JACC: Cardiovascular Interventions最新文献

{"title":"Timing and Outcomes of PCI in Conjunction With TAVR With Balloon-Expandable Valves.","authors":"Abhijeet Dhoble,Talha Ahmed,Raymond G Mckay,Chad Kliger,Nirat Beohar,Suzanne J Baron,James B Hermiller","doi":"10.1016/j.jcin.2024.10.055","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.055","url":null,"abstract":"BACKGROUNDThe optimal timing for percutaneous coronary intervention (PCI) in patients undergoing transcatheter aortic valve replacement (TAVR) is debatable.OBJECTIVESThe aim of this study was to compare outcomes based on the timing of PCI in stable coronary artery disease patients undergoing TAVR.METHODSLeveraging the STS/ACC TVT Registry and Medicare Linkage, we analyzed patients with stable coronary artery disease undergoing PCI and TAVR between 2015 and 2023 using the SAPIEN 3 balloon-expandable valve platform. This analysis included patients who underwent PCI within ±90 days of the index TAVR procedure. All-cause mortality, stroke, and a composite of mortality and stroke were analyzed up to 3 years using Medicare Linkage.RESULTSOf the 51,480 patients who underwent PCI and TAVR with SAPIEN 3 platforms during the study period, 84.7% had PCI within 90 days before TAVR, 13.9% had concomitant PCI, and 1.4% had PCI within 90 days after TAVR. In the propensity-matched analysis, patients undergoing PCI before TAVR had better outcomes in terms of all cause-mortality (38.1% vs 38.8%; P = 0.013) and a composite of mortality and stroke (42.8% vs 43.5%; P = 0.012) compared with the ones undergoing concomitant PCI at 3-year follow-up. Major vascular complications were higher in patients undergoing concomitant PCI and TAVR (2% vs 1.4%; P = 0.003) CONCLUSIONS: Patients undergoing concomitant PCI and TAVR had higher major vascular complications, and slightly higher composite of all-cause mortality and stroke compared with those who underwent PCI within 90 days before the TAVR procedure.","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"36 1","pages":"244-254"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will Understanding Coronary Pathophysiology in Severe Aortic Stenosis Help Guide Revascularization?","authors":"Habib Samady","doi":"10.1016/j.jcin.2024.11.018","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.11.018","url":null,"abstract":"","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"60 1","pages":"213-216"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Need to Refine Diagnostic Tools for Patients With Intermediate Coronary Stenoses: A Clinical Imperative.","authors":"Goran Stankovic","doi":"10.1016/j.jcin.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.11.005","url":null,"abstract":"","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"7 1","pages":"184-186"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Valve Deterioration After Transcatheter Aortic Valve Replacement: Incidence, Predictors, and Clinical Outcomes.","authors":"Bashir Alaour,Daijiro Tomii,Masaaki Nakase,Dik Heg,Stefan Stortecky,Jonas Lanz,Daryoush Samim,David Reineke,Fabien Praz,Stephan Windecker,Thomas Pilgrim","doi":"10.1016/j.jcin.2024.09.039","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.09.039","url":null,"abstract":"BACKGROUNDReports on the durability of transcatheter aortic valve replacement (TAVR) prostheses are scarce and confounded by varying definitions and competing risks of death.OBJECTIVESThe authors sought to determine the incidence, predictors, and clinical outcomes of hemodynamic valve deterioration (HVD) according to the Valve Academic Research Consortium 3 definition after TAVR.METHODSWe analyzed consecutive patients undergoing TAVR in the prospective Bern TAVI (Transcatheter Aortic Valve Implantation) registry between August 2007 and June 2022 for the incidence and predictors of HVD and performed case control-matching to compare outcomes according to HVD.RESULTSA total of 2,403 eligible patients (mean age 81.8 ± 6.2 years, median Society of Thoracic Surgeons Predicted Risk of Mortality score 3.8% [Q1-Q3: 2.4%-6.0%]) were included and had a median duration of follow-up of 376 days (Q1-Q3: 365-1,825 days). The cumulative incidence of moderate or severe HVD was 2.2% (95% CI: 1.6%-3.1%), 10.8% (95% CI: 9.2%-12.7%), and 25.6% (95% CI: 17.5%-36.5%) at 1, 5, and 10 years, respectively. Aortic valve complex calcium volume (HR: 1.81; 95% CI: 1.11-2.97; P = 0.018), residual aortic regurgitation at discharge (HR: 1.87; 95% CI: 1.34-2.60; P < 0.001), and treatment with oral anticoagulants (HR: 1.78; 95% CI: 1.00-3.15; P = 0.048) were independent predictors of HVD. In the case control-matched