Early U.S. Commercial Experience With a Novel Transcatheter Edge-to-Edge Repair System: Insights From Real-World Data.

Background: The PASCAL Precision transcatheter valve repair system provides a new option for treating prohibitive surgical risk patients with significant, symptomatic degenerative mitral regurgitation (DMR).

Objectives: The authors report early U.S.

Clinical Outcomes of Transcatheter Aortic Valve Replacement in Patients with Various Flow-Gradient and Ejection Fraction Profiles.

Background: To compare the clinical outcomes of transcatheter aortic valve replace-ment (TAVR) for severe aortic stenosis (AS) in patients with different flow-gradient and left ventricular ejection fraction (EF) profiles.

Methods: Patients with severe AS who underwent TAVR with newer generation valves (Sapien3/3 Ultra, Evolut Pro/Pro+/FX) were retrospectively analyzed. Patients were divided into 5 groups: normal-flow high-gradient (NF-HG) AS (stroke volume index ≥ 35 mL/m2 and mean pressure gradient ≥ 40 mm Hg), low-flow high-gradient (LF-HG) with preserved EF (pEF, ≥ 50%), LF-HG with reduced EF (rEF), low-flow low-gradient (LF-LG) with pEF, and LF-LG with rEF.

ACURATE neo2 valve versus commercially available transcatheter heart valves in patients with severe aortic stenosis (ACURATE IDE): a multicentre, randomised, controlled, non-inferiority trial.

Background: ACURATE neo2 is an open-cell, supra-annular, self-expanding transcatheter heart valve that is commercially available in over 50 countries but has not previously been evaluated in a randomised trial. ACURATE-IDE aimed to prospectively evaluate the safety and efficacy of transcatheter aortic valve replacement (TAVR) with the ACURATE neo2 valve compared with commercially available valves for the treatment of severe symptomatic aortic stenosis.

Methods: In this multicentre, randomised, controlled, non-inferiority trial, patients with symptomatic severe aortic stenosis and any level of surgical risk were recruited from 71 medical centres in the USA and Canada.

Valve Underexpansion and Clinical Outcomes With ACURATE neo2: Findings From the ACURATE IDE Trial.

Background: In the ACURATE IDE (Safety and Effectiveness Study of ACURATE Valve for Transcatheter Aortic Valve Replacement) randomized controlled trial, ACURATE neo2 failed to show noninferiority to commercially available balloon-expandable (SAPIEN 3/3 Ultra) and self-expanding (Evolut R/PRO/PRO+/FX) valves for the primary endpoint of all-cause mortality, stroke, or rehospitalization at 1 year. A retrospective investigation was undertaken to evaluate potential factors contributing to these outcomes.

Objectives: The goal of this study was to assess the impact of ACURATE neo2 valve expansion on clinical outcomes in the ACURATE IDE trial.

Evolution of Untreated Moderate Mitral Regurgitation After Transcatheter Aortic Valve Implantation.

: Associated mitral regurgitation (MR) is frequently observed during transcatheter aortic valve implantation (TAVI). The progression of moderate MR remains undetermined, given uncertain clinical significance and natural history. This study aims to assess the evolution of moderate MR following TAVI.

Temporal Changes in Procedural Success and Clinical Outcomes of MTEER by Mechanism of MR: Analysis of the STS/TVT Registry.

Background: With the expansion of indications for mitral transcatheter edge-to-edge repair into nondegenerative etiologies, it is unknown whether changes in technical success and clinical outcomes have occurred.

Methods: The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/TVT) registry was analyzed from 2013 to 2023. Patients in shock were excluded.

Transcatheter aortic valve-in-valve implantation in failed stentless valves: a single-center experience.

Objectives: Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) offers an alternative to repeat cardiac surgery in selected patients. However, ViV-TAVI in previously implanted stentless valves is more challenging than in a stented valve. This single-center study aimed to analyze the outcomes of ViV-TAVI in stentless valves.

Regrowth Rate of a Cardiac Myxoma After Percutaneous Aspiration.

Cardiac myxomas are typically treated surgically; however, the operative mortality and recurrence rates are not negligible. In the current report we describe a case of repeat percutaneous aspiration of a right atrial myxoma. The report supports feasibility of the procedure, provides the asymptomatic timeframe after debulking, and the regrowth rate.

Transcatheter Aortic Valve-in-Valve Implantation with Newer Generation Evolut Valve by Size of Failed Bioprosthesis.

Background: To evaluate the clinical outcomes of valve-in-valve transcatheter aortic valve replacement (ViV TAVR) with newer-generation self-expanding Evolut valves according to the size of the failed surgical bioprosthesis.

Methods: This single-center retrospective study evaluated consecutive patients undergoing ViV TAVR with the Evolut Pro/Pro+/Fx between 2018 and 2022. These patients were compared based on the true internal diameter (ID) of the failed bioprosthesis, specifically ≤19 mm (small group) vs.

Impact of Atrial Fibrillation Type on Outcomes of Transcatheter Aortic Valve Replacement for Aortic Stenosis: A Single-Center Analysis.

Background: Atrial fibrillation (AF) is a recognized risk factor for mortality after transcatheter aortic valve replacement for severe aortic stenosis, but the impact of different types of AF on clinical outcomes remains unclear.

Methods: This retrospective study included 982 patients divided into 3 groups: no AF, paroxysmal AF, and nonparoxysmal AF (persistent or permanent). Clinical outcomes were analyzed using inverse probability weighting and multivariate models.

Impact of Flow-Gradient Patterns on Outcomes of Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis with Preserved Left Ventricular Ejection Fraction.

