CT assessment of right heart anatomy across tricuspid regurgitation severity grades: implications for transcatheter interventions.

Purpose: A five-grade severity scheme has been introduced for echocardiographic grading of tricuspid regurgitation (TR). Although higher TR grades have been associated with worse prognosis, it is unknown whether they can help determining patient eligibility for transcatheter tricuspid valve interventions (TTVI) and correspond to different anatomical phenotypes. The aim of our study was to investigate the relationship between TR severity and tricuspid valve (TV) anatomy and determine the screening failure rate for TTVI.

Transcatheter Aortic Valve Replacement With Balloon- Versus Self-Expandable Bioprostheses for the Treatment of Bicuspid Aortic Valve Stenosis.

Background: Differences between balloon- and self-expandable transcatheter heart valves (BE-THVs and SE-THVs, respectively) may influence the outcomes of transcatheter aortic valve replacement for bicuspid aortic valve (BAV) stenosis.

Methods: Consecutive patients undergoing transcatheter aortic valve replacement with BE-THV or SE-THV for computed tomography-diagnosed bicuspid aortic valve stenosis at 29 centers were included. The primary outcome was death or stroke.

Interdisciplinary periprocedural management of patients undergoing transapical tmvi with the tendyne™ system: A narrative review and institutional experience.

Objectives: Mitral regurgitation (MR) represents the most common valvular heart disease (VHD) in the Western world. While transcatheter mitral valve repair (M-TEER) is the leading interventional treatment for surgically high-risk patients, transcatheter mitral valve implantation (TMVI) is reserved for selected patients with unsuitable anatomy for M-TEER. This review aims to summarize our institutional experience with TMVI using the Tendyne™ valve (Abbott Vascular, CA, USA), focusing on interdisciplinary preoperative, intraoperative, and postoperative management strategies.

Intake of high-intensity statin after acute myocardial infarction assessed by direct drug concentration measurement: association with LDL-C response and coronary plaque modifications in the PACMAN-AMI trial.

Background: In real-world settings, adherence to preventive cardiovascular medications is often suboptimal. However, in clinical trials, adherence is crucial for ensuring the validity and generalizability of study results, and their clinical implications.

Methods And Aims: This pre-specified sub-study of the PACMAN-AMI randomized controlled trial investigated the intake of protocol-mandated high-intensity statin background therapy in patients with acute myocardial infarction (AMI), as assessed by direct measurement of rosuvastatin or atorvastatin blood concentrations at 4 and 52 weeks using liquid chromatography tandem mass spectrometry analysis.

Atrioventricular Conduction Disturbances in Patients Undergoing Transcatheter Tricuspid Valve Intervention: A Multidisciplinary Consensus.

Tricuspid regurgitation (TR) is a highly prevalent valve disease, and cardiac surgery has been used in patients with severe symptomatic TR undergoing surgery for other cardiac lesions or less frequently for isolated TR. More recently, transcatheter therapies, particularly transcatheter edge-to-edge repair and valve replacement, have emerged as therapeutic alternatives in those considered at high to extreme risk for surgery. Because of the anatomical proximity of the tricuspid valve (TV) and the atrioventricular conduction system, the risk for high-degree atrioventricular block and permanent pacemaker implantation remains important, as they are common adverse events after transcatheter valve replacement.

Educational level, clinical outcomes and quality of care in a Swiss cohort of patients with acute coronary syndromes.

Background: Despite universal coverage, inequities persist in acute coronary syndrome (ACS) care. This study examines how educational levels impact the quality and outcomes of health care.

Methods: A cohort of ACS patients hospitalized in five Swiss university hospitals was categorized into four educational levels (EL) with EL1 defined as lower than vocational school and EL4 as a university degree.

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.

Less Symptom Improvement in Patients Undergoing TAVI With Concomitant COPD, Atrial Fibrillation and Heart Failure.

Background: Comorbidities like a history of chronic obstructive pulmonary disease (COPD), atrial fibrillation (AF) and heart failure (HF) can cause similar symptoms as aortic stenosis (AS). However, how they influence symptom improvement and long-term outcomes after transcatheter aortic valve implantation (TAVI) is unclear.

Aims: To study the impact of COPD, AF and HF on outcomes after TAVI.

Clinical and health status after permanent pacemaker implantation in patients undergoing transcatheter aortic valve replacement: Insights from the SCOPE I randomized trial.

Background: The impact of new permanent pacemaker (PPM) implantation on prognosis after transcatheter aortic valve replacement (TAVR) is controversial.

Objectives: To investigate the impact of new PPM implantation on combined outcomes of vital and patient-reported health status after TAVR.

