Circulation: Cardiovascular Interventions最新文献

{"title":"Novel Application of a Familiar Concept: TR Proportionality and T-TEER Outcomes.","authors":"Jonathan E Labin, Serge Harb, Grant W Reed","doi":"10.1161/CIRCINTERVENTIONS.126.016819","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016819","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016819"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764440","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":"Direct Oral Anticoagulant Monotherapy Versus Dual Antiplatelet Therapy After Left Atrial Appendage Closure: A Meta-Analysis of Randomized Trials.","authors":"Nicola Ammirabile, Daniele Giacoppo, Placido Maria Mazzone, Davide Landolina, Davide Capodanno","doi":"10.1161/CIRCINTERVENTIONS.126.016554","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016554","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016554"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971087","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":"Diagnostic Yield and Safety of Invasive Coronary Function Testing After Radial Versus Femoral Access.","authors":"Fleur W Adriaansen, Caïa Crooijmans, Tijn P J Jansen, Behruz Yosofi, Joan G Meeder, Yolande Appelman, Marcel A M Beijk, Tim P van de Hoef, Timo Nijkamp, Hester M den Ruijter, Annemiek M J de Vos, Valeria Paradies, Martijn Meuwissen, Nicola S Vos, Els G M Olde Bijvank, Ibtihal Al Amri, Melina C den Haan, Jonathan Halim, Stijn C H van den Oord, Karin Arkenbout, Marlies M Kok, Pier Woudstra, Tessel N E Vossenberg, Nick D Fagel, Ton A C M Heestermans, Jan H Cornel, Niels van Royen, Suzette E Elias-Smale, Aukelien C Dimitriu-Leen, Peter Damman","doi":"10.1161/CIRCINTERVENTIONS.125.016450","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016450","url":null,"abstract":"<p><strong>Background: </strong>Coronary vasomotor dysfunction is diagnosed by a coronary function testing (CFT). However, protocols vary, and the influence of access site and concomitant vasodilator medication on the diagnostic yield and safety of CFT is unclear. This study assessed the diagnostic yield and safety of CFT by radial access with intraarterial calcium channel blockers compared with CFT by femoral access.</p><p><strong>Methods: </strong>Data were obtained from the Netherlands Registry of Invasive Coronary Vasomotor Function Testing, a Dutch multicenter collaboration on CFT. Patients who underwent CFT between December 2020 and July 2025 were included.</p><p><strong>Results: </strong>A total of 1885 patients were included, 1436 (76.2%) with primary radial access and 380 (20.2%) with primary femoral access. In 69 (3.7%) patients conversion from radial to femoral access was necessary. The conversion group was analyzed separately. The total diagnostic yield of coronary vasomotor dysfunction was 78.5%. There was no significant difference in the prevalence of coronary vasomotor dysfunction between patients with primary radial versus femoral access (79.2% versus 75.3%; <i>P</i>=0.1). There was also no difference in total diagnostic yield between the group without conversion and the conversion group (78.4% versus 82.6%; <i>P</i>=0.4); however, spasm was more prevalent in the conversion group (67.7% versus 79.4%; <i>P</i>=0.04). There were no differences in CFT complication rates between groups.</p><p><strong>Conclusions: </strong>Primary radial access with routine administration of calcium channel blockers was not associated with a lower diagnostic yield in CFT than primary femoral access. Procedural safety was comparable.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016450"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572524","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":"Letter by Lin et al Regarding Article, \"Prospective Validation of the MIRACLE2 Score for Early Neurological Stratification After Out-of-Hospital Cardiac Arrest: The GLOBAL-MIRACLE Registry\".","authors":"Bin Lin, Lianglei Hou, Anwu Huang","doi":"10.1161/CIRCINTERVENTIONS.126.016830","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016830","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016830"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927005","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":"Postapproval Study Outcomes of Muscular Ventricular Septal Defect Closure With the Amplatzer Muscular VSD Occluder.","authors":"Athar M Qureshi, Henri Justino, Carl Owada, Mohammed Numan, Makram Ebeid, Thomas J Forbes, David Nykanen, Daisuke Kobayashi, Jillian Kolles, Dan Gutfinger, David Balzer","doi":"10.1161/CIRCINTERVENTIONS.125.016121","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016121","url":null,"abstract":"<p><strong>Background: </strong>The Amplatzer Muscular Ventricular Septal Defect (VSD) Occluder (Abbott Structural Heart, Plymouth, MN) was approved by the US Food and Drug Administration in 2007. As a condition of approval, a postapproval study was required to further evaluate its safety and effectiveness. This study reports the clinical outcomes from the postapproval study over 5 years of follow-up.