Tricuspid Transcatheter Edge-to-Edge Repair Versus Medical Management for Tricuspid Regurgitation: A Systematic Review and Meta-Analysis.

Background: Severe tricuspid regurgitation (TR) is associated with poor prognosis, and guideline-directed medical therapy (GDMT) alone has limited efficacy. Transcatheter edge-to-edge repair (T-TEER) has emerged as a promising therapeutic option, but its impact on clinical outcomes remains debated.

Aims: Evaluation of the efficacy and safety of T-TEER compared to GDMT.

Left Ventricular to Right and Left Atrial Shunts Post-Myxoma Resection: A Multimodality Imaging Perspective.

Two-dimensional TEE, aortic valve short-axis systolic view without and with color flow Doppler, long-axis (140°) LVOT view , and three-dimensional volume-rendered display , demonstrates both the acquired Gerbode defect and the LVOT-mitral anterior leaflet shunts with high-velocity turbulent flow patterns. , Interatrial septum; , left atrium; , left ventricle; , left ventricular outflow tract; , mitral valve; , right atrium; , right ventricle; , transesophageal echocardiogram.

Leveraging institutional echocardiographic registry to assess clinical profiles and outcomes in tricuspid regurgitation.

Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. We utilized our large institutional echocardiographic registry, integrated with the electronic medical record-based health system registry to identify patients with varying degrees of TR, and to assess its association with long-term outcomes. Patients were categorized by TR severity as none, mild, moderate, or severe.

Impact of Natriuretic Peptide and Prior Hospitalization in Patients With Severe Mitral Regurgitation: COAPT Trial.

Background: The clinical significance of elevated baseline natriuretic peptide level and prior heart failure hospitalization (HFH) within the prior year in mitral transcatheter edge-to-edge repair outcomes is unclear. This analysis examined the impact of BNP (B-type natriuretic peptide) or NT-proBNP (N-terminal pro-B-type natriuretic peptide) and prior HFH on outcomes in patients with severe secondary mitral regurgitation.

Methods: The COAPT trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) was a randomized controlled trial of subjects assigned to mitral valve transcatheter edge-to-edge repair with the MitraClip device versus guideline-directed medical therapy alone.

Concomitant Mitral Transcatheter Edge-to-Edge Repair and Transcatheter Closure of Perforated Anterior Mitral Valve Leaflet.

We present the case of a 76-year-old man with a previous history of surgical aortic valve replacement 3 years earlier for infective endocarditis, nonischemic cardiomyopathy, and severe secondary mitral regurgitation (SMR) who presented with worsening dyspnea on exertion. Echocardiography revealed severe SMR and a perforation at the base of the A1 scallop of the anterior mitral valve leaflet (AMVL). The patient was deemed at high surgical risk.

Mitral Transcatheter Edge-to-Edge Repair In-Hospital Outcomes and Mitral Valve Surgery Readmission Trends: National Readmission Database 2018-2020.

•Study design: Utilized the National Readmission Database from 2018-2020. The study included patients over 18 years of age who underwent transcatheter edge-to-edge repair and analyzed readmission for mitral valve (MV) surgery within 180 days.•Readmission rate: Only 1.

Understanding the Effects of Mitral Transcatheter Edge-to-Edge Repair on Left Ventricular Function Using Pressure-Volume Loops.

Background: Mitral transcatheter edge-to-edge repair (M-TEER) is an effective treatment for mitral regurgitation (MR) patients.

Objectives: The aim of this research was to study M-TEER effects on left atrial (LA) and left ventricular (LV) functions.

Methods: LV function was evaluated using conductance catheters for pressure volume loops in 22 patients with primary MR and a control group of 17 heart transplant recipients with normal function.

Transcatheter Management of Tricuspid Regurgitation: A Review of Contemporary Evidence.

Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. Traditional surgical interventions, though definitive, carry considerable complexities and risks, especially for high-risk patients, with in-hospital mortality rates of ˜9%. This resulted in the undertreatment of many patients with TR, creating a substantial unmet need.

Meta-Analysis of Dedicated vs Off-Label Transcatheter Devices for Native Aortic Regurgitation.

Background: Transcatheter aortic valve replacement (TAVR) for high surgical risk patients with severe native aortic regurgitation (AR) presents unique challenges. Dedicated devices such as the JenaValve (JenaValve Technology) and J-Valve (JC Medical Inc) show promising results in addressing these challenges.

Objectives: This study compares the safety and efficacy of dedicated vs off-label devices among high surgical risk patients with pure native AR.

Outcomes of mitral transcatheter edge-to-edge repair in patients with mitral annular calcification: A meta-analysis.

Background: The impact of mitral annular calcification (MAC) on the clinical outcomes of patients undergoing mitral transcatheter edge-to-edge repair (MTEER) remains unclear. This meta-analysis aims to evaluate the clinical outcomes of MTEER among patients with moderate to severe MAC compared to those with mild or no MAC.