To compare the clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis (AS) and preserved ejection fraction (pEF) according to flow-gradient status.This retrospective study focused on patients with severe AS and pEF (≥ 50%) undergoing TAVR with newer generation valves (Sapien3/3 Ultra, Evolut Pro/Pro+/FX) between 2018 and 2022 (n = 781). Patients were divided into 3 groups: normal-flow high-gradient (NF-HG, stroke volume index ≥ 35 mL/m and mean pressure gradient ≥ 40 mmHg or peak velocity ≥ 4 m/second), low-flow high-gradient (LF-HG), and paradoxical low-flow low-gradient (pLF-LG) groups.

Percutaneous aspiration for shortening time to blood cultures sterilization in right-sided infective endocarditis and vegetations.

Background: Surgical intervention is associated with earlier clearance of bacteremia in infective endocarditis (IE).

Aim: We hypothesized that vegetectomies using percutaneous aspiration shortens time to sterilization of blood cultures in patients with right-sided IE and vegetations.

Results: The cohort included 37 patients, 23 treated conservatively, and 14 underwent percutaneous vegetectomy.

Effect of Elevated Body Mass Index on Outcomes of Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.

Background: The association of body mass index (BMI) and an "obesity paradox" with cardiovascular risk prediction is controversial. This study aimed to evaluate the impact of elevated BMI on the outcome of transcatheter aortic valve replacement (TAVR) for aortic stenosis.

Methods: This retrospective study included 1019 patients with a BMI of ≥18.

Impact of prior coronary artery bypass grafting and coronary lesion complexity on outcomes of transcatheter aortic valve replacement for severe aortic stenosis.

Objective: To investigate the impact of prior coronary artery bypass grafting (CABG) and coronary lesion complexity on transcatheter aortic valve replacement (TAVR) outcomes for aortic stenosis.

Methods: Clinical outcomes of TAVR were retrospectively compared between patients with and without prior CABG, and between patients with prior CABG and without coronary artery disease (CAD). The impact of the CABG SYNTAX score was also evaluated in patients with prior CABG.

Mechanical Support in High-Risk Pulmonary Embolism: Review Article.

Acute pulmonary embolism (PE) may manifest with mild nonspecific symptoms or progress to a more severe hemodynamic collapse and sudden cardiac arrest. A substantial thrombotic burden can precipitate sudden right ventricular strain and failure. Traditionally, systemic thrombolytics have been employed in such scenarios; however, patients often present with contraindications, or these interventions may prove ineffective.

Impact of coronary artery disease and revascularization on outcomes of transcatheter aortic valve replacement for severe aortic stenosis.

Background/purpose: To evaluate the impact of coronary artery disease (CAD), percutaneous coronary intervention (PCI), and coronary lesion complexity on outcomes of transcatheter aortic valve replacement (TAVR) for aortic stenosis.

Methods/materials: This retrospective study included 1042 patients divided into two groups by the presence or absence of CAD (SYNTAX score 0, no history of revascularization). Propensity score matching was used to compare the two groups.

Improved Hemodynamics With Self-Expanding Compared to Balloon-Expandable Transcatheter Aortic Valve Implantation in Small Annulus Patients: A Propensity-Matched Analysis.

Patients with small aortic annuli (SAA) pose a challenge in patients undergoing aortic valve replacement because of the potential for prosthesis-patient mismatch (PPM). This study aimed to compare the clinical and hemodynamic outcomes of self-expandable valve (SEV) versus balloon-expandable valve (BEV) transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis and SAA. All patients who underwent TAVI for severe native aortic stenosis with a SAA between January 2018 and December 2022 were retrospectively included in the study from a single center.

Paradoxical pulmonary artery systolic pressure response with catheter-directed therapies for pulmonary embolism.

Background: Early data on use of catheter-directed therapies (CDT) for treatment of Intermediate or High-Risk pulmonary embolism (PE) show improvement in pulmonary artery systolic pressures (PAsP) and RV/LV ratios. Occasionally a paradoxical rise in PAsP was observed with CDT utilizing ultrasound-assisted thrombolysis (USAT). It is unclear whether this pattern is seen with CDT utilizing mechanical aspiration.

Impact of mitral stenosis on early and late outcomes of transcatheter aortic valve replacement for aortic stenosis: a single-center analysis.

Objectives: To assess the impact of concomitant mitral stenosis (MS) on early and late outcomes of transcatheter aortic valve replacement (TAVR) for aortic stenosis.

Methods: This study involved 952 patients undergoing TAVR for severe tricuspid aortic stenosis. The patients were classified into 3 groups: without MS, with progressive MS, and severe MS (mitral valve area ≤ 1.

Long-term clinical outcomes of robotic-assisted surgical coronary artery revascularisation.

Background: Patients who are not candidates for traditional coronary artery bypass grafting (CABG) and amenable only for percutaneous coronary intervention (PCI) with stents can receive the "gold standard" left internal thoracic artery (LITA) to left anterior descending artery (LAD) anastomosis through robotic-assisted CABG and PCI to non-LAD coronary targets.

Aims: We aimed to analyse clinical outcomes of robotic-assisted CABG.

Methods: A total of 2,280 consecutive patients who had undergone robotic-assisted CABG between May 2005 and June 2021 were included in our study.

Clinical and Echocardiographic Outcomes of Patients Undergoing Transcatheter Edge-to-Edge Repair for Functional vs Degenerative Mitral Valve Regurgitation.

To analyze clinical and echocardiographic outcomes after transcatheter edge-to-edge repair (TEER) with mitral valve clip device (MitraClip-TM) for functional vs degenerative mitral valve regurgitation (MR). All consecutive 185 patients undergoing TEER between January 2019 and March 2023 were included in the study. A propensity-adjusted analysis investigated differences among functional vs degenerative MR mechanism groups.