent pacemaker implantation rate (P=0.04) than did the no-PMI group. Our findings may enable better estimation of which patients are at higher risk of MI after TAVR and thus improve the planning and course of clinical care. CI - (c) 2022 by the Texas Heart(R) Institute, Houston. FAU - Guney, Murat Can AU - Guney MC AD - Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Keles, Telat AU - Keles T AD - Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Karaduman, Bilge Duran AU - Karaduman BD AD - Department of Cardiology, Faculty of Medicine, Atilim University, Medicana International Ankara Hospital, Ankara, Turkey. FAU - Ayhan, Huseyin AU - Ayhan H AD - Department of Cardiology, Faculty of Medicine, Atilim University, Medicana International Ankara Hospital, Ankara, Turkey. FAU - Suygun, Hakan AU - Suygun H AD - Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey. FAU - Kahyaoglu, Muzaffer AU - Kahyaoglu M AD - Department of Cardiology, Gaziantep Abdulkadir Yuksel State Hospital, Gaziantep, Turkey. FAU - Bozkurt, Engin AU - Bozkurt E AD - Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey. LA - eng PT - Journal Article PL - United States TA - Tex Heart Inst J JT - Texas Heart Institute journal JID - 8214622 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnosis/etiology/surgery MH - Female MH - *Heart Injuries/diagnosis/epidemiology/etiology MH - Humans MH - Prognosis MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome PMC - PMC9427054 OTO - NOTNLM OT - Aortic stenosis/diagnosis OT - decision support techniques OT - heart injuries/etiology OT - patient selection OT - postoperative complications OT - retrospective studies OT - risk assessment/methods OT - severity of illness index OT - transcatheter aortic valve replacement/adverse effects OT - treatment outcome EDAT- 2022/07/16 06:00 MHDA- 2022/07/20 06:00 PMCR- 2022/07/01 CRDT- 2022/07/15 11:12 PHST- 2022/07/15 11:12 [entrez] PHST- 2022/07/16 06:00 [pubmed] PHST- 2022/07/20 06:00 [medline] PHST- 2022/07/01 00:00 [pmc-release] AID - 483735 [pii] AID - 10.14503/THIJ-20-7380 [doi] PST - ppublish SO - Tex Heart Inst J. 2022 Jul 1;49(4):e207380. doi: 10.14503/THIJ-20-7380. PMID- 35794691 OWN - NLM STAT- MEDLINE DCOM- 20220708 LR - 20220723 IS - 1862-1783 (Electronic) IS - 1673-1581 (Print) IS - 1673-1581 (Linking) VI - 23 IP - 7 DP - 2022 Jul 15 TI - Novel apical-to-femoral rail technique for horizontal aorta in transcatheter aortic valve replacement. PG - 613-616 LID - 1673-1581(2022)07-0613-04 [pii] LID - 10.1631/jzus.B2100860 [doi] AB - Transcatheter aortic valve replacement (TAVR) has emerged as a viable treatment option for patients with severe aortic stenosis regardless of its surgical risk stratification (Otto et al., 2021). Aortic angulation is usually measured as the angle between the horizontal and the aortic annulus planes based on preproced‍ural multidetector computed tomography (MDCT) (Al-Lamee et al., 2011). Extremely horizontal aorta, defined as an aortic angulation greater than 70 degrees , is an unfavorable anatomic structure that poses particular technical challenges for TAVR. Abramowitz et al. (2016) have proved that an extremely horizontal aorta increased the risk of procedural complications, such as lower device success rates, more moderate or even severe perivalvular leakage (PVL), and the need for second valve implantation. Because of the long stent frame, inflexibility, and non-steerability, it is challenging to pass the delivery system of self-expanding valves (SEVs) through an extremely horizontal aorta. As a result, patients with an extremely horizontal aorta have always been excluded from the clinical trials of TAVR, and transfemoral (TF)-TAVR with SEV is considered as an "off-label" use of TAVR (Adams et al., 2014; Kaneko et al., 2020). Herein, we present a technically difficult case, in which a patient with an extremely horizontal aorta underwent TF-TAVR with SEV by applying a unique apical-to-femoral rail strategy. FAU - Liu, Xianbao AU - Liu X AD - Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou 310058, China. FAU - Dai, Hanyi AU - Dai H AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou 310058, China. FAU - Wang, Lihan AU - Wang L AD - Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Fan, Jiaqi AU - Fan J AD - Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China. wangjianan111@zju.edu.cn. AD - Internal Medicine, Zhejiang University School of Medicine, Hangzhou 310058, China. wangjianan111@zju.edu.cn. LA - eng GR - 2021C03097 and 2018C03084/the Zhejiang Province Science and Technology Department Key R&D Program/ PT - Journal Article PL - China TA - J Zhejiang Univ Sci B JT - Journal of Zhejiang University. Science. B JID - 101236535 SB - IM MH - Aorta MH - Humans MH - Lower Extremity MH - Multidetector Computed Tomography MH - *Transcatheter Aortic Valve Replacement PMC - PMC9264111 COIS- Xianbao LIU, Hanyi DAI, Lihan WANG, Jiaqi FAN, and Jian'an WANG declare that they have no conflict of interest. EDAT- 2022/07/07 06:00 MHDA- 2022/07/09 06:00 PMCR- 2022/07/15 CRDT- 2022/07/06 23:52 PHST- 2022/07/06 23:52 [entrez] PHST- 2022/07/07 06:00 [pubmed] PHST- 2022/07/09 06:00 [medline] PHST- 2022/07/15 00:00 [pmc-release] AID - 1673-1581(2022)07-0613-04 [pii] AID - 1673-1581（2022）07-0613-04 [pii] AID - 10.1631/jzus.B2100860 [doi] PST - ppublish SO - J Zhejiang Univ Sci B. 2022 Jul 15;23(7):613-616. doi: 10.1631/jzus.B2100860. PMID- 35791709 OWN - NLM STAT- MEDLINE DCOM- 20220708 LR - 20220827 IS - 2149-2271 (Electronic) IS - 2149-2263 (Print) IS - 2149-2263 (Linking) VI - 26 IP - 7 DP - 2022 Jul TI - Structural Changesofthe Right Fibrous Trigone as a Risk Factor for Conduction Disturbance After Transcatheter Aortic Valve Implantation. PG - 532-542 LID - 10.5152/AnatolJCardiol.2022.987 [doi] AB - BACKGROUND: The right fibrous trigone, which the His bundle penetrates, is part of the subaortic area adjacent to the membranous septum. Structural alterations of the right fibrous trigone may cause conduction disturbance as a result of compression in this area after transcatheter aortic valve implantation. This study analyzed the hypothesis of whether imaging parameters of the RFT could predict the risk of conduction disturbance after transcatheter aortic valve implantation. METHODS: We retrospectively examined 209 patients who underwent transfemoral transcatheter aortic valve implantationat a tertiary cardiac center. The different valve models were divided into 2 groups: self-expanding valve and balloon-expandable valve. Using pre-procedure computed tomography, we evaluated for the alterations of the right fibrous trigone. RESULTS: New conduction disturbance was seen in 75 of 209 (35.8%) patients. Receiver operating characteristics plots displayed a right fibrous trigone density of -6 Hounsfieldunit for SEV and -16 Hounsfield unit for balloon-expandable valve as the optimal cut- off points for prediction conduction disturbance. In multiple regression analyses, the high density of RFT emerged as an independent predictor of conduction disturbance in both the self-expanding valve (odds ratio: 1.01, 95% CI: 1.01 to 1.02, P = 0.035) and bal- loon-expandable valve (odds ratio: 1.01, 95% CI: 1.01 to 1.03, P = 0.017) groups. A shorter membranous septum length and a greater implantation depth were also found to be significantly associated with a higher incidence of conduction disturbance in both trans- catheter aortic valve implantation groups. CONCLUSION: High density of right fibrous trigone is independently associated with con- duction disturbance after transcatheter aortic valve implantation, and its pre-proce- dure computed tomography evaluation can help predict the new-onset of conduction disturbance. FAU - Aslan, Serkan AU - Aslan S AD - Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Turkvatan, Aysel AU - Turkvatan A AD - Department of Radiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Topel, Cagdas AU - Topel C AD - Department of Radiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Guner, Ahmet AU - Guner A AD - Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Demir, Ali Riza AU - Demir AR AD - Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Kahraman, Serkan AU - Kahraman S AD - Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Celik, Omer AU - Celik O AD - Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. FAU - Erturk, Mehmet AU - Erturk M AD - Department of Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Turkey. LA - eng PT - Journal Article PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 SB - IM MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis MH - Humans MH - Retrospective Studies MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects PMC - PMC9361055 EDAT- 2022/07/07 06:00 MHDA- 2022/07/09 06:00 PMCR- 2022/07/01 CRDT- 2022/07/06 03:43 PHST- 2022/07/06 03:43 [entrez] PHST- 2022/07/07 06:00 [pubmed] PHST- 2022/07/09 06:00 [medline] PHST- 2022/07/01 00:00 [pmc-release] AID - ajc-26-7-532 [pii] AID - 10.5152/AnatolJCardiol.2022.987 [doi] PST - ppublish SO - Anatol J Cardiol. 2022 Jul;26(7):532-542. doi: 10.5152/AnatolJCardiol.2022.987. PMID- 35766367 OWN - NLM STAT- MEDLINE DCOM- 20231110 LR - 20231114 IS - 1545-1550 (Electronic) IS - 1526-6028 (Linking) VI - 30 IP - 6 DP - 2023 Dec TI - Alternative Application Technique for the MANTA Vascular Closure Device for Percutaneous Large-Bore Arterial Access Closure: The Fluoroscopic DOT Technique. PG - 885-891 LID - 10.1177/15266028221105187 [doi] AB - BACKGROUND: Vascular complications are a cause of increased morbidity and mortality when performing percutaneous procedures requiring large-bore arterial access. MANTA vascular closure device (VCD) is currently the only large-bore VCD using an intraluminal foot plate and an extraluminal collagen plug. The traditional depth locator approach might be compromised in; emergent cases without the required measurements, cases of hematoma formation, or other patient, procedure, or operator-specific variables. Furthermore, this technique can be used for postclosure in cases without the required measurement of depth. We describe vascular outcomes using fluoroscopy (fluoroscopic DOT technique) rather than traditional depth locator approach for vascular closure with the MANTA VCD. METHODS: Fifty patients who underwent transcatheter aortic valve implantation (TAVI) were retrospectively analyzed using fluoroscopic DOT technique with 18F MANTA VCD between May and August 2021. All patients >18 years of age who qualified for transfemoral TAVI were included. Access was obtained with ultrasound guidance with vessel diameter of at least > 6 mm and free from anterior vessel wall calcification. Patient related factors and primary outcomes of access site bleeding and acute flow-limited limb ischemia requiring intervention were prospectively analyzed. Furthermore, 1 patient who failed hemostasis with suture-mediated VCD had successful hemostasis with fluoroscopic DOT technique as dry postclosure after balloon aortic valvuloplasty. RESULTS: In total, 50 patients were analyzed with a mean age of 81 years and majority were male (56%). Majority had comorbidities of hypertension (88%) and hyperlipidemia (94%), 24% had peripheral arterial disease, 38% coronary artery disease, and 58% were former smokers. Importantly, 40% were obese with an average body mass index (BMI) of 29 kg/m(2). There were no bleeding or ischemic limb complications post MANTA VCD deployment using the fluoroscopic DOT technique. Furthermore, none of the patients required peripheral intervention from index procedure to 1 month post verified during their 1-month post TAVR follow-up. CONCLUSION: Fluoroscopic DOT technique using the MANTA VCD is highly reproducible and allows hemostasis in a predictable manner for procedures requiring large-bore arterial access in the absence of MANTA depth measurement. FAU - Memon, Sehrish AU - Memon S AUID- ORCID: 0000-0003-1087-4011 AD - Division of Cardiovascular Diseases, Lankenau Medical Center, Lankenau Institute of Medical Research, Wynnewood, PA, USA. FAU - Goldman, Scott AU - Goldman S AD - Division of Cardiothoracic Surgery, Lankenau Medical Center, Lankenau Institute of Medical Research, Wynnewood, PA, USA. FAU - Rodriguez, Roberto AU - Rodriguez R AD - Division of Cardiothoracic Surgery, Lankenau Medical Center, Lankenau Institute of Medical Research, Wynnewood, PA, USA. FAU - Ramlawi, Basel AU - Ramlawi B AD - Division of Cardiothoracic Surgery, Lankenau Medical Center, Lankenau Institute of Medical Research, Wynnewood, PA, USA. FAU - Coady, Paul M AU - Coady PM AD - Division of Cardiovascular Diseases, Lankenau Medical Center, Lankenau Institute of Medical Research, Wynnewood, PA, USA. FAU - Gnall, Eric M AU - Gnall EM AD - Division of Cardiovascular Diseases, Lankenau Medical Center, Lankenau Institute of Medical Research, Wynnewood, PA, USA. LA - eng PT - Journal Article DEP - 20220629 PL - United States TA - J Endovasc Ther JT - Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists JID - 100896915 SB - IM MH - Humans MH - Male MH - Female MH - Aged, 80 and over MH - *Vascular Closure Devices/adverse effects MH - Hemostatic Techniques/adverse effects MH - Retrospective Studies MH - *Catheterization, Peripheral/adverse effects MH - Treatment Outcome MH - Femoral Artery/diagnostic imaging/surgery MH - Hemorrhage/etiology MH - *Aortic Valve Stenosis/complications/surgery OTO - NOTNLM OT - aortic valve OT - endovascular treatment/therapy OT - peripheral vascular disease OT - vascular access OT - vascular closure devices COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2022/06/30 06:00 MHDA- 2023/11/10 06:44 CRDT- 2022/06/29 08:32 PHST- 2023/11/10 06:44 [medline] PHST- 2022/06/30 06:00 [pubmed] PHST- 2022/06/29 08:32 [entrez] AID - 10.1177/15266028221105187 [doi] PST - ppublish SO - J Endovasc Ther. 2023 Dec;30(6):885-891. doi: 10.1177/15266028221105187. Epub 2022 Jun 29. PMID- 35710281 OWN - NLM STAT- MEDLINE DCOM- 20220620 LR - 20260728 IS - 2211-7466 (Electronic) IS - 2211-7458 (Print) IS - 2211-7458 (Linking) VI - 11 IP - 3 DP - 2022 Jul TI - Use of Electrosurgery in Interventional Cardiology. PG - 257-266 LID - S2211-7458(22)00007-4 [pii] LID - 10.1016/j.iccl.2022.01.004 [doi] AB - Transcatheter electrosurgery is a versatile tool that can be used to cut cardiac tissue without the need for a sternotomy, cardiopulmonary bypass, and cardioplegia. With adequate imaging and suitable anatomy, any cardiac tissue can be cut. Thus, transcatheter electrosurgery can provide bespoke therapies for complex patients who often have no other good treatment options. In this review, we will discuss the common applications for electrosurgical tissue traversal and laceration, including transcaval access, BASILICA, LAMPOON, and ELASTA-Clip, summarizing the evidence and the key technical steps for each. CI - Copyright (c) 2022. Published by Elsevier Inc. FAU - Khan, Jaffar M AU - Khan JM AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Building 10, Room 2c713, MSC 1538, Bethesda, MD 20892-1538, USA. Electronic address: https://twitter.com/CathElectroSurg. FAU - Rogers, Toby AU - Rogers T AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Building 10, Room 2c713, MSC 1538, Bethesda, MD 20892-1538, USA; Medstar Washington Hospital Center, 110 Irving Street, Northwest, Washington, DC 20010, USA. FAU - Greenbaum, Adam B AU - Greenbaum AB AD - Structural Heart and Valve Center, Emory University Hospital, 550 Peachtree Street Northeast, Medical Office Tower, Fl 6, Atlanta, GA 30308, USA. Electronic address: https://twitter.com/AdamGreenbaumMD. FAU - Babaliaros, Vasilis C AU - Babaliaros VC AD - Structural Heart and Valve Center, Emory University Hospital, 550 Peachtree Street Northeast, Medical Office Tower, Fl 6, Atlanta, GA 30308, USA. FAU - Bruce, Christopher G AU - Bruce CG AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Building 10, Room 2c713, MSC 1538, Bethesda, MD 20892-1538, USA. Electronic address: https://twitter.com/ChrisGBruce13. FAU - Lederman, Robert J AU - Lederman RJ AD - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Building 10, Room 2c713, MSC 1538, Bethesda, MD 20892-1538, USA. Electronic address: lederman@nih.gov. LA - eng GR - ZIA HL006040/ImNIH/Intramural NIH HHS/United States GR - ZIA HL006041/ImNIH/Intramural NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Intramural PT - Review PL - Netherlands TA - Interv Cardiol Clin JT - Interventional cardiology clinics JID - 101615153 SB - IM MH - *Cardiology MH - *Electrosurgery/methods MH - Humans PMC - PMC9596132 MID - NIHMS1841048 OTO - NOTNLM OT - Basilica OT - Lampoon OT - TAVR OT - TMVR COIS- DISCLOSURE (J.M.Khan), (T.Rogers), and (R.J.Lederman) are co-inventors on patents, assigned to NIH, on catheter devices to lacerate valve leaflets.(A.B.Greenbaum) is a proctor for Edwards Lifesciences, Medtronic, and Abbott Vascular. He has equity in Transmural Systems. (V.C.Babaliaros) is a consultant for Edwards Lifesciences, Abbott Vascular and Transmural Systems, and his employer has research contracts for clinical investigation of transcatheter aortic and mitral devices from Edwards Lifesciences, Abbott Vascular, Medtronic, St Jude Medical, and Boston Scientific. (T.Rogers) is a consultant/proctor for Edwards Lifesciences and Medtronic. He has equity in Transmural Systems. (R.J.Lederman) is the principal investigator on a Cooperative Research and Development Agreement between NIH and Edwards Lifesciences on transcatheter modification of the mitral valve. No other author has a financial conflict of interest related to this research. EDAT- 2022/06/17 06:00 MHDA- 2022/06/22 06:00 PMCR- 2023/01/01 CRDT- 2022/06/16 21:10 PHST- 2022/06/16 21:10 [entrez] PHST- 2022/06/17 06:00 [pubmed] PHST- 2022/06/22 06:00 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - S2211-7458(22)00007-4 [pii] AID - 10.1016/j.iccl.2022.01.004 [doi] PST - ppublish SO - Interv Cardiol Clin. 2022 Jul;11(3):257-266. doi: 10.1016/j.iccl.2022.01.004. PMID- 35691708 OWN - NLM STAT- MEDLINE DCOM- 20220719 LR - 20220831 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 177 DP - 2022 Aug 15 TI - Prognostic Implications of Change in Left Ventricular Ejection Fraction After Transcatheter Aortic Valve Implantation. PG - 90-99 LID - S0002-9149(22)00537-9 [pii] LID - 10.1016/j.amjcard.2022.04.060 [doi] AB - Reduced left ventricular (LV) systolic function is associated with worse prognosis in patients with severe aortic stenosis (AS) treated with transcatheter aortic valve implantation (TAVI). We aimed to examine the changes in left ventricular ejection fraction (LVEF) after TAVI among patients with varying baseline LVEF. Moreover, variables associated with lack of LVEF improvement were identified and the association with long-term outcomes was investigated. A total of 560 patients (age 80 +/- 7 years, 53% men) with severe AS who underwent transfemoral TAVI between 2007 and 2019 were selected. LVEF was assessed from transthoracic echocardiography at baseline (before TAVI) and at 6 and 12 months after TAVI. Patients were stratified according to baseline LVEF: (1) LVEF >/=50%, (2) LVEF 40% to 49%, and (3) LVEF <40%. The clinical end point was >/=5% LVEF improvement. The primary outcome was all-cause mortality. Patients with baseline LVEF<40% showed greater increase in LVEF than those with baseline LVEF 40% to 49% and LVEF >/=50% (from 33% +/- 6% to 43% +/- 10%, p <0.001; from 45% +/- 3% to 52% +/- 8%, p <0.001; and from 58% +/- 5% to 59% +/- 7%, p = 0.012, respectively, p for interaction <0.001). Coronary artery disease (odds ratio [OR] 1.80 [95% confidence interval (CI) 1.06 to 3.06], p = 0.031), myocardial infarction (OR 2.07 [95% CI 1.19 to 3.61], p = 0.010), and permanent pacemaker (OR: 1.93 [95% CI 1.25 to 3.00], p = 0.003) were independently associated with the lack of >/=5% LVEF improvement. During a median follow-up of 3.8 (interquartile range 2.6 to 5.2) years, 176 patients died (31%). Patients with >/=5% LVEF improvement had similar outcomes compared with those with <5% LVEF improvement (log-rank p = 0.89). In conclusion, patients with severe AS and baseline LVEF <40% had the greatest improvement in LVEF at 1-year follow-up after TAVI. Coronary artery disease, myocardial infarction, and permanent pacemaker were associated with lack of LVEF improvement. However, LVEF improvement at 12 months was not associated with long-term outcomes. CI - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kuneman, Jurrien H AU - Kuneman JH AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Butcher, Steele C AU - Butcher SC AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia. FAU - Singh, Gurpreet K AU - Singh GK AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Wang, Xu AU - Wang X AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Hirasawa, Kensuke AU - Hirasawa K AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - van der Kley, Frank AU - van der Kley F AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Leon, Martin B AU - Leon MB AD - Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York; Cardiovascular Research Foundation, New York, New York. FAU - Knuuti, Juhani AU - Knuuti J AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland. FAU - Pibarot, Philippe AU - Pibarot P AD - Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. FAU - Ajmone Marsan, Nina AU - Ajmone Marsan N AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Delgado, Victoria AU - Delgado V AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Bax, Jeroen J AU - Bax JJ AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Turku Heart Center, University of Turku and Turku University Hospital, Turku, Finland. Electronic address: j.j.bax@lumc.nl. LA - eng PT - Journal Article DEP - 20220609 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/complications MH - *Coronary Artery Disease/complications MH - Female MH - *Heart Valve Prosthesis Implantation/adverse effects MH - Humans MH - Male MH - *Myocardial Infarction/complications MH - Prognosis MH - Stroke Volume MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - *Ventricular Dysfunction, Left MH - Ventricular Function, Left EDAT- 2022/06/13 06:00 MHDA- 2022/07/20 06:00 CRDT- 2022/06/12 22:02 PHST- 2022/02/23 00:00 [received] PHST- 2022/04/15 00:00 [revised] PHST- 2022/04/23 00:00 [accepted] PHST- 2022/06/13 06:00 [pubmed] PHST- 2022/07/20 06:00 [medline] PHST- 2022/06/12 22:02 [entrez] AID - S0002-9149(22)00537-9 [pii] AID - 10.1016/j.amjcard.2022.04.060 [doi] PST - ppublish SO - Am J Cardiol. 2022 Aug 15;177:90-99. doi: 10.1016/j.amjcard.2022.04.060. Epub 2022 Jun 9. PMID- 35690553 OWN - NLM STAT- MEDLINE DCOM- 20220928 LR - 20220928 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 43 DP - 2022 Oct TI - Transcatheter Aortic Bioprosthesis Durability: A Single-Center Experience. PG - 1-6 LID - S1553-8389(22)00241-X [pii] LID - 10.1016/j.carrev.2022.05.011 [doi] AB - BACKGROUND: Transcatheter aortic valve implant (TAVI) is gaining momentum in the treatment of severe, symptomatic aortic valve stenosis, and its indication is expanding to lower surgical risk individuals, who are generally younger and have a long life expectancy. Therefore, transcatheter bioprostheses durability appears of critical importance. Aim of the present study is to evaluate mid-term outcomes of TAVI in a high-volume single center cohort. METHODS: We analyzed all consecutive patients (n = 408) who underwent transfemoral TAVI at a single, high-volume center, between 2007 and 2014. Study objectives were all-cause death and bioprosthetic valve failure (BVF) at long term follow-up. Structural valve deterioration (SVD), BVF and valve-related death were defined according to current international standards. Follow-up was performed by in person visit and transthoracic echocardiography, which was obtained only in a minority of patients, or phone call as per patient preference. RESULTS: At a median follow-up of 1821 days, overall mortality was 64.5%, with cardiovascular disease accounting for roughly half of total deaths. Valve-related deaths occurred in 10 patients. Seventeen patients were diagnosed with BVF, and 15 required repeat intervention. Moderate and severe SVD were observed in 10 and 7 patients, respectively. In the subgroup of patients with echocardiographic mid-term follow-up (n = 76), no significant increase of transprosthetic gradients nor increase of significant regurgitation was detected. CONCLUSION: In the present unselected, all-comers cohort, TAVI bioprostheses appeared to have excellent durability at long-term follow-up. