Circulation: Cardiovascular Interventions最新文献

{"title":"Editors and Editorial Board.","authors":"","doi":"10.1161/HCV.0000000000000098","DOIUrl":"https://doi.org/10.1161/HCV.0000000000000098","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":"19 1","pages":"e000098"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Hemodynamics and Risk Stratification in T-TEER: Moving Beyond ESC Thresholds - EuroTR Registry Insights.","authors":"Giulia Masiero, Federico Arturi, Sara Ceni, Andrea Panza, Karl-Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Benedikt Koell, Wolfgang Rottbauer, Mohammad Kassar, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro-Perez, Peter Boekstegers, Andreas Rück, Monika Zdanyte, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Sebastian Rosch, Mirjam G Wild, Christian Besler, Stefan Toggweiler, Stephanie Brunner, Julia Grapsa, Tiffany Patterson, Holger Thiele, Tobias Kister, Alessandro Sticchi, Marco De Carlo, Fabian Voss, Amin Polzin, Antonio Popolo Rubbio, Francesco Bedogni, Thorald Stolte, Thomas Nestelberger, Tomás Benito-González, Enrique Sánchez-Muñóz, Mathias H Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Amir Abbas Mahabadi, Nicole Karam, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Kessler, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Philipp Lurz, Jörg Hausleiter, Lukas Stolz, Giuseppe Tarantini","doi":"10.1161/CIRCINTERVENTIONS.125.015964","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015964","url":null,"abstract":"<p><strong>Background: </strong>Right heart catheterization plays a pivotal role in the preprocedural evaluation of patients considered for transcatheter tricuspid valve edge-to-edge repair. This study aimed to explore the potential impact of hemodynamic parameters obtained through right heart catheterization on patient-centered outcomes.</p><p><strong>Methods: </strong>This study represents a subanalysis from the multicenter EuroTR registry (European Registry of Transcatheter Repair for Tricuspid Regurgitation). Patients with invasive hemodynamic data who underwent isolated transcatheter tricuspid valve edge-to-edge repair for significant tricuspid regurgitation were included. Outcomes of interest were a composite of 2-year all-cause death or hospitalization for heart failure (HFH) and a patient-centered composite of 6-month all-cause mortality, HFH, New York Heart Association class IV/worsening New York Heart Association class compared with baseline. Secondary outcome included postprocedural New York Heart Association class improvement.</p><p><strong>Results: </strong>Seven hundred and eleven patients were included in the analysis. Two-year survival free from death and HFH was 63%. Optimal prognostic thresholds identified for death and HFH at 2 years were: mean pulmonary artery pressure≥32 mm Hg, pulmonary capillary wedge pressure (PCWP)≥20 mm Hg, and pulmonary vascular resistance≥5 wood units (WU). The early patient-centered composite outcome occurred in 25% of cases. PCWP≥20 mm Hg was independently associated with an early clinical deterioration (hazard ratio, 2.77 [95% CI, 1.47-5.28]; <i>P</i><0.001) and with 2-year death/HFH (hazard ratio, 1.75 [95% CI, 1.03-3.02]; <i>P</i>=0.04). No invasive parameter was associated with residual tricuspid regurgitation ≥3+. New York Heart Association class improved significantly throughout the follow-up (<i>P</i><0.001), although patients with elevated mean pulmonary artery pressure (<i>P</i>=0.04) or PCWP (<i>P</i><0.01) experienced less symptomatic benefit.</p><p><strong>Conclusions: </strong>In patients undergoing transcatheter tricuspid valve edge-to-edge repair, invasive hemodynamics-especially elevated PCWP-are independently associated with early patient-centered outcomes and late adverse clinical events. Despite overall improvement of the functional status and no impact on residual tricuspid regurgitation, patients with higher mean pulmonary artery pressure or PCWP benefit less. These findings support the role of comprehensive right heart catheterization in preprocedural risk stratification.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov; Unique identifier: NCT06307262.