</p><p><strong>Methods: </strong>Patients with complex congenital muscular VSDs at high risk for surgical closure were enrolled between May 2008 and February 2020 in the United States and Canada. The primary effectiveness end points were technical implant success, acute procedure shunt-closure success, and 1-year shunt-closure success. The primary safety end point was the proportion of patients with any serious adverse event within 12 months of the procedure.</p><p><strong>Results: </strong>A total of 92 patients (median age, 2 years; 50 females) were enrolled in the study. Technical implant success was achieved in 93.8% of patients, and acute shunt-closure success was achieved in 78.0%. Successful shunt closure at 1-year was 94.4% and increased to >98% between 2 and 5 years. Within 12 months of the procedure, all-cause serious adverse events occurred in 47 of the 90 (52.2%) patients which included 7 device-related and 23 procedure-related serious adverse events. Between 1 and 5 years, there was 1 additional device- and procedure-related serious adverse event.</p><p><strong>Conclusions: </strong>This postapproval study demonstrates that transcatheter muscular VSD closure with the Amplatzer Muscular VSD Occluder is a safe and effective therapy for the treatment of complex congenital muscular VSDs in patients who are at high-risk for surgical closure.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT00647387.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016121"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834367","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":"Timing of Intervention and Long-Term Outcomes in Mild Congenital Heart Disease: A 35-Year Study From the Pediatric Cardiac Care Consortium.","authors":"Gabriel L Perlow, Yanxu Yang, Jessica H Knight, Caroline Y Shi, Amanda S Thomas, Matthew E Oster, Lazaros K Kochilas","doi":"10.1161/CIRCINTERVENTIONS.125.015719","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015719","url":null,"abstract":"<p><strong>Background: </strong>Mild congenital heart diseases such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, and pulmonary valve stenosis constitute a significant public health problem. Understanding long-term outcomes after interventions for mild congenital heart disease is essential to inform lifelong care.</p><p><strong>Methods: </strong>We queried the Pediatric Cardiac Care Consortium, a multicenter US-based registry of patients with congenital heart disease interventions, for patients undergoing surgical or transcatheter procedures for atrial septal defect, ventricular septal defect, patent ductus arteriosus, and pulmonary valve stenosis; 17 407 patients were included. Statistical methods included survival analysis using Kaplan-Meier plots, multivariable Cox proportional hazards models for risk factors for death and standardized mortality ratios.</p><p><strong>Results: </strong>There were 115 in-hospital deaths (0.7%), with the remaining patients included in the postdischarge. The 35-year post-discharge survival ranged from 95.5% for pulmonary valve stenosis to 92.1% for ventricular septal defect. Survival patterns differed by lesion and age at intervention, with intervention at 1≤5 years generally associated with more favorable outcomes. Lower weight-for-age at intervention was associated with an increased hazard of death across all shunt lesions but not for pulmonary valve stenosis. Compared with the general population, mortality risk remained elevated for up to 18 to 20 years after intervention.</p><p><strong>Conclusions: </strong>Long-term survival after intervention for mild congenital heart disease is excellent; yet lesion-specific risks persist for decades. Age and weight-for-age at intervention are associated with survival, together with excess mortality beyond childhood underscore the need for lifelong, lesion-tailored surveillance in this growing population.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015719"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497509","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":"Coronary Function Testing: When Access Does Not Matter, But Pharmacology Might.","authors":"Olga Toleva","doi":"10.1161/CIRCINTERVENTIONS.126.016817","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016817","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016817"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926994","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":"Clopidogrel Versus Aspirin Monotherapy Beyond 1 Year After PCI: The Final 5-Year Results of the STOPDAPT-2 ACS and STOPDAPT-2 Total Cohort.","authors":"Hirotoshi Watanabe, Takeshi Morimoto, Masahiro Natsuaki, Ko Yamamoto, Yuki Obayashi, Ryusuke Nishikawa, Tomoya Kimura, Kazuaki Imada, Satoru Suwa, Tsuyoshi Isawa, Kenji Ando, Takanari Fujita, Kazushige Kadota, Hideo Tokuyama, Hiroki Sakamoto, Hiroshi Suzuki, Kohei Wakabayashi, Koh Ono, Fujio Hayashi, Kengo Tanabe, Masaharu Akao, Yuko Onishi, Ruka Yoshida, Takanori Kusuyama, Toshihiro Tamura, Yoshiro Onoue, Masahiro Yagi, Kazuaki Kaitani, Takeshi Kimura","doi":"10.1161/CIRCINTERVENTIONS.125.016280","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016280","url":null,"abstract":"<p><strong>Background: </strong>Clopidogrel may have ischemic benefit over aspirin as long-term monotherapy in patients receiving percutaneous coronary intervention.