Colchicine in patients with aortic stenosis undergoing transcatheter aortic valve replacement: a double-blind randomized trial.

An inflammatory process may increase the risk of arrhythmias after transcatheter aortic valve replacement (TAVR). In this single-centre, double-blind, placebo-controlled, randomized trial we investigated the efficacy of colchicine to reduce a composite of new-onset atrial fibrillation or atrioventricular conduction disturbances requiring the implantation of a permanent pacemaker at 30 days after TAVR. Between September 21, 2021 and April 25, 2024, 120 patients with aortic stenosis undergoing TAVR (mean age 80.

Risk of major bleeding in recurrent fallers receiving anticoagulation for atrial fibrillation: a prospective cohort study.

Background: The risk of fall-related bleeding is a frequent reason for not following recommendations on anticoagulation in patients with atrial fibrillation (AF).

Objectives: To assess whether patients on anticoagulation therapy with recurrent falls are at an increased risk of bleeding.

Methods: We used data from the Swiss-AF multicenter cohort study, including patients aged ≥65 years with documented AF and oral anticoagulant treatment.

Early Outcomes of Real-World Transcatheter Tricuspid Valve Replacement.

Background: Transcatheter tricuspid valve replacement (TTVR) has been recently approved for the treatment of patients with severe tricuspid regurgitation (TR). Real-world evidence regarding the commercial use of TTVR is lacking.

Objectives: The aim of this study was to investigate the real-world safety and efficacy of the EVOQUE TTVR system in patients with severe TR treated at 12 experienced heart valve centers in 5 European countries.

Prognostic value of NT-proBNP in patients with primary mitral regurgitation undergoing transcatheter edge-to-edge repair.

Aims: The prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for primary mitral regurgitation (PMR) is unclear. This study assessed the association between NT-proBNP and outcomes and explored its additive value to the Mitral Regurgitation International Database (MIDA) score.

Methods And Results: PRIME-MR, a retrospective, international, multicentre registry, includes 3083 consecutive PMR patients treated with M-TEER.

Impact of Noncoaxial Transcatheter Aortic Valve Implantation on Clinical Outcomes.

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.

Incidence, predictors and clinical impact of upper gastrointestinal bleeding after transcatheter aortic valve replacement.

Background: Upper gastrointestinal (GI) bleeding following transcatheter aortic valve replacement (TAVR) is common in patients with aortic stenosis due to the combination of acquired type 2A von Willebrand disease and aspirin-based antiplatelet therapy. We aimed to investigate the incidence, predictors and clinical outcomes of late upper GI bleeding in patients undergoing TAVR.

Methods: In a prospective TAVR registry, patients were stratified according to upper GI bleeding within 1 year of discharge.

Flow Status-Based Predicted Prosthesis-Patient Mismatch in Patients Undergoing Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve.

Background: Effective orifice area (EOA) is flow dependent. However, established methods for the assessment of predicted prosthesis-patient mismatch (PPM) do not consider flow status and therefore may underestimate the rate and impact of PPM in patients with abnormal flow status. This study aimed to investigate the clinical impact of flow status-based predicted PPM in patients undergoing transcatheter aortic valve replacement (TAVR).

Treatment of Mitral and Tricuspid Atrioventricular Valve Disease by Double Transcatheter Valve Replacement.

Topic: Double transcatheter replacement of the atrioventricular valves.

Images: Transesophageal images, fluoroscopic images, images simulated with Laralab.

Case Summary: This case report illustrates a novel staged transcatheter approach for managing concomitant mitral and tricuspid valve disease in a high-risk surgical patient.

Transapical Transcatheter Mitral Valve Replacement After Failed Transcatheter Edge-to-Edge Repair: A Multicenter Experience.

Background: Management of recurrent mitral regurgitation (MR) or relevant iatrogenic mitral valve (MV) stenosis after mitral transcatheter edge-to-edge repair (M-TEER) emerges as an increasingly relevant clinical issue. Surgery after M-TEER is associated with higher morbidity and mortality. Electrosurgical leaflet laceration and stabilization of the implant (ELASTA-Clip) followed by transcatheter mitral valve replacement (TMVR) is an innovative, less-invasive treatment option for patients with TEER failure.