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015964"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Outcomes of Self-Expandable Versus Balloon-Expandable Valves for Managing Dysfunctional Right Ventricular Outflow Tracts.","authors":"Raymond N Haddad, Quentin Rouau, Grégoire Albenque, Sarah Cohen, Jelena Radojevic, Estibaliz Valdeolmillos, Lisa Guirgis, Emmanuelle Fournier, Valentin Chevalet, Emre Belli, Jérôme Petit, Magalie Ladouceur, Clément Batteux, Sébastien Hascoët","doi":"10.1161/CIRCINTERVENTIONS.125.015325","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015325","url":null,"abstract":"<p><strong>Background: </strong>Self-expandable valves are emerging complements to balloon-expandable valves for transcatheter pulmonary valve replacement in dysfunctional right ventricular outflow tracts, though their safety and efficacy remain underexplored. We aim to compare patient characteristics and outcomes of self-expandable valves and balloon-expandable valves in transcatheter pulmonary valve replacement.</p><p><strong>Methods: </strong>Baseline and early follow-up data were prospectively analyzed for 145 patients who underwent transcatheter pulmonary valve replacement with Edwards SAPIEN 3 (ES3) balloon-expandable valves or Venus-P self-expandable valves (January 2022-December 2024). An independent adjudication expert analyzed and classified adverse events.</p><p><strong>Results: </strong>Cohort: 58.6% males, median weight of 65 kg, median age of 36.3 years; 64.1% of ES3, 35.9% of Venus-P. Tetralogy of Fallot was present in 55.2%, with native/patched right ventricular outflow tracts in 41.9% of ES3 and 100% of Venus-P cases (<i>P</i><0.001). Severe pulmonary regurgitation was found in 64.5% of ES3 and 100% of Venus-P (<i>P</i><0.001). Median valve diameter was 26 mm (Q1-Q3: 23-29) for ES3 and 36 mm (32-36) for Venus-P (<i>P</i><0.001). All implantations were successful, with no significant difference in procedure or fluoroscopy times between groups. Postoperative median right ventricular outflow tract maximum velocity was 2.2 m/s (1.9-2.6) for ES3 and 1.6 m/s (1.1-1.8) for Venus-P (<i>P</i><0.001). Procedural and vascular-access adverse events occurred in 14 patients (ES3: 9.7%, Venus-P: 9.6%; <i>P</i>=0.992), including 8 moderate and 1 major (ES3: 5.4%, Venus-P: 7.7%; <i>P</i>=0.582). New-onset ventricular arrhythmias occurred in 14 patients (ES3: 3.2%, Venus-P: 21.1%; <i>P</i><0.001), including 5 classified as moderate adverse events, all in Venus-P (<i>P</i>=0.002). All arrhythmias resolved with short-term therapy; no permanent antiarrhythmics or ablations were needed.</p><p><strong>Conclusions: </strong>Self-expandable valves are effective for transcatheter pulmonary valve replacement but linked to higher transient arrhythmic adverse event rates than balloon-expandable valves in the early postoperative period.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015325"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Beat: Tracing the Journey of Transcatheter Pulmonary Valve Replacement.","authors":"Harsimran Sachdeva Singh, David A Kerling, Oliver Barry","doi":"10.1161/CIRCINTERVENTIONS.125.016351","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016351","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016351"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Aorto-Coronary Bypass Graft to Prevent Coronary Obstruction Following TAVR: First Human VECTOR Procedure.","authors":"Christopher G Bruce, Vasilis C Babaliaros, Gaetano Paone, Patrick T Gleason, Rim N Halaby, Jaffar M Khan, Toby Rogers, Ellen Richter, Robert J Lederman, Adam B Greenbaum","doi":"10.1161/CIRCINTERVENTIONS.125.016130","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016130","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016130"},"PeriodicalIF":7.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12778967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: A Nationwide Prospective Multicenter Registry in Japan (J-BPA).","authors":"Takeshi Ogo, Toshiro Shinke, Takumi Inami, Nobutaka Ikeda, Kohtaro Abe, Toshihiko Sugiura, Atsushi Anzai, Hiroshi Ito, Yu Taniguchi, Ichizo Tsujino, Yuichi Tamura, Keiichi Ishida, Yusuke Shimahara, Hiromi Matsubara","doi":"10.1161/CIRCINTERVENTIONS.125.016172","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016172","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension has shown improved outcomes with procedural refinement in expert hospitals with high procedural volume. Whether the outcomes of BPA are reproducible in hospitals with limited procedural volumes remains unknown. The Japan BPA registry was designed to assess the outcomes of contemporary BPA from a nationwide perspective, including hospitals with low treatment volume.