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Moroni, Francesco AU - Moroni F AD - Universita Vita-Salute San Raffaele, Milan, Italy. FAU - Ziviello, Francesca AU - Ziviello F AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Federico, Francesco AU - Federico F AD - Universita Vita-Salute San Raffaele, Milan, Italy. FAU - Di Stefano, Daniele AU - Di Stefano D AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Beneduce, Alessandro AU - Beneduce A AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Vella, Ciro Salvatore AU - Vella CS AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Ancona, Francesco AU - Ancona F AD - Cardiovascular Imaging Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Ingallina, Giacomo AU - Ingallina G AD - Cardiovascular Imaging Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Ancona, Marco AU - Ancona M AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Ferri, Luca A AU - Ferri LA AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Russo, Filippo AU - Russo F AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Bellini, Barbara AU - Bellini B AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Agricola, Eustachio AU - Agricola E AD - Cardiovascular Imaging Unit, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Chieffo, Alaide AU - Chieffo A AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. Electronic address: chieffo.alaide@hsr.it. FAU - Montorfano, Matteo AU - Montorfano M AD - Interventional Cardiology Unit, IRCCS Ospedale San Raffaele, Milan, Italy. Electronic address: montorfano.matteo@hsr.it. LA - eng PT - Journal Article DEP - 20220519 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Bioprosthesis MH - *Heart Valve Prosthesis MH - Humans MH - Prosthesis Design MH - Prosthesis Failure MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - Bioprosthesis OT - Bioprosthesis degeneration OT - TAVI OT - TAVI durability COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/06/12 06:00 MHDA- 2022/09/28 06:00 CRDT- 2022/06/11 22:06 PHST- 2022/02/25 00:00 [received] PHST- 2022/05/10 00:00 [revised] PHST- 2022/05/10 00:00 [accepted] PHST- 2022/06/12 06:00 [pubmed] PHST- 2022/09/28 06:00 [medline] PHST- 2022/06/11 22:06 [entrez] AID - S1553-8389(22)00241-X [pii] AID - 10.1016/j.carrev.2022.05.011 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2022 Oct;43:1-6. doi: 10.1016/j.carrev.2022.05.011. Epub 2022 May 19. PMID- 35686532 OWN - NLM STAT- MEDLINE DCOM- 20220804 LR - 20260728 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 100 IP - 2 DP - 2022 Aug TI - Clinical outcomes following single access transfemoral transcatheter aortic valve implantation. PG - 227-232 LID - 10.1002/ccd.30246 [doi] AB - OBJECTIVES: We describe the first experience using calcification of anatomical landmarks to obviate the need for transcatheter aortic valve implantation (TAVI) alignment aortography and secondary TAVI access. BACKGROUND: TAVI alignment conventionally involves secondary femoral access for contrast aortography using a second catheter. Secondary femoral access accounts for up to 25% of all vascular complications. Heavily calcified aortic leaflets are often visible fluoroscopically and can act as markers for TAVI alignment. METHODS: We considered 100 consecutive patients for transfemoral TAVI. The first group was considered for a conventional dual access technique and the subsequent group was considered for a single access technique. Relevant baseline, and procedural and outcome measures were recorded. RESULTS: Baseline characteristics were comparable between groups. Balloon-expandable transcatheter heart valves (THV) were used in all cases. THV implantation was successful in 100% of cases with no procedural or in-hospital mortality. Procedural time and contrast use were lower in the single access group. There were no Valve Academic Research Consortium (VARC)-2 major vascular complications with the single access technique. CONCLUSIONS: This is the first study describing the use of calcification of anatomical landmarks to obviate the need for secondary TAVI access. Notable observations included successful device implantation in all cases, no VARC-2 major vascular complications, comparable rates of paravalvular leak and permanent pacemaker requirement, shorter procedural times, and lower contrast use. Single access TAVI is a viable alternative technique to minimize vascular access, contrast use, and procedural duration in experienced centers and with selected patients, allowing successful device implantation and low complication rates while further streamlining TAVI workflow. CI - (c) 2022 Wiley Periodicals LLC. FAU - Aroney, Nicholas P AU - Aroney NP AUID- ORCID: 0000-0002-7199-0609 AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Patterson, Tiffany AU - Patterson T AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Kalogeropoulos, Andreas AU - Kalogeropoulos A AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Allen, Christopher J AU - Allen CJ AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Hurrell, Harriet AU - Hurrell H AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Chehab, Omar AU - Chehab O AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Grapsa, Julia AU - Grapsa J AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Rajani, Ronak AU - Rajani R AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. AD - School of Bioengineering and Imaging Sciences, King's College London, London, UK. FAU - Prendergast, Bernard AU - Prendergast B AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Redwood, Simon AU - Redwood S AD - Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK. LA - eng GR - FS/CRTF/22/24312/BHF_/British Heart Foundation/United Kingdom PT - Journal Article DEP - 20220610 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2022 Aug;100(2):233-234. doi: 10.1002/ccd.30334. PMID: 35920372 MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Calcinosis MH - Femoral Artery/diagnostic imaging MH - *Heart Valve Prosthesis MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome OTO - NOTNLM OT - TAVI OT - access OT - calcium OT - marker OT - single OT - vascular EDAT- 2022/06/11 06:00 MHDA- 2022/08/05 06:00 CRDT- 2022/06/10 04:53 PHST- 2022/05/12 00:00 [revised] PHST- 2021/09/28 00:00 [received] PHST- 2022/05/14 00:00 [accepted] PHST- 2022/06/11 06:00 [pubmed] PHST- 2022/08/05 06:00 [medline] PHST- 2022/06/10 04:53 [entrez] AID - 10.1002/ccd.30246 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2022 Aug;100(2):227-232. doi: 10.1002/ccd.30246. Epub 2022 Jun 10. PMID- 35678222 OWN - NLM STAT- MEDLINE DCOM- 20221123 LR - 20260127 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 18 IP - 10 DP - 2022 Nov 18 TI - Haemodynamic performance and clinical outcomes of transcatheter aortic valve replacement with the self-expanding ACURATE neo2. PG - 804-811 LID - EIJ-D-22-00289 [pii] LID - 10.4244/EIJ-D-22-00289 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) with the ACURATE neo device has been associated with a non-negligible incidence of paravalvular aortic regurgitation (AR). The new-generation ACURATE neo2 has been designed to mitigate this limitation. AIMS: The aim of the study was to compare TAVR with the ACURATE neo and neo2 devices. METHODS: The NEOPRO and NEOPRO-2 registries retrospectively included patients undergoing transfemoral TAVR with self-expanding valves at 24 and 20 centres, respectively. Patients receiving the ACURATE neo and neo2 devices (from January 2012 to December 2021) were included in this study. Predischarge and 30-day VARC-3 defined outcomes were evaluated. The primary endpoint was predischarge moderate or severe paravalvular AR. Subgroup analyses per degree of aortic valve calcification were performed. RESULTS: A total of 2,026 patients (neo: 1,263, neo2: 763) were included. Predischarge moderate or severe paravalvular AR was less frequent for the neo2 group (2% vs 5%; p<0.001), resulting in higher VARC-3 intended valve performance (96% vs 90%; p<0.001). Furthermore, more patients receiving the neo2 had none/trace paravalvular AR (59% vs 38%; p<0.001). The reduction in paravalvular AR with neo2 was mainly observed with heavy aortic valve calcification. New pacemaker implantation and VARC-3 technical and device success rates were similar between the 2 groups; there were more frequent vascular and bleeding complications for the neo device. Similar 1-year survival was detected after TAVR (neo2: 90% vs neo: 87%; p=0.14). CONCLUSIONS: TAVR with the ACURATE neo2 device was associated with a lower prevalence of moderate or severe paravalvular AR and more patients with none/trace paravalvular AR. This difference was particularly evident with heavy aortic valve calcification. FAU - Scotti, Andrea AU - Scotti A AD - Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. AD - Cardiovascular Research Foundation, New York, NY, USA. FAU - Pagnesi, Matteo AU - Pagnesi M AD - ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Kim, Won-Keun AU - Kim WK AD - Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany. FAU - Schafer, Ulrich AU - Schafer U AD - Department of Cardiology, University Heart & Vascular Center, Hamburg, Germany. FAU - Barbanti, Marco AU - Barbanti M AD - Department of Cardiology, C.A.S.T. Policlinic G. Rodolico Hospital, University of Catania, Catania, Italy. FAU - Costa, Giuliano AU - Costa G AD - Department of Cardiology, C.A.S.T. Policlinic G. Rodolico Hospital, University of Catania, Catania, Italy. FAU - Baggio, Sara AU - Baggio S AD - Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Casenghi, Matteo AU - Casenghi M AD - Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy. FAU - De Marco, Federico AU - De Marco F AD - Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy. FAU - Vanhaverbeke, Maarten AU - Vanhaverbeke M AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. FAU - Wolf, Alexander AU - Wolf A AD - Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Essen, Germany. AD - Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Essen, Germany. FAU - Schofer, Joachim AU - Schofer J AD - Department for Percutaneous Treatment of Structural Heart Disease, Albertinen Heart Center, Hamburg, Germany. FAU - Ancona, Marco Bruno AU - Ancona MB AD - Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy. AD - Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy. FAU - Montorfano, Matteo AU - Montorfano M AD - Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy. AD - Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy. FAU - Kornowski, Ran AU - Kornowski R AD - Department of Cardiology, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel. AD - Department of Cardiology, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel. FAU - Assa, Hana Vaknin AU - Assa HV AD - Department of Cardiology, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel. AD - Department of Cardiology, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel. FAU - Toggweiler, Stefan AU - Toggweiler S AD - Department of Cardiology, Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. AD - Department of Cardiology, Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland. FAU - Ielasi, Alfonso AU - Ielasi A AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy. AD - Clinical and Interventional Cardiology Unit, Istituto Clinico Sant'Ambrogio, Milan, Italy. FAU - Hildick-Smith, David AU - Hildick-Smith D AD - Department of Cardiology, Royal Sussex County Hospital, Brighton, UK. AD - Department of Cardiology, Royal Sussex County Hospital, Brighton, UK. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Schmidt, Albrecht AU - Schmidt A AD - Division of Cardiology, Medical University of Graz, Graz, Austria. AD - Division of Cardiology, Medical University of Graz, Graz, Austria. FAU - Buono, Andrea AU - Buono A AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy. AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy. AD - Interventional Cardiology Unit, Fondazione Poliambulanza, Brescia, Italy. FAU - Siqueira, Dimytri AU - Siqueira D AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil. FAU - Giannini, Francesco AU - Giannini F AD - GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy. AD - GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy. FAU - Adamo, Marianna AU - Adamo M AD - ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. AD - ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Massussi, Mauro AU - Massussi M AD - ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. AD - ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. FAU - Wood, David A AU - Wood DA AD - Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, BC, Canada. AD - Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, BC, Canada. FAU - Sinning, Jan-Malte AU - Sinning JM AD - Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. AD - Department of Cardiology, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Van Der Heyden, Jan AU - Van Der Heyden J AD - Sint-Jan Hospital, Bruges, Belgium. AD - Sint-Jan Hospital, Bruges, Belgium. FAU - van Ginkel, Dirk-Jan AU - van Ginkel DJ AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands. AD - Department of Cardiology, St Antonius Hospital, Nieuwegein, the Netherlands. FAU - Van Mieghem, Nicholas AU - Van Mieghem N AD - Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. AD - Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Veulemans, Verena AU - Veulemans V AD - Division of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Dusseldorf, Dusseldorf, Germany. AD - Division of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Dusseldorf, Dusseldorf, Germany. FAU - Mylotte, Darren AU - Mylotte D AD - Department of Cardiology, Galway University Hospital, Galway, Ireland. AD - Department of Cardiology, Galway University Hospital, Galway, Ireland. FAU - Tzalamouras, Vasileios AU - Tzalamouras V AD - Cardiology, King's College Hospital, London, UK. AD - Cardiology, King's College Hospital, London, UK. FAU - Taramasso, Maurizio AU - Taramasso M AD - Division of Cardiothoracic Surgery, Arzt bei HerzZentrum Hirslanden Zurich, Zurich, Switzerland. AD - Division of Cardiothoracic Surgery, Arzt bei HerzZentrum Hirslanden Zurich, Zurich, Switzerland. FAU - Estevez-Loureiro, Rodrigo AU - Estevez-Loureiro R AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain. AD - Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain. FAU - Colombo, Antonio AU - Colombo A AD - Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy. AD - Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy. AD - Cardio Center, Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Latib, Azeem AU - Latib A AD - Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. AD - Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - Aortic Valve, Calcification of SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Heart Valve Prosthesis/adverse effects MH - Retrospective Studies MH - Prosthesis Design MH - Treatment Outcome MH - Time Factors MH - *Aortic Valve Stenosis MH - Aortic Valve/diagnostic imaging/surgery/pathology MH - *Aortic Valve Insufficiency/etiology/surgery MH - Hemodynamics MH - Calcinosis PMC - PMC9725034 COIS- A. Latib has served on advisory boards or as a consultant for Medtronic, Boston Scientific, Philips, Edwards Lifesciences, and Abbott. W-K. Kim is a proctor for Boston Scientific and Abbott Vascular; and has received speaker fees from Edwards Lifesciences. U. Schafer is proctor for Boston Scientific and Medtronic and has received lecture fees and travel support from both companies. M. Barbanti has served as a consultant for Edwards Lifesciences. D. Hildick-Smith is an advisor and a proctor for Boston Scientific, Symetis, and Medtronic. A. Wolf is a proctor for Medtronic and Boston Scientific. N. Van Mieghem has received research grant support from Boston Scientific, Abbott Vascular, Medtronic, Claret, and Essential Medical. S. Toggweiler is a consultant and proctor for Boston Scientific, Medtronic, Abbott, and Biosensors; is a consultant for Medira, Atheart Medical, Veosource, Shockwave, and Teleflex; has received institutional research grants from Boston Scientific and Fumedica AG; and holds equity in Hi-D Imaging. D. Mylotte is a proctor for Medtronic and Microport. V. Veulemans has received lecture fees and travel support from Medtronic and Edwards Lifesciences. S. Windecker has received grants from Abbott Vascular, Biotronik, Boston Scientific, Edwards Lifesciences, and Medtronic. D. Siqueira is proctor for Medtronic, Symetis, and Edwards Lifesciences. M. Adamo reports speaker honoraria from Abbott Vascular and Medtronic. J-M. Sinning is a proctor for Medtronic and Boston Scientific; and has received speaking honoraria and research grants from Medtronic, Edwards Lifesciences, and Boston Scientific. D.A. Wood has received grant support from Boston Scientific; and is a consultant for Medtronic. L. Sondergaard has received consultant fees and institutional research grants from Boston Scientific. The other authors have no conflicts of interest to declare. The Guest Editor reports lecture fees paid to his institution from Amgen, Bayer Healthcare, Biotronik, Boehringer Ingelheim, Boston Scientific, Daiichi Sankyo, Edwards Lifesciences, Ferrer, Pfizer, and Novartis; consultancy fees paid to his institution from Boehringer Ingelheim; and grant support from Bayer Healthcare, Boston Scientific, Biotronik, Edwards Lifesciences, GlaxoSmithKline, Medtronic, and Pfizer. EDAT- 2022/06/10 06:00 MHDA- 2022/11/24 06:00 PMCR- 2023/11/18 CRDT- 2022/06/09 05:33 PHST- 2022/06/10 06:00 [pubmed] PHST- 2022/11/24 06:00 [medline] PHST- 2022/06/09 05:33 [entrez] PHST- 2023/11/18 00:00 [pmc-release] AID - EIJ-D-22-00289 [pii] AID - 10.4244/EIJ-D-22-00289 [doi] PST - ppublish SO - EuroIntervention. 2022 Nov 18;18(10):804-811. doi: 10.4244/EIJ-D-22-00289. PMID- 35661552 OWN - NLM STAT- MEDLINE DCOM- 20220804 LR - 20250728 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 100 IP - 2 DP - 2022 Aug TI - Transcatheter aortic valve implantation in patients with uninterrupted vitamin K antagonists. PG - 235-242 LID - 10.1002/ccd.30248 [doi] AB - BACKGROUND: Bridging of vitamin K antagonist (VKA) with heparin is usually not promoted during interventional or surgical procedures related to increased risk of bleeding and thrombotic events but this strategy has not been evaluated during transcatheter aortic valve implantation (TAVI). PURPOSE: The aim of this study was to evaluate the rate of major bleeding and vascular complications after TAVI performed in patients with uninterrupted VKA. METHODS: From January 2016 to October 2017, consecutive patients who underwent TAVI with uninterrupted VKA (International Normalized Ratio [INR] between 1.5 and 3.5) were prospectively included in a monocentric registry. TAVI was performed according to current guidelines and a 50 U/kg bolus of heparin was injected at the beginning of the procedure for all patients. Vascular and bleeding complications were assessed using the Valve Academic Research Consortium 3 (VARC3) and the Bleeding Academic Research Consortium (BARC) definitions at a 30-day follow-up. RESULTS: A total of 88 patients were included with a median age of 84 years (81.8-87.0), 42% being female. The median society of thoracic surgeons score was 5.1 (4.1-7.5), the median CHADS2-VASc was 5.5 (5-6) and 60.2% had a chronic kidney failure. Median INR at the time of implantation was 2.1 (1.8-2.6). The main VKA indication was atrial fibrillation. Transfemoral access was used in 88.6% of the patients. Major bleeding (BARC >/= 3b) occurred in five patients (5.7%) and major vascular complications occurred in seven patients (8.0%). At 1 month follow-up, major bleeding (BARC >/= 3) or vascular complications occurred in 10 patients (11.4%). In patients with major bleeding peripheral arterial disease (RR = 10.95; 95% confidence interval (CI) 1.63-73.75; p = 0.014) and carotid access (RR = 8.56; 95% CI 1.19-1.51; p = 0.033) were more common. INR > 2.5 was significantly associated with vascular complications (RR = 7.14; 95% CI 1.29-39.63; p = 0.025). At 30 days, mortality and stroke rates were 2.3% and 4.5%, respectively. CONCLUSION: TAVI with uninterrupted VKA treatment seems feasible and safe with a low risk of major bleeding and vascular complications in this first single-center experience. Particular caution is advocated in high body mass index patients and to keep INR < 2.5. CI - (c) 2022 Wiley Periodicals LLC. FAU - Robert, Pierre AU - Robert P AUID- ORCID: 0000-0001-6664-6849 AD - Department of Cardiology, Montpellier University Hospital, Montpellier, France. AD - Department of Cardiology, Nimes University Hospital, Nimes, France. FAU - Akodad, Mariama AU - Akodad M AD - Department of Cardiology, Montpellier University Hospital, Montpellier, France. AD - PhyMedExp, INSERM U1046, CNRS, Montpellier, France. FAU - Lattuca, Benoit AU - Lattuca B AUID- ORCID: 0000-0001-6167-500X AD - Department of Cardiology, Nimes University Hospital, Nimes, France. FAU - Gandet, Thomas AU - Gandet T AD - Department of Cardiovascular surgery, Montpellier University Hospital, France. FAU - Macia, Jean-Christophe AU - Macia JC AD - Department of Cardiology, Montpellier University Hospital, Montpellier, France. FAU - Schmutz, Laurent AU - Schmutz L AD - Department of Cardiology, Nimes University Hospital, Nimes, France. FAU - Delseny, Delphine AU - Delseny D AD - Department of Cardiology, Montpellier University Hospital, Montpellier, France. FAU - Piot, Christophe AU - Piot C AD - Millenaire Clinic, Montpellier, France. FAU - Leclercq, Florence AU - Leclercq F AD - Department of Cardiology, Montpellier University Hospital, Montpellier, France. FAU - Cayla, Guillaume AU - Cayla G AD - Department of Cardiology, Nimes University Hospital, Nimes, France. LA - eng PT - Journal Article DEP - 20220605 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Anticoagulants) RN - 0 (Fibrinolytic Agents) RN - 12001-79-5 (Vitamin K) RN - 9005-49-6 (Heparin) SB - IM CIN - Catheter Cardiovasc Interv. 