Estimation of Coronary Obstruction Risk for the Transcatheter Aortic Valve Implantation in Surgical Aortic Valve (TAV-in-SAV) Procedure.

Background: To consider transcatheter aortic valve-in-surgical aortic valve (TAV-in-SAV) as a secondary intervention, the risk of coronary obstruction during future TAV-in-SAV should be assessed prior to initial SAV replacement (SAVR), especially in Japanese patients with a small body size and aortic root anatomy. In this study we simulated the risk of coronary obstruction and identified associated anatomical factors.

Methods And Results: We retrospectively analyzed pre- and post-SAVR computed tomography scans of 115 patients and simulated the risk of coronary obstruction.

Clinical Phenotypes of Patients With Ischemic Cardiomyopathy After Percutaneous Coronary Intervention.

Background: Percutaneous coronary intervention (PCI) is a good option for patients with ischemic cardiomyopathy (ICM) at high operative risk. However, evidence shows little benefit of PCI, potentially due to heterogeneity in ICM. Here, we applied latent class analysis (LCA) to clinical data to characterize ICM phenotypes based on clinical features and to assess differences in clinical outcomes.

Elevated Serum Immunoglobulin G1 Levels and Left Ventricular Diastolic Dysfunction in Anti-Centromere Antibody-Positive Patients With Lower Extremity Arterial Disease: A Cross-Sectional Study.

This cross-sectional pilot study investigated the clinical characteristics of anti-centromere antibody (ACA)-positive patients with below-the-knee arterial disease. Sixteen ACA-positive patients (mean age 69 ± 10 years; 94% women) underwent contrast-enhanced computed tomography evaluation, with arterial damage scored using the Global Limb Anatomic Staging System. Lower extremity arterial disease (LEAD) was defined as a below-the-knee arterial score ≥ 1 or > 50% stenosis in above-the-knee lesions.

Impact of Elevated Preprocedural Left Ventricular Filling Pressure on Prognosis of Mild Paravalvular Regurgitation Following Transcatheter Aortic Valve Replacement.

Background: Paravalvular regurgitation (PVR) following transcatheter aortic valve replacement (TAVR) is a complication linked to poor outcomes. The prognostic impact of mild PVR, particularly in patients with elevated preprocedural left ventricular (LV) filling pressure, remains uncertain.

Aims: This study aimed to assess the influence of elevated preprocedural LV filling pressure on mild PVR prognosis following TAVR.

Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy.

The clinical course of cardiac sarcoidosis is typically subacute, and fulminant cases requiring mechanical circulatory support are rare. Here, we report the case of a patient with pathologically diagnosed cardiac sarcoidosis who presented with fulminant myocarditis and whose cardiac function was improved by aggressive immunosuppressive therapy based on the treatment of giant cell myocarditis. A 55-year-old woman presented with progressive dyspnoea and nausea that persisted for 1 month and was eventually diagnosed with acute heart failure.

Serial Change and Clinical Impact of Irregular Protrusion in Lesions With Chronic Coronary Syndrome.

Background: The changes over time and effects on long-term clinical outcomes beyond 1 year of irregular protrusion (IP) in chronic coronary syndrome (CCS) remains unclear.

Aims: This study aimed to assess the time-dependent change and long-term clinical impact of IP in CCS lesions.

Methods: This study was a post hoc analysis of COLLABORATION study, which was a multicenter, prospective, observational study conducted from July 2018 to February 2020, assessing 1- and 12-month serial vessel responses after stent implantation using OCT and coronary angioscopy.

Comparison of Vessel Responses Following Combined Sirolimus-Eluting and Endothelial Progenitor Cell Stent and Ultra-Thin Sirolimus-Eluting Stent Implantation by Serial Optical Coherence Tomography and Coronary Angioscopy: A Multicenter Observational Study.

A dual-therapy sirolimus-eluting and CD34+ antibody-coated Combo Stent (DTS) has been developed to enhance endothelization and capture endothelial progenitor cells; however, vessel responses following DTS implantation remain unclear. Therefore, we evaluated early- and mid-term intravascular characteristics of DTS using intravascular imaging modalities. This multicenter, prospective, observational study enrolled 88 patients (95 lesions) who underwent DTS (43 patients, 48 lesions) or sirolimus-eluting Orsiro stent (SES, 45 patients, 47 lesions) implantation.

Long-Term Bioprosthetic Valve Durability After Transcatheter Aortic Valve Replacement With Supra-Annular Self-Expanding Versus Intra-Annular Balloon-Expandable Valves in Patients With a Small Aortic Annulus.

Background: The long-term valve durability of supra-annular self-expanding valves (SEV) and intra-annular balloon-expandable valves (BEV) in patients with small aortic annuli remains unexplored.

Aims: This study aimed to determine the long-term bioprosthetic valve durability with SEV versus BEV in patients with small aortic annuli.

Methods: This retrospective study included patients with severe aortic stenosis (AS) and an aortic annulus area of 430 mm or less who underwent transcatheter aortic valve replacement using SEV and BEV between October 2009 and December 2022.

A case report of pre-implantation feasibility test for combining leadless pacemaker and subcutaneous implantable cardioverter-defibrillator in adult congenital heart disease.

Unlabelled: New cardiac implantable electronic devices (CIEDs), such as leadless pacemakers and subcutaneous implantable cardioverter defibrillators (S-ICDs), are being used in patients with adult congenital heart disease. The selection of CIEDs often requires careful consideration due to technical challenges posed by a unique heart structure. A 27-year-old man following a surgical tetralogy of Fallot (TOF) repair developed non-sustained ventricular tachycardia, sick sinus syndrome, and complete atrioventricular block.