</p><p><strong>Methods: </strong>Both the STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy-2) and STOPDAPT-2 ACS (Short and Optimal Duration of Dual Antiplatelet Therapy-2 Study for the Patients With Acute Coronary Syndrome) were multicenter, open-label, adjudicator-blinded, randomized clinical trials in Japan, with the same protocol except that the STOPDAPT-2 ACS enrolled patients with acute coronary syndrome, exclusively. The patients after percutaneous coronary intervention with cobalt-chromium everolimus-eluting stents were randomized into 1-month dual antiplatelet therapy followed by clopidogrel monotherapy (clopidogrel group) or 12-month dual antiplatelet therapy followed by aspirin monotherapy (aspirin group). Follow-up duration was 5 years. The clinical effect between clopidogrel and aspirin monotherapy was compared by the 1-year landmark analysis in the STOPDAPT-2 ACS and STOPDAPT-2 total cohort, a pooled cohort of the 2 trials. The primary end point was the composite of cardiovascular end point (cardiovascular death, myocardial infarction, stroke, or definite stent thrombosis) and bleeding end point (Thrombolysis in Myocardial Infarction major/minor). The major secondary end points were each of the cardiovascular composite end point and the bleeding end point.</p><p><strong>Results: </strong>Of 2986 patients (clopidogrel group: 1492, aspirin group: 1494) in the 5-year analysis of the STOPDAPT-2 ACS, 2875 (96.3%) completed follow-up. By the 1-year landmark analysis, clopidogrel group was superior to aspirin group for both the primary end point (6.18% and 8.27%; hazard ratio, 0.75 [95% CI, 0.57-0.997]; <i>P</i>=0.048) and the major secondary cardiovascular end point (4.73% and 6.77%; hazard ratio, 0.70 [95% CI, 0.51-0.96]; <i>P</i>=0.03). In the STOPDAPT-2 total cohort, including 5991 patients, the superiority of clopidogrel over aspirin for the cardiovascular end point was highly significant (hazard ratio, 0.74 [95% CI, 0.60-0.91]; <i>P</i>=0.004), although the superiority on the primary end point was insignificant (hazard ratio, 0.86 [95% CI, 0.72-1.03]; <i>P</i>=0.11). There was no between-groups difference in the major secondary bleeding end point, both in the STOPDAPT-2 ACS and STOPDAPT-2 total cohort.</p><p><strong>Conclusions: </strong>Clopidogrel monotherapy was superior to aspirin monotherapy for cardiovascular outcomes beyond 1 year after percutaneous coronary intervention, without increased bleeding risk.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02619760 and NCT03462498.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016280"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472665","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 Proportionality of Secondary Tricuspid Regurgitation on Outcomes After Tricuspid Transcatheter Edge-to-Edge Repair.","authors":"Giulio Russo, Daniela Pedicino, Marianna Adamo, Hannes Alessandrini, Martin Andreas, Daniel Braun, Kim A Connelly, Paolo Denti, Rodrigo Estevez-Loureiro, Neil Fam, Rebecca T Hahn, Claudia Harr, Joerg Hausleiter, Daniel Kalbacher, Edwin Ho, Azeem Latib, Edith Lubos, Sebastian Ludwig, Philipp Lurz, Marco Metra, Vanessa Monivas, Georg Nickenig, Giovanni Pedrazzini, Alberto Pozzoli, Fabien Praz, Josep Rodes-Cabau, Christian Besler, Karl-Philipp Rommel, Joachim Schofer, Andrea Scotti, Nicolò Lentini, Roberta Pastorino, Kerstin Piayda, Horst Sievert, Gilbert H L Tang, Isaac Pascual, Holger Thiele, Florian Schlotter, Giuseppe Massimo Sangiorgi, Ralph Stephan von Bardeleben, John Webb, Stephan Windecker, Martin Leon, Maurice Enriquez-Sarano, Francesco Maisano, Stefan Bloechlinger, Maurizio Taramasso","doi":"10.1161/CIRCINTERVENTIONS.125.016269","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016269","url":null,"abstract":"<p><strong>Background: </strong>The impact of proportionality to heart valve regurgitation has been widely investigated in mitral regurgitation, helping to better characterize the best candidates for therapies. However, it has never been studied in tricuspid regurgitation (TR). The aim of the present study is to investigate the impact of the proportionality of TR on outcomes.