2022 Aug;100(2):243-244. doi: 10.1002/ccd.30333. PMID: 35920373 MH - Aged, 80 and over MH - Anticoagulants/adverse effects MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Female MH - Fibrinolytic Agents MH - Hemorrhage/chemically induced MH - Heparin MH - Humans MH - Male MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome MH - Vitamin K OTO - NOTNLM OT - anticoagulation OT - procedure simplification OT - transcatheter aortic valve implantation OT - vitamin K antagonists EDAT- 2022/06/07 06:00 MHDA- 2022/08/05 06:00 CRDT- 2022/06/06 12:42 PHST- 2022/04/13 00:00 [revised] PHST- 2022/01/06 00:00 [received] PHST- 2022/05/17 00:00 [accepted] PHST- 2022/06/07 06:00 [pubmed] PHST- 2022/08/05 06:00 [medline] PHST- 2022/06/06 12:42 [entrez] AID - 10.1002/ccd.30248 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2022 Aug;100(2):235-242. doi: 10.1002/ccd.30248. Epub 2022 Jun 5. PMID- 35661440 OWN - NLM STAT- MEDLINE DCOM- 20220719 LR - 20240831 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 9 IP - 4 DP - 2022 Aug TI - Cystatin C in risk prediction after transcatheter aortic valve replacement: a retrospective analysis. PG - 2601-2609 LID - 10.1002/ehf2.13977 [doi] AB - AIMS: No study has evaluated the prognostic value of the chronic kidney disease (CKD) classification by cystatin C-based estimated glomerular filtration rate (eGFR) (CKD(Cys) classification) in patients undergoing transcatheter aortic valve replacement (TAVR). This study aimed to compare the prognostic value of CKD(Cys) classification and CKD classification by creatinine-based eGFR (CKD(Cr) classification) in risk prediction after TAVR. METHODS AND RESULTS: We retrospectively analysed consecutive 219 patients with symptomatic severe aortic stenosis who underwent TAVR at our institute between December 2016 and June 2019. Pre-operative CKD(Cr) and CKD(Cys) classifications were evaluated for their prognostic value of 2-year major adverse cardiovascular and cerebrovascular events (MACCE) after TAVR. MACCE was defined as the composite of all-cause mortality, non-fatal myocardial infarction, stroke, and rehospitalization for worsening congestive heart failure. Participants had a median age of 86.0 years and were predominantly female (76.9%). In 96.6% of the cases, TAVR was performed using transfemoral access. The median creatinine-based eGFR (52.85 mL/min/1.73 m(2) ) was higher than the cystatin C-based eGFR (41.50 mL/min/1.73 m(2) ). Downward reclassification in CKD stages based on eGFR(Cys) was observed in 49.0% of patients. During a median follow-up period of 575.5 (interquartile range: 367.0-730.0) days, 58 patients presented with MACCE. CKD(Cys) classification, but not CKD(Cr) classification, significantly stratified the risk of 2-year MACCE in patients after TAVR by log-rank test (P = 0.003). In multivariate Cox regression analysis, only CKD(Cys) stage 3b [hazard ratio (HR) = 4.37; 95% confidence interval (CI): 1.28-14.91; P = 0.019] and CKD(Cys) stage 4 + 5 (HR = 3.72; 95% CI: 1.06-12.99; P = 0.040) were significant predictors of MACCE after adjustment for potential confounders. CONCLUSIONS: The CKD(Cys) classification could better assess the risk than the CKD(Cr) classification in patients undergoing TAVR. CKD(Cys) stage 3b and stage 4 + 5 correlated with adverse outcomes. CI - (c) 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Kuwabara, Kensuke AU - Kuwabara K AUID- ORCID: 0000-0002-6238-0040 AD - Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan. AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Zen, Kan AU - Zen K AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Yashige, Masaki AU - Yashige M AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Takamatsu, Kazuaki AU - Takamatsu K AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Ito, Nobuyasu AU - Ito N AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Kadoya, Yoshito AU - Kadoya Y AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Yamano, Michiyo AU - Yamano M AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Yamano, Tetsuhiro AU - Yamano T AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Nakamura, Takeshi AU - Nakamura T AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Yaku, Hitoshi AU - Yaku H AD - Department of Cardiovascular Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. FAU - Matoba, Satoaki AU - Matoba S AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. LA - eng PT - Journal Article DEP - 20220606 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 RN - 0 (Cystatin C) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Creatinine MH - Cystatin C MH - Female MH - Humans MH - Male MH - *Renal Insufficiency, Chronic/complications/epidemiology MH - Retrospective Studies MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome PMC - PMC9288764 OTO - NOTNLM OT - CKD OT - Creatinine OT - Cystatin C OT - Glomerular filtration rate OT - Transcatheter aortic valve replacement COIS- Dr Zen is a clinical proctor for Edwards Lifesciences and Medtronic. The other authors have no conflicts of interest to declare. EDAT- 2022/06/07 06:00 MHDA- 2022/07/20 06:00 PMCR- 2022/06/06 CRDT- 2022/06/06 12:32 PHST- 2022/03/31 00:00 [revised] PHST- 2021/12/06 00:00 [received] PHST- 2022/05/09 00:00 [accepted] PHST- 2022/06/07 06:00 [pubmed] PHST- 2022/07/20 06:00 [medline] PHST- 2022/06/06 12:32 [entrez] PHST- 2022/06/06 00:00 [pmc-release] AID - EHF213977 [pii] AID - 10.1002/ehf2.13977 [doi] PST - ppublish SO - ESC Heart Fail. 2022 Aug;9(4):2601-2609. doi: 10.1002/ehf2.13977. Epub 2022 Jun 6. PMID- 35638242 OWN - NLM STAT- MEDLINE DCOM- 20221220 LR - 20221222 IS - 1827-1898 (Electronic) IS - 0031-0808 (Linking) VI - 64 IP - 4 DP - 2022 Dec TI - Percutaneous vs. surgical axillary access for transcatheter aortic valve implantation: the TAXI registry. PG - 427-437 LID - 10.23736/S0031-0808.22.04750-4 [doi] AB - BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established management strategy for severe aortic valve stenosis. Percutaneous axillary approach for TAVI holds the promise of improving safety without jeopardizing effectiveness in comparison to surgical access. We aimed at appraising the comparative effectiveness of percutaneous vs. surgical axillary approaches for TAVI. METHODS: We performed an international retrospective observational study using de-identified details on baseline, procedural, and 1-month follow-up features. Valve Academic Research Consortium (VARC)-3 criteria were applied throughout. Outcomes of interest were clinical events up to 1 month of follow-up, compared with unadjusted and propensity score-adjusted analyses. RESULTS: A total of 432 patients were included, 189 (43.8%) receiving surgical access, and 243 (56.2%) undergoing percutaneous access. Primary hemostasis failure was more common in the percutaneous group (13.2% vs. 4.2%, P<0.001), leading to more common use of covered stent implantation (13.2% vs. 3.7%, P<0.001). Irrespectively, percutaneous access was associated with shorter hospital stay (-2.6 days [95% confidence interval: -5.0; -0.1], P=0.038), a lower risk of major adverse events (a composite of death, myocardial infarction, stroke, type 3 bleeding, and major access-site related complication; odds ratio=0.44 [0.21; 0.95], P=0.036), major access-site non-vascular complications (odds ratio=0.21 [0.06; 0.77], P=0.018), and brachial plexus impairment (odds ratio=0.16 [0.03; 0.76], P=0.021), and shorter hospital stay (-2.6 days [-5.0; -0.1], P=0.038). CONCLUSIONS: Percutaneous axillary access provides similar or better results than surgical access in patients undergoing TAVI with absolute or relative contraindications to femoral access. FAU - Giordano, Arturo AU - Giordano A AD - Unit of Interventional Cardiology, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Schaefer, Andreas AU - Schaefer A AD - Department of Cardiovascular Surgery, University Heart and Vascular Center of Hamburg, Hamburg, Germany. FAU - Bhadra, Oliver D AU - Bhadra OD AD - Department of Cardiovascular Surgery, University Heart and Vascular Center of Hamburg, Hamburg, Germany. FAU - Conradi, Lenard AU - Conradi L AD - Department of Cardiovascular Surgery, University Heart and Vascular Center of Hamburg, Hamburg, Germany. FAU - Westermann, Dirk AU - Westermann D AD - Department of Cardiology, University Heart and Vascular Center of Hamburg, Hamburg, Germany. FAU - DE Backer, Ole AU - DE Backer O AD - The Heart Center - Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark. FAU - Bajoras, Vilhelmas AU - Bajoras V AD - The Heart Center - Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark. FAU - Sondergaard, Lars AU - Sondergaard L AD - The Heart Center - Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark. FAU - Qureshi, Waqas T AU - Qureshi WT AD - Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA. FAU - Kakouros, Nikolaos AU - Kakouros N AD - Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA. FAU - Aldrugh, Summer AU - Aldrugh S AD - Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA. FAU - Amat-Santos, Ignacio AU - Amat-Santos I AD - Department of Cardiology, CIBERCV, University Clinical Hospital of Valladolid, Valladolid, Spain. FAU - Santos Martinez, Sandra AU - Santos Martinez S AD - Department of Cardiology, CIBERCV, University Clinical Hospital of Valladolid, Valladolid, Spain. FAU - Kaneko, Tsuyoshi AU - Kaneko T AD - Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Medical School of Harvard, Boston, MA, USA. FAU - Harloff, Morgan AU - Harloff M AD - Division of Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital, Medical School of Harvard, Boston, MA, USA. FAU - Teles, Rui AU - Teles R AD - Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Lisbon, Portugal. FAU - Nolasco, Tiago AU - Nolasco T AD - Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Lisbon, Portugal. FAU - Neves, Jose P AU - Neves JP AD - Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Lisbon, Portugal. FAU - Abecasis, Miguel AU - Abecasis M AD - Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Lisbon, Portugal. FAU - Werner, Nikos AU - Werner N AD - Department of Medicine3, Barmherzige Bruder Hospital, Trier, Germany. FAU - Lauterbach, Michael AU - Lauterbach M AD - Department of Medicine3, Barmherzige Bruder Hospital, Trier, Germany. FAU - Sacha, Jerzy AU - Sacha J AD - Department of Cardiology, Institute of Medical Sciences, University Hospital of Opole, Opole, Poland. FAU - Krawczyk, Krzysztof AU - Krawczyk K AD - Department of Cardiology, Institute of Medical Sciences, University Hospital of Opole, Opole, Poland. FAU - Trani, Carlo AU - Trani C AD - Institute of Cardiology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Institute of Cardiology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy. FAU - Mangieri, Antonio AU - Mangieri A AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Condello, Francesco AU - Condello F AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. FAU - Regueiro, Ander AU - Regueiro A AD - Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. FAU - Brugaletta, Salvatore AU - Brugaletta S AD - Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy. AD - Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. FAU - Biancari, Fausto AU - Biancari F AD - Clinica Montevergine, GVM Care & Research, Mercogliano, Avellino, Italy. AD - Heart and Lung Center, University Hospital of Helsinki, Helsinki, Finland. FAU - Niemela, Matti AU - Niemela M AD - Department of Internal Medicine, Oulu University Hospital, Oulu, Finland. FAU - Giannini, Francesco AU - Giannini F AD - Heart and Lung Center, University Hospital of Helsinki, Helsinki, Finland. FAU - Toselli, Marco AU - Toselli M AD - Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Ravenna, Italy. FAU - Ruggiero, Rossella AU - Ruggiero R AD - Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Ravenna, Italy. FAU - Buono, Andrea AU - Buono A AD - Unit of Interventional Cardiology, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Maffeo, Diego AU - Maffeo D AD - Unit of Interventional Cardiology, Cardiovascular Department, Fondazione Poliambulanza Institute, Brescia, Italy. FAU - Bruno, Francesco AU - Bruno F AD - Division of Cardiology, Department of Medical Science, Citta Della Salute e della Scienza, Turin, Italy. FAU - Conrotto, Federico AU - Conrotto F AD - Division of Cardiology, Department of Medical Science, Citta Della Salute e della Scienza, Turin, Italy. FAU - D'Ascenzo, Fabrizio AU - D'Ascenzo F AD - Division of Cardiology, Department of Medical Science, Citta Della Salute e della Scienza, Turin, Italy. FAU - Savontaus, Mikko AU - Savontaus M AD - Heart Center, Turku University Hospital, Turku, Finland. FAU - Pykari, Jouni AU - Pykari J AD - Heart Center, Turku University Hospital, Turku, Finland. FAU - Ielasi, Alfonso AU - Ielasi A AD - Unit of Clinical and Interventional Cardiology, Sant'Ambrogio Clinical Institute, Gruppo Ospedaliero San Donato, Milan, Italy. FAU - Tespili, Maurizio AU - Tespili M AD - Unit of Clinical and Interventional Cardiology, Sant'Ambrogio Clinical Institute, Gruppo Ospedaliero San Donato, Milan, Italy. FAU - Corcione, Nicola AU - Corcione N AD - Unit of Interventional Cardiology, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Ferraro, Paolo AU - Ferraro P AD - Unit of Interventional Cardiology, Santa Lucia Clinic, S. Giuseppe Vesuviano, Naples, Italy. FAU - Morello, Alberto AU - Morello A AD - Unit of Interventional Cardiology, Pineta Grande Hospital, Castel Volturno, Caserta, Italy. FAU - Albanese, Michele AU - Albanese M AD - Unit of Interventional Cardiology, Santa Lucia Clinic, S. Giuseppe Vesuviano, Naples, Italy. FAU - Biondi-Zoccai, Giuseppe AU - Biondi-Zoccai G AD - Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy - giuseppe.biondizoccai@uniroma1.com. AD - Mediterranea Cardiocentro, Naples, Italy. LA - eng PT - Journal Article PT - Observational Study DEP - 20220530 PL - Italy TA - Panminerva Med JT - Panminerva medica JID - 0421110 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome MH - *Aortic Valve Stenosis/surgery/etiology MH - Registries MH - Retrospective Studies MH - Aortic Valve/surgery MH - Risk Factors EDAT- 2022/06/01 06:00 MHDA- 2022/12/21 06:00 CRDT- 2022/05/31 14:36 PHST- 2022/06/01 06:00 [pubmed] PHST- 2022/12/21 06:00 [medline] PHST- 2022/05/31 14:36 [entrez] AID - S0031-0808.22.04750-4 [pii] AID - 10.23736/S0031-0808.22.04750-4 [doi] PST - ppublish SO - Panminerva Med. 2022 Dec;64(4):427-437. doi: 10.23736/S0031-0808.22.04750-4. Epub 2022 May 30. PMID- 35622220 OWN - NLM STAT- MEDLINE DCOM- 20221025 LR - 20221025 IS - 1863-6713 (Electronic) IS - 1863-6705 (Linking) VI - 70 IP - 11 DP - 2022 Nov TI - Transcatheter tricuspid valve-in-valve implantation with bioprosthetic balloon expandable valve. PG - 947-953 LID - 10.1007/s11748-022-01829-z [doi] AB - OBJECTIVES: This study was conducted to evaluate the outcome of the transcatheter valve-in-valve implantation for degenerated tricuspid bioprosthetic valves with transcatheter aortic valves. METHODS: This retrospective study enrolled all consecutive patients who were considered high risk for reoperations by the heart team and who underwent transcatheter valve-in-valve implantation for degenerated tricuspid bioprosthetic valves in Tehran Heart Center, Tehran, Iran. All the procedures were performed via the transfemoral venous route under echocardiography and fluoroscopy guidance with Edwards SAPIEN transcatheter heart valves (Edwards Lifesciences, Irvine, CA). RESULTS: Ten patients underwent successful transcatheter valve-in-valve implantation in the tricuspid position without any major complications or need for emergency surgical interventions. The mean age was 54.1 +/- 17.1 years, and 8 patients were female. The median follow-up was 19.5 months (16-32.25 mon). The mean period between the last tricuspid valve replacement and transcatheter valve-in-valve implantation was 4.9 +/- 2.2 years. The bioprosthetic valves were Hancock in three patients, Mosaic in the other three patients, and Biocor, Pericarbon, Perimount, and Epic in the other patients. After the procedure, the clinical and functional status improved significantly in all the patients. The mean transvalvular gradient decreased from 6.75 +/- 2.66 mm Hg to 2.85 +/- 0.89 (P < 0.001), and the postoperative tricuspid regurgitation severity decreased significantly in almost all the patients. The hospitalization period after the procedure was 4.4 +/- 1.7 days. CONCLUSIONS: In high-risk patients, transcatheter valve-in-valve implantation seems to be a safe and minimally invasive alternative to reoperations for degenerated tricuspid bioprosthetic valves. CI - (c) 2022. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery. FAU - Haji-Zeinali, Ali-Mohammad AU - Haji-Zeinali AM AD - Interventional Cardiology, Head of the Endovascular and Structural Heart Intervention Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. ali_zeinali_cardio@yahoo.com. FAU - Etesamifard, Nasrin AU - Etesamifard N AD - Interventional Cardiology, Head of the Endovascular and Structural Heart Intervention Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. FAU - Mohammadi, Zohre AU - Mohammadi Z AD - Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. FAU - Haji-Zeinali, Mohammad-Mohsen AU - Haji-Zeinali MM AD - Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. FAU - Sahebjam, Mohammad AU - Sahebjam M AD - Department of Echocardiography, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. FAU - Abbasi, Kiomars AU - Abbasi K AD - Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. LA - eng PT - Journal Article DEP - 20220527 PL - Japan TA - Gen Thorac Cardiovasc Surg JT - General thoracic and cardiovascular surgery JID - 101303952 SB - IM MH - Humans MH - Female MH - Adult MH - Middle Aged MH - Aged MH - Male MH - *Heart Valve Prosthesis MH - Tricuspid Valve/diagnostic imaging/surgery MH - *Bioprosthesis MH - *Heart Valve Prosthesis Implantation/adverse effects/methods MH - Cardiac Catheterization/methods MH - *Transcatheter Aortic Valve Replacement MH - Retrospective Studies MH - Prosthesis Failure MH - Prosthesis Design MH - Treatment Outcome MH - Iran OTO - NOTNLM OT - Balloon expandable valve OT - Bioprosthetic valve OT - Transcatheter tricuspid valve in valve OT - Tricuspid valve disease EDAT- 2022/05/28 06:00 MHDA- 2022/10/26 06:00 CRDT- 2022/05/27 11:18 PHST- 2021/11/23 00:00 [received] PHST- 2022/05/02 00:00 [accepted] PHST- 2022/05/28 06:00 [pubmed] PHST- 2022/10/26 06:00 [medline] PHST- 2022/05/27 11:18 [entrez] AID - 10.1007/s11748-022-01829-z [pii] AID - 10.1007/s11748-022-01829-z [doi] PST - ppublish SO - Gen Thorac Cardiovasc Surg. 2022 Nov;70(11):947-953. doi: 10.1007/s11748-022-01829-z. Epub 2022 May 27. PMID- 35610545 OWN - NLM STAT- MEDLINE DCOM- 20220704 LR - 20220705 IS - 1540-8191 (Electronic) IS - 0886-0440 (Linking) VI - 37 IP - 8 DP - 2022 Aug TI - Early outcomes of the suprasternal transcatheter aortic valve replacement technique. PG - 2360-2364 LID - 10.1111/jocs.16603 [doi] AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is now an established treatment option for patients with severe aortic stenosis. The most utilized approach remains transfemoral. In patients with difficult femoral access a variety of alternate approaches have been used. Recently, suprasternal access has emerged as a viable alternate approach in patients with very complex vascular access. We describe our 30-day outcomes of patients who underwent suprasternal transcatheter aortic valve replacement (suprasternal [SS]-TAVR), which constitutes the largest single-center cohort to date. METHODS: From May 2016 to September 2021, 658 patients underwent TAVR at our institution. Of which 29 underwent SS-TAVR. We performed a retrospective analysis to evaluate early (30 days) outcomes of this procedure. Main outcomes evaluated included 30-day mortality, stroke and pacemaker rates, length of stay, readmission, and valvular function. RESULTS: All patients were alive 30 days after the procedure. The median hospital length-of-stay was 2 days. Two patients (6.9%) had a stroke on the contra-lateral side of access. Two patients (6.90%) had significant cardiac arrhythmias requiring pacemaker placement. In 30 days, one patient was readmitted (3.45%). CONCLUSIONS: Our data confirm the SS-TAVR as a feasible and safe alternative with comparable results to established approaches in patients who are unsuitable for femoral artery access and offers clinicians another access site in patients with very complex anatomy. CI - (c) 2022 Wiley Periodicals LLC. FAU - de Oliveira, Guilherme C AU - de Oliveira GC AUID- ORCID: 0000-0003-4574-4516 AD - Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. FAU - Kessel, Julia AU - Kessel J AD - School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. FAU - Vavalle, John AU - Vavalle J AUID- ORCID: 0000-0002-7820-4789 AD - Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. FAU - Caranasos, Thomas AU - Caranasos T AUID- ORCID: 0000-0002-4347-0219 AD - Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. LA - eng PT - Journal Article DEP - 20220524 PL - United States TA - J Card Surg JT - Journal of cardiac surgery JID - 8908809 SB - IM CIN - J Card Surg. 2022 Aug;37(8):2365-2366. doi: 10.1111/jocs.16602. PMID: 35560999 MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis MH - Femoral Artery/surgery MH - *Heart Valve Prosthesis MH - Humans MH - Retrospective Studies MH - Risk Factors MH - *Stroke/etiology/prevention & control MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome OTO - NOTNLM OT - TAVR OT - aortic valve OT - branchiocephalic artery OT - cardiology OT - suprasternal OT - thoracic surgery OT - transinnominate EDAT- 2022/05/25 06:00 MHDA- 2022/07/06 06:00 CRDT- 2022/05/24 23:34 PHST- 2022/02/14 00:00 [received] PHST- 2022/04/06 00:00 [accepted] PHST- 2022/05/25 06:00 [pubmed] PHST- 2022/07/06 06:00 [medline] PHST- 2022/05/24 23:34 [entrez] AID - 10.1111/jocs.16603 [doi] PST - ppublish SO - J Card Surg. 2022 Aug;37(8):2360-2364. doi: 10.1111/jocs.16603. Epub 2022 May 24. PMID- 35597495 OWN - NLM STAT- MEDLINE DCOM- 20220608 LR - 20220915 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 360 DP - 2022 Aug 1 TI - Comparison of left ventricular with right ventricular rapid pacing on tamponade during TAVI. PG - 46-52 LID - S0167-5273(22)00746-X [pii] LID - 10.1016/j.ijcard.2022.05.035 [doi] AB - BACKGROUND: Small studies have suggested left ventricular (LV) rapid pacing has similar safety and efficacy to conventional right ventricular (RV) rapid pacing in transcatheter aortic valve implantation (TAVI). However, there are limited data on the comparative rates of tamponade. The study compared the rate of cardiac tamponade between LV and RV-pacing during TAVI. METHODS: Between 2008 and 2021, 1226 consecutive patients undergoing transfemoral or transaxillary TAVI were included. 470(38.3%) patients had TAVI deployment with RV-pacing and 756(61.7%) with LV-pacing. The primary outcome was the frequency and cause of cardiac tamponade. Secondary outcomes included efficacy, procedure duration and crossover rates. RESULTS: There was a trend to less tamponade with LV-pacing, which did not reach statistical significance [11(2.3%) vs 11(1.5%);P = 0.27]. There was no significant difference in the frequency of tamponade due to annular tear [4(0.9%) vs 9(1.2%);P = 0.59] or LV free-wall perforation [1(0.2%) vs 2(0.3%);P = 0.86]. The frequency of tamponade due to RV perforation was significantly lower in the LV-pacing group [0 vs 6(2.3%);P < 0.005)]. Two patients with tamponade due to RV perforation required emergency sternotomy of whom one died. Deployment success was similar (99% vs 99.6%;P=NS). Procedure duration was shorter with LV-pacing (70 vs 80 mins;P < 0.005). Crossover to RV-pacing was low (0.9%). There were no embolizations caused by loss-of-capture in either group. CONCLUSIONS: LV-pacing appears equally efficacious and is associated with a lower risk of tamponade due to RV perforation caused by the temporary pacing wire. LV-pacing was not associated with an increased risk of tamponade due to LV free-wall perforation. CI - Copyright (c) 2022. Published by Elsevier B.V. FAU - Savvoulidis, Panagiotis AU - Savvoulidis P AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. FAU - Mechery, Anthony AU - Mechery A AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. FAU - Lawton, Ewa AU - Lawton E AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. FAU - Ludman, Peter F AU - Ludman PF AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. FAU - Sharma, Harish AU - Sharma H AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. FAU - Thompson, Sophie AU - Thompson S AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. FAU - Khalil, Arsalan AU - Khalil A AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. FAU - Kalogeropoulos, Andreas AU - Kalogeropoulos A AD - Division of Cardiology, Department of Medicine, Stony Brook University, USA. FAU - Q Khan, Sohail AU - Q Khan S AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. FAU - Nadir, Adnan AU - Nadir A AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. FAU - Doshi, Sagar N AU - Doshi SN AD - Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.. Electronic address: Sagar.Doshi@uhb.nhs.uk. LA - eng PT - Journal Article DEP - 20220518 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/diagnosis/etiology/surgery MH - Cardiac Pacing, Artificial MH - *Cardiac Tamponade/diagnosis/epidemiology/etiology MH - *Heart Injuries/etiology MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - LV pacing OT - RV pacing OT - TAVI OT - Tamponade OT - Transcatheter aortic valve implantation EDAT- 2022/05/22 06:00 MHDA- 2022/06/09 06:00 CRDT- 2022/05/21 19:27 PHST- 2022/03/17 00:00 [received] PHST- 2022/04/28 00:00 [revised] PHST- 2022/05/16 00:00 [accepted] PHST- 2022/05/22 06:00 [pubmed] PHST- 2022/06/09 06:00 [medline] PHST- 2022/05/21 19:27 [entrez] AID - S0167-5273(22)00746-X [pii] AID - 10.1016/j.ijcard.2022.05.035 [doi] PST - ppublish SO - Int J Cardiol. 2022 Aug 1;360:46-52. doi: 10.1016/j.ijcard.2022.05.035. Epub 2022 May 18. PMID- 35508295 OWN - NLM STAT- MEDLINE DCOM- 20220816 LR - 20260728 IS - 2241-5955 (Electronic) IS - 1109-9666 (Linking) VI - 66 DP - 2022 Jul-Aug TI - TAVI with the ACURATE neo transcatheter heart valve in special populations: A systematic review. PG - 67-71 LID - S1109-9666(22)00059-8 [pii] LID - 10.1016/j.hjc.2022.04.005 [doi] AB - The ACURATE neo transcatheter aortic valve is a self-expanding device suitable for both transfemoral and transapical approach, but specific groups of patients are under-represented in clinical trials. We aim to provide a comprehensive systematic review on TAVI with ACURATE neo in those special populations. TAVI in bicuspid aortic valve, TAVI in patients with small aortic annulus, TAVI for pure aortic regurgitation and valve-in-valve procedures, were systematically reviewed. The primary endpoint was device success as defined by VARC-2 criteria. The secondary endpoints were safety and performance outcomes according to VARC-2 consensus document.ACURATE neo exhibited similar outcomes in bicuspid vs tricuspid aortic valve except for pre and post-dilatation rates in one observational study. Lower mean aortic gradient and higher pre-dilatation rates with comparable safety outcomes were described for ACURATE neo when compared to Lotus and Evolut-R for bicuspid aortic valve stenosis. 