</p><p><strong>Methods: </strong>This prospective multicenter registry enrolled 1202 consecutive patients with chronic thromboembolic pulmonary hypertension who underwent BPA at 44 hospitals between April 2018 and March 2023. We assessed the efficacy and safety of BPA and survival rates, comparing high- and low-volume hospitals based on the BPA center definition (≥50 procedures per year) from the seventh World Symposium on Pulmonary Hypertension.</p><p><strong>Results: </strong>A total of 5207 procedures were performed. Thirty-five low-volume hospitals (79.5%) performed 40.8% of all BPA procedures. BPA significantly improved symptoms, clinical parameters, and hemodynamics (55.6% reduction in pulmonary vascular resistance), with 0.2% periprocedural BPA-related mortality. Severe lung injury (0.3%), balloon overdilatation (0.67%), and mechanical ventilation (0.3%) were less common in high-volume hospitals than in low-volume hospitals (1.3%, 1.7%, and 1.5%, respectively; <i>P</i><0.001). In the Kaplan-Meier analysis, the survival rate of all patients at 3 years was 94.7% (95% CI, 92.5%-96.3%). Multivariable Cox regression analysis showed an increased mortality risk with higher right atrial pressure, and high-volume hospitals were associated with a reduced mortality risk.</p><p><strong>Conclusions: </strong>This nationwide registry demonstrated the outcomes of contemporary BPA in patients with chronic thromboembolic pulmonary hypertension. No significant differences were observed in efficacy and periprocedural mortality between low- and high-volume hospitals. However, the significantly lower rate of severe complications in high-volume hospitals indicates that BPA may be safer in high-volume hospitals.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016172"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Balloon Postdilation on Long-Term Bioprosthesis Durability After TAVR.","authors":"Antonin Trimaille, Pedro Cepas-Guillén, Juan Hernando Del Portillo, Carlos Giuliani, Jean-Michel Paradis, Eric Dumont, Anthony Poulin, Dimitri Kalavrouziotis, Frederic Beaupré, Jean Porterie, Siamak Mohammadi, Josep Rodés-Cabau","doi":"10.1161/CIRCINTERVENTIONS.125.015577","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015577","url":null,"abstract":"<p><strong>Background: </strong>While balloon postdilation (BPD) during transcatheter aortic valve replacement may enhance hemodynamic performance by optimizing valve expansion, it was also linked with leaflet mechanical stress, potentially reducing valve durability. The aim of this study was to investigate the impact of BPD on long-term bioprosthetic valve durability.</p><p><strong>Methods: </strong>We analyzed the data of a prospective single-center registry including consecutive patients undergoing transcatheter aortic valve replacement between May 2007 and March 2024 alive at 1-year and without a valve-in-valve procedure. To reduce imbalance in baseline and procedural characteristics, the effect of BPD on events was assessed using a propensity score-matched population (215 patients with BPD versus 761 patients without BPD, out of a total of 1911 patients). The primary end point was the occurrence of stage 2 or 3 hemodynamic valve deterioration according to Valve Academic Research Consortium-3.</p><p><strong>Results: </strong>In the propensity-score matched population, BPD was associated with a lower risk of stage 2 or 3 hemodynamic valve deterioration occurrence compared with no-BPD (2.8% versus 5.8%; subdistribution hazard ratio, 0.37 [95% CI, 0.15-0.95]; <i>P</i>=0.039), and a lower rate of bioprosthetic valve failure (2.8% versus 5.1%; subdistribution hazard ratio, 0.39 [95% CI, 0.15-0.98]; <i>P</i>=0.046). Long-term echocardiographic follow-up up to 10 years showed better hemodynamic parameters over time in patients with BPD. A trend toward a higher prevalence of heart failure hospitalization was observed in patients with BPD.</p><p><strong>Conclusions: </strong>BPD was associated with a lower incidence of stage 2 and 3 hemodynamic valve deterioration and bioprosthetic valve failure, along with improved bioprosthetic valve hemodynamic parameters over time. Further studies are warranted.