Sex-specific outcomes after transcatheter or surgical treatment of aortic valve stenosis: the DEDICATE-DZHK6 trial.

Background And Aims: Aortic stenosis may be managed differently in women and men, but evidence remains limited. Sex-specific characteristics and outcomes of low- to intermediate-risk patients assigned to transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) from the DEDICATE-DZHK6 trial are described.

Methods: The DEDICATE-DZHK6 trial demonstrated non-inferiority for the primary outcome of all-cause death or stroke at 1 year.

Partial Removal of Mechanical Aortic Valve to Enable Direct Transcatheter Valve Implantation During Left Ventricular Assist Device Placement.

In patients with a mechanical aortic valve in need of left ventricular assist device (LVAD) support, replacement with a biological valve should be considered. We present a case of partial mechanical valve explantation followed by direct transcatheter valve replacement during LVAD implantation. This approach offers a simpler and faster alternative to conventional valve replacement, with reduced cross-clamp time.

Sex Differences in Clinical and Patient-Reported Outcomes in Transcatheter Aortic Valve Implantation: The TAVI-COMIC Trial.

Background: Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic valve stenosis. Data regarding sex-specific differences in patient-centered endpoints, such as patient-reported outcomes (PROs), and in sociodemographic characteristics are scarce.

Objectives: This study aimed to investigate patient-centered, sex-specific characteristics and their associations with the overall patient outcome, that is, clinical course and PROs in patients undergoing TAVI.

Transcatheter management of left-sided valvular heart disease following heart transplantation.

Objectives: Aortic stenosis (AS) and mitral regurgitation (MR) are rare in heart transplant (HTx) recipients, but their incidence increases with extended post-transplant survival. This study assesses the safety, efficacy and outcomes of transcatheter interventions in this high-risk population.

Methods: An institutional series of HTx patients undergoing a transcatheter aortic valve implant (TAVI) or mitral transcatheter edge-to-edge repair (M-TEER) from March 2015 through April 2024 was analysed retrospectively.

Transapical vs. Transaxillary Access in Transcatheter Aortic Valve Implantation: Comparative Mortality and Long-Term Outcomes Using Inverse Probability of Treatment Weighting Analysis.

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.

Propensity-Matched Analysis of Early and Long-Term Clinical Outcomes with Self-Expandable Prostheses in TAVR: Portico vs. CoreValve Evolut R.

: Transcatheter aortic valve replacement (TAVR) has emerged as a well-established option for patients with severe aortic stenosis who present high or extreme surgical risk. Direct comparisons of outcomes between different valve prostheses are important to assist operators in making an informed device selection. We aimed to perform a comparative analysis of early clinical outcomes at 30 days and long-term outcomes up to 3 years after TAVR using self-expandable Portico or CoreValve Evolut R valve prostheses.

Integrated double redo percutaneous valve replacement: simultaneous transcatheter aortic and mitral valve management.

Objectives: The growing elderly population contributes to an increasing prevalence of severe degenerative native aortic valve (AV) or mitral valve (MV) disease in combination with bio-prosthetic valve failure of prior implanted (aortic or mitral) bio-prostheses, as well as concomitant failure of both aortic and mitral bio-prosthetic valves. A combined surgical AV and MV replacement carries a markedly higher risk, especially in the redo setting. Transcatheter double-valve implantation (TDVI) is emerging as a promising alternative that may mitigate the risks of redo surgery.

The Influence of Audiovisual Distraction on Pain Reduction During Transcatheter Aortic Valve Implantation Under Monitored Anesthesia Care: A Prospective Randomized Trial.

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.

Transcatheter management of pure native aortic valve regurgitation in patients with left ventricular assist device.

Objectives: Aortic valve regurgitation (AR) frequently complicates the clinical course after left ventricular assist device (LVAD) implantation. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement (SAVR) in this cohort with a mostly high surgical risk profile. The unique challenges in LVAD patients, such as presence of non-calcified aortic valves and annular dilatation, raise concerns about device migration and paravalvular leakage (PVL) leading to missing device success.

Alternative minimally invasive surgical explantation techniques for failed transcatheter mitral valve repair devices.

Objective: The use of transcatheter mitral valve repair (TMVr) devices is increasing in elderly and high-risk patients. However, the increasing number of patients with recurrent mitral regurgitation (MR) has confronted surgeons with the issue of how to explant the devices and whether the mitral valve should be repaired or replaced. The aim of the study is to summarize our clinical experience with the explantation of different TMVr devices and to provide alternative surgical techniques that can be performed in different clinical scenarios.

Clinical value of CT-derived simulations of transcatheter-aortic-valve-implantation in challenging anatomies the PRECISE-TAVI trial.

Background: Preprocedural computed tomography planning improves procedural safety and efficacy of transcatheter aortic valve implantation (TAVI). However, contemporary imaging modalities do not account for device-host interactions.

Aims: This study evaluates the value of preprocedural computer simulation with FEops HEARTguide on overall device success in patients with challenging anatomies undergoing TAVI with a contemporary self-expanding supra-annular transcatheter heart valve.

Transcatheter Aortic Valve Replacement for Isolated Aortic Regurgitation Using a New Self-Expanding TAVR System.

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 Conformité Européenne-marked transfemoral transcatheter aortic valve replacement system (JenaValve Trilogy [JV]) for the treatment of patients with AR.

Procedural and one-year outcomes of the BASILICA technique in Europe: the multicentre EURO-BASILICA registry.

Background: The real-world outcomes of the use of the BASILICA (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction) transcatheter technique in Europe have not been described.

Aims: We sought to evaluate the procedural and one-year outcomes of BASILICA in patients at high risk for coronary artery obstruction (CAO) undergoing transcatheter aortic valve implantation (TAVI) in a multicentre European registry (EURO-BASILICA).

Methods: Seventy-six patients undergoing BASILICA and TAVI at ten European centres were included.

First-in-Human Dedicated Leaflet Splitting Device for Prevention of Coronary Obstruction in Transcatheter Aortic Valve Replacement.

Background: Coronary artery obstruction is a life-threatening complication of transcatheter aortic valve replacement (TAVR) procedures. Current preventive strategies are suboptimal.

Objectives: The aim of this study was to describe bench testing and clinical experience with a novel device that splits valve leaflets that are at risk for causing coronary obstruction after TAVR, allowing normal coronary flow.

Leaflet-splitting device to prevent coronary artery obstruction in valve-in-valve transcatheter aortic valve implantation.

Coronary artery obstruction is a life-threatening complication of transcatheter aortic valve replacement procedures, and current preventive strategies are suboptimal. The novel ShortCut device splits bioprosthetic valve leaflets that are at risk of causing coronary artery obstruction after transcatheter aortic valve implantation, allowing for normal coronary flow. In this video tutorial, we demonstrate a valve-in-valve transcatheter aortic valve implantation using a dedicated leaflet-splitting device for prevention of coronary artery obstruction in transcatheter aortic valve replacement.

Minimally invasive surgical aortic valve replacement via a partial upper ministernotomy.

Minimally invasive aortic valve replacement has become a feasible approach to treat various aortic valve pathologies with limited procedural trauma. Several minimally invasive aortic valve replacement approaches with different levels of complexity and technical requirements are currently available.