2 studies compared ACURATE in small aortic annuli. ACURATE neo showed lower transvalvular gradients and lower patient prosthesis mismatch rates compared to Sapien 3 and when compared to Evolut R/ Evolut PRO/ Portico, results were similar except for pre-dilatation rates. 3 studies investigated ACURATE neo for pure aortic regurgitation and one for valve-in-valve procedure and demonstrated safety and efficacy, with the exception of malposition events in patients designated for higher valve deployment in the valve-in-valve implantation study.ACURATE neo valve may be a feasible and safe option for patients with bicuspid anatomy, small aortic annulus, previously implanted bioprosthetic aortic valve and pure aortic regurgitation. REGISTRATION NUMBER: Available at https://osf.io/aus26 (DOI 10.17605/OSF.IO/AUS26). CI - Copyright (c) 2022 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved. FAU - Koliastasis, Leonidas AU - Koliastasis L AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece; Athens Naval and Veterans Hospital, Athens, Greece. Electronic address: lkoliastasis@gmail.com. FAU - Doundoulakis, Ioannis AU - Doundoulakis I AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece; Department of Cardiology, 424 General Military Training Hospital, Thessaloniki, Greece. FAU - Kokkinidis, Damianos G AU - Kokkinidis DG AD - Section of Cardiovascular Medicine, Yale University School of Medicine, Yale New Haven Hospital, New Haven, CT, United States. FAU - Milkas, Anastasios AU - Milkas A AD - Athens Naval and Veterans Hospital, Athens, Greece. FAU - Drakopoulou, Maria AU - Drakopoulou M AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Benetos, George AU - Benetos G AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Latsios, Georgios AU - Latsios G AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Synetos, Andreas AU - Synetos A AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Aggeli, Konstantina AU - Aggeli K AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Tousoulis, Dimitrios AU - Tousoulis D AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Tsioufis, Konstantinos AU - Tsioufis K AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. FAU - Toutouzas, Konstantinos AU - Toutouzas K AD - First Department of Cardiology, National and Kapodistrian University, "Hippokration" Hospital, Athens, Greece. LA - eng PT - Journal Article PT - Systematic Review DEP - 20220501 PL - Netherlands TA - Hellenic J Cardiol JT - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese JID - 101257381 SB - IM MH - Aortic Valve/surgery MH - *Aortic Valve Insufficiency/etiology/surgery MH - *Aortic Valve Stenosis/surgery MH - *Bicuspid Aortic Valve Disease MH - *Heart Valve Prosthesis MH - Humans MH - Observational Studies as Topic MH - Prosthesis Design MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome OTO - NOTNLM OT - ACURATE OT - TAVI OT - systematic review COIS- Conflicts of interest None. EDAT- 2022/05/05 06:00 MHDA- 2022/08/17 06:00 CRDT- 2022/05/04 19:24 PHST- 2021/09/03 00:00 [received] PHST- 2022/03/23 00:00 [revised] PHST- 2022/04/21 00:00 [accepted] PHST- 2022/05/05 06:00 [pubmed] PHST- 2022/08/17 06:00 [medline] PHST- 2022/05/04 19:24 [entrez] AID - S1109-9666(22)00059-8 [pii] AID - 10.1016/j.hjc.2022.04.005 [doi] PST - ppublish SO - Hellenic J Cardiol. 2022 Jul-Aug;66:67-71. doi: 10.1016/j.hjc.2022.04.005. Epub 2022 May 1. PMID- 35505257 OWN - NLM STAT- MEDLINE DCOM- 20220825 LR - 20250728 IS - 1615-2573 (Electronic) IS - 0910-8327 (Print) IS - 0910-8327 (Linking) VI - 37 IP - 10 DP - 2022 Oct TI - Percutaneous trans-axilla transcatheter aortic valve replacement. PG - 1801-1807 LID - 10.1007/s00380-022-02082-3 [doi] AB - The left axillary artery is an attractive alternative access route for transcatheter aortic valve replacement (TAVR) and may provide better outcomes compared to other alternatives. Nevertheless, there remain concerns about vascular complications, lack of compressibility, and thorax-related complications. Between March 2019 and March 2021, 13 patients underwent transaxillary TAVR for severe aortic stenosis at the University Hospital Bonn. The puncture was performed with a puncture at the distal segment of the axillary artery through the axilla, with additional femoral access for applying a safety wire inside the axillary artery. Device success was defined according to the VARC 2 criteria. The study participants were advanced in age (77 +/- 9 years old), and 54% were female, with an intermediate risk for surgery (STS risk score 4.7 +/- 2.0%). The average diameter of the distal segment of the axillary artery was 5.8 +/- 1.0 mm (i.e., the puncture site) and 7.6 +/- 0.9 mm for the proximal axillary artery. Device success was achieved in all patients. 30-day major adverse cardiac and cerebrovascular events were 0%. With complete percutaneous management, stent-graft implantation was performed at the puncture site in 38.5% of patients. Minor bleeding was successfully managed with manual compression. Moreover, no thorax-related complications, hematomas, or nerve injuries were observed. Percutaneous trans-axilla TAVR was found to be feasible and safe. This modified approach may mitigate the risk of bleeding and serious complications in the thorax and be less invasive than surgical alternatives. CI - (c) 2022. The Author(s). FAU - Sugiura, Atsushi AU - Sugiura A AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Sudo, Mitsumasa AU - Sudo M AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Al-Kassou, Baravan AU - Al-Kassou B AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Shamekhi, Jasmin AU - Shamekhi J AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Silaschi, Miriam AU - Silaschi M AD - Department of Cardiac Surgery, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Wilde, Nihal AU - Wilde N AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Sedaghat, Alexander AU - Sedaghat A AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Becher, Ulrich Marc AU - Becher UM AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Weber, Marcel AU - Weber M AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Sinning, Jan-Malte AU - Sinning JM AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Grube, Eberhard AU - Grube E AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Nickenig, Georg AU - Nickenig G AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Charitos, Efstratios I AU - Charitos EI AD - Department of Cardiac Surgery, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. FAU - Zimmer, Sebastian AU - Zimmer S AD - Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany. Sebastian.zimmer@ukbonn.de. LA - eng PT - Journal Article DEP - 20220503 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/complications MH - Axilla/surgery MH - Female MH - Femoral Artery/surgery MH - Hemorrhage/etiology MH - Humans MH - Male MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome PMC - PMC9399016 OTO - NOTNLM OT - Axilla OT - Distal puncture OT - Percutaneous OT - TAVR OT - Transaxillary COIS- Mitsumasa Sudo has received manuscript fees from Boston scientific Japan KK. Marcel Weber has received lecture or proctoring fees from Edwards Lifesciences. Eberhard Grube serves on an advisory board for Medtronic and Boston scientific and has received speaking honoraria and research grants from Abbott, Medtronic, Boston scientific, and Edwards Lifesciences. Georg Nickenig has received research funding from Edwards Lifesciences, Medtronic, and St Jude Medical and has received honoraria for lectures or advisory boards from Edwards Lifesciences, Medtronic, and St Jude Medical. Efstratios I. Charitos: significant stock: Edwards Lifesciences; Medtronic. The other authors have no conflicts of interest. EDAT- 2022/05/04 06:00 MHDA- 2022/08/26 06:00 PMCR- 2022/05/03 CRDT- 2022/05/03 23:32 PHST- 2021/12/27 00:00 [received] PHST- 2022/04/15 00:00 [accepted] PHST- 2022/05/04 06:00 [pubmed] PHST- 2022/08/26 06:00 [medline] PHST- 2022/05/03 23:32 [entrez] PHST- 2022/05/03 00:00 [pmc-release] AID - 10.1007/s00380-022-02082-3 [pii] AID - 2082 [pii] AID - 10.1007/s00380-022-02082-3 [doi] PST - ppublish SO - Heart Vessels. 2022 Oct;37(10):1801-1807. doi: 10.1007/s00380-022-02082-3. Epub 2022 May 3. PMID- 35505123 OWN - NLM STAT- MEDLINE DCOM- 20220801 LR - 20250728 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 111 IP - 8 DP - 2022 Aug TI - Cerebral oxygen saturation as outcome predictor after transfemoral transcatheter aortic valve implantation. PG - 955-965 LID - 10.1007/s00392-022-02019-w [doi] AB - BACKGROUND: Cerebral oxygen saturation (ScO(2)) can be measured non-invasively by near-infrared spectroscopy (NIRS) and correlates with cerebral perfusion. We investigated cerebral saturation during transfemoral transcatheter aortic valve implantation (TAVI) and its impact on outcome. METHODS AND RESULTS: Cerebral oxygenation was measured continuously by NIRS in 173 analgo-sedated patients during transfemoral TAVI (female 47%, mean age 81 years) with self-expanding (39%) and balloon-expanding valves (61%). We investigated the periprocedural dynamics of cerebral oxygenation. Mean ScO(2) at baseline without oxygen supply was 60%. During rapid ventricular pacing, ScO(2) dropped significantly (before 64% vs. after 55%, p < 0.001). ScO(2) at baseline correlated positively with baseline left-ventricular ejection fraction (0.230, p < 0.006) and hemoglobin (0.327, p < 0.001), and inversely with EuroSCORE-II ( - 0.285, p < 0.001) and length of in-hospital stay ( - 0.229, p < 0.01). Patients with ScO2 < 56% despite oxygen supply at baseline had impaired 1 year survival (log-rank test p < 0.01) and prolonged in-hospital stay (p = 0.03). Furthermore, baseline ScO(2) was found to be a predictor for 1 year survival independent of age and sex (multivariable adjusted Cox regression, p = 0.020, hazard ratio (HR 0.94, 95% CI 0.90-0.99) and independent of overall perioperative risk estimated by EuroSCORE-II and hemoglobin (p = 0.03, HR 0.95, 95% CI 0.91-0.99). CONCLUSIONS: Low baseline ScO(2) not responding to oxygen supply might act as a surrogate for impaired cardiopulmonary function and is associated with worse 1 year survival and prolonged in-hospital stay after transfemoral TAVI. ScO(2) monitoring is an easy to implement diagnostic tool to screen patients at risk with a potential preserved recovery and worse outcome after TAVI. CI - (c) 2022. The Author(s). FAU - Seppelt, Philipp C AU - Seppelt PC AUID- ORCID: 0000-0003-4743-6920 AD - Division of Cardiology, Department of Medicine III, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. Philipp.Seppelt@kgu.de. AD - DZHK Partner Site Rhine-Main, German Centre for Cardiovascular Research, Berlin, Germany. Philipp.Seppelt@kgu.de. FAU - Mas-Peiro, Silvia AU - Mas-Peiro S AD - Division of Cardiology, Department of Medicine III, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. AD - DZHK Partner Site Rhine-Main, German Centre for Cardiovascular Research, Berlin, Germany. FAU - Van Linden, Arnaud AU - Van Linden A AD - DZHK Partner Site Rhine-Main, German Centre for Cardiovascular Research, Berlin, Germany. AD - Department of Cardiothoracic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. FAU - Iken, Sonja AU - Iken S AD - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. FAU - Zacharowski, Kai AU - Zacharowski K AD - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. FAU - Walther, Thomas AU - Walther T AD - DZHK Partner Site Rhine-Main, German Centre for Cardiovascular Research, Berlin, Germany. AD - Department of Cardiothoracic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. FAU - Fichtlscherer, Stephan AU - Fichtlscherer S AD - Division of Cardiology, Department of Medicine III, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. AD - DZHK Partner Site Rhine-Main, German Centre for Cardiovascular Research, Berlin, Germany. FAU - Vasa-Nicotera, Mariuca AU - Vasa-Nicotera M AD - Division of Cardiology, Department of Medicine III, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. AD - DZHK Partner Site Rhine-Main, German Centre for Cardiovascular Research, Berlin, Germany. LA - eng PT - Journal Article DEP - 20220504 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - S88TT14065 (Oxygen) SB - IM MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Female MH - Humans MH - Oxygen MH - Oxygen Saturation MH - Stroke Volume MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome MH - Ventricular Function, Left PMC - PMC9334442 OTO - NOTNLM OT - Aortic stenosis OT - Cerebral oxygen saturation OT - TAVI OT - Valvular cardiomyopathy COIS- The other authors declare that they have no conflict of interest. EDAT- 2022/05/04 06:00 MHDA- 2022/08/02 06:00 PMCR- 2022/05/04 CRDT- 2022/05/03 23:27 PHST- 2021/12/12 00:00 [received] PHST- 2022/03/31 00:00 [accepted] PHST- 2022/05/04 06:00 [pubmed] PHST- 2022/08/02 06:00 [medline] PHST- 2022/05/03 23:27 [entrez] PHST- 2022/05/04 00:00 [pmc-release] AID - 10.1007/s00392-022-02019-w [pii] AID - 2019 [pii] AID - 10.1007/s00392-022-02019-w [doi] PST - ppublish SO - Clin Res Cardiol. 2022 Aug;111(8):955-965. doi: 10.1007/s00392-022-02019-w. Epub 2022 May 4. PMID- 35469937 OWN - NLM STAT- MEDLINE DCOM- 20220523 LR - 20220714 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 358 DP - 2022 Jul 1 TI - Carotid ultrasound following transcarotid transcatheter aortic valve replacement. PG - 12-16 LID - S0167-5273(22)00570-8 [pii] LID - 10.1016/j.ijcard.2022.04.054 [doi] AB - BACKGROUND: Transcarotid (TC) is a common alternative access for transcatheter aortic valve replacement (TAVR) when the transfemoral route is not suitable. However, scarce data exist on systematic ultrasound (US) follow-up of these patients. This study aims to evaluate the safety of TC-TAVR using pre-and post-procedure carotid artery US assessment. METHODS: We performed an observational prospective study including 50 consecutive patients who underwent TC-TAVR that had a follow-up at our institution between September 2016 and July 2020. RESULTS: All patients had a carotid US examination at a median time of 13 months (IQR: 5-17) following the procedure. Thirty-six (71%) patients also had a US examination prior to the procedure. Mean pre-procedural access route common carotid artery (AR-CCA) peak systolic velocity (PSV) was 62.9 cm/s (SD:16.8) vs. 69.0 cm/s (SD: 53.4) in the contralateral CCA (CL-CCA), p = 0.562). There was a significant increase in post-procedural PSV values in the AR-CCA (30.3 cm/s (SD: 36.3), p < 0.001) but not in the CL-CCA (5.8 cm/s (SD: 51.7), p = 0.503). Two new carotid stenoses (4%) were diagnosed after the procedure. No baseline or procedural variables were associated with a higher increase in carotid flow velocities at follow-up. There were no cerebrovascular events related to these findings after a median follow-up of 29 months (IQR:13-33). CONCLUSIONS: TC-TAVR was associated with a mild but significant increase in carotid flow velocities, with new significant (>50%) carotid stenosis diagnosed in 4% of patients. These findings were not associated with clinical events after a median follow-up of 2 years. Further studies are warranted. CI - Copyright (c) 2022 Elsevier B.V. All rights reserved. FAU - Panagides, Vassili AU - Panagides V AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Kalavrouziotis, Dimitri AU - Kalavrouziotis D AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Dumont, Eric AU - Dumont E AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Delarochelliere, Robert AU - Delarochelliere R AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Paradis, Jean-Michel AU - Paradis JM AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Mesnier, Jules AU - Mesnier J AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Mohammadi, Siamak AU - Mohammadi S AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca. LA - eng PT - Journal Article PT - Observational Study DEP - 20220423 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM CIN - Int J Cardiol. 2022 Jul 1;358:26. doi: 10.1016/j.ijcard.2022.04.017. PMID: 35398475 MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Carotid Arteries/diagnostic imaging/surgery MH - *Carotid Stenosis/diagnostic imaging/surgery MH - Humans MH - Prospective Studies MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - Doppler OT - TAVI OT - TAVR OT - Transcarotid OT - Ultrasound EDAT- 2022/04/27 06:00 MHDA- 2022/05/24 06:00 CRDT- 2022/04/26 05:57 PHST- 2022/02/27 00:00 [received] PHST- 2022/04/16 00:00 [revised] PHST- 2022/04/20 00:00 [accepted] PHST- 2022/04/27 06:00 [pubmed] PHST- 2022/05/24 06:00 [medline] PHST- 2022/04/26 05:57 [entrez] AID - S0167-5273(22)00570-8 [pii] AID - 10.1016/j.ijcard.2022.04.054 [doi] PST - ppublish SO - Int J Cardiol. 2022 Jul 1;358:12-16. doi: 10.1016/j.ijcard.2022.04.054. Epub 2022 Apr 23. PMID- 35436560 OWN - NLM STAT- MEDLINE DCOM- 20220523 LR - 20220924 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 358 DP - 2022 Jul 1 TI - Micro-dislodgement of a self-expanding transcatheter heart valve: Incidence, predictors, and outcomes. PG - 77-82 LID - S0167-5273(22)00511-3 [pii] LID - 10.1016/j.ijcard.2022.04.031 [doi] AB - OBJECTIVES: Malpositioning of transcatheter heart valves increases the risk of procedural failure. For the ACURATE system, inadvertent movement of the prosthesis to a varying extent is sometimes observed upon full release, but the incidence, mechanisms, and clinical impact of such valve micro-dislodgement (VMD) are poorly understood. The aim of the present study was to assess the incidence, predictors, and clinical outcomes of VMD in an all-comers population that underwent transcatheter aortic valve implantation (TAVI) with the ACURATE neo2 prosthesis (NEO2). METHODS: This was a retrospective analysis of 448 consecutive patients who underwent transfemoral TAVI with NEO2 at our institution. VMD was defined as displacement >/=2 mm between the initial position and immediately after valve release as measured on fluoroscopy at the non-coronary cusp. The initial valve position prior to step 2 was categorized using the radiopaque marker band (RMB) relative to the annular plane. In addition, further anatomical and procedural characteristics were assessed. RESULTS: A total of 68 (15.2%) cases with VMD were identified. A larger cover index, higher RMB position, partial detachment of the lower crown, and severe parallax prior to deployment were independent predictors of VMD, whereas a position of the delivery system in the outer curvature was protective against VMD. Among patients with VMD, the rates of valvular malpositioning and thus technical failure (VARC-3) were higher, but mean transprosthetic gradients were lower. CONCLUSIONS: VMD occurs in a notable proportion of transfemoral TAVI cases with NEO2 and is associated with more frequent technical failure of the procedure. CI - Copyright (c) 2022 Elsevier B.V. All rights reserved. FAU - Kim, Won-Keun AU - Kim WK AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany; Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany; Justus Liebig University of Giessen, Department of Cardiology, Giessen, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. Electronic address: dr.won.kim@gmail.com. FAU - Renker, Matthias AU - Renker M AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany; Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Dorr, Oliver AU - Dorr O AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany; Justus Liebig University of Giessen, Department of Cardiology, Giessen, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Nef, Holger AU - Nef H AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany; Justus Liebig University of Giessen, Department of Cardiology, Giessen, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Fischer-Rasokat, Ulrich AU - Fischer-Rasokat U AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany. FAU - Choi, Yeong-Hoon AU - Choi YH AD - Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Hamm, Christian W AU - Hamm CW AD - Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany; Justus Liebig University of Giessen, Department of Cardiology, Giessen, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. FAU - Charitos, Efstratios AU - Charitos E AD - Kerckhoff Heart Center, Department of Cardiac Surgery, Bad Nauheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main, Bad Nauheim, Germany. LA - eng PT - Journal Article DEP - 20220415 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM CIN - Int J Cardiol. 2022 Aug 15;361:29-30. doi: 10.1016/j.ijcard.2022.05.020. PMID: 35569610 MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/epidemiology MH - *Heart Valve Prosthesis MH - Humans MH - Incidence MH - Prosthesis Design MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - ACURATE OT - Migration OT - NEO2 OT - Positioning OT - Self-expanding prosthesis EDAT- 2022/04/19 06:00 MHDA- 2022/05/24 06:00 CRDT- 2022/04/18 20:07 PHST- 2022/03/01 00:00 [received] PHST- 2022/04/08 00:00 [revised] PHST- 2022/04/11 00:00 [accepted] PHST- 2022/04/19 06:00 [pubmed] PHST- 2022/05/24 06:00 [medline] PHST- 2022/04/18 20:07 [entrez] AID - S0167-5273(22)00511-3 [pii] AID - 10.1016/j.ijcard.2022.04.031 [doi] PST - ppublish SO - Int J Cardiol. 2022 Jul 1;358:77-82. doi: 10.1016/j.ijcard.2022.04.031. Epub 2022 Apr 15. PMID- 35428555 OWN - NLM STAT- MEDLINE DCOM- 20220802 LR - 20250728 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 80 IP - 3 DP - 2022 Sep TI - Non-cardiovascular readmissions after transcatheter aortic valve replacement: Insights from a Japanese nationwide registry of transcatheter valve therapies. PG - 197-203 LID - S0914-5087(22)00070-3 [pii] LID - 10.1016/j.jjcc.2022.03.010 [doi] AB - BACKGROUND: Despite advances in technology and technique, a certain proportion of patients experience non-cardiovascular (CV) readmissions after transcatheter aortic valve replacement (TAVR). However, the actual burden and details of non-CV readmission remain uncertain. METHODS: The Japan-Transcatheter Valve Therapies (J-TVT) registry is a representative nationwide registry, and mandates complete data entry, including 1-year outcomes, for patients undergoing TAVR in Japan. We analyzed the non-CV adverse events (AEs) requiring readmission after the index TAVR procedure between 2013 and 2018. RESULTS: A total of 14,472 patients were analyzed (68.8% of women with median age of 85 years). Overall, 367 patients (2.5%) and 1050 patients (7.2%) had non-CV readmission at 30 days and 1 year, respectively. The most frequent non-CV AEs were related to respiratory (24.0%) and gastrointestinal disease (19.3%). Specifically, 79.0% of all respiratory AEs were pneumonia (infectious, interstitial, or aspiration). Of the gastrointestinal AEs, 22.1% were malignancies, and 18.5% were non-procedural-related bleeding. Age >/=90 years, male sex, body mass index <20 kg/m(2), New York Heart Association functional class III/IV, atrial fibrillation/flutter, malignancy, chronic obstructive pulmonary disease, dialysis, hemoglobin level, albumin level, creatinine level, and non-transfemoral approach were independent predictors of non-CV readmission. CONCLUSIONS: In this analysis of the nationwide registry of patients undergoing TAVR, rate of non-CV readmission at 30 days and 1 year, particularly those related to respiratory and gastrointestinal conditions, were lower than those previously reported. However, caution is still needed when performing TAVR on patients susceptible to these conditions. CI - Copyright (c) 2022 Elsevier Ltd. All rights reserved. FAU - Saji, Mike AU - Saji M AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. Electronic address: mikesaji8@gmail.com. FAU - Kumamaru, Hiraku AU - Kumamaru H AD - Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. FAU - Kohsaka, Shun AU - Kohsaka S AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Higuchi, Ryosuke AU - Higuchi R AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Izumi, Yuki AU - Izumi Y AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Takamisawa, Itaru AU - Takamisawa I AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Tobaru, Tetsuya AU - Tobaru T AD - Department of Cardiology, Kawasaki Saiwai Hospital, Kanagawa, Japan. FAU - Shimokawa, Tomoki AU - Shimokawa T AD - Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. FAU - Takanashi, Shuichiro AU - Takanashi S AD - Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan; Department of Cardiovascular Surgery, Kawasaki Saiwai Hospital, Kanagawa, Japan. FAU - Shimizu, Hideyuki AU - Shimizu H AD - Department of Cardiovascular Surgery, Keio University, Tokyo, Japan. FAU - Takayama, Morimasa AU - Takayama M AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. CN - Japanese TAVR registry participants LA - eng PT - Journal Article DEP - 20220412 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 SB - IM MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis MH - Female MH - Humans MH - Japan/epidemiology MH - Male MH - Patient Readmission MH - Registries MH - Risk Factors MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - Adverse events OT - Comorbidity OT - Transcatheter aortic valve replacement COIS- Declaration of competing interest Dr. Takamisawa and Dr. Tobaru are proctors for Edwards Lifesciences and Medtronic. Dr. Kumamaru is affiliated with the Department of Healthcare Quality Assessment. The department is supported by National Clinical Database, Johnson & Johnson K.K., and the Nipro corporation. The other authors declare that there are no conflicts of interest. EDAT- 2022/04/17 06:00 MHDA- 2022/08/03 06:00 CRDT- 2022/04/16 05:19 PHST- 2021/12/27 00:00 [received] PHST- 2022/02/12 00:00 [revised] PHST- 2022/03/11 00:00 [accepted] PHST- 2022/04/17 06:00 [pubmed] PHST- 2022/08/03 06:00 [medline] PHST- 2022/04/16 05:19 [entrez] AID - S0914-5087(22)00070-3 [pii] AID - 10.1016/j.jjcc.2022.03.010 [doi] PST - ppublish SO - J Cardiol. 