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015577"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145387573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Clinical Outcomes and Durability of a Self-Expanding Transcatheter Heart Valve With Intra-Annular Leaflets.","authors":"Rishi Puri, Holger Thiele, Stephan Fichtlscherer, Dirk Westermann, Raj Makkar, Ron Waksman, Samer Hakmi, Lars Sondergaard, Mark Groh, Joseph K Montarello, Joerg Kempfert, Gerald Yong, Francesco Bedogni, Francesco Maisano, Stephen G Worthley, Josep Rodes-Cabau, Gregory P Fontana, Helge Möllmann","doi":"10.1161/CIRCINTERVENTIONS.125.015430","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015430","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data regarding the longer-term durability of transcatheter heart valves. This analysis aimed to describe the 5-year clinical outcomes and valve durability for patients treated with the Portico transcatheter heart valves across 3 studies harmonized in their prospective enrollment, inclusion/exclusion criteria, centralized independent core laboratory echocardiographic analysis, and independent clinical events committee adjudication.</p><p><strong>Methods: </strong>Patient-level data from the PORTICO IDE randomized controlled trial, the PORTICO I postmarket study, and the PORTICO continued access protocol were pooled using a random-effects meta-analysis model. All 3 studies collected follow-up data at discharge, 30 days, and annually through 5 years. Adverse events and pooled echocardiographic data were assessed using Valve Academic Research Consortium-2 definitions. Durability definitions were adapted from Valve Academic Research Consortium-3 and European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology/European Association for Cardio-Thoracic Surgery consensus guidelines.</p><p><strong>Results: </strong>A total of 1464 patients with severe symptomatic aortic stenosis and high or extreme surgical risk were included. Median age was 83 years, 61.7% were women, and the median Society of Thoracic Surgeons score was 4.9%. At 5 years, all-cause mortality and stroke rates were 49.4% and 12.3%, respectively. Transvalvular gradient and effective orifice area at 5 years were 6.2 mm Hg and 1.83 cm², respectively, with paravalvular leak ≥moderate severity occurring in 1.9%. The 5-year bioprosthetic valve failure rate was 2.7%, including a 0.7% valve-related death rate and a 2.0% valve reintervention rate, but no patients with severe hemodynamic structural valve deterioration. Moderate hemodynamic structural valve deterioration occurred in 0.9% of the patients at 5 years. Hemodynamic performance and transcatheter heart valve durability remained stable irrespective of annular size.</p><p><strong>Conclusions: </strong>The use of the Portico transcatheter heart valve system in patients at high or extreme surgical risk demonstrated favorable clinical outcomes and hemodynamic performance with low transvalvular gradients and greater than mild paravalvular leak. Furthermore, bioprosthetic valve failure rates were low with no incidence of severe hemodynamic structural valve deterioration at 5 years, irrespective of annular size.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02000115 and NCT01802788.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015430"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Valve Replacement in Adults With Congenital Heart Disease-The Mayo Clinic Experience.","authors":"Alexander C Egbe, Allison K Cabalka, Nathaniel W Taggart, Donald J Hagler, Mackram F Eleid, Charanjit S Rihal, Jason H Anderson","doi":"10.1161/CIRCINTERVENTIONS.125.015667","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015667","url":null,"abstract":"<p><strong>Background: </strong>The current study aims to describe outcomes after transcatheter valve replacement in adults with congenital heart disease.</p><p><strong>Methods: </strong>Retrospective study of adults with congenital heart disease who underwent transcatheter valve replacement and had a 1-year follow-up postintervention at Mayo Clinic (2010-2024). The study period was divided into early (2010-2014), mid (2015-2019), and late (2020-2024) eras. The primary outcome was valve reintervention. The secondary outcomes were all-cause mortality and temporal change in prosthetic valve gradient and clinical indices of disease severity.