Publications by authors named "Santiago Garcia"

Background And Aims: The TRISCEND II trial demonstrated superior clinical benefits for patients with ≥severe tricuspid regurgitation (TR) treated with the EVOQUE transcatheter tricuspid valve replacement (TTVR) system plus medical therapy versus medical therapy alone. This work reports 1-year and 18-month outcomes in patients stratified by baseline TR severity.

Methods: The multicentre, prospective TRISCEND II trial enrolled 400 patients with symptomatic, ≥severe TR and randomised 2:1 to TTVR (n=267) or control (n=133).

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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.

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Objective: Successful use of a novel percutaneous retrieval system (ŌNŌ retrieval system, ŌNŌCOR) to remove a significantly dislodged left atrial appendage occlusion device (Watchman FLX, Boston Scientific).

Key Steps: First, a 17-F Bayliss VersaConnect and TruSteer catheter was advanced through a 20-F DrySeal sheath (Gore Medical). Then, the ŌNŌ retrieval system was advanced and positioned against the Watchman FLX device.

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Background And Aims: There is a lack of data on perioperative outcomes for patients undergoing non-cardiac surgery (NCS) after transcatheter aortic valve implantation (TAVI). Hence, we aimed to determine the incidence, type of surgery, timing and perioperative outcomes of individuals undergoing elective NCS after TAVI.

Methods And Results: Hospitalizations for TAVI were identified from the US National Readmission Database between 2012 and 2021, and patients who received NCS within six months were included for analysis.

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Background: Frailty is associated with a greater risk of readmission after cardiovascular procedures. However, the impact of frailty on readmission rates and outcomes after Impella mechanical circulatory support (MCS) remains unknown. We aimed to explore the impact of frailty on readmission outcomes in patients who received Impella MCS.

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Agavins are some of the most recently characterized fructans. FT-MIR is the fastest approach to detect them, and GC-MS provides valuable structural features. Thus, we explored the feasibility of integrating data from these two analytical platforms to characterize the metabolism of agavins from two emblematic agave species, and .

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Background: Aortic regurgitation (AR) is commonly reported in patients with left ventricular assist device (LVAD) and is associated with poor outcomes. Surgical management of AR in these patients carries high operative mortality. Dedicated transcatheter options for AR are limited to research trials and are not commercially available.

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Background: Nonagenarians with ST-elevation myocardial infarction (STEMI) represent a unique and growing population and are underrepresented in clinical trials due to arbitrary exclusion criteria. Therefore, a thorough examination of STEMI in this age population may better inform management decisions.

Methods: This is a cohort study examining the Midwest STEMI Consortium database from March 2003 through October 2020.

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Background: Variable evidence exists about the efficacy of Cardiac resynchronization therapy (CRT) in women vs. men with reduced left ventricular ejection fraction (LVEF) and wide QRS complex. Current guidelines, hindered by underrepresentation of women in clinical trials, lack definitive recommendations.

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Background: Transcatheter aortic valves (TAVs) are subject to degeneration and repeat intervention. TAVs are increasingly used in clinical practice, but there is a paucity of data regarding repeat interventions.

Methods: We sought to describe and compare clinical characteristics and outcomes of TAV in TAV procedures vs.

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Introduction And Objectives: Transcatheter aortic valve implantation (TAVI) for pure aortic regurgitation is challenging due to inadequate device anchoring and increased risks of device embolization and paravalvular regurgitation (PVR). This study aimed to review the safety and efficacy of TAVI for aortic regurgitation with devices specifically designed for this indication.

Methods: A comprehensive search of PubMed, Web of Science, Cochrane Library, and major conference archives up to April 2024 identified 143 unique results based on predefined criteria.

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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.

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Left ventricular assist devices (LVADs) have changed the landscape for patients with advanced heart failure (HF). With advances in pump design and management, patients with LVADs are living longer with improved quality of life despite having more comorbidities and complex structural heart disease. As such, HF cardiologists and surgeons collaborate more frequently with structural heart interventionalists to address the complex problems of patients with LVADs who present at different points of failure in their circuits.

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Background: To describe the impact of clinical presentation among patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR).

Methods: We analyzed a real-world dataset including patients from 29 US hospitals (egnite Database, egnite). Patients over 18 years old with moderate or greater AS undergoing AVR were included.

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Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options.

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Background: Preoperative tumour size is a key prognostic marker in tailoring surgical treatment in early-stage cervical cancer. This post-hoc analysis assessed the accuracy of preoperative tumour size evaluation via imaging, utilizing data from the prospective, international, multicentre SENTIX study that evaluated safety of sentinel lymph node (SLN) biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer.

Methods: Between 05/2016-09/2020, forty-seven sites across 18 countries enrolled cervical cancer patients (FIGO2018 stages 1A1/lymphovascular-space-invasion-positive to 1B2).

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Valve-in-valve transcatheter aortic valve replacement is an established alternative to conventional surgical reoperation for failed aortic bioprosthetic valves. The technique has undergone significant refinements in recent years, aiming to tackle pain points of the procedure such as subpar hemodynamics and coronary obstruction. In this state-of-the-art review, we aim to discuss these refinements, including novel surgical valves, transcatheter heart valve positioning, bioprosthetic valve fracture, and prevention of coronary obstruction, among others.

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Background: The Small Annuli Randomized to Evolut or SAPIEN Trial showed superior hemodynamics of self-expanding valves (SEVs) over balloon-expandable valves (BEVs) in patients with small aortic annuli (SAA). The long-term clinical implications of these hemodynamic differences are unknown.

Methods: We conducted an observational cohort study of patients with SAA, defined as an aortic valve annular area ≤430 mm on cardiac computed tomography, who underwent transcatheter aortic valve replacement using BEV or SEV at a single institution between August 2013 and February 2021.

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Elevation in left atrial pressure with subsequent pulmonary congestion is central to the pathology of heart failure. Interatrial shunts have emerged as a potential therapeutic strategy in patients with heart failure, especially those with diastolic dysfunction. These devices decrease left atrial pressure by shunting blood into the right atrium.

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Backgrounds:  Cold snare EMR (CS-EMR) in large flat nonpedunculated colonic lesions (LFNPCLs) is an alternative to the standard EMR procedure with a better safety profile, but scientific evidence on its efficacy is unavailable. This study aimed to compare the recurrence rate between the two techniques at 6 months. Secondary aims were comparison of the safety profile and procedure-related outcomes.

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