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.

Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement.

Background: There is paucity of data regarding sex-related differences among patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR).

Methods: The AD-HOC was an observational, retrospective, investigator-initiated registry enrolling consecutive patients with Sievers type 1 BAV stenosis who underwent TAVR at 24 international centers from 2016 to 2023. The primary endpoint was major adverse events (MAEs), including death, neurologic events and heart failure hospitalization.

High residual gradients after transcatheter aortic valve implantation in raphe-type bicuspid aortic valve stenosis: insights from the AD-HOC registry.

Background: Bicuspid aortic valve (BAV) stenosis poses several challenges when transcatheter aortic valve implantation (TAVI) is performed, including the risk of high residual gradients (HRG).

Objective: To identify incidence, predictors and outcomes of HRG after TAVI in Sievers type 1 BAV stenosis.

Methods: Consecutive patients with Sievers type 1 BAV stenosis undergoing TAVI at 24 international centers from 2016 to 2023 were enrolled.

Comparison between severe R-L and R-NC raphe-type bicuspid aortic valve stenosis treated with TAVI: insights from the international AD HOC Registry.

Background: Sievers type 1 bicuspid aortic valve (BAV) stenosis presents unique challenges for trans-catheter aortic valve implantation (TAVI), particularly when calcified raphe is present. The impact of raphe localization on TAVI outcomes remains unclear.

Objectives: This study aimed to compare procedural and clinical outcomes in patients with right-left (R-L) and right-non coronary (R-NC) raphe-type BAV treated with TAVI.

PVL in ACURATE neo2 self-expanding aortic valve prosthesis for transcatheter aortic valve replacement - A multicenter retrospective registry analysis.

Background: The self-expanding aortic valve prosthesis ACURATE neo2 features an extended external sealing skirt aiming to reduce postprocedural paravalvular leak (PVL). There is limited knowledge if PVL can be further reduced by dedicated implantation techniques. We aim to examine predictors of PVL after implantation of the ACURATE neo2 with focus on implantation technique.

Procedural and Clinical Outcomes According to Ultrasound-Guided Access in TAVI: A Propensity-Matched Comparative Subanalysis From the PULSE Registry.

Background: Access-related vascular and bleeding complications during transcatheter aortic valve implantation (TAVI) are associated with significant morbidity and mortality. Ultrasound-guided (USG) puncture may reduce the incidence of these adverse events, particularly in large-bore arterial access. However, large-scale data on this approach are limited, and it has not yet been fully implemented into standard clinical practice.

Observer variabilities for the diagnosis of coronary artery disease using anatomical and functional testing: the impact of certification.

Aim: To compare the reproducibility in reporting of coronary computed tomography angiography (CCTA) or cardiovascular magnetic resonance imaging (CMR) by certified readers for CCTA and CMR by the German Society of Cardiology (DGK) versus that by non-certified readers.

Methods: The study included 40 randomly selected CCTA and vasodilator stress CMR patient datasets. For CCTA, the degree of lumen narrowing, plaque composition, and high-risk plaque features were assessed.

Clinical Impact of Midframe Underexpansion Following TAVR Using a Self-Expanding Transcatheter Heart Valve.

Background: The occurrence and clinical impact of transcatheter heart valve midframe underexpansion following transcatheter aortic valve replacement are not well understood.

Objectives: The aim of this study was to evaluate midframe underexpansion among patients treated with the self-expanding ACURATE neo2 device.

Methods: This retrospective analysis included 604 patients (median age 82 years; Q1-Q3: 78-85 years; 61.

Successful pharmaco-mechanical treatment of a subtotally occluded venous bypass graft in a patient presenting with acute coronary syndrome: a case report and review of the current literature on the role of local thrombolysis.

Coronary artery bypass grafting (CABG) is a common and effective treatment for patients with complex coronary artery disease. This case report discusses a 75-year-old male patient who presented with angina and shortness of breath due to thrombus formation in a venous graft 20 years after CABG. Initial diagnostics indicated non-ST-elevation myocardial infarction, leading to immediate intervention.

Predictors of Diagnostic Inaccuracy of Detecting Coronary Artery Stenosis by Preprocedural CT Angiography in Patients Prior to Transcatheter Aortic Valve Implantation.

The diagnostic performance of preprocedural CT angiography in detecting coronary artery disease (CAD) in patients scheduled for transcatheter aortic valve implantation (TAVI) has been reported. However, data on predictors of diagnostic inaccuracy are sparse. We sought to investigate clinical characteristics and imaging criteria that predict the inaccurate assessment of coronary artery stenosis based on pre-TAVI-CT.

A propensity-matched comparison of plug- versus suture-based vascular closure after TAVI.

Background: Vascular access site complications are associated with increased morbidity and mortality after transcatheter aortic valve implantation (TAVI). Current results comparing strategies with plug- (P-VCD; MANTA) and suture-based vascular closure devices (S-VCD; Perclose ProGlide) remain inconsistent.

Aims: It was our aim to assess the incidence of access-related vascular complications after P-VCD or S-VCD strategies after transfemoral TAVI.

Composite cardiac computed tomography angiography score for improved risk assessment in chronic coronary syndromes.