Predictive Factors of Unexpected Hospitalization within Six Months of Undergoing Percutaneous Coronary Intervention in Patients with Chronic Coronary Disease.

Objective Recent guidelines recommend dual antiplatelet therapy (DAPT) for six months following percutaneous coronary intervention (PCI) in patients with chronic coronary disease, as unexpected hospitalization can trigger DAPT discontinuation. This study evaluated the predictive factors for unexpected hospitalization within six months after PCI in patients with chronic coronary disease. Methods This prospective multicenter study included 412 patients who underwent PCI for chronic coronary disease.

Differences between valve types in anatomic changes of the aortic root after surgical aortic valve replacement.

Background: When transcatheter aortic valve-in-surgical aortic valve (TAV-in-SAV) is considered as a secondary interventional option, it is desirable to estimate the risk of coronary obstruction during future TAV-in-SAV before the initial surgical aortic valve replacement (SAVR), for which knowledge of the anatomic changes after SAVR is essential. We investigated the changes in the aortic root and evaluated the differences in changes between valve types.

Methods: Pre- and post-SAVR computed tomography scans of 124 patients with aortic stenosis who underwent SAVR with various bioprosthetic valves were analyzed retrospectively.

Long-term outcomes of transapical-transcatheter aortic valve replacement.

Objective: Transapical-transcatheter aortic valve replacement is one of the main interventions indicated for patients where access via peripheral vessels is challenging. However, there have been no reports on the long-term outcomes of this intervention. Here, we report the long-term outcomes of this intervention.

A risk model of mortality rate in dialysis patients following transcatheter aortic valve replacement.

Background: Dialysis patients undergoing transcatheter aortic valve replacement (TAVR) generally have poor prognosis compared with non-dialysis patients. Furthermore, there are few reliable risk models in this clinical setting. Therefore, we aimed to establish a risk model in dialysis patients undergoing TAVR that would be informative for their prognosis and the decision-making process of TAVR.

Five-Year Transcatheter Aortic Valve Replacement Outcomes in Chronic Hemodialysis vs. Non-Hemodialysis Patients Using Balloon-Expandable Devices.

Background: Based on the results of a clinical trial in Japan, transcatheter aortic valve replacement (TAVR) for hemodialysis (HD) patients gained approval; however, mid-term TAVR outcomes and transcatheter aortic valve (TAV) durability in HD patients remain unexplored.

Methods and results: We analyzed background, procedural, in-hospital outcome, and follow-up data for 101 HD patients and 494 non-HD patients who underwent TAVR using balloon-expandable valves (SAPIEN XT or SAPIEN 3) retrieved from Osaka University Hospital TAVR database. Periprocedural mortality and TAVR-related complications were comparable between HD and non-HD patients.

Impact of baseline yellow plaque assessed by coronary angioscopy on vascular response after stent implantation.

Background: The relationship between baseline yellow plaque (YP) and vascular response after stent implantation has not been fully investigated.

Methods: This was a sub-analysis of the Collaboration-1 study (multicenter, retrospective, observational study). A total of 88 lesions from 80 patients with chronic coronary syndrome who underwent percutaneous coronary intervention were analyzed.

One-year outcome of transcatheter aortic valve replacement for bicuspid aortic valve stenosis: a report from the Japanese Nationwide registry (J-TVT registry).

The outcome of transcatheter aortic valve replacement (TAVR) for patients with bicuspid aortic valve (BAV) remains unclear, particularly among Asian patients that are known to have different valvular morphology and lower body habitus. This study investigated patient characteristics, procedural and 1-year outcome of TAVR for BAV within national TAVR registry in Japan. The patient-level data were extracted from the J-TVT (Japanese Transcatheter Valvular Therapy) registry between August 2013 and December 2018; overall, there were 423 patients (2.

Impact of calcified nodule on target lesion failure after stent implantation in hemodialysis patients.

Background: Little is known about intravascular imaging predictors of cardiac events after drug-eluting stent (DES) implantation in hemodialysis (HD) patients. We aimed to reveal the association between calcified nodules (CN) and target lesion failure (TLF) in HD patients after DES implantation.

Methods: We enrolled 114 HD patients who underwent DES implantation between October 2016 and October 2020.

Coronary access after repeat transcatheter aortic valve replacement in patients of small body size: A simulation study.

Background: Coronary artery access after repeat transcatheter aortic valve replacement (TAV-in-TAV) is reportedly more difficult because leaflet displacement of the first transcatheter heart valve (THV) impairs coronary cannulation; however, its effects in small patients are unknown. This study aimed to simulate coronary accessibility after TAV-in-TAV in patients of small body size.

Methods: We retrospectively analyzed computed tomography scans after initial THV implantation and classified patients by THV and coronary artery location, valve-to-aorta distance, and valve-to-coronary distance.

A Risk Model for 1-Year Mortality After Transcatheter Aortic Valve Replacement From the J-TVT Registry.

Background: Although transcatheter aortic valve replacement (TAVR) has demonstrated favorable outcomes in randomized studies, there remains a sizable group of patients in whom TAVR may be futile. Characterizing the survival rate in a wide array of patients undergoing TAVR can help develop effective strategies for improving the allocation of medial resources.

Objectives: The aim of this study was to develop a risk model to estimate 1-year mortality after TAVR from a representative nationwide registry in Japan.