Publications by authors named "Amit N Vora"
Variability in State-Level Regulations Regarding Occupational Radiation Exposure.
J Soc Cardiovasc Angiogr Interv
June 2025
30-Day and 1-Year Outcomes From the Optimize PRO TAVR Evolut FX Addendum Study.
JACC Cardiovasc Interv
August 2025
Background: Primary results from the Optimize PRO study demonstrated that transcatheter aortic valve replacement (TAVR) with the cusp overlap technique (COT) resulted in low 30-day permanent pacemaker implantation (PPI) rates and no moderate or greater aortic regurgitation (AR).
Objectives: The aim of this study was to evaluate outcomes after Evolut FX implantation using the COT and postprocedural computed tomography (CT).
Methods: The Optimize PRO FX Addendum study is a postmarket, prospective, multicenter, nonrandomized study.
Article Synopsis
- This study focused on comparing long-term outcomes between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in lower-risk patients with severe aortic stenosis.
- The analysis included data from six trials with over 5,300 participants and found that TAVR led to a 20% lower risk of all-cause death and a 19% lower risk of death or disabling stroke compared to SAVR after five years.
- However, there was no significant difference in stroke rates between the two procedures.
Beyond Echo-Derived Gradients: Balloon-Expandable Valve Outcomes in Small Annuli Patients.
JACC Cardiovasc Interv
February 2025
Effect of Sodium-Glucose Cotransporter-2 Inhibitors on the Progression of Aortic Stenosis.
JACC Cardiovasc Interv
March 2025
Background: Aortic stenosis (AS) is the leading cause of valvular heart disease-related morbidity and mortality, but there are no medical treatments to slow its progression. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have pleiotropic effects which could be disease modifying in AS.
Objectives: The purpose of this study was to determine if SGLT2i usage is associated with slower progression of AS.
In-Hospital Outcomes and 30-Day Readmission Rate After Transcatheter and Surgical Aortic Valve Replacement in Liver Cirrhosis: A Contemporary Propensity-Matched Analysis.
Struct Heart
November 2024
Background: Liver cirrhosis is not included in surgical risk prediction models despite being a significant risk factor associated with high periprocedural morbidity and mortality in patients undergoing cardiac surgery. Limited contemporary data exists assessing the outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with cirrhosis.
Methods: Patients with cirrhosis who underwent TAVR or SAVR were identified from the Nationwide Readmissions Database.
Article Synopsis
- Traditional analyses in clinical trials for antithrombotic agents evaluate bleeding and ischemic events separately, which have limitations; this study proposes using days alive and out of hospital (DAOH) as an alternative endpoint.
- The AUGUSTUS trial involving 4614 patients compared two treatments (apixaban vs. warfarin and aspirin vs. placebo) and measured DAOH, finding no significant differences between treatment groups.
- Despite apixaban showing lower rates of major bleeding and hospitalization, the study concludes that DAOH may not effectively capture the impact of antithrombotic therapies for patients with atrial fibrillation and acute coronary syndrome.
Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion.
JACC Cardiovasc Interv
March 2025
Article Synopsis
- The study examines outcomes of percutaneous left atrial appendage occlusion (LAAO) procedures performed by either electrophysiologists (EPs) or interventional cardiologists (ICs) between 2020 and 2022, focusing on patient safety and complications.
- Key findings indicate that EPs utilized intracardiac echocardiography more frequently and achieved lower radiation exposure; however, rates of major adverse events (MAE) and in-hospital mortality were comparable between the two groups.
- Overall, LAAO was deemed safe with no significant differences in outcomes based on operator certification, highlighting the importance of continued use of these techniques by both specialties for broader patient access.
Article Synopsis
- This study looked at how men and women do after a heart procedure called TAVI, which helps with a problem called aortic stenosis.
- It found that women faced more serious complications right after the procedure, like higher chances of dying and having strokes, compared to men.
- However, men had a higher chance of needing to go back to the hospital within 30 and 90 days after the procedure, but both men and women got better faster from 2016 to 2020.