Hemodynamic Valve Deterioration After Transcatheter Aortic Valve Replacement: Incidence, Predictors, and Clinical Outcomes.

Background: Reports on the durability of transcatheter aortic valve replacement (TAVR) prostheses are scarce and confounded by varying definitions and competing risks of death.

Objectives: The authors sought to determine the incidence, predictors, and clinical outcomes of hemodynamic valve deterioration (HVD) according to the Valve Academic Research Consortium 3 definition after TAVR.

Methods: We analyzed consecutive patients undergoing TAVR in the prospective Bern TAVI (Transcatheter Aortic Valve Implantation) registry between August 2007 and June 2022 for the incidence and predictors of HVD and performed case control-matching to compare outcomes according to HVD.

Cardiovascular Involvement in Tuberculosis Patients Treated in Southern Africa.

Background: Tuberculosis (TB) is the leading cause of death among people with HIV and a major global health challenge. Subclinical cardiovascular manifestations of TB are poorly documented in high TB and HIV burden countries.

Objectives: The purpose of this study was to quantify the prevalence of cardiovascular involvement in TB patients and investigate changes after completion of anti-TB treatment.

Five-year outcomes with self-expanding versus balloon-expandable TAVI in patients with left ventricular systolic dysfunction.

Background: The importance of transcatheter heart valve (THV) design on clinical outcome in patients with aortic stenosis (AS) and left ventricular (LV) systolic dysfunction remains unknown.

Objectives: We aimed to compare 5-year outcomes of patients with severe AS and reduced LV ejection fraction (LVEF), undergoing transcatheter aortic valve implantation (TAVI) with balloon-expandable vs. self-expanding THVs.

Findings from transoesophageal echocardiographic follow-up after mitral transcatheter edge-to-edge repair.

Background: Transoesophageal echocardiography (TOE) provides accurate evaluation of mitral valve (MV) function following mitral transcatheter edge-to-edge repair (M-TEER) and may better detect complications in case of suboptimal result.

Aims: We aimed to evaluate midterm anatomical changes and structural complications after M-TEER using TOE and investigate their association with clinical outcomes at 2 years.

Methods: A follow-up TOE at 6 months was systematically recommended to all patients included in our institutional prospective M-TEER registry until December 2021.

Renin-Angiotensin System Inhibition in Patients With Myocardial Injury Complicating Transcatheter Aortic Valve Replacement.

Background: Periprocedural myocardial injury impacts clinical outcome after transcatheter aortic valve replacement (TAVR). The optimal medical management strategy for TAVR-related periprocedural myocardial injury has not been established.

Objectives: The authors aimed to investigate the prognostic association of renin-angiotensin system (RAS) inhibitors in patients with periprocedural myocardial injury after TAVR.

Sex-Specific Differences in Upstream Cardiac Damage in Patients With Aortic Stenosis Undergoing TAVR.

Background: Cardiac damage caused by aortic stenosis (AS) can be categorized into stages, which are associated with a progressively increasing risk of death after transcatheter aortic valve replacement (TAVR).

Objectives: The authors investigated sex-related differences in cardiac damage among patients with symptomatic AS and the prognostic value of cardiac damage classification in women and men undergoing TAVR.

Methods: In a prospective registry, pre-TAVR echocardiograms were used to categorize patients into 5 stages of cardiac damage caused by AS.

Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement.

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.

Acute Heart Failure During the Peripartum Period Due to Aggravated Tricuspid Regurgitation.

Latent valvular heart disease may be aggravated or demasked during pregnancy because of physiologic hemodynamic changes, including higher circulating volume, heart rate, and cardiac index, as well as stress during labor. The presence of valvular heart disease increases the risk of maternal and fetal/newborn adverse events. Early diagnosis, risk assessment, and specific management are crucial.

Contemporary Approach to Tricuspid Regurgitation: Knowns, Unknowns, and Future Challenges.

Severe tricuspid regurgitation (TR) worsens heart failure and is associated with impaired survival. In daily clinical practice, patients are referred late, and tricuspid valve interventions (surgical or transcatheter) are underutilised, which may lead to irreversible right ventricular damage and increases risk. This article addresses the appropriate timing and modality for an intervention (surgical or transcatheter), and its potential benefits on clinical outcomes.