Methods: We systematically searched PubMed, EMBASE, and Cochrane CENTRAL databases through March 31st, 2024, comparing clinical outcomes of MTEER among patients with moderate/severe (MAC+) versus no/mild MAC (MAC-).

Transcatheter Aortic Valve Implantation Using the Evolut FX+ Platform With Optimal Diamond-Coronary Alignment.

We present one of the inaugural transcatheter aortic valve implantation procedures using the latest Medtronic platform, Evolut FX+. Successful coronary angiography was achieved within 28 seconds and 1 minute 49 seconds for the left and right coronary arteries, respectively. Postoperative cardiac computed tomography scan demonstrated optimal commissural and diamond-coronary alignment.

Pulmonary Vein Systolic Flow Reversal and Outcomes in Patients From the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation (COAPT) Trial.

Background: The implications of pulmonary vein (PV) flow patterns in patients with heart failure (HF) and mitral regurgitation (MR) are uncertain. We examined PV flow patterns in the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation (COAPT) trial (NCT01626079), in which patients with HF and moderate-to-severe or severe functional MR were randomized to transcatheter edge-to-edge repair (TEER) with the MitraClip device plus guideline-directed medical therapy (GDMT) vs. GDMT alone.

Impact of Left Atrial Pressure on Outcomes After Mitral Transcatheter Edge-to-Edge Repair.

Background: Increased left atrial pressure (LAP) has been associated with adverse outcomes after mitral transcatheter edge-to-edge repair (M-TEER). We sought to evaluate outcomes based on differences in postprocedural LAP measured after the final clip deployment.

Methods: We included consecutive patients who underwent M-TEER at our institution between 2014 and 2022 with LAP monitoring.

Myocardial Blood Flow Reserve, Microvascular Coronary Health, and Myocardial Remodeling in Patients With Aortic Stenosis.

Background: Coronary microvascular function and hemodynamics may play a role in coronary circulation and myocardial remodeling in patients with aortic stenosis (AS). We aimed to evaluate the relationship between myocardial blood flow and myocardial function in patients with AS, no AS, and aortic valve sclerosis.

Methods And Results: We included consecutive patients who had resting transthoracic echocardiography and clinically indicated positron emission tomography myocardial perfusion imaging to capture their left ventricular ejection fraction, global longitudinal strain (GLS), and myocardial flow reserve (MFR).

Examining the typical hemodynamic performance of nearly 3000 modern surgical aortic bioprostheses.

Objectives: The objective of this analysis was to assess the normal haemodynamic performance of contemporary surgical aortic valves at 1 year postimplant in patients undergoing surgical aortic valve replacement for significant valvular dysfunction. By pooling data from 4 multicentre studies, this study will contribute to a better understanding of the effectiveness of surgical aortic valve replacement procedures, aiding clinicians and researchers in making informed decisions regarding valve selection and patient management.

Methods: Echocardiograms were assessed by a single core laboratory.

Physical and Computational Modeling for Transcatheter Structural Heart Interventions.

Structural heart disease interventions rely heavily on preprocedural planning and simulation to improve procedural outcomes and predict and prevent potential procedural complications. Modeling technologies, namely 3-dimensional (3D) printing and computational modeling, are nowadays increasingly used to predict the interaction between cardiac anatomy and implantable devices. Such models play a role in patient education, operator training, procedural simulation, and appropriate device selection.

Prognostic Value of Right Ventricular Afterload in Patients Undergoing Mitral Transcatheter Edge-to-Edge Repair.

Background: Pulmonary hypertension (PH) and secondary mitral regurgitation (MR) are associated with adverse outcomes after mitral transcatheter edge-to-edge repair. We aim to study the prognostic value of invasively measured right ventricular afterload in patients undergoing mitral transcatheter edge-to-edge repair.

Methods And Results: We identified patients who underwent right heart catheterization ≤1 month before transcatheter edge-to-edge repair.

Echocardiographic Profiling Predicts Clinical Outcomes After Mitral Transcatheter Edge-to-Edge Repair.

Background: Prior studies investigating the impact of residual mitral regurgitation (MR), tricuspid regurgitation (TR), and elevated predischarge transmitral mean pressure gradient (TMPG) on outcomes after mitral transcatheter edge-to-edge repair (TEER) have assessed each parameter in isolation. We sought to examine the prognostic value of combining predischarge MR, TR, and TMPG to study long-term outcomes after TEER.

Methods And Results: We reviewed the records of 291 patients who underwent successful mitral TEER at our institution between March 2014 and June 2022.

Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography.

In patients with significant cardiac valvular disease, intervention with either valve repair or valve replacement may be inevitable. Although valve repair is frequently performed, especially for mitral and tricuspid regurgitation, valve replacement remains common, particularly in adults. Diagnostic methods are often needed to assess the function of the prosthesis.