2022 Sep;80(3):197-203. doi: 10.1016/j.jjcc.2022.03.010. Epub 2022 Apr 12. PMID- 35427700 OWN - NLM STAT- MEDLINE DCOM- 20220603 LR - 20220914 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 359 DP - 2022 Jul 15 TI - Percutaneous plug-based vascular closure device in 1000 consecutive transfemoral transcatheter aortic valve implantations. PG - 7-13 LID - S0167-5273(22)00513-7 [pii] LID - 10.1016/j.ijcard.2022.04.033 [doi] AB - BACKGROUND: Arterial access-site related complications constitute a large proportion of adverse events related to cardiac interventions requiring large-bore devices and have significant implications on morbidity, mortality and hospital cost. AIMS: To evaluate the safety and effectiveness of a novel percutaneous plug-based vascular closure device (VCD) in 1000 consecutive patients undergoing transfemoral transcatheter aortic valve implantation (TAVI). METHODS: A single-center observational study evaluating a plug-based VCD (MANTA, Teleflex/Essential Medical Inc., Malvern, Pennsylvania, USA) in patients undergoing TAVI at the Karolinska University Hospital, Stockholm, Sweden. The primary outcome was VCD-related major vascular complication according to the criteria of the Valve Academic Research Consortium (VARC)-2. RESULTS: From May 2017 to September 2020 a total of 1000 consecutive patients underwent transfemoral TAVI with arterial access-site management using the MANTA VCD. VARC-2 major vascular complications occurred in 42 (4.2%) patients: 17 (1.7%) patients intraoperatively received a covered stent, 17 (1.7%) patients underwent surgical repair during hospital stay, 3 (0.3%) patients underwent vascular surgery after discharge, 3 (0.3%) patients had major bleeding and 2 (0.2%) patients had symptoms of claudication with conservative treatment. No significant differences in major complications were seen between individual interventionists irrespective of experience with the device. A larger sheath outer diameter to femoral artery inner diameter ratio was the only factor associated with a significant increase of VCD-related major vascular complications. CONCLUSION: This largest ever real-world evaluation of MANTA for large-bore arteriotomy closure in transfemoral TAVI patients indicates effective and safe arterial access-site management with low complication rates and short learning curve. CLINICAL TRIAL REGISTRATION: http://www. CLINICALTRIALS: gov. Unique identifier: NCT04392492. CI - Copyright (c) 2022 The Author(s). Published by Elsevier B.V. All rights reserved. FAU - Kastengren, Mikael AU - Kastengren M AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. Electronic address: mikael.kastengren@ki.se. FAU - Settergren, Magnus AU - Settergren M AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Ruck, Andreas AU - Ruck A AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Feldt, Kari AU - Feldt K AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Saleh, Nawsad AU - Saleh N AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Linder, Rickard AU - Linder R AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Verouhis, Dinos AU - Verouhis D AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Meduri, Christopher U AU - Meduri CU AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Bager, Jessica AU - Bager J AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. FAU - Dalen, Magnus AU - Dalen M AD - Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. LA - eng SI - ClinicalTrials.gov/NCT04392492 PT - Journal Article PT - Observational Study DEP - 20220412 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - *Catheterization, Peripheral/adverse effects MH - Femoral Artery/surgery MH - Hemostatic Techniques MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome MH - *Vascular Closure Devices/adverse effects OTO - NOTNLM OT - Cardiac intervention OT - MANTA OT - Transcatheter aortic valve implantation OT - Vascular closure device EDAT- 2022/04/16 06:00 MHDA- 2022/06/07 06:00 CRDT- 2022/04/15 20:11 PHST- 2022/02/09 00:00 [received] PHST- 2022/04/05 00:00 [revised] PHST- 2022/04/11 00:00 [accepted] PHST- 2022/04/16 06:00 [pubmed] PHST- 2022/06/07 06:00 [medline] PHST- 2022/04/15 20:11 [entrez] AID - S0167-5273(22)00513-7 [pii] AID - 10.1016/j.ijcard.2022.04.033 [doi] PST - ppublish SO - Int J Cardiol. 2022 Jul 15;359:7-13. doi: 10.1016/j.ijcard.2022.04.033. Epub 2022 Apr 12. PMID- 37274547 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240202 IS - 2474-8714 (Electronic) IS - 2474-8706 (Print) IS - 2474-8706 (Linking) VI - 6 IP - 3 DP - 2022 Jul TI - Conduction Disturbance, Pacemaker Rates, and Hospital Length of Stay Following Transcatheter Aortic Valve Implantation with the Sapien 3 Valve. PG - 100019 LID - 10.1016/j.shj.2022.100019 [doi] LID - 100019 AB - BACKGROUND: In the absence of randomized data, an expert panel recently proposed an algorithm for conduction disturbance management in transcatheter aortic valve implantation (TAVI) recipients. However, external validations of its recommendations are limited. METHODS: We retrospectively identified 808 patients without a pre-existing pacing device who underwent transfemoral TAVI with the Sapien 3 valve at our institution in 2018-2019. Patients were grouped based on pre-existing conduction disturbance and immediate post-TAVI electrocardiogram. Timing of temporary pacemaker (TPM) removal and hospital discharge were compared with those of the expert panel recommendations to evaluate the associated risk of TPM reinsertion and permanent pacemaker (PPM) implantation. RESULTS: In most group 1 patients (no electrocardiogram changes without pre-existing right bundle branch block), the timing of TPM removal and discharge were concordant with those of the expert panel recommendations, with low TPM reinsertion (0.8%) and postdischarge PPM (0.8%) rates. In the majority of group 5 patients (procedural high-degree/complete atrioventricular block), TPM was maintained, followed by PPM implantation, compatible with the expert panel recommendations. In contrast, in groups 2-4 (pre-existing/new conduction disturbances), earlier TPM removal than recommended by the expert panel (mostly, immediately after procedure) was feasible in 97.5%-100% of patients, with a low TPM reinsertion rate (0.0%-1.8%); earlier discharge was also feasible in 50.0%-65.5%, with a low 30-day postdischarge PPM rate (0.0%-2.8%) and no 30-day death. CONCLUSIONS: Early TPM removal and discharge after TAVI appear safe and feasible in the majority of cases. These data may provide a framework for an early, streamlined hospital discharge plan for TAVI recipients, optimizing both cost savings and patient safety. CI - (c) 2022 The Authors. FAU - Isogai, Toshiaki AU - Isogai T AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Shekhar, Shashank AU - Shekhar S AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Saad, Anas M AU - Saad AM AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Abdelfattah, Omar M AU - Abdelfattah OM AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Tarakji, Khaldoun G AU - Tarakji KG AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Wazni, Oussama M AU - Wazni OM AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Kalra, Ankur AU - Kalra A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Yun, James J AU - Yun JJ AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Reed, Grant W AU - Reed GW AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Kapadia, Samir R AU - Kapadia SR AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Puri, Rishi AU - Puri R AD - Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. LA - eng PT - Journal Article DEP - 20220330 PL - United States TA - Struct Heart JT - Structural heart : the journal of the Heart Team JID - 101743256 CIN - Struct Heart. 2022 Jun 11;6(3):100047. doi: 10.1016/j.shj.2022.100047. PMID: 38304015 PMC - PMC10236805 OTO - NOTNLM OT - Complete heart block OT - Length of stay OT - Permanent pacemaker OT - Temporary pacemaker OT - Transcatheter aortic valve implantation COIS- The authors declare no conflict of interest. EDAT- 2022/03/30 00:00 MHDA- 2022/03/30 00:01 PMCR- 2022/03/30 CRDT- 2023/06/05 12:04 PHST- 2021/08/19 00:00 [received] PHST- 2022/01/03 00:00 [revised] PHST- 2022/01/14 00:00 [accepted] PHST- 2022/03/30 00:01 [medline] PHST- 2022/03/30 00:00 [pubmed] PHST- 2023/06/05 12:04 [entrez] PHST- 2022/03/30 00:00 [pmc-release] AID - S2474-8706(22)01269-6 [pii] AID - 100019 [pii] AID - 10.1016/j.shj.2022.100019 [doi] PST - epublish SO - Struct Heart. 2022 Mar 30;6(3):100019. doi: 10.1016/j.shj.2022.100019. eCollection 2022 Jul. PMID- 35346628 OWN - NLM STAT- MEDLINE DCOM- 20221129 LR - 20221202 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 114 IP - 6 DP - 2022 Dec TI - Transcarotid Transcatheter Aortic Valve Replacement With Simple "Flip-n-Flex" Technique. PG - e475-e477 LID - S0003-4975(22)00380-0 [pii] LID - 10.1016/j.athoracsur.2022.03.014 [doi] AB - Transcarotid transcatheter aortic valve replacement (TAVR) is increasingly accepted as a safe and efficacious alternative when transfemoral access is contraindicated. Technical and anatomic considerations unique to transcarotid access warrant several adaptations to the routine TAVR procedure. This report describes an approach to overcome these challenges and improve efficiency, including adoption of the "flip-n-flex" technique originally developed for right transaxillary TAVR. This technique has been used at Tufts Medical Center (Boston, MA) since 2019 in both left and right transcarotid TAVR approaches with success to ensure coaxial alignment of the transcatheter heart valve to the aortic root. CI - Copyright (c) 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - McGrath, Daniel AU - McGrath D AD - Division of Cardiac Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Salehi, Payam AU - Salehi P AD - Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Weintraub, Andrew AU - Weintraub A AD - Division of Interventional Cardiology, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Kawabori, Masashi AU - Kawabori M AD - Division of Cardiac Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Irshad, Ali AU - Irshad A AD - Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Ayoob, Faez AU - Ayoob F AD - Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Resor, Charles AU - Resor C AD - Division of Interventional Cardiology, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Chen, Frederick Y AU - Chen FY AD - Division of Cardiac Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. FAU - Zhan, Yong AU - Zhan Y AD - Division of Cardiac Surgery, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. Electronic address: yzhan@tuftsmedicalcenter.org. LA - eng PT - Journal Article DEP - 20220326 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/diagnostic imaging/surgery MH - Retrospective Studies MH - Treatment Outcome MH - Risk Factors MH - *Heart Valve Prosthesis EDAT- 2022/03/30 06:00 MHDA- 2022/11/30 06:00 CRDT- 2022/03/29 05:42 PHST- 2022/01/26 00:00 [received] PHST- 2022/02/15 00:00 [revised] PHST- 2022/03/06 00:00 [accepted] PHST- 2022/03/30 06:00 [pubmed] PHST- 2022/11/30 06:00 [medline] PHST- 2022/03/29 05:42 [entrez] AID - S0003-4975(22)00380-0 [pii] AID - 10.1016/j.athoracsur.2022.03.014 [doi] PST - ppublish SO - Ann Thorac Surg. 2022 Dec;114(6):e475-e477. doi: 10.1016/j.athoracsur.2022.03.014. Epub 2022 Mar 26. PMID- 35341937 OWN - NLM STAT- MEDLINE DCOM- 20220908 LR - 20250728 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 84 DP - 2022 Aug TI - Prevalence and Prognostic Impact of Carotid Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation. PG - 61-68 LID - S0890-5096(22)00147-9 [pii] LID - 10.1016/j.avsg.2022.03.018 [doi] AB - BACKGROUND: To assess the prevalence of atherosclerotic carotid artery disease (ACAD) in patients undergoing transcatheter aortic valve implantation (TAVI) and postoperative cerebrovascular accidents (CVAs) and evaluate its prognostic impact on postoperative CVAs. METHODS: A retrospective review of all consecutive patients with severe symptomatic aortic valve stenosis (AVS) who underwent TAVI was conducted at a single tertiary university hospital (January 2008-December 2018). Patients with AVS scheduled for TAVI and concomitant carotid stenosis were evaluated for prophylactic carotid revascularization (carotid endarterectomy [CEA] or carotid artery stenting [CAS]). RESULTS: Seven hundred and seventy one consecutive patients (mean age: 80 years, 52% males) were treated by TAVI procedures. Carotid stenosis > 70% was detected in 69 patients (9%); it was unilateral in 47 (68%) and bilateral in 22 (32%) patients. Prophylactic carotid revascularization was performed before TAVI in 45 patients (31%): in 63.1% of patients (30/47) with unilateral carotid stenosis > 70% and in 68.1% (15/22) with bilateral carotid stenosis > 70%. Postoperative CVA following TAVI procedures were recorded in 25 patients (3.2%): 22 cases of stroke (2.8%) and 3 cases of transient ischemic attack (0.4%). At a multiple logistic regression, only bilateral carotid stenosis > 70% (odds ratio [OR] 1.16, confidence interval [CI] 95% 1.03-1.31; P = 0.0009) was found as independent predictors of periprocedural CVA. CONCLUSIONS: In patients with severe symptomatic AVS undergoing TAVI, carotid stenosis was frequently observed. Unilateral carotid stenosis > 70% did not show a significant association with early CVA following TAVI. However, in the cohort of patients with bilateral carotid stenosis > 70%, a significant association with postoperative CVA was observed. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Lepidi, Sandro AU - Lepidi S AD - Division of Vascular and Endovascular Surgery, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy; Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy. Electronic address: slepidi@units.it. FAU - Squizzato, Francesco AU - Squizzato F AD - Division of Vascular and Endovascular Surgery, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy. FAU - Fovino, Luca Nai AU - Fovino LN AD - Division of Cardiology, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy. FAU - D'Oria, Mario AU - D'Oria M AD - Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy. FAU - Badawy, Mostafa Rabea AU - Badawy MR AD - Division of Cardiology, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy. FAU - Fraccaro, Chiara AU - Fraccaro C AD - Division of Cardiology, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy. FAU - Antonello, Michele AU - Antonello M AD - Division of Vascular and Endovascular Surgery, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy. FAU - Tarantini, Giuseppe AU - Tarantini G AD - Division of Cardiology, Department of Cardiac Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy. LA - eng PT - Journal Article DEP - 20220325 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 SB - IM MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/complications/diagnostic imaging/surgery MH - *Carotid Artery Diseases/surgery MH - *Carotid Stenosis/diagnostic imaging/epidemiology/surgery MH - Female MH - Humans MH - Male MH - Prevalence MH - Prognosis MH - Retrospective Studies MH - Risk Factors MH - Stents MH - *Stroke/epidemiology/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome EDAT- 2022/03/29 06:00 MHDA- 2022/09/09 06:00 CRDT- 2022/03/28 05:29 PHST- 2022/01/23 00:00 [received] PHST- 2022/03/09 00:00 [revised] PHST- 2022/03/10 00:00 [accepted] PHST- 2022/03/29 06:00 [pubmed] PHST- 2022/09/09 06:00 [medline] PHST- 2022/03/28 05:29 [entrez] AID - S0890-5096(22)00147-9 [pii] AID - 10.1016/j.avsg.2022.03.018 [doi] PST - ppublish SO - Ann Vasc Surg. 2022 Aug;84:61-68. doi: 10.1016/j.avsg.2022.03.018. Epub 2022 Mar 25. PMID- 35277348 OWN - NLM STAT- MEDLINE DCOM- 20220628 LR - 20220628 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 31 IP - 7 DP - 2022 Jul TI - Transbrachial Secondary Vascular Access in Transcatheter Aortic Valve Replacement Procedures: A Single-Centre Retrospective Analysis. PG - 1023-1028 LID - S1443-9506(22)00045-2 [pii] LID - 10.1016/j.hlc.2022.01.013 [doi] AB - BACKGROUND: Transfemoral transcatheter aortic valve replacement (TAVR) procedures require secondary vascular access for inserting accessory catheters and performing percutaneous repair of femoral artery injury. Use of the transbrachial approach for secondary vascular access in TAVR procedures has not been reported. METHODS: This study identified 48 patients at the current institution who had undergone transfemoral TAVR utilising transbrachial secondary vascular access. Efficacy and safety of this strategy for achieving a successful totally percutaneous procedure were examined. Study endpoints were occurrence of vascular complications and bleeding related to transbrachial access, as well as periprocedural and 1-year mortality. RESULTS: Mean patient age was 80+/-7 years and Society of Thoracic Surgeons Predicted Risk of Mortality score was 10.6+/-3.1. Sizes of sheaths inserted into the brachial artery were 6 Fr (85%), 8 Fr (2%), and 9 Fr (13%). Transbrachial access was used for delivering stent grafts to the femoral artery in 13% of the patients, inflation of an occlusive balloon within the iliac artery in 10%, and treatment of iatrogenic femoral artery stenosis in 2%. Successful valve replacement was achieved in all cases. Brachial sheaths were removed by manual compression following administration of protamine sulfate. There were no major access site complications or VARC-3 type >/=2 bleeding related to the brachial vascular access. Brachial artery occlusion occurred in two patients (4%) who underwent surgical vascular repair. Two (2) additional patients developed mild arm ischaemia, which was treated conservatively. Periprocedural mortality was 0% and early mortality was 8%. CONCLUSIONS: Transbrachial secondary access in TAVR procedures was feasible and enabled percutaneous vascular repair in cases of femoral artery injury. CI - Copyright (c) 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Sliman, Hussein AU - Sliman H AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel. FAU - Eitan, Amnon AU - Eitan A AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel. FAU - Shiran, Avinoam AU - Shiran A AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel. FAU - Zafrir, Barak AU - Zafrir B AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel. FAU - Jaffe, Ronen AU - Jaffe R AD - Department of Cardiology, Carmel Medical Center, Haifa, Israel. Electronic address: jafferonen@gmail.com. LA - eng PT - Journal Article DEP - 20220308 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/complications/surgery MH - *Catheterization, Peripheral/adverse effects/methods MH - Femoral Artery/surgery MH - Hemorrhage/etiology MH - Humans MH - Retrospective Studies MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - *Vascular Diseases/surgery MH - *Vascular System Injuries/diagnosis/etiology/surgery OTO - NOTNLM OT - Stent graft OT - Transbrachial OT - Transcatheter aortic valve replacement OT - Vascular access EDAT- 2022/03/13 06:00 MHDA- 2022/06/29 06:00 CRDT- 2022/03/12 05:24 PHST- 2021/09/18 00:00 [received] PHST- 2021/11/30 00:00 [revised] PHST- 2022/01/27 00:00 [accepted] PHST- 2022/03/13 06:00 [pubmed] PHST- 2022/06/29 06:00 [medline] PHST- 2022/03/12 05:24 [entrez] AID - S1443-9506(22)00045-2 [pii] AID - 10.1016/j.hlc.2022.01.013 [doi] PST - ppublish SO - Heart Lung Circ. 2022 Jul;31(7):1023-1028. doi: 10.1016/j.hlc.2022.01.013. Epub 2022 Mar 8. PMID- 35275379 OWN - NLM STAT- MEDLINE DCOM- 20220916 LR - 20230115 IS - 1868-4297 (Electronic) IS - 1868-4297 (Linking) VI - 37 IP - 4 DP - 2022 Oct TI - Successful bailout transfemoral transcatheter aortic valve implantation by placing a long sheath in the aortic arch after eSheath kinking in an extremely tortuous aorta. PG - 756-757 LID - 10.1007/s12928-022-00850-6 [doi] FAU - Hayakawa, Minako AU - Hayakawa M AUID- ORCID: 0000-0002-9886-3992 AD - Departments of Cardiovascular Surgery and Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku Ward, Tokyo, 162-8666, Japan. hayakawa.minako@twmu.ac.jp. FAU - Domoto, Satoru AU - Domoto S AD - Departments of Cardiovascular Surgery and Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku Ward, Tokyo, 162-8666, Japan. FAU - Otsuki, Hisao AU - Otsuki H AD - Departments of Cardiovascular Surgery and Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku Ward, Tokyo, 162-8666, Japan. FAU - Yamaguchi, Junichi AU - Yamaguchi J AD - Departments of Cardiovascular Surgery and Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku Ward, Tokyo, 162-8666, Japan. FAU - Hagiwara, Nobuhisa AU - Hagiwara N AD - Departments of Cardiovascular Surgery and Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku Ward, Tokyo, 162-8666, Japan. FAU - Niinami, Hiroshi AU - Niinami H AD - Departments of Cardiovascular Surgery and Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku Ward, Tokyo, 162-8666, Japan. LA - eng PT - Journal Article DEP - 20220311 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 SB - IM MH - Aorta, Thoracic/diagnostic imaging/surgery MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/surgery MH - Femoral Artery/diagnostic imaging/surgery MH - *Heart Valve Prosthesis MH - *Heart Valve Prosthesis Implantation MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Treatment Outcome EDAT- 2022/03/12 06:00 MHDA- 2022/09/17 06:00 CRDT- 2022/03/11 12:13 PHST- 2021/12/04 00:00 [received] PHST- 2022/02/24 00:00 [accepted] PHST- 2022/03/12 06:00 [pubmed] PHST- 2022/09/17 06:00 [medline] PHST- 2022/03/11 12:13 [entrez] AID - 10.1007/s12928-022-00850-6 [pii] AID - 10.1007/s12928-022-00850-6 [doi] PST - ppublish SO - Cardiovasc Interv Ther. 2022 Oct;37(4):756-757. doi: 10.1007/s12928-022-00850-6. Epub 2022 Mar 11. PMID- 35212972 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220827 IS - 1568-5888 (Print) IS - 1876-6250 (Electronic) IS - 1568-5888 (Linking) VI - 30 IP - 9 DP - 2022 Sep TI - Changes in demographics, treatment and outcomes in a consecutive cohort who underwent transcatheter aortic valve implantation between 2005 and 2020. PG - 411-422 LID - 10.1007/s12471-022-01662-2 [doi] AB - INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has matured to the treatment of choice for most patients with aortic stenosis (AS). We sought to identify trends in patient and procedural characteristics, and