</p><p><strong>Results: </strong>Overall, 341 patients (age 38±17 years; 175 [51%] men) received 346 prostheses (pulmonary [N=236, 68%], tricuspid [N=75, 22%], aortic [N=22, 8%], and mitral [N=7, 2%]). The prostheses were Sapien (N=181, 52%), Melody (N=142, 41%), and Harmony prostheses (N=23, 7%). The number of transcatheter valve implantations increased from the early era (N=75), mid era (N=109), to the late era (N=162). The 10-year incidence of valve reintervention was 35%, and was similar between Sapien versus Melody prosthesis (41% versus 33%; <i>P</i>=0.11). The 10-year incidence of all-cause mortality was 13%. There was a temporal increase in prosthetic valve Doppler mean gradient (baseline versus 10 years) for pulmonary (12±5 versus 28±11 mmHg; <i>P</i><0.001), tricuspid (3±1 versus 8±3 mmHg; <i>P</i><0.001), and aortic prosthesis (13±5 versus 26±12 mmHg; <i>P</i><0.001). There was a temporal increase in predicted peak oxygen consumption (absolute ∆, 9% [95% CI, 4-13]; <i>P</i>=0.006) and a decrease in NT-proBNP (N-terminal pro-B-type natriuretic peptide) level (absolute ∆, -138 pg/mL [95% CI, -209 to -64]; <i>P</i><0.001) at 1-year postintervention.</p><p><strong>Conclusions: </strong>There has been a temporal increase in the number of transcatheter valve implantations over time. Transcatheter valve replacement was associated with clinical improvement across multiple domains. However, there was a significant increase in prosthetic valve gradient within 10 years of follow-up, suggesting limited prosthesis longevity. There is a need for strategies to improve prosthetic valve longevity, which in turn may improve outcomes in this population.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015667"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12667561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pullback Pressure Gradient on Clinical Outcomes after Percutaneous Coronary Interventions.","authors":"Kazumasa Ikeda, Takuya Mizukami, Koshiro Sakai, Frederic Bouisset, Jeroen Sonck, Adriaan Wilgenhof, Hitoshi Matsuo, Toshiro Shinke, Hirohiko Ando, Masahiro Hada, Brian Ko, Simone Biscaglia, Fernando Rivero, Thomas Engstrøm, Antonio Maria Leone, Lokien X van Nunen, William F Fearon, Evald Høj Christiansen, Stephane Fournier, Liyew Desta, Andy Yong, Julien Adjedj, Javier Escaned, Masafumi Nakayama, Ashkan Eftekhari, Danielle Keulards, Frederik M Zimmermann, Tatyana Storozhenko, Bruno R da Costa, Gianluca Campo, Colin Berry, Damien Collison, Thomas W Johnson, Daniel Munhoz, Tetsuya Amano, Divaka Perera, Allen Jeremias, Ziad A Ali, Takashi Kubo, Kazuhiro Satomi, Nobuhiro Tanaka, Bernard De Bruyne, Nils P Johnson, Carlos Collet","doi":"10.1161/CIRCINTERVENTIONS.125.016022","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016022","url":null,"abstract":"<p><strong>Background: </strong>Impaired flow following percutaneous coronary intervention (PCI) is a known predictor of adverse outcomes. The pullback pressure gradient (PPG) is a novel physiological metric that differentiates focal from diffuse disease and enables prediction of post-PCI fractional flow reserve (FFR). This post hoc analysis of the PPG Global (NCT04789317) study aimed to evaluate the prognostic performance of a PPG model for predicting post-PCI FFR and to determine whether the predicted physiological outcome is associated with adverse events following PCI.</p><p><strong>Methods: </strong>Prospective and multicenter study including patients with hemodynamically significant coronary artery disease undergoing PCI. A prediction model based on FFR and PPG was used to estimate post-PCI FFR. Based on the predicted values, vessels were classified as having either optimal or suboptimal post-PCI physiology. The primary end point was target vessel failure at 1 year. Target vessel failure was defined as a composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target vessel revascularization.</p><p><strong>Results: </strong>A total of 855 patients (890 vessels) were analyzed. The mean difference between predicted and measured post-PCI FFR was 0.001 (limits of agreement, -0.10 to 0.10). There was a strong correlation between predicted and measured delta FFR (<i>r</i>=0.92 [95% CI, 0.91-0.93]; <i>P</i><0.001). Vessels with predicted suboptimal post-PCI physiology had a significantly higher incidence of target vessel failure (adjusted hazard ratio, 1.97 [95% CI, 1.24-3.15]; <i>P</i>=0.004). Predicted suboptimal physiology was independently associated with adverse clinical outcomes.</p><p><strong>Conclusions: </strong>PPG-predicted post-PCI physiology was associated with target vessel failure at 1 year. These findings extend the role of coronary physiology beyond diagnostic assessment to include risk stratification and outcome prediction following PCI.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016022"},"PeriodicalIF":7.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}