</p><p><strong>Methods: </strong>Patients undergoing tricuspid transcatheter edge-to-edge repair were selected from the TRIVALVE registry (International Multisite Transcatheter Tricuspid Valve Therapies Registry). Patients were divided according to the ratio between effective regurgitant orifice area (EROA) and right ventricular (RV) end diastolic diameter (RVEDD) into tertiles: patients with low EROA/RVEDD (RV, dominant); intermediate EROA/RVEDD (RV and TR, RV-TR, codominant), and high EROA/RVEDD (TR, dominant). The primary outcome was all-cause mortality. Median follow-up was 9.7 months (4.2-12.0).</p><p><strong>Results: </strong>A total of 204 patients were included in the present study: 67 for the RV dominant, 68 for the RV-TR codominant, and 69 for the TR dominant group. The 3 groups presented different baseline characteristics. Survival analysis among the 3 groups showed a trend towards worse prognosis for the RV-dominant group, as compared with the RV-TR codominant and TR dominant groups.</p><p><strong>Conclusions: </strong>The conceptual framework of proportionality is applicable to TR with EROA/RVEDD, defining a higher risk RV-dominant phenotype with a trend towards worse survival after tricuspid transcatheter edge-to-edge repair.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016269"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510044","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 TAVR Failure Mechanism on Outcomes After Reintervention: From the EXPLANTORREDO-TAVR Registry.","authors":"Bhavanadhar Penta, Gilbert H L Tang, Mohamed Abdel-Wahab, Rik Adrichem, Hasan Ahmad, Martin Andreas, Anita W Asgar, Igor Belluschi, Walid Ben-Ali, Oliver D Bhadra, Anson Cheung, Andrea Colli, Lenard Conradi, Silvia Corona, Ole De Backer, Paolo Denti, Nimesh D Desai, Marco Di Eusanio, J Michael DiMaio, John K Forrest, Shinichi Fukuhara, Arnar Geirsson, Sachin S Goel, Joshua B Goldberg, Christian Hagl, Howard C Herrmann, Thijmen W Hokken, Jorg Kempfert, Philipp Kiefer, Neal S Kleiman, Chad Kliger, Markus Mach, Mateo Marin-Cuartas, David Meier, Thomas Modine, George Petrossian, Luigi Pirelli, Basel Ramlawi, Newell B Robinson, Joshua D Rovin, Hendrik Ruge, Shekhar Saha, Christian C Schults, Emily Shih, Molly Szerlip, Maurizio Taramasso, Axel Unbehaun, Nicolas M Van Mieghem, Keti Vitanova, Ron Waksman, Lin Wang, John G Webb, Moritz C Wyler von Ballmoos, Michael J Reardon, Tamim N Nazif, Martin B Leon, Michael J Mack, Tsuyoshi Kaneko, Vinayak N Bapat, Syed Zaid","doi":"10.1161/CIRCINTERVENTIONS.125.016068","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016068","url":null,"abstract":"<p><strong>Background: </strong>As transcatheter aortic valve replacement (TAVR) expands to patients with longer life expectancy, the impact of failure mechanisms on outcomes of TAVR-explant and redo-TAVR remains uncertain. We sought to evaluate outcomes of TAVR reintervention based on the failure mechanism of the index transcatheter aortic valve.</p><p><strong>Methods: </strong>From 2009 to 2022, 553 patients from 29 centers in the EXPLANTORREDO-TAVR registry (Explant or Redo Transcatheter Aortic Valve Replacement) underwent TAVR-explant or redo-TAVR for transcatheter aortic valve failure. Patients with endocarditis were excluded. Patients with structural valve deterioration (SVD, N=224 [64.9%]) were compared with those with nonstructural valve dysfunction (NSVD, N=121 [35.1%]), comprising paravalvular leak (86.0%) and prosthesis-patient mismatch (14.0%). Outcomes were assessed at 30 days and 1 year.</p><p><strong>Results: </strong>Mean age was 75.6±9.3 years, with 42% women. There were no differences in reintervention type between groups (redo-TAVR in 58.0% SVD versus 49.6% NSVD; TAVR-explant: 42.0% versus 50.4%; <i>P</i>=0.14). Compared with NSVD, SVD was the predominant mode of failure in balloon-expandable valves (50.7% versus 24.8%; <i>P</i><0.001), had a longer time to reintervention (50.7 versus 5.5 months; <i>P</i><0.001), and favored non-balloon-expandable valves at redo-TAVR (56.9% versus 33.3%; <i>P</i>=0.003). Mortality at 30 days and 1 year did not differ significantly between SVD and NSVD for either redo-TAVR (30 days: 3.2% versus 1.7%, <i>P</i>=1.00; 1 year: 18.0% versus 12.0%; <i>P</i>=0.47) or TAVR-explant (30 days: 16.3% versus 12.1%, <i>P</i>=0.63; 1 year: 40.0% versus 29.5%; <i>P</i>=0.39). There were also no differences in risk-adjusted 3-year cumulative mortality between groups (redo-TAVR: hazard ratio, 1.30 [95% CI, 0.68-2.46], <i>P</i>=0.43 [ref=NSVD]; TAVR-explant: hazard ratio, 1.24 [95% CI, 0.64-2.41]; <i>P</i>=0.53).</p><p><strong>Conclusions: </strong>SVD and NSVD failures had distinct valve types and reintervention timing, with SVD having a longer time to TAVR reintervention, but the failure mechanism did not impact reintervention type or clinical outcomes.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016068"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688662","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}