clinical outcomes in all patients who underwent TAVI between 2005 and 2020. METHODS: A single-centre analysis was performed on 1500 consecutive patients who underwent TAVI, divided into three tertiles (T) of 500 patients treated between November 2005 and December 2014 (T1), January 2015 and May 2018 (T2) and June 2018 and April 2020 (T3). RESULTS: Over time, mean age and gender did not change (T1 to T3: 80, 80 and 79 years and 53%, 55% and 52% men, respectively), while the Society of Thoracic Surgeons risk score declined (T1: 4.5% to T3: 2.7%, p < 0.001). Use of general anaesthesia also declined over time (100%, 24% and 1% from T1 to T3) and transfemoral TAVI remained the default approach (87%, 94% and 92%). Median procedure time and contrast volume decreased significantly (186, 114 and 56 min and 120, 100 and 80 ml, respectively). Thirty-day mortality (7%, 4% and 2%), stroke (7%, 3% and 3%), need for a pacemaker (19%, 22% and 8%) and delirium (17%, 12% and 8%) improved significantly, while major bleeding/vascular complications did not change (both approximately 9%, 6% and 6%). One-year survival was 80%, 88% and 92%, respectively. CONCLUSION: Over our 15 years' experience, patient age remained unchanged but the patient risk profile became more favourable. Simplification of the TAVI procedure occurred in parallel with major improvement in outcomes and survival. Bleeding/vascular complications and the need for pacemaker implantation remain the Achilles' heel of TAVI. CI - (c) 2022. The Author(s). FAU - De Ronde-Tillmans, M J A G AU - De Ronde-Tillmans MJAG AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Nuis, R M AU - Nuis RM AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Goudzwaard, J A AU - Goudzwaard JA AD - Department of Internal Medicine, Section of Geriatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Cummins, P A AU - Cummins PA AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Hokken, T W AU - Hokken TW AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Van Wiechen, M P H AU - Van Wiechen MPH AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Ooms, J F W AU - Ooms JFW AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Daemen, J AU - Daemen J AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Van Mieghem, N M D A AU - Van Mieghem NMDA AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Mattace-Raso, F U S AU - Mattace-Raso FUS AD - Department of Internal Medicine, Section of Geriatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Lenzen, M J AU - Lenzen MJ AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - de Jaegere, P P T AU - de Jaegere PPT AD - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands. p.dejaegere@erasmusmc.nl. LA - eng PT - Journal Article DEP - 20220225 PL - Netherlands TA - Neth Heart J JT - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation JID - 101095458 PMC - PMC9402869 OTO - NOTNLM OT - Aortic stenosis OT - Clinical outcomes OT - Survival OT - Transcatheter aortic valve implantation COIS- J. Daemen received institutional research support from Abbott Vascular, Boston Scientific, Medtronic, Pie Medical and PulseCath BV, and consultancy and speaker fees from Boston Scientific, ReCor, Pie Medical, Medtronic and PulseCath BV. N.M.D.A. Van Mieghem received research grants and advisory fees from Abbott, Boston Scientific, Edwards, Teleflex, Medtronic, PulseCath BV, Daiichi Sankyo and Abiomed. M.J.A.G. De Ronde-Tillmans, R.M. Nuis, J.A. Goudzwaard, P.A. Cummins, T.W. Hokken, M.P.H. van Wiechen, J.F.W. Ooms, F.U.S. Mattace-Raso, M.J. Lenzen and P.P.T. de Jaegere declare that they have no competing interests. EDAT- 2022/02/26 06:00 MHDA- 2022/02/26 06:01 PMCR- 2022/02/25 CRDT- 2022/02/25 12:24 PHST- 2021/12/13 00:00 [accepted] PHST- 2022/02/26 06:00 [pubmed] PHST- 2022/02/26 06:01 [medline] PHST- 2022/02/25 12:24 [entrez] PHST- 2022/02/25 00:00 [pmc-release] AID - 10.1007/s12471-022-01662-2 [pii] AID - 1662 [pii] AID - 10.1007/s12471-022-01662-2 [doi] PST - ppublish SO - Neth Heart J. 2022 Sep;30(9):411-422. doi: 10.1007/s12471-022-01662-2. Epub 2022 Feb 25. PMID- 35211830 OWN - NLM STAT- MEDLINE DCOM- 20230921 LR - 20261028 IS - 1875-8312 (Electronic) IS - 1569-5794 (Linking) VI - 38 IP - 8 DP - 2022 Aug TI - Incidence and predictors of transcatheter aortic valve replacement device emboligenic matter detected by transesophageal echocardiography. PG - 1741-1750 LID - 10.1007/s10554-022-02567-2 [doi] AB - During transfemoral (TF) or transcatheter aortic valve replacement (TAVR), transesophageal echocardiography (TEE) sometimes reveals an unexpected mobile membranous mass on the catheter tip within the proximal part of the descending thoracic aorta. Such mobile masses may cause critical embolic events if the TAVR device advances into the ascending aorta in the absence of preventive measures. This study aimed to investigate the incidence and predictors of emboligenic matter (EM) during TAVR, impact of EM on the procedure, and incidence of symptomatic ischemic stroke post procedure. Among 436 consecutive patients who underwent TF-TAVR, 407 were evaluated in this study. The primary end point was incidence of symptomatic ischemic stroke within 24 h post procedure while taking appropriate preventive measures. Incidence of EM, factors associated with EM, and the impact of EM on the procedure were also investigated. Among the 407 cases, 15 cases (3.7%) of EM were identified but no ischemic stroke occurred in the EM (+) group (0% vs. 2.04%, p = 1.00). In the EM (+) group, a self-expandable valve was used in all 15 cases (100% vs. 42.6%, p < 0.0001) while 14 cases used a CoreValve's InLine sheath system initially (93.3% vs. 27.3%, p < 0.0001). CoreValve's InLine sheath system usage was the only independent predictor of EM. The CoreValve's InLine delivery system was identified as a predictor of EM during TF-TAVR, but symptomatic ischemic stroke was avoided while taking appropriate embolization preventive measures. CI - (c) 2022. The Author(s), under exclusive licence to Springer Nature B.V. FAU - Yashige, Masaki AU - Yashige M AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Zen, Kan AU - Zen K AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. k-zen@koto.kpu-m.ac.jp. FAU - Nakamura, Shunsuke AU - Nakamura S AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Fujimoto, Tomotaka AU - Fujimoto T AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Takamatsu, Kazuaki AU - Takamatsu K AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Ito, Nobuyasu AU - Ito N AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Kadoya, Yoshito AU - Kadoya Y AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Yamano, Michiyo AU - Yamano M AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Yamano, Tetsuhiro AU - Yamano T AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Nakamura, Takeshi AU - Nakamura T AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Yaku, Hitoshi AU - Yaku H AD - Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan. FAU - Matoba, Satoaki AU - Matoba S AD - Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. LA - eng PT - Journal Article DEP - 20220224 PL - United States TA - Int J Cardiovasc Imaging JT - The international journal of cardiovascular imaging JID - 100969716 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Echocardiography, Transesophageal MH - *Aortic Valve Stenosis/diagnostic imaging/surgery/epidemiology MH - Incidence MH - *Heart Valve Prosthesis MH - Treatment Outcome MH - Risk Factors MH - Predictive Value of Tests MH - *Ischemic Stroke/surgery MH - Aortic Valve/diagnostic imaging/surgery OTO - NOTNLM OT - Aortic stenosis OT - Embolization OT - Ischemic stroke OT - Transcatheter aortic valve replacement OT - Transesophageal echocardiography EDAT- 2022/02/26 06:00 MHDA- 2023/09/21 06:42 CRDT- 2022/02/25 05:41 PHST- 2021/11/04 00:00 [received] PHST- 2022/02/12 00:00 [accepted] PHST- 2023/09/21 06:42 [medline] PHST- 2022/02/26 06:00 [pubmed] PHST- 2022/02/25 05:41 [entrez] AID - 10.1007/s10554-022-02567-2 [pii] AID - 10.1007/s10554-022-02567-2 [doi] PST - ppublish SO - Int J Cardiovasc Imaging. 2022 Aug;38(8):1741-1750. doi: 10.1007/s10554-022-02567-2. Epub 2022 Feb 24. PMID- 35147041 OWN - NLM STAT- MEDLINE DCOM- 20220707 LR - 20220707 IS - 1940-1574 (Electronic) IS - 0003-3197 (Linking) VI - 73 IP - 7 DP - 2022 Aug TI - Vascular Complications Among Patients Undergoing Trans-femoral Transcatheter Aortic Valve Implantation: Prostar vs ProGlide Parallel Technique. PG - 635-642 LID - 10.1177/00033197211058498 [doi] AB - Reliable femoral artery closure devices are essential for the success of trans-femoral Transcatheter Aortic Valve Implantation (TAVI) procedures. Accordingly, device choice might affect vascular complications and bleeding rates. This was a retrospective analysis, comparing vascular complication rates among patients who underwent trans-femoral TAVI with vascular access closure using either the ProGlide parallel suture or Prostar closure devices. We included 191 patients: 106 were treated with Prostar and 85 with ProGlide. The ProGlide group had higher rate of diabetes, chronic kidney disease, peripheral arterial disease, and significantly smaller femoral arteries that were treated via larger sheaths. Valve Academic Research Consortium (VARC)-2 major complications were similar between the groups. (4.7% for ProGlide vs 3.8% for Prostar, P=1), with similar incidence of closure device failure (2 vs 3, P=1). No differences were found after univariant analysis and propensity-score matching in the incidence of major and minor bleeding nor in the rate of in-hospital mortality between ProGlide and Prostar (4.7 vs 2.8%, P=.7, 1.2 vs 2.8%, P=.63, and 1.2 vs .0%, P=.45, respectively). Parallel suture technique using two ProGlide sutures showed comparable rates of vascular complications to the Prostar closure device in higher risk population of TAVI patients. FAU - Marcusohn, Erez AU - Marcusohn E AUID- ORCID: 0000-0003-1004-0826 AD - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. FAU - Qasum, Majd AU - Qasum M AD - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. FAU - Epstein, Danny AU - Epstein D AD - Critical Care Division, Rambam Health Care Campus, Haifa, Israel. FAU - Solomonica, Amir AU - Solomonica A AD - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. AD - Rappaport - Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. FAU - Orbach, Ady AU - Orbach A AD - Schulich Heart Center - Sunnybrook Health Science Center, Toronto, ON, Canada. FAU - Musallam, Anees AU - Musallam A AD - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. FAU - Kerner, Arthur AU - Kerner A AD - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. AD - Rappaport - Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. FAU - Feld, Yair AU - Feld Y AD - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. AD - Rappaport - Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. LA - eng PT - Journal Article DEP - 20220211 PL - United States TA - Angiology JT - Angiology JID - 0203706 SB - IM MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/complications/surgery MH - *Cardiovascular Diseases/etiology MH - Femoral Artery/surgery MH - Hemorrhage/etiology MH - Humans MH - Retrospective Studies MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome MH - *Vascular Closure Devices/adverse effects OTO - NOTNLM OT - access site OT - femoral OT - trans catheter aortic valve implantation EDAT- 2022/02/12 06:00 MHDA- 2022/07/08 06:00 CRDT- 2022/02/11 08:41 PHST- 2022/02/12 06:00 [pubmed] PHST- 2022/07/08 06:00 [medline] PHST- 2022/02/11 08:41 [entrez] AID - 10.1177/00033197211058498 [doi] PST - ppublish SO - Angiology. 2022 Aug;73(7):635-642. doi: 10.1177/00033197211058498. Epub 2022 Feb 11. PMID- 35133548 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20261028 IS - 1875-8312 (Electronic) IS - 1569-5794 (Linking) VI - 38 IP - 7 DP - 2022 Jul TI - Left atrial volume index predicts future improvement of B-type natriuretic peptide levels after transcatheter aortic valve replacement. PG - 1463-1471 LID - 10.1007/s10554-022-02538-7 [doi] AB - In patients with symptomatic severe aortic stenosis (AS), those who experienced readmission due to heart failure after transcatheter aortic valve replacement (TAVR) showed poor prognosis. Furthermore, poor B-type natriuretic peptide (BNP) improvement is associated with increased morbidity and mortality. However, little is known about the clinical parameters related to the change in BNP levels after TAVR procedure. This study population consisted of 127 consecutive patients of symptomatic severe AS with preserved ejection fraction (EF) who underwent transfemoral TAVR (TF-TAVR). Comprehensive transthoracic echocardiography was performed prior to the day of TF-TAVR. BNP was measured serially before and 1 year after TF-TAVR. The median BNP level was significantly decreased from 252.5 pg/ml to 146.8 pg/ml in all 127 patients 1 year after TF-TAVR (P < 0.01). However, the patients could be divided into 2 groups according to decrease (72%) or increase (28%) in plasma BNP level. Multivariate logistic regression analysis revealed that Aortic valve (AV) peak velocity, pre-procedural BNP, and larger left atrial volume index (LAVI) were found to be an independent predictor of increased BNP level 1 year after TAVR (OR 0.55, 95% CI 0.38-0.77; P < 0.01). LAVI were negatively correlated with the change in BNP level before and 1 year after TAVR (r = 0.47, P < 0.01). The ROC analysis demonstrated that 52.9 ml/m(2) was the optimal cut-off value of LAVI for decreasing BNP 1 year after TAVR (area under the curve 0.69) with 64% sensitivity and 70% specificity. In addition to AV peak velocity and pre-procedural BNP, LAVI independently predicts future improvement of BNP levels 1 year after TAVR. Our findings indicate an additive predictive value of assessment of LAVI before TAVR procedure for risk stratification. CI - (c) 2022. The Author(s), under exclusive licence to Springer Nature B.V. FAU - Ito, Asahiro AU - Ito A AUID- ORCID: 0000-0003-4041-7460 AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. m2023641@med.osaka-cu.ac.jp. FAU - Izumiya, Yasuhiro AU - Izumiya Y AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Iwata, Shinichi AU - Iwata S AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Ogawa, Mana AU - Ogawa M AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Kim, Andrew T AU - Kim AT AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Yahiro, Ryosuke AU - Yahiro R AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Kure, Yusuke AU - Kure Y AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Yamaguchi, Tomohiro AU - Yamaguchi T AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Okai, Tsukasa AU - Okai T AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. FAU - Takahashi, Yosuke AU - Takahashi Y AD - Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. FAU - Shibata, Toshihiko AU - Shibata T AD - Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. FAU - Yoshiyama, Minoru AU - Yoshiyama M AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan. LA - eng PT - Journal Article DEP - 20220208 PL - United States TA - Int J Cardiovasc Imaging JT - The international journal of cardiovascular imaging JID - 100969716 SB - IM OTO - NOTNLM OT - Aortic stenosis OT - B-type natriuretic peptide OT - Left atrium OT - Transcatheter aortic valve replacement EDAT- 2022/02/09 06:00 MHDA- 2022/02/09 06:01 CRDT- 2022/02/08 12:16 PHST- 2021/10/24 00:00 [received] PHST- 2022/01/23 00:00 [accepted] PHST- 2022/02/09 06:01 [medline] PHST- 2022/02/09 06:00 [pubmed] PHST- 2022/02/08 12:16 [entrez] AID - 10.1007/s10554-022-02538-7 [pii] AID - 10.1007/s10554-022-02538-7 [doi] PST - ppublish SO - Int J Cardiovasc Imaging. 2022 Jul;38(7):1463-1471. doi: 10.1007/s10554-022-02538-7. Epub 2022 Feb 8. PMID- 35033460 OWN - NLM STAT- MEDLINE DCOM- 20220719 LR - 20220811 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 41 DP - 2022 Aug TI - One-Year Outcomes for Patients Undergoing Transcatheter Aortic Valve Replacement: The Gulf TAVR Registry. PG - 19-26 LID - S1553-8389(21)00825-3 [pii] LID - 10.1016/j.carrev.2021.12.024 [doi] AB - BACKGROUND: The use of transcatheter aortic valve replacement (TAVR) is steadily increasing with TAVR procedures offered to patients across the entire spectrum of surgical risks. The Gulf TAVR registry captures the demographics of patients undergoing TAVR in the Gulf region, comorbidities that drive outcomes, procedural success, complications, and one-year outcomes of death or rehospitalization. METHODS: This is a retrospective cohort study for adult patients aged at least 18 years undergoing TAVR at eight centers in the Gulf region. The primary outcome was a composite of death or re-hospitalization at one-year. Secondary outcomes included the individual components of the composite, stroke, and myocardial infarction (MI). We used multivariable Cox regression to determine factors associated with the composite endpoint. RESULTS: A total of 795 patients (56% male) were included in the final analysis with a mean age of 74.6 (standard deviation (SD) 8.9) years, Society of Thoracic Surgeons Score (STS) Score 4.9 (4.2), ejection fraction of 53% (12.7%). Transfemoral approach was employed in over 95% (762/795). The primary outcomes rate was 12.8% (95% confidence interval [CI]: 10.6-15.4); secondary endpoints were death 5.4% (95% CI 4.0-7.2); stroke 0.8% (95% CI 0.3, 1.7), MI 0.8% (95% CI 0.4-1.9), rehospitalization: 9.3% (95% CI 7.5-11.5) of whom 71.6% were related to cardiovascular causes. 77% of the cardiovascular admissions were attributable to heart failure or the need for pacemaker implantation. Stage IV or V chronic kidney disease was significantly associated with the primary composite endpoint (Hazard Ratio: 2.49, [95% CI: 1.31, 4.73], p = 0.005). Although not significant, paravalvular leak and severe left ventricular dysfunction showed a 2-fold and 3-fold increased risk for the composite endpoint, respectively. CONCLUSIONS: The Gulf TAVR registry is the first of its kind in the region. It profiles an elderly population with a high procedural success rate and a low rate of complications. One-year outcomes were primarily driven by repeat hospitalization for heart failure and pacemaker implantation indicating a need to optimize heart failure management and improve algorithms for the detection of conduction abnormalities. CI - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Alasnag, Mirvat AU - Alasnag M AD - Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia. FAU - AlMerri, Khaled AU - AlMerri K AD - Chest Disease Hospital, Al Shuwaikh, Kuwait city, Kuwait. FAU - Almoghairi, Abdulrahman AU - Almoghairi A AD - Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. FAU - Alenezi, Abdullah AU - Alenezi A AD - Chest Disease Hospital, Al Shuwaikh, Kuwait city, Kuwait. FAU - Bardooli, Fawaz AU - Bardooli F AD - Mohammed bin Khalifa Cardiac Centre, Riffa, Bahrain. FAU - Al-Sheikh, Shereen AU - Al-Sheikh S AD - Mohammed bin Khalifa Cardiac Centre, Riffa, Bahrain. FAU - Alanazi, Nouf AU - Alanazi N AD - King Saud University, Riyadh, Saudi Arabia. FAU - AlHarbi, Waleed AU - AlHarbi W AD - King Saud University, Riyadh, Saudi Arabia. FAU - Al Lawati, Hatim AU - Al Lawati H AD - Sultan Qaboos University Hospital, Muscat, Oman. FAU - Al Faraidy, Khalid AU - Al Faraidy K AD - King Fahd Military Medical Complex, Dhahran, Saudi Arabia. FAU - AlShehri, Mohammed AU - AlShehri M AD - Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia. FAU - Thabane, Michael AU - Thabane M AD - Department of Health research methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, Ontario, Canada. FAU - Thabane, Lehana AU - Thabane L AD - Department of Health research methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, Ontario, Canada. FAU - Al-Shaibi, Khaled AU - Al-Shaibi K AD - Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia. Electronic address: kfalshaibi@gmail.com. LA - eng PT - Journal Article DEP - 20211231 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM CIN - Cardiovasc Revasc Med. 2022 Aug;41:27-28. doi: 10.1016/j.carrev.2022.05.033. PMID: 35667966 MH - Adolescent MH - Adult MH - Aged MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Female MH - *Heart Failure MH - Humans MH - Male MH - Registries MH - Retrospective Studies MH - Risk Factors MH - *Stroke/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - Aortic stenosis OT - Cardiovascular outcomes OT - STS score OT - TAVR COIS- Declaration of competing interest None of the authors has any conflicts of interest or relevant financial disclosures. EDAT- 2022/01/17 06:00 MHDA- 2022/07/20 06:00 CRDT- 2022/01/16 20:45 PHST- 2021/10/05 00:00 [received] PHST- 2021/12/22 00:00 [revised] PHST- 2021/12/22 00:00 [accepted] PHST- 2022/01/17 06:00 [pubmed] PHST- 2022/07/20 06:00 [medline] PHST- 2022/01/16 20:45 [entrez] AID - S1553-8389(21)00825-3 [pii] AID - 10.1016/j.carrev.2021.12.024 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2022 Aug;41:19-26. doi: 10.1016/j.carrev.2021.12.024. Epub 2021 Dec 31. PMID- 34995743 OWN - NLM STAT- MEDLINE DCOM- 20220908 LR - 20250728 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 84 DP - 2022 Aug TI - Carotid Duplex Poorly Predicts Stroke Risk During Transcatheter Aortic Valve Replacement. PG - 107-113 LID - S0890-5096(21)01053-0 [pii] LID - 10.1016/j.avsg.2021.12.075 [doi] AB - INTRODUCTION: Patients undergoing surgical aortic valve replacement, in isolation or with concomitant coronary artery bypass grafting, have historically been screened for carotid artery disease prior to surgery. Over the past decade, transcatheter aortic valve replacement (TAVR) has incrementally become the predominant technique for the treatment of severe aortic stenosis. The relationship between internal carotid artery stenosis (ICAS) and risk of periprocedural stroke in the TAVR population is uncertain. We sought to evaluate our institution's outcomes with the TAVR procedure and the association with preoperative carotid duplex scan (CDS) results. METHODS: A retrospective review of a single institution TAVR registry over a 5-year period was performed. All patients with pre-operative carotid imaging were included. Outcomes included in-hospital, 30-day, and 1-year stroke and all-cause mortality rates. The diagnosis of post-operative stroke was based on neurological exam and confirmed by radiologic imaging. Standard statistical analysis was performed. RESULTS: A total of 436 patients met inclusion criteria. The prevalence of ICAS >50% was 18.3% and 70-99% stenosis was 4.8%. The in-hospital stroke and mortality rates were 2.3% and 1.2%, respectively. The cumulative 30-day and 1- year stroke rates were 3.7% and 6%, respectively. All were ischemic in nature. Bilateral infarcts were identified in 46.2% of stroke patients and 11.5% had an ipsilateral ICAS >50%. A large majority of stroke patients (23, 88.5%) had an ipsilateral ICAS of <50%. Less than 0.5% of patients had ICAS >70% and subsequently had an ipsilateral stroke within 30 days of procedure. CONCLUSIONS: The preoperative CDS identified carotid lesions that met criteria for elective repair in only 4.8% of patients. Of these, 9.5% suffered a stroke in the first 30 days after surgery. Over 90% of patients who had a stroke had less than 70% stenosis present in either carotid artery and there was no correlation between degree of ICAS and risk of stroke during the follow-up period. Routine CDS prior to TAVR does not predict in-hospital or 30-day stroke. As TAVR programs evolve, expand, and proliferate across the country, routine preoperative CDS is unlikely to determine the need for pre-operative carotid revascularization or predict stroke risk. CI - Copyright (c) 2022. Published by Elsevier Inc. FAU - St Hilaire, Cameron AU - St Hilaire C AD - Santa Barbara Cottage Hospital, Department of General Surgery, Santa Barbara, CA. FAU - DeRieux, Jaclyn AU - DeRieux J AD - Santa Barbara Cottage Hospital, Department of General Surgery, Santa Barbara, CA. FAU - Shenoda, Michael AU - Shenoda M AD - Santa Barbara Cottage Hospital, Department of Cardiology, Santa Barbara, CA. FAU - Casey, Kevin AU - Casey K AD - Santa Barbara Cottage Hospital, Department of General Surgery, Santa Barbara, CA. Electronic address: kcasey@sbvascularspecialists.com. LA - eng PT - Journal Article DEP - 20220105 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 SB - IM MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/complications/diagnostic imaging/surgery MH - Carotid Arteries/surgery MH - Constriction, Pathologic/surgery MH - Humans MH - Risk Assessment MH - Risk Factors MH - *Stroke/epidemiology/etiology MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome EDAT- 2022/01/08 06:00 MHDA- 2022/09/09 06:00 CRDT- 2022/01/07 20:14 PHST- 2021/09/10 00:00 [received] PHST- 2021/12/10 00:00 [revised] PHST- 2021/12/22 00:00 [accepted] PHST- 2022/01/08 06:00 [pubmed] PHST- 2022/09/09 06:00 [medline] PHST- 2022/01/07 20:14 [entrez] AID - S0890-5096(21)01053-0 [pii] AID - 10.1016/j.avsg.2021.12.075 [doi] PST - ppublish SO - Ann Vasc Surg. 2022 Aug;84:107-113. doi: 10.1016/j.avsg.2021.12.075. Epub 2022 Jan 5. PMID- 34972667 OWN - NLM STAT- MEDLINE DCOM- 20220627 LR - 20260911 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 40 DP - 2022 Jul TI - Network Meta-Analysis Comparing the Short- and Long-Term Outcomes of Alternative Access for Transcatheter Aortic Valve Replacement. PG - 1-10 LID - S1553-8389(21)00767-3 [pii] LID - 10.1016/j.carrev.2021.11.040 [doi] AB - BACKGROUND: Several studies have pair-wise compared access sites for transcatheter aortic valve replacement (TAVR) but pooled estimate of overall comparative efficacy and safety outcomes are not well known. We sought to compare short- and long-term outcomes following various alternative access routes for TAVR. METHODS: Thirty-four studies with a pooled sample size of 32,756 patients were selected by searching PubMed and Cochrane library databases from inception through 11th June 2021 for patients undergoing TAVR via 1 of 6 different access sites: Transfemoral (TF), Transaortic (TAO), Transapical (TA), Transcarotid (TC), Transaxillary/Subclavian (TSA), and Transcaval (TCV). Data were extracted to conduct a frequentist network meta-analysis with a random-effects model using TF access as a reference group. RESULTS: Compared with TF, both TAO [RR 1.91, 95% CI (1.46-2.50)] and TA access [RR 2.12, 95% CI (1.84-2.46)] were associated with an increased risk of 30-day mortality. No significant difference was observed for stroke, myocardial infarction, major bleeding, conversion to open surgery, and major adverse cardiovascular or cerebrovascular events at 30 days between different accesses. Major vascular complications were lower in TA [RR 0.43, (95% CI, 0.28-0.67)] and TC [RR 0.51, 95% CI (0.35-0.73)] access compared to TF. The 1-year mortality was higher in TAO [RR of 1.35, (95% CI, 1.01-1.81)] and TA [RR 1.44, (95% CI, 1.14-1.81)] groups. CONCLUSION: Non-thoracic alternative access site utilization for TAVR implantation (TC, TSA and TCV) is associated with outcomes similar to conventional TF access. Thoracic TAVR access (TAO and TA) translates into increased short and long-term mortality. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Ranka, Sagar AU - Ranka S AD - Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, United States. FAU - Lahan, Shubham AU - Lahan S AD - Division of Cardiovascular Prevention & Wellness, Department of Cardiology, Houston Methodist, Houston, TX, United States. FAU - Chhatriwalla, Adnan K AU - Chhatriwalla AK AD - Department of Cardiothoracic Surgery, Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, United States. FAU - Allen, Keith B AU - Allen KB AD - Department of Cardiothoracic Surgery, Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, United States. FAU - Chiang, Michael AU - Chiang M AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. FAU - O'Neill, Brian AU - O'Neill B AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. FAU - Verma, Sadhika AU - Verma S AD - Department of Family Medicine, Henry Ford Allegiance Health, Jackson, MI, United States. FAU - Wang, Dee Dee AU - Wang DD AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. FAU - Lee, James AU - Lee J AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. FAU - Frisoli, Tiberio AU - Frisoli T AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. FAU - Eng, Marvin AU - Eng M AD - Department of Cardiology, Banner University Medical Center, Phoenix, AZ, United States. FAU - Bagur, Rodrigo AU - Bagur R AD - Division of Cardiology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada. FAU - O'Neill, William AU - O'Neill W AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. FAU - Villablanca, Pedro AU - Villablanca P AD - Department of Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI, United States. Electronic address: pvillab1@hfhs.org. LA - eng PT - Journal Article PT - Network Meta-Analysis DEP - 20211203 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM CIN - Cardiovasc Revasc Med. 2022 Jul;40:11-12. doi: 10.1016/j.carrev.2022.05.013. PMID: 35738726 MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/etiology/surgery MH - Humans MH - Risk Assessment MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - Mortality OT - Network meta-analysis OT - TAVR OT - Transcarotid TAVR OT - Transfemoral access COIS- Declaration of competing interest Adnan K. Chhatriwalla: Speakers Bureau: Abbott Vascular, Edwards Lifesciences, Medtronic Inc.; Proctor: Edwards Lifesciences, Medtronic Inc.; Consultant: Boston Scientific, Silk Road Medical; Research Grant: Boston Scientific. Keith B. Allen: Institutional Research/Grant support: Edwards, Abbott, Medtronic, Boston Scientific; Speakers Bureau: Edwards Lifesciences, Medtronic Inc.; Proctor: Edwards Lifesciences, Medtronic Inc.; Consultant: Abbott, Edwards, Medtronic, Boston Scientific; (all payments are to the institution and none to me personally). EDAT- 2022/01/02 06:00 MHDA- 2022/06/28 06:00 CRDT- 2022/01/01 05:17 PHST- 2021/10/13 00:00 [received] PHST- 2021/11/15 00:00 [revised] PHST- 2021/11/29 00:00 [accepted] PHST- 2022/01/02 06:00 [pubmed] PHST- 2022/06/28 06:00 [medline] PHST- 2022/01/01 05:17 [entrez] AID - S1553-8389(21)00767-3 [pii] AID - 10.1016/j.carrev.2021.11.040 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2022 Jul;40:1-10. doi: 10.1016/j.carrev.2021.11.040. Epub 2021 Dec 3. PMID- 34958771 OWN - NLM STAT- MEDLINE DCOM- 20221130 LR - 20230206 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 114 IP - 6 DP - 2022 Dec TI - Minimally Invasive Versus Full Sternotomy for Isolated Aortic Valve Replacement in Low-Risk Patients. PG - 2124-2130 LID - S0003-4975(21)02134-2 [pii] LID - 10.1016/j.athoracsur.2021.11.048 [doi] AB - BACKGROUND: Surgical aortic valve replacement can be performed through a minimally invasive (MI) or full sternotomy (FS) approach. The present study compared outcomes of MI vs FS for isolated surgery among patients enrolled in the Placement of Aortic Transcatheter Valves (PARTNER) 3 low-risk trial. METHODS: Patients with severe, symptomatic aortic stenosis at low surgical risk with anatomy suitable for transfemoral access were eligible for PARTNER 3 enrollment. The primary outcome was the composite end point of death, stroke, or rehospitalization (valve-, procedure-, or heart failure-related) at 1 year. Secondary outcomes included the individual components of the primary end point as well as patient-reported health status at 30 days and 1 year. RESULTS: In the PARTNER 3 study, 358 patients underwent isolated valve replacement at 68 centers through an MI (n = 107) or FS (n = 251) approach (8 patients were converted from MI to FS). Mean age and Society of Thoracic Surgeons score were similar between groups. The Kaplan-Meier estimate of the primary outcome was similar in the MI vs FS groups (16.9% vs 14.9%; hazard ratio, 1.15; 95% CI, 0.66-2.03; P = .618). There were no significant differences in the 1-year rates of all-cause death (2.8% vs 2.8%), all stroke (1.9% vs 3.6%), or rehospitalization (13.3% vs 10.6%, P > .05 for all). Quality of life, as assessed by the Kansas City Cardiomyopathy Questionnaire score at 30 days or 1 year, was comparable in both groups. CONCLUSIONS: For patients at low risk for isolated surgery, MI and FS approaches were associated with similar in-hospital and 1-year outcomes. CI - Copyright (c) 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Russo, Mark J AU - Russo MJ AD - Division of Cardiac Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey. Electronic address: mrusso@markrussomd.net. FAU - Thourani, Vinod H AU - Thourani VH AD - Marcus Heart and Vascular Center, Piedmont Heart Institute, Atlanta, Georgia. FAU - Cohen, David J AU - Cohen DJ AD - Clinical and Outcomes Research, St. Francis Hospital, Roslyn, New York; Cardiovascular Research Foundation, New York, New York. FAU - Malaisrie, S Chris AU - Malaisrie SC AD - Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. FAU - Szeto, Wilson Y AU - Szeto WY AD - Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. FAU - George, Isaac AU - George I AD - Cardiovascular Research Foundation, New York, New York; Department of Surgery, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Kodali, Susheel K AU - Kodali SK AD - Cardiovascular Research Foundation, New York, New York; Department of Surgery, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Makkar, Raj AU - Makkar R AD - Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. FAU - Lu, Michael AU - Lu M AD - Edwards Lifesciences, Irvine, California. FAU - Williams, Mathew AU - Williams M AD - Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York. FAU - Nguyen, Tom AU - Nguyen T AD - Memorial Herrmann Heart & Vascular Institute, University of Texas, Houston, Texas. FAU - Aldea, Gabriel AU - Aldea G AD - Department of Surgery, University of Washington, Seattle, Washington. FAU - Genereux, Philippe AU - Genereux P AD - Cardiovascular Research Foundation, New York, New York; Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey. FAU - Fang, H Kenith AU - Fang HK AD - Division of CardioThoracic Surgery, Banner University Medical Center, Phoenix, Arizona. FAU - Alu, Maria C AU - Alu MC AD - Cardiovascular Research Foundation, New York, New York; Department of Surgery, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Rogers, Erin AU - Rogers E AD - Edwards Lifesciences, Irvine, California. FAU - Okoh, Alexis AU - Okoh A AD - Department of Medicine, Emory University, Atlanta, Georgia. FAU - Herrmann, Howard C AU - Herrmann HC AD - Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. FAU - Kapadia, Samir AU - Kapadia S AD - Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Webb, John G AU - Webb JG AD - Centre for Cardiovascular Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada. FAU - Smith, Craig R AU - Smith CR AD - Department of Surgery, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Leon, Martin B AU - Leon MB AD - Cardiovascular Research Foundation, New York, New York; Department of Surgery, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York. FAU - Mack, Michael J AU - Mack MJ AD - Department of Cardiothoracic Surgery, Baylor Scott & White Healthcare, Plano, Texas. LA - eng PT - Clinical Trial PT - Journal Article DEP - 20211224 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM CIN - Ann Thorac Surg. 2023 Feb;115(2):552-553. doi: 10.1016/j.athoracsur.2022.03.069. PMID: 35439454 MH - Humans MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/complications MH - *Heart Valve Prosthesis/adverse effects MH - *Heart Valve Prosthesis Implantation/adverse effects MH - Postoperative Complications/etiology MH - Quality of Life MH - Sternotomy/adverse effects MH - *Stroke/etiology/complications MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome EDAT- 2021/12/28 06:00 MHDA- 2022/11/30 06:00 CRDT- 2021/12/27 20:09 PHST- 2021/05/06 00:00 [received] PHST- 2021/11/19 00:00 [revised] PHST- 2021/11/19 00:00 [accepted] PHST- 2021/12/28 06:00 [pubmed] PHST- 2022/11/30 06:00 [medline] PHST- 2021/12/27 20:09 [entrez] AID - S0003-4975(21)02134-2 [pii] AID - 10.1016/j.athoracsur.2021.11.048 [doi] PST - ppublish SO - Ann Thorac Surg. 2022 Dec;114(6):2124-2130. doi: 10.1016/j.athoracsur.2021.11.048. Epub 2021 Dec 24. PMID- 34915823 OWN - NLM STAT- MEDLINE DCOM- 20220802 LR - 20250728 IS - 1365-2931 (Electronic) IS - 1364-5706 (Linking) VI - 31 IP - 6 DP - 2022 Aug TI - Alternative access in high-risk patients in the era of transfemoral aortic valve replacement. PG - 909-916 LID - 10.1080/13645706.2021.2015392 [doi] AB - BACKGROUND: We aimed to evaluate the outcomes of transapical and transaortic transcatheter aortic valve replacement (TAVR) in high-risk patients who were not suitable for transfemoral access and had a logistic EuroSCORE-I >/= 25% and Society of Thoracic Surgeons (STS) score >6%. 'STS/ACC TAVR In-Hospital Mortality Risk App' was evaluated. MATERIAL AND METHODS: Between January 2016 and May 2020, 126 patients at very high risk for aortic valve replacement underwent transapical (n = 121) or transaortic (n = 5) transcatheter aortic valve replacement. TAVR was performed using SAPIEN 3 or ACURATE TA prosthesis. RESULTS: The logistic EuroSCORE-I was 40.6 +/- 14.0%, the STS-score 7.9 +/- 4.6%, and STS/ACC-score 8.4 +/- 3.4%. Valve implantation was successful in all patients. Operative, in-hospital and 30-days mortality, were 0, 7.9, and 13.5%, respectively. Survival was 72% at one year and 48% at four years. Expected/observed in-hospital mortality was 1.0 for the STS-score and 1.06 for the STS/ACC-score. Renal failure, low ejection fraction, and postoperative acute kidney injury, hemorrhage, and vascular complications were identified as independent predictors for 30-day mortality. CONCLUSIONS: Transapical and transaortic TAVR in high-risk patients unsuitable for transfemoral access is still a reasonable alternative in these patients. STS and STS/ACC-score appear to be highly accurate in predicting in-hospital mortality in high-risk patients undergoing TAVR. FAU - Zubarevich, Alina AU - Zubarevich A AUID- ORCID: 0000-0002-2444-5747 AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Szczechowicz, Marcin AU - Szczechowicz M AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Janosi, Rolf-Alexander AU - Janosi RA AD - Department of Cardiology, West-German Heart Center Essen, University Hospital Essen, Essen, Germany. FAU - Lind, Alexander AU - Lind A AD - Department of Cardiology, West-German Heart Center Essen, University Hospital Essen, Essen, Germany. FAU - Rassaf, Tienush AU - Rassaf T AD - Department of Cardiology, West-German Heart Center Essen, University Hospital Essen, Essen, Germany. FAU - Malik, Rizwan AU - Malik R AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Thielmann, Matthias AU - Thielmann M AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Schmack, Bastian AU - Schmack B AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Kamler, Markus AU - Kamler M AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Ruhparwar, Arjang AU - Ruhparwar A AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Weymann, Alexander AU - Weymann A AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. FAU - Wendt, Daniel AU - Wendt D AD - Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany. LA - eng PT - Journal Article DEP - 20211216 PL - England TA - Minim Invasive Ther Allied Technol JT - Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy JID - 9612996 SB - IM MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - *Heart Valve Prosthesis Implantation/adverse effects MH - Humans MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - Aortic valve disease OT - risk stratification OT - transcatheter valve implantation EDAT- 2021/12/18 06:00 MHDA- 2022/08/03 06:00 CRDT- 2021/12/17 05:36 PHST- 2021/12/18 06:00 [pubmed] PHST- 2022/08/03 06:00 [medline] PHST- 2021/12/17 05:36 [entrez] AID - 10.1080/13645706.2021.2015392 [doi] PST - ppublish SO - Minim Invasive Ther Allied Technol. 2022 Aug;31(6):909-916. doi: 10.1080/13645706.2021.2015392. Epub 2021 Dec 16. PMID- 34852659 OWN - NLM STAT- MEDLINE DCOM- 20220711 LR - 20220716 IS - 1545-1550 (Electronic) IS - 1526-6028 (Print) IS - 1526-6028 (Linking) VI - 29 IP - 4 DP - 2022 Aug TI - Incidence and Predictors of Access Site Vascular Complications Following Ultrasound-Guided MANTA Closure Deployment. PG - 576-585 LID - 10.1177/15266028211059446 [doi] AB - PURPOSE: There is no report on the reproducibility of the ultrasound-navigated MANTA deployment (US-MANTA) technique and little is known about predictors for US-MANTA-related vascular complication (VC). This study aimed to assess the incidence and predictors of access-site VC using the US-MANTA technique and report insights of MANTA-related VC from consecutive cases following large-bore arteriotomy. MATERIALS AND METHODS: Consecutive patients who underwent transfemoral transcatheter aortic valve replacement with the US-MANTA technique from November 2018 to February 2020 were evaluated. MANTA-related VC was defined as access-site complications leading to major or minor VCs based on Valve Academic Research Consortium-2 criteria. RESULTS: Among 378 patients, 23 cases (6.1%) of MANTA-related VC (major VC: n=7 [1.9%], minor VC: n=16 [4.2%]) were identified. No significant difference was observed in the incidence of MANTA-related VC over the observational period (first quartile: 5.3%, second: 5.4%, third: 7.4%, and fourth: 6.3%, p>.50). In 7 patients with MANTA-related major VC, 4 (57.1%) of complications resulted from incomplete apposition of the toggle due to anterior wall calcification of the common femoral artery (CFA). Anterior calcification of the CFA determined by computed tomography was identified as an independent predictor of MANTA-related VCs. CONCLUSIONS: The US-MANTA technique sustainably provides a low rate of access-site VCs following large-bore arteriotomy. Incomplete apposition of the toggle due to anterior calcification of the CFA may lead to ongoing vascular and bleeding complications. FAU - Miyashita, Hirokazu AU - Miyashita H AUID- ORCID: 0000-0003-1562-9437 AD - Department of Cardiology, Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. AD - Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Moriyama, Noriaki AU - Moriyama N AD - Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Laine, Mika AU - Laine M AD - Department of Cardiology, Heart and Lung Center, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland. LA - eng PT - Journal Article DEP - 20211201 PL - United States TA - J Endovasc Ther JT - Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists JID - 100896915 SB - IM MH - Aortic Valve Stenosis MH - *Catheterization, Peripheral/adverse effects/methods MH - Femoral Artery/diagnostic imaging MH - Humans MH - Incidence MH - Reproducibility of Results MH - Treatment Outcome MH - *Ultrasonography, Interventional/adverse effects PMC - PMC9270567 OTO - NOTNLM OT - aortic stenosis OT - vascular closure devices OT - vascular complication COIS- Declaration of Conflicting Interest: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Miyashita has nothing to disclose. Dr Moriyama reports a consulting fee from Teleflex and is a clinical proctor of Edwards Lifesciences (SAPIEN) and Boston Scientific (ACURATE neo and LOTUS Edge). Dr Laine reports non-regulatory research grants from Teleflex and consulting fees from Edwards Lifesciences, Boston Scientific, and Medtronic. EDAT- 2021/12/03 06:00 MHDA- 2022/07/12 06:00 PMCR- 2022/07/09 CRDT- 2021/12/02 05:29 PHST- 2021/12/03 06:00 [pubmed] PHST- 2022/07/12 06:00 [medline] PHST- 2021/12/02 05:29 [entrez] PHST- 2022/07/09 00:00 [pmc-release] AID - 10.1177_15266028211059446 [pii] AID - 10.1177/15266028211059446 [doi] PST - ppublish SO - J Endovasc Ther. 2022 Aug;29(4):576-585. doi: 10.1177/15266028211059446. Epub 2021 Dec 1. PMID- 34848177 OWN - NLM STAT- MEDLINE DCOM- 20220627 LR - 20220722 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 40 DP - 2022 Jul TI - Distal Radial Secondary Access for Transcatheter Aortic Valve Implantation: The Minimalistic Approach. PG - 152-157 LID - S1553-8389(21)00748-X [pii] LID - 10.1016/j.carrev.2021.11.021 [doi] AB - BACKGROUND: Although not yet recommended by the guidelines, distal radial access, a new site for cardiovascular interventions, has been rapidly acknowledged and adopted by many centers due to its high rate of success, safety and fewer complications. We present our experience using secondary distal radial access during transcatheter aortic valve implantation (TAVI), proposing a new, even more minimal approach. METHODS: As of November 2020, a systematic distal radial approach as secondary access site for TAVI was adopted in our center. Primary endpoints were technical success and major adverse events (MAEs). Secondary endpoints: the access site complication rate, hemodynamic and clinical results of the intervention, procedural related factors, crossover rate to the femoral access site, and hospitalization duration (in days). RESULTS: From November 2020, 41 patients underwent TAVI using this strategy. Patients had a mean age of 76 +/- 11.2 years, 41% were male. Six (14.63%) patients received a balloon-expandable valve and 35 (85.37%) received a self-expandable valve. TAVI was successful in all cases. No complications occurred due to transradial access. Puncture success, defined as completed sheath placement was maximum (N = 41/41,100%) and emergent transfemoral secondary access was not required in any case. Primary transfemoral vascular access site complications occurred in 7 cases (17%) of which 4 (13.63%) were resolved through distal radial access: one occlusion, two flow-limiting stenoses and four perforations of the common femoral artery. There were no additional major vascular complications at 30 days. Overall MACE rate was 2.4%. CONCLUSION: The use of the distal radial approach for secondary access in TAVI is safe, feasible and has several advantages over old access sites. CI - Copyright (c) 2021. Published by Elsevier Inc. FAU - Achim, Alexandru AU - Achim A AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary; Medicala 1 Invasive Cardiology Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. FAU - Szucsborus, Tamas AU - Szucsborus T AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. FAU - Sasi, Viktor AU - Sasi V AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. FAU - Nagy, Ferenc AU - Nagy F AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. FAU - Jambrik, Zoltan AU - Jambrik Z AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. FAU - Nemes, Attila AU - Nemes A AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. FAU - Varga, Albert AU - Varga A AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. FAU - Bertrand, Olivier F AU - Bertrand OF AD - Quebec Heart-Lung Institute, University Laval, Quebec, Canada. FAU - Ruzsa, Zoltan AU - Ruzsa Z AD - 2(nd) Department of Internal Medicine, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary. Electronic address: ruzsa.zoltan@med.u-szeged.hu. LA - eng PT - Journal Article DEP - 20211122 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM CIN - Cardiovasc Revasc Med. 2022 Jul;40:158-159. doi: 10.1016/j.carrev.2022.05.005. PMID: 35568689 MH - Aged MH - Aged, 80 and over MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/etiology/surgery MH - Female MH - Femoral Artery/diagnostic imaging/surgery MH - *Heart Valve Prosthesis MH - Humans MH - Male MH - Middle Aged MH - Radial Artery/diagnostic imaging MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Treatment Outcome OTO - NOTNLM OT - Aortic stenosis OT - Distal radial access OT - Distal radial artery approach OT - Outcome of TAVI OT - Radial access OT - Snuffbox approach OT - TAVI OT - Transcatheter aortic valve OT - Vascular complication COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2021/12/02 06:00 MHDA- 2022/06/28 06:00 CRDT- 2021/12/01 06:00 PHST- 2021/09/28 00:00 [received] PHST- 2021/11/16 00:00 [revised] PHST- 2021/11/17 00:00 [accepted] PHST- 2021/12/02 06:00 [pubmed] PHST- 2022/06/28 06:00 [medline] PHST- 2021/12/01 06:00 [entrez] AID - S1553-8389(21)00748-X [pii] AID - 10.1016/j.carrev.2021.11.021 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2022 Jul;40:152-157. doi: 10.1016/j.carrev.2021.11.021. Epub 2021 Nov 22. PMID- 34673514 OWN - NLM STAT- MEDLINE DCOM- 20221130 LR - 20221207 IS - 1678-9741 (Electronic) IS - 0102-7638 (Print) IS - 0102-7638 (Linking) VI - 37 IP - 6 DP - 2022 Dec 1 TI - Risk of Bleeding after Transcatheter Aortic Valve Replacement: impact of Preoperative Antithrombotic Regimens. PG - 836-842 LID - 10.21470/1678-9741-2020-0538 [doi] AB - INTRODUCTION: Bleeding after transcatheter aortic valve replacement (TAVR) has a negative impact on the