Agatston score, the degree of lumen narrowing categorized by CAD-RADS, high-risk atherosclerotic plaque features and pericoronary adipose tissue attenuation (PCAT) are parameters, which can be assessed non-invasively by coronary computed tomography angiography (CCTA) and aid risk stratification in patients with chronic coronary syndromes (CCS). However, few studies have so far compared the prognostic value of all those parameters together. To develop and test the prognostic value of a composite CCTA score, derived from Agatston score, CAD-RADS, high-risk plaques and PCAT in patients undergoing CCTA due to CCS.

Femoral or Radial Secondary Access in TAVR: A Subanalysis From the Multicenter PULSE Registry.

Background: Transradial secondary access (TR-SA) may serve as an alternative to the traditional femoral secondary access (TF-SA) for pigtail placement in transcatheter aortic valve replacement (TAVR).

Objectives: The aim of this study was to assess the incidence of secondary access-related vascular complications after TR-SA or TF-SA in TAVR.

Methods: The PULSE (Plug or sUture based vascuLar cloSurE after TAVR) registry retrospectively evaluated data of 10,120 patients who underwent transfemoral TAVR at 10 heart centers from 2016 to 2021.

Impact of Measured and Predicted Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement.

Background: Prosthesis-patient mismatch after transcatheter aortic valve replacement (TAVR) can be measured echocardiographically (measured prosthesis-patient mismatch [PPMm]) or predicted (predicted prosthesis-patient mismatch [PPMp]) using published effective orifice area (EOA) reference values. However, the clinical implications of PPM post-TAVR remain unclear.

Objectives: This study aimed to elucidate the prevalence of PPMm and PPMp post-TAVR and their impact on mortality in a large international cohort.

TAVI with the ACURATE neo2 in severe bicuspid aortic valve stenosis: the Neo2 BAV Registry.

Background: The ACURATE neo2 is a contemporary transcatheter aortic valve implantation (TAVI) system approved for the treatment of severe aortic stenosis in Europe. The ACURATE neo2 has not been evaluated in bicuspid aortic valve (BAV) stenosis.

Aims: We sought to evaluate the safety and efficacy of ACURATE neo2 in patients with BAV stenosis.

1-Year Outcomes of Transcatheter Aortic Valve Replacement Using a Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve.

Background: Mid-term comparative data for the self-expanding ACURATE neo2 transcatheter heart valve and the balloon-expandable SAPIEN 3 Ultra are lacking.

Objectives: The aim of this study was to compare 1-year outcomes after transcatheter aortic valve replacement of these 2 valves.

Methods: A total of 2,106 patients from 3 centers (neo2, n = 1,166; Ultra, n = 940) undergoing transfemoral transcatheter aortic valve replacement were analyzed retrospectively.

Aortic valve calcification volume and prognosis in patients undergoing transcatheter aortic valve implantation.

Introduction And Objectives: It is unknown whether aortic valve calcium volume, as measured by contrast-enhanced computed tomography angiography (angio-CT), is associated with mortality in patients undergoing transcatheter aortic valve implantation (TAVI). We aimed to confirm that contrast-enhanced aortic valve calcium correlates with noncontrast-enhanced calcium score and provides useful prognostic information in patients undergoing TAVI.

Methods: This retrospective observational study included patients from 2 high-volume TAVI centers in Germany, all of whom underwent high-quality angio-CT prior to TAVI.

Effects of high- versus low-intensity lipid-lowering treatment in patients undergoing serial coronary computed tomography angiography: results of the multi-center LOCATE study.

Aim: To evaluate the effects of lipid-lowering medications of different intensities on total, calcified, and non-calcified plaque volumes in patients undergoing serial cardiac computed tomography angiography (CCTA).

Methods: Individuals with chronic coronary syndromes from 11 centers were included in a retrospective registry. Total, calcified, and non-calcified plaque volumes were quantified and the relative difference in plaque volumes between baseline and follow-up CCTA was calculated.

Commissural alignment and the ACURATE neo2 transcatheter aortic valve: Impact on valve performance.

Background: Transcatheter aortic valve replacement (TAVR) is increasingly being used to treat severe aortic stenosis in younger patients. Accordingly, lifetime management regarding future reintervention and coronary access is a concern.

Aims: To assess the impact of commissural alignment on ACURATE neo2 transcatheter aortic valve (TAV) performance.

[Catheter-based and surgical treatment for aortic valve diseases].

The pathophysiology of aortic valve diseases is of predominantly degenerative nature, characterized by calcific aortic valve stenosis, which is associated with a reduction in prognosis. The prevalence of aortic valve insufficiency also increases with advancing age. Timely causal treatment is crucial in the management of aortic valve diseases.

ACURATE neo2 Versus SAPIEN 3 Ultra Transcatheter Heart Valve in Severe Aortic Valve Calcification: A Propensity-Matched Analysis.

Background: Comparative data on transcatheter self-expanding ACURATE neo2 (NEO2) and balloon-expandable SAPIEN 3 Ultra prostheses in technically challenging anatomy of severe aortic valve calcified aortic annuli are scarce.

Methods: A total of 1987 patients with severe native aortic stenosis treated with the self-expanding NEO2 (n=1457) or balloon-expandable SAPIEN 3 Ultra (n=530) from January 2017 to April 2023 were evaluated. The primary end point was procedural outcome according to the Valve Academic Research Consortium 3 definitions.