Methods: Patients in the SCOPE (Safety and Efficacy of the ACURATE Neo/TF Compared to the SAPIEN 3 Bioprosthesis) trial were stratified according to new PPM implantation within 30 days of TAVR.

Aortic Valve Replacement in Women: A Pooled Analysis of the RHEIA and PARTNER 3 Trials.

Background: In women with severe aortic stenosis, there are limited data regarding outcome differences following transcatheter (TAVR) vs surgical aortic valve replacement (SAVR).

Objectives: The authors sought to examine outcomes of TAVR vs SAVR in a patient-level pooled analysis of women in the RHEIA and PARTNER 3 trials.

Methods: Patients in both trials were randomly allocated to a balloon-expandable SAPIEN 3/Ultra valve or to surgical bioprostheses.

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.

Mortality after transcatheter aortic valve replacement in young multimorbid patients as compared to an age-, gender- and comorbidity-matched background population.

Introduction: Contrary to the current guidelines patients with symptomatic severe aortic stenosis and ≤65 years of age are often referred for transcatheter aortic valve replacement (TAVR). However, the outcome after TAVR in this patient cohort remains unclear.

Objectives: This study aimed to assess the rationale for denial of surgical aortic valve replacement (SAVR) in young multimorbid patients referred for TAVR, to evaluate 3-year all-cause mortality and to compare outcomes with a matched control cohort.

One- versus three-month DAPT after everolimus-eluting stent implantation in diabetic patients at high bleeding risk: results from the XIENCE Short DAPT programme.

Background: In patients with diabetes mellitus (DM) and high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI), the optimal duration of dual antiplatelet therapy (DAPT) remains uncertain.

Aims: We sought to compare early DAPT discontinuation in DM and non-DM patients enrolled in the prospective XIENCE Short DAPT programme.

Methods: The effects of 1- versus 3-month DAPT on ischaemic and bleeding outcomes were compared using propensity score stratification.

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.

Recurrent Events Analysis of MASTER DAPT: Total Ischemic and Bleeding Events After Abbreviated vs Prolonged DAPT in HBR Patients.

Background: The effect of dual antiplatelet therapy (DAPT) duration on total events in patients at high bleeding risk (HBR) after percutaneous coronary intervention (PCI) is unclear.

Objectives: This study aimed to evaluate an abbreviated (median duration, 34 days) vs prolonged (median duration, 192 days) DAPT regimen on total events in 4,579 HBR patients from the MASTER DAPT (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Standard DAPT Regimen) trial.

Methods: The MASTER DAPT coprimary outcomes at 335 days were as follows: 1) net adverse clinical events (NACEs), the composite of all-cause death, myocardial infarction (MI), stroke, and Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding events; 2) major adverse cardiac and cerebral events (MACCEs), including all-cause death, MI, and stroke; and 3) major or clinically relevant nonmajor bleeding (MCB, type 2, 3, or 5 BARC bleeding).

Long-term structural valve deterioration after TAVI: insights from the EORP ESC Valve Durability TAVI Registry.

Background: Valve durability is a key consideration as the patient population eligible for transcatheter aortic valve implantation (TAVI) expands to include lower-risk and younger individuals who are expected to live many years after the procedure.

Aims: This registry aimed to assess the incidence of long-term structural valve deterioration (SVD) beyond 5 years post-TAVI.

Methods: Consecutive living patients who underwent TAVI up until 2014 using any commercially available transcatheter heart valve (THV) at 22 participant centres were enrolled in the European Valve Durability TAVI 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.

Bicuspid aortic valve disease: advancements and challenges of transcatheter aortic valve implantation.

Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of patients with severe aortic stenosis (AS). Initially developed for patients with tricuspid aortic valve (TAV) anatomy, the procedural success and expanding indications of TAVI have spurred interest in its application to more complex aortic valve anatomies, such as the bicuspid aortic valve (BAV). The growing interest in this specific sub-set of patients with AS is driven by the recent extension of TAVI indications to younger individuals, who exhibit a notably higher incidence of bicuspid anatomy compared with older populations.

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).

Clinical Outcomes in Patients With Acute Pulmonary Embolism Undergoing Ultrasound-Assisted Catheter-Directed Thrombolysis.

Background: Ultrasound-assisted catheter-directed thrombolysis (USAT) for acute pulmonary embolism (PE) has garnered specific interest and is commonly employed in intermediate-risk PE to prevent cardiac decompensation and death. However, evidence supporting the effectiveness and safety of USAT in routine clinical practice is limited. We therefore aimed to investigate the safety and effectiveness of USAT in a large patient population with PE.