outcome of the procedure. Risk factors for bleeding vary widely in the literature, and the impact of preoperative antithrombotic agents has not been fully established. The objectives of our study were to assess bleeding after TAVR as defined by the Valve Academic Research Consortium-2 (VARC-2), identify its risk factors, and correlate with antithrombotic treatment in addition to its effect on procedural mortality. METHODS: The study included 374 patients who underwent TAVR from 2009 to 2018. We grouped the patients into four groups according to the VARC-2 definition of bleeding. Group 1 included patients without bleeding (n=265), group 2 with minor bleeding (n=22), group 3 with major bleeding (n=61), and group 4 with life-threatening bleeding (n=26). The median age was 78 (25th-75th percentiles: 71-82), and 226 (60.4%) were male. The median EuroSCORE was 3.4 (2-6.3), and there was no difference among groups (P=0.886). The TAVR approach was transfemoral (90.9%), transapical (5.6%), and trans-subclavian (1.9%). Results: Predictors of bleeding were stroke (OR: 2.465; P=0.024) and kidney failure (OR: 2.060; P=0.046). Preoperative single and dual antiplatelet therapy did not increase the risk of bleeding (P=0.163 and 0.1, respectively). Thirty-day mortality occurred in 14 patients (3.7%), and was significantly higher in patients with life-threatening bleeding (n=8 [30.8%]; P<0.001). Conclusion: Bleeding after TAVR is common and can be predicted based on preprocedural comorbidities. Preprocedural antithrombotic therapy did not affect bleeding after TAVR in our population. FAU - Albabtain, Monirah A AU - Albabtain MA AD - Pharmacy Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. FAU - Arafat, Amr A AU - Arafat AA AUID- ORCID: 0000-0003-0951-7287 AD - Adult Cardiac Surgery Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. AD - Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt. FAU - Alonazi, Zaid AU - Alonazi Z AD - Pharmacy Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. FAU - Aluhaydan, Hanan AU - Aluhaydan H AD - Pharmacy College, Prince Noura Bint Abdulrahman University, Riyadh, Saudi Arabia. FAU - Alkharji, Mashael AU - Alkharji M AD - Pharmacy College, Prince Noura Bint Abdulrahman University, Riyadh, Saudi Arabia. FAU - Alsaleh, Raneem AU - Alsaleh R AD - Pharmacy College, Prince Noura Bint Abdulrahman University, Riyadh, Saudi Arabia. FAU - Alboghdadly, Amany AU - Alboghdadly A AD - Department of Pharmacy Practice, Batterjee Medical College, Jeddah, Saudi Arabia. FAU - AlOtaiby, Mohammed AU - AlOtaiby M AD - Cardiology Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. FAU - AlAhmari, Saeed AU - AlAhmari S AD - Cardiology Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. LA - eng PT - Journal Article DEP - 20221201 PL - Brazil TA - Braz J Cardiovasc Surg JT - Brazilian journal of cardiovascular surgery JID - 101677045 RN - 0 (Fibrinolytic Agents) SB - IM MH - Humans MH - Male MH - Aged MH - Female MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Fibrinolytic Agents/adverse effects MH - *Aortic Valve Stenosis/surgery MH - Aortic Valve/surgery MH - Treatment Outcome MH - Hemorrhage/etiology MH - Risk Factors MH - Risk Assessment PMC - PMC9713669 OTO - NOTNLM OT - Fibrinolytic Agents OT - Hemorrhage OT - Patelet Aggregation Inhibitors OT - Renal Insufficiency OT - Stroke OT - Transcatheter Aortic Valve Replacement COIS- No conflict of interest. EDAT- 2021/10/22 06:00 MHDA- 2022/12/01 06:00 PMCR- 2022/11/01 CRDT- 2021/10/21 21:07 PHST- 2021/10/22 06:00 [pubmed] PHST- 2022/12/01 06:00 [medline] PHST- 2021/10/21 21:07 [entrez] PHST- 2022/11/01 00:00 [pmc-release] AID - 10.21470/1678-9741-2020-0538 [doi] PST - epublish SO - Braz J Cardiovasc Surg. 2022 Dec 1;37(6):836-842. doi: 10.21470/1678-9741-2020-0538. PMID- 34643745 OWN - NLM STAT- MEDLINE DCOM- 20221004 LR - 20221004 IS - 1615-6692 (Electronic) IS - 0340-9937 (Print) IS - 0340-9937 (Linking) VI - 47 IP - 5 DP - 2022 Oct TI - First experiences with a new balloon-expandable Myval transcatheter aortic valve: a preliminary study. PG - 449-455 LID - 10.1007/s00059-021-05069-4 [doi] AB - BACKGROUND: In the present article, we present our first experiences with a new type of balloon-expandable Myval valve (Meril Life Sciences, Gujarat, India). MATERIALS AND METHODS: A total of 25 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) from June 2020 to November 2020 were included in the study. RESULTS: The mean age of the study population was 83 (75-87) years; 17 (68%) were female, and 20 (80%) had hypertension. The Society of Thoracic Surgeons (STS) score of the group was 5.4% +/- 3.5%. TAVI was performed via the transfemoral route on all patients. In 19 (76%) cases, we started the procedure without predilation. In two (10.5%) cases performed without predilation, the prosthesis did not pass the native valve. We had to implant the valve from the descending aorta in one (4%) patient. We used Prostar XL (Abbott Vascular, Santa Clara, CA, USA) for six (24%) patients and ProGlide (Abbott Vascular) for 19 (76%) patients for vascular closure. Two (8%) in-hospital deaths occurred in our study but there were no deaths in the 30-day and 90-day follow-up. Vascular complications were observed in one (4%) patient. None of the patients in our study had severe paravalvular leak (PVL), while two (8%) patients had moderate PVL. A permanent pacemaker (PPM) was required in two (8%) patients for the indication of complete atrioventricular block. The mean hospital stay for the whole group was 4 (3-7) days. CONCLUSION: Based on our experiences, the new balloon-expandable valve Myval is easy to use, efficient, and has only a few negligible drawbacks such as the need for predilation of the sheath. While shaft flexibility may have advantages in some situations including in very tortuous arteries, it may cause some difficulties in alignment of the valves. CI - (c) 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature. FAU - Akyuz, Ali Riza AU - Akyuz AR AUID- ORCID: 0000-0003-3327-7850 AD - Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey. dralirizaakyuz@gmail.com. FAU - Konus, Ali Hakan AU - Konus AH AD - Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey. FAU - Cirakoglu, Omer Faruk AU - Cirakoglu OF AD - Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey. FAU - Sahin, Sinan AU - Sahin S AD - Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey. FAU - Kul, Selim AU - Kul S AD - Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey. FAU - Korkmaz, Levent AU - Korkmaz L AD - Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey. LA - eng PT - Journal Article TT - Erste Erfahrungen mit einer neuen ballonexpandierbaren Myval-Transkatheter-Aortenklappe: eine vorlaufige Studie. DEP - 20211013 PL - Germany TA - Herz JT - Herz JID - 7801231 SB - IM MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/surgery MH - Female MH - *Heart Valve Prosthesis MH - Humans MH - Male MH - Prosthesis Design MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome PMC - PMC8512594 OTO - NOTNLM OT - Aortic valve disease OT - Complications OT - Percutaneous intervention OT - Transcatheter valve implantation OT - Vascular access COIS- A.R. Akyuz, A.H. Konus, O.F. Cirakoglu, S. Sahin, S. Kul and L. Korkmaz declare that they have no competing interests. EDAT- 2021/10/14 06:00 MHDA- 2022/10/05 06:00 PMCR- 2021/10/13 CRDT- 2021/10/13 12:24 PHST- 2021/04/03 00:00 [received] PHST- 2021/09/12 00:00 [accepted] PHST- 2021/08/02 00:00 [revised] PHST- 2021/10/14 06:00 [pubmed] PHST- 2022/10/05 06:00 [medline] PHST- 2021/10/13 12:24 [entrez] PHST- 2021/10/13 00:00 [pmc-release] AID - 10.1007/s00059-021-05069-4 [pii] AID - 5069 [pii] AID - 10.1007/s00059-021-05069-4 [doi] PST - ppublish SO - Herz. 2022 Oct;47(5):449-455. doi: 10.1007/s00059-021-05069-4. Epub 2021 Oct 13. PMID- 34312832 OWN - NLM STAT- MEDLINE DCOM- 20230424 LR - 20230504 IS - 1898-018X (Electronic) IS - 1897-5593 (Print) IS - 1898-018X (Linking) VI - 30 IP - 2 DP - 2023 TI - The impact of transcatheter aortic valve implantation planning and procedure on acute and chronic renal failure. PG - 247-255 LID - 10.5603/CJ.a2021.0057 [doi] AB - BACKGROUND: Severe aortic valve stenosis inhibits renal perfusion, thereby potentially worsening renal function, in particular in elderly patients most often assigned to transcatheter aortic valve implantation (TAVI). Pre-TAVI diagnostics and the procedure itself may adversely impact renal function, however renal perfusion and function may also improve post-procedure. This study aimed to clarify the impact of TAVI planning and procedure on kidney function METHODS: In this retrospective study, kidney function of patients who underwent transfemoral TAVI at a tertiary university hospital between 2016 and 2019 was analyzed. The present study investigated kidney function at baseline, after computed tomography (CT) was performed for evaluation of TAVI, after TAVI, at discharge and at follow-up. RESULTS: Among 366 patients, the prevalence of acute kidney injury (AKI) was 14.5% after TAVI. Independent predictors of AKI were arterial hypertension, baseline creatinine, AKI post CT and coronary intervention during pre-procedural diagnostics. At discharge and follow-up, 2.1% and 3.4%, respectively had sustained relevant impairment of kidney function (defined as creatinine/baseline creatinine > 1.5 or renal replacement therapy). Patients with known chronic kidney disease showed no higher rates of short- and long-term impairment, but higher rates of improvement of renal function after TAVI. CONCLUSIONS: In most cases TAVI does not worsen renal function. A sustained impairment after TAVI was found in only a few cases. This was independent of reduced baseline kidney function. Transfemoral TAVI can thus be planned and performed even in patients with higher stages of chronic kidney disease. FAU - Jackel, Markus AU - Jackel M AUID- ORCID: 0000-0001-8638-5228 AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. markus.jaeckel@uniklinik-freiburg.de. AD - Department of Internal Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. markus.jaeckel@uniklinik-freiburg.de. FAU - Keller, Simon AU - Keller S AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. FAU - Prager, Eric Peter AU - Prager EP AD - Department of Nephrology, University Hospital Freiburg, Faculty of Medicine, University of Freiburg, Germany. FAU - Staudacher, Dawid Leander AU - Staudacher DL AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. AD - Department of Internal Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. FAU - Schlett, Christopher AU - Schlett C AD - Department of Diagnostic and Interventional Radiology, Medical Center - Faculty of Medicine, University of Freiburg, Germany. AD - Division of Cardiac, Vascular and Thoracic Imaging, University Heart Center Freiburg - Bad Krozingen, Faculty of Medicine, University of Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. AD - Department of Internal Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. AD - Center of Big Data Analysis in Cardiology (CeBAC), Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Germany. FAU - Bamberg, Fabian AU - Bamberg F AD - Department of Diagnostic and Interventional Radiology, Medical Center - Faculty of Medicine, University of Freiburg, Germany. FAU - Bode, Christoph AU - Bode C AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. AD - Department of Internal Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. AD - Department of Internal Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. AD - Center of Big Data Analysis in Cardiology (CeBAC), Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Germany. FAU - Stachon, Peter AU - Stachon P AD - Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany. AD - Department of Internal Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. AD - Center of Big Data Analysis in Cardiology (CeBAC), Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Germany. LA - eng PT - Journal Article DEP - 20210727 PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 RN - AYI8EX34EU (Creatinine) SB - IM MH - Humans MH - Aged MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - Retrospective Studies MH - Creatinine MH - *Renal Insufficiency, Chronic/complications/diagnosis/epidemiology MH - *Aortic Valve Stenosis/diagnosis/surgery MH - *Kidney Failure, Chronic MH - *Acute Kidney Injury/diagnosis/epidemiology/etiology MH - Aortic Valve/surgery MH - Risk Factors MH - Treatment Outcome PMC - PMC10129259 OTO - NOTNLM OT - acute kidney failure OT - computed tomography OT - kidney function OT - transcatheter aortic valve implantation COIS- Conflict of interest: None declared EDAT- 2021/07/28 06:00 MHDA- 2023/04/24 06:42 PMCR- 2023/04/17 CRDT- 2021/07/27 07:22 PHST- 2020/11/19 00:00 [received] PHST- 2021/04/23 00:00 [accepted] PHST- 2021/06/09 00:00 [revised] PHST- 2023/04/24 06:42 [medline] PHST- 2021/07/28 06:00 [pubmed] PHST- 2021/07/27 07:22 [entrez] PHST- 2023/04/17 00:00 [pmc-release] AID - VM/OJS/J/71838 [pii] AID - cardj-30-2-247 [pii] AID - 10.5603/CJ.a2021.0057 [doi] PST - ppublish SO - Cardiol J. 2023;30(2):247-255. doi: 10.5603/CJ.a2021.0057. Epub 2021 Jul 27. PMID- 34308536 OWN - NLM STAT- MEDLINE DCOM- 20230424 LR - 20230504 IS - 1898-018X (Electronic) IS - 1897-5593 (Print) IS - 1898-018X (Linking) VI - 30 IP - 2 DP - 2023 TI - Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access. PG - 188-195 LID - 10.5603/CJ.a2021.0071 [doi] AB - BACKGROUND: The purpose of this study was to compare the safety and clinical outcomes of transcarotid (TC) and transapical access (TA) transcatheter aortic valve implantation (TAVI) patients whom the transfemoral approach (TF) was not feasible. METHODS: The analysis included consecutive patients with severe symptomatic aortic stenosis treated from 2017 to 2020 with TC-TAVI or TA-TAVI in two high-volume TAVI centers. The approach was selected by multidisciplinary heart teams after analyzing multislice computed tomography of the heart, aorta and peripheral arteries, transthoracic echocardiography and coronary angiography. RESULTS: One hundred and two patients were treated with alternative TAVI accesses (TC; n = 49 and TA; n = 53) in our centers. The groups were similar regarding age, gender, New York Heart Association class, and echocardiography parameters. Patients treated with TC-TAVI had significantly higher surgical risk. The procedural success rate was similar in both groups (TC-TAVI 98%; TA-TAVI 98.1%; p = 0.95). The rate of Valve Academic Research Consortium-2 defined clinical events was low in both groups. The percentage of new-onset rhythm disturbances and permanent pacemaker implantation was similar in TC and TA TAVI (4.1% vs. 11.3%; p = 0.17 and 10.2% vs. 5.7%; p = 0.39, respectively). In the TA-TAVI group, significantly more cases of pneumonia and blood transfusions were observed (11% vs. 0%; p = 0.01 and 30.2% vs. 12.2%; p = 0.03). The 30-day mortality was similar in TC and TA groups (4.1% vs. 5.7%; p = 0.71, respectively). CONCLUSIONS: Both TC and TA TAVI are safe procedures in appropriately selected patients and are associated with a low risk of complications. FAU - Hudziak, Damian AU - Hudziak D AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. damhud@gmail.com. FAU - Targonski, Radoslaw AU - Targonski R AD - Department of Cardiac and Vascular Surgery Medical University of Gdansk, Poland. FAU - Wanha, Wojciech AU - Wanha W AD - Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Gocol, Radoslaw AU - Gocol R AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. FAU - Hajder, Adrianna AU - Hajder A AD - Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Parma, Radoslaw AU - Parma R AD - Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Figatowski, Tomasz AU - Figatowski T AD - First Department of Cardiology, Medical University of Gdansk, Poland. FAU - Darocha, Tomasz AU - Darocha T AD - Department of Anesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland. FAU - Deja, Marek A AU - Deja MA AD - Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland. FAU - Wojakowski, Wojciech AU - Wojakowski W AD - Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Jagielak, Dariusz AU - Jagielak D AD - Department of Cardiac and Vascular Surgery Medical University of Gdansk, Poland. LA - eng PT - Journal Article DEP - 20210726 PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/methods MH - *Aortic Valve Stenosis/diagnosis/surgery MH - Aortic Valve/diagnostic imaging/surgery MH - Echocardiography MH - Contraindications MH - Treatment Outcome MH - Cardiac Catheterization/adverse effects/methods PMC - PMC10129253 OTO - NOTNLM OT - aortic stenosis OT - transapical access OT - transcarotid access OT - transcatheter aortic valve implantation (TAVI) COIS- Conflict of interest: None declared EDAT- 2021/07/27 06:00 MHDA- 2023/04/24 06:41 PMCR- 2023/04/17 CRDT- 2021/07/26 06:57 PHST- 2021/03/08 00:00 [received] PHST- 2021/06/06 00:00 [accepted] PHST- 2021/05/12 00:00 [revised] PHST- 2023/04/24 06:41 [medline] PHST- 2021/07/27 06:00 [pubmed] PHST- 2021/07/26 06:57 [entrez] PHST- 2023/04/17 00:00 [pmc-release] AID - VM/OJS/J/75477 [pii] AID - cardj-30-2-188 [pii] AID - 10.5603/CJ.a2021.0071 [doi] PST - ppublish SO - Cardiol J. 2023;30(2):188-195. doi: 10.5603/CJ.a2021.0071. Epub 2021 Jul 26. PMID- 34176110 OWN - NLM STAT- MEDLINE DCOM- 20230313 LR - 20230313 IS - 1439-1902 (Electronic) IS - 0171-6425 (Linking) VI - 71 IP - 2 DP - 2023 Mar TI - Evaluation of the MANTA Vascular Closure Device in Transfemoral TAVI. PG - 84-93 LID - 10.1055/s-0041-1730972 [doi] AB - BACKGROUND: The MANTA vascular closure device (VCD) is a novel collagen plug-based VCD for large bore arteriotomies. The current literature regarding complication rates of this device is quite variable and mostly limited to relatively small case series. METHODS: This study is retrospective analysis of the MANTA VCD-related main access site complications according to Valve Academic Research Consortium-2 (VARC-2) criteria during the hospital stay. Particular attention was paid to the detailed analysis of multislice computed tomography with regard to the anatomy of the access vessel and the puncture site itself. RESULTS: A total of 524 patients underwent transfemoral transcatheter aortic valve implantation (TF TAVI) including the use of the MANTA device (18F) for percutaneous vascular closure. A group of 22 patients was excluded from the study due to incomplete imaging data. During the study period, we observed 28 major (5.6%) and five minor (1.0%) MANTA device-related vascular complications. There was no patient death related to these adverse events. Female gender, vessel angulation at the puncture site, and at least moderate calcification of the dorsal vessel segment were identified as independent predictors for major complications. CONCLUSIONS: The MANTA device is a feasible option for vascular closure of large bore arteriotomies in patients undergoing TF TAVI or other percutaneous transfemoral interventions. Furthermore, we have identified novel predictors for device failure/complications that should be taken into account for selection of the appropriate closure device. To our knowledge, this report is one of the largest case series analyzing the use of the MANTA VCD. CI - Thieme. All rights reserved. FAU - Kmiec, Lukasz AU - Kmiec L AUID- ORCID: 0000-0003-2831-0492 AD - Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. FAU - Zerdzitzki, Matthaeus AU - Zerdzitzki M AD - Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. FAU - Schmid, Christof AU - Schmid C AD - Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. FAU - Debl, Kurt AU - Debl K AD - Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany. FAU - Sossalla, Samuel AU - Sossalla S AD - Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany. FAU - Hilker, Michael AU - Hilker M AD - Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. FAU - Holzamer, Andreas AU - Holzamer A AD - Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. LA - eng PT - Journal Article DEP - 20210627 PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 SB - IM MH - Humans MH - Female MH - *Vascular Closure Devices/adverse effects MH - Hemostatic Techniques/adverse effects MH - Retrospective Studies MH - Treatment Outcome MH - Femoral Artery/diagnostic imaging/surgery MH - *Transcatheter Aortic Valve Replacement/adverse effects/methods MH - *Aortic Valve Stenosis/diagnostic imaging/surgery COIS- None declared. EDAT- 2021/06/28 06:00 MHDA- 2023/03/14 06:00 CRDT- 2021/06/27 21:10 PHST- 2021/06/28 06:00 [pubmed] PHST- 2023/03/14 06:00 [medline] PHST- 2021/06/27 21:10 [entrez] AID - 10.1055/s-0041-1730972 [doi] PST - ppublish SO - Thorac Cardiovasc Surg. 2023 Mar;71(2):84-93. doi: 10.1055/s-0041-1730972. Epub 2021 Jun 27. PMID- 34176108 OWN - NLM STAT- MEDLINE DCOM- 20230313 LR - 20230313 IS - 1439-1902 (Electronic) IS - 0171-6425 (Linking) VI - 71 IP - 2 DP - 2023 Mar TI - New Intercostal Transcatheter Aortic Valve Replacement Access: No Touch. PG - 118-120 LID - 10.1055/s-0041-1730449 [doi] AB - Transcatheter aortic valve replacement (TAVR) is routinely performed via the transfemoral or transapical route. Subclavian, transcarotid, and transaortic access are described as alternative routes for TAVR. The small intercostal approach can be used for a safe TAVR without touching the ribs and sternum. CI - Thieme. All rights reserved. FAU - Lutter, Georg AU - Lutter G AD - Department of Experimental Cardiac Surgery and Heart Valve Replacement, University Hospital Schleswig-Holstein, Campus Kiel, Germany. AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany. FAU - Lozonschi, Lucian AU - Lozonschi L AD - Department of Cardiovascular Surgery, School of Medicine, Tampa General Hospital, University of South Florida, Florida, United States. FAU - Frank, Derk AU - Frank D AD - Department of Cardiology and Angiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany. FAU - Puehler, Thomas AU - Puehler T AUID- ORCID: 0000-0002-4990-1892 AD - Department of Experimental Cardiac Surgery and Heart Valve Replacement, University Hospital Schleswig-Holstein, Campus Kiel, Germany. AD - Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany. LA - eng PT - Journal Article DEP - 20210627 PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome MH - *Heart Valve Prosthesis MH - Retrospective Studies MH - Aortic Valve/diagnostic imaging/surgery MH - Risk Factors COIS- None declared. EDAT- 2021/06/28 06:00 MHDA- 2023/03/14 06:00 CRDT- 2021/06/27 21:10 PHST- 2021/06/28 06:00 [pubmed] PHST- 2023/03/14 06:00 [medline] PHST- 2021/06/27 21:10 [entrez] AID - 10.1055/s-0041-1730449 [doi] PST - ppublish SO - Thorac Cardiovasc Surg. 2023 Mar;71(2):118-120. doi: 10.1055/s-0041-1730449. Epub 2021 Jun 27. PMID- 34053738 OWN - NLM STAT- MEDLINE DCOM- 20230314 LR - 20230320 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 165 IP - 4 DP - 2023 Apr TI - Outcomes of procedural complications in transfemoral transcatheter aortic valve replacement. PG - 1346-1355.e5 LID - S0022-5223(21)00767-4 [pii] LID - 10.1016/j.jtcvs.2021.04.082 [doi] AB - OBJECTIVES: As the application of transcatheter aortic valve replacement (TAVR) expands, the longitudinal implications of periprocedural complications are increasingly relevant. We examine the influence of TAVR complications on midterm survival. METHODS: Patients undergoing transfemoral TAVR at our institution between November 2011 and June 2018 were reviewed. Stroke severity was classified according to the National Institutes of Health stroke score. Kaplan-Meier analysis was used to assess survival, and a Cox proportional hazards model was created to examine independent associations with survival. The median follow-up time was 36 months for a total of 2789 patient-years. RESULTS: Overall, 866 patients were included. The mean age was 80 +/- 9.5 years and mean Society of Thoracic Surgeons score was 4.8% +/- 2.7%. The mortality rate at 30-days was 2.8% and 11.8% at 1 year. In-hospital left bundle branch block and 30-day permanent pacemaker insertion occurred in 14.8% and 7.9%, respectively. Postprocedural greater-than-mild paravalvular leak was present in 4.4% and stroke occurred in 3.8% at 30-days. Greater-than-mild paravalvular leak was associated with decreased survival at 2 years (P = .02), but not at 5 years. Severe stroke was independently associated with decreased survival at 5 years (hazard ratio, 5.73; 95% confidence interval, 2.29-14.36; P