Residual Holes: Areas for Future Research on Device Closure of Atrial Septal Defects.
JACC Cardiovasc Interv
October 2024
Breaking Down Barriers to Transcatheter Aortic Valve Replacement.
J Soc Cardiovasc Angiogr Interv
March 2024
The Current Landscape of Transcatheter Tricuspid Valve Intervention.
J Soc Cardiovasc Angiogr Interv
December 2023
Tricuspid regurgitation (TR) is common, and its prevalence increases with age. It was previously estimated that there are 1.6 million patients in the United States with moderate or worse TR, and more contemporary data suggest the age-adjusted prevalence of TR is 0.
View Article and Find Full Text PDFCutting the Cord: Time for Leadless Pacemakers to Untether Post-TAVR Patients?
JACC Cardiovasc Interv
August 2024
Patients with moderate aortic stenosis (AS) have a greater risk of adverse clinical outcomes than that of the general population. How this risk compares with those with severe AS, along with factors associated with outcomes and disease progression, is less clear. We analyzed serial echoes (from 2017 to 2019) from a single healthcare system using Tempus Next (Chicago, Illinois) software.
View Article and Find Full Text PDFArticle Synopsis
- Aortic stenosis (AS) presents a serious public health issue, and the new Digital AS Severity index (DASSi) leverages AI to improve detection of severe AS through simple echocardiography, without needing complex Doppler analysis.
- The study focused on patients with no severe AS initially (from Yale and Cedars-Sinai hospitals) to assess how well DASSi could predict AS onset and progression, with results analyzed from August 2023 to February 2024.
- Findings revealed that a higher DASSi score was linked to a quicker increase in peak aortic valve velocity and significantly elevated risks for aortic valve replacement, especially for scores above 0.2
National Variability in Pacemaker Implantation Rate Following TAVR: Insights From the STS/ACC TVT Registry.
JACC Cardiovasc Interv
February 2024
Article Synopsis
- This study analyzed the rates of permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR) across various hospitals from 2016 to 2020, revealing significant variations in implantation rates.
- Overall, the PPM implantation rate was 11.3%, with some hospitals showing rates as low as 0% and others as high as 36.4%, but these rates have trended downward over the years.
- Even after adjusting for patient characteristics and hospital factors like volume and teaching status, notable differences in PPM rates among hospitals persisted, suggesting further research is needed to understand the causes of these variations.
What Do We Really Know About Transcatheter Mitral Valve-in-Valve Procedures?
J Am Coll Cardiol
January 2024
The Search for Optimal Antithrombotic Therapy With LAAO: Are We There Yet?
JACC Cardiovasc Interv
November 2023
Unlabelled: 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.
View Article and Find Full Text PDFArticle Synopsis
- Aortic stenosis (AS) is a significant public health issue with limited current biomarkers for personalized monitoring, prompting the investigation of a new AI-based method, the Digital AS Severity index (DASSi), for assessing AS severity through echocardiography.* -
- This study followed two patient groups from Yale-New Haven Health System and Cedars-Sinai Medical Center who had no severe AS at the start, using DASSi scores to predict the development and worsening of AS over several years.* -
- Results indicated that higher baseline DASSi scores correlated with faster increases in aortic valve velocity, significantly raising the likelihood of patients needing aortic valve replacement, demonstrating DASSi's potential for improving AS patient management
Article Synopsis
- The study analyzed the use of medical devices and outcomes related to lower extremity peripheral arterial interventions for different racial groups using data from the American College of Cardiology National Cardiovascular Data Registry from 2014 to 2019.
- It found that while Black patients had higher rates of specific health conditions and socio-economic challenges, they received drug-eluting technologies more often than White patients, but there were no significant differences in the use of atherectomy or intravascular imaging.
- Interestingly, Black patients were less likely to undergo surgical or repeat procedures after 1 year, although there were no differences in mortality or major amputations between the groups.