cohort (HVD, n = 155, no-HVD, n = 600), patients with HVD had similar yearly rates of all-cause and cardiovascular mortality, and infective endocarditis, but higher rates of repeat aortic valve intervention (rate ratio [RR]: 4.81 [95% CI: 1.74-13.26]; P = 0.001).CONCLUSIONSHVD occurred in up to 1 in 4 patients throughout 10-year post-TAVR and was associated with a 5-fold increase in the risk of aortic valve reintervention.","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"30 1","pages":"72-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Incidence, Trends, and Clinical Outcomes.","authors":"Hugo M Aarts,Astrid C van Nieuwkerk,Kimberley I Hemelrijk,Jorge Salgado Fernandez,Didier Tchétché,Fabio S de Brito,Marco Barbanti,Ran Kornowski,Azeem Latib,Augusto D'Onofrio,Flavio Ribichini,María Cruz Ferrer,Nicolas Dumonteil,Alexandre Abizaid,Samantha Sartori,Paola D'Errigo,Giuseppe Tarantini,Alberto Paolo Del Sole,Katia Orvin,Matteo Pagnesi,Eduardo Pinar,George Dangas,Roxana Mehran,Michiel Voskuil,Ronak Delewi","doi":"10.1016/j.jcin.2024.09.050","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.09.050","url":null,"abstract":"BACKGROUNDTranscatheter aortic valve replacement (TAVR) harbors the risk of periprocedural complications that require emergent cardiac surgery, or \"surgical bailout.\" Surgical bailout intends to be lifesaving but is associated with high mortality. This has given rise to discussion on the necessity of surgical backup during TAVR. Therefore, recent studies in contemporary TAVR patients are warranted.OBJECTIVESThis study aimed to assess the incidence, trends, and clinical outcomes of surgical bailout in patients undergoing transfemoral TAVR.METHODSThe CENTER2 (Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation With Balloon-Expandable Valves Versus Self-Expandable Valves 2) study contains patient-level data from 10 clinical studies with patients undergoing TAVR between 2007 and 2022.RESULTSA total of 24,010 patients undergoing transfemoral TAVR were included. The mean age was 81.5 ± 6.7 years, and 56% were female. The median Society of Thoracic Surgeons Predicted Risk of Mortality declined over time (2007-2014: 7.1% [Q1-Q3: 4.3%-14.8%] vs 2015-2022: 3.9% [Q1-Q3: 2.6%-6.0%]; P < 0.001). Surgical bailout was reported in 125 (0.52%) patients, and its incidence decreased over time, from 0.84% in 2007 to 2010 to 0.25% in 2019 to 2022 (Ptrend < 0.001). Surgical bailout was more frequently observed in women compared with men (0.61% vs 0.41%; P = 0.03). Ventricular perforation was the most prevalent reason for surgical bailout (28.0%). Patients who underwent surgical bailout reported higher mortality rates during the 1-year follow-up compared with patients without surgical bailout (68.3% vs 15.3%; HR: 8.60; 95% CI: 6.74-10.97; P < 0.001). Interestingly, patients surviving the first 90 days reported a similar mortality risk (HR: 2.19; 95% CI: 0.91-5.27; P = 0.08).CONCLUSIONSThe incidence of surgical bailout is very low in the contemporary TAVR population. Mortality rates remain high among patients requiring surgical bailout during transfemoral TAVR, but this risk diminishes in patients surviving the postprocedural period. (Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation With Balloon-Expandable Valves Versus Self-Expandable Valves 2 [CENTER2]; NCT03588247).","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"98 1","pages":"89-99"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Multicenter Experience With a Novel Self-Expanding TAVR System in Patients With Aortic Valve Stenosis.","authors":"Alexander R Tamm,Hendrik Wienemann,Hendrik Treede,Martin Geyer,Martin Arnold,Mohamed Marwan,Hans Theiss,Daniel Braun,Sabine Bleiziffer,Arseniy Goncharov,Elmar Kuhn,Ralph Stephan von Bardeleben,Stephan Achenbach,Steffen Massberg,Stephan Baldus,Matti Adam,Tanja K Rudolph","doi":"10.1016/j.jcin.2024.10.056","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.056","url":null,"abstract":"BACKGROUNDAs transcatheter aortic valve replacement is performed increasingly in younger, low-risk patients, the need for commissural alignment and coronary access has increased. Design elements of the JenaValve Trilogy (JVT) transcatheter heart valve (THV) ensure both.OBJECTIVESThis study sought to evaluate the outcome of patients with aortic stenosis (AS) treated with this novel transfemoral, self-expanding THV.METHODSWe included 43 consecutive patients with severe AS treated with the JVT system at 5 German sites. The primary endpoint of the study was technical success of the procedure. Procedural outcomes, hemodynamic valve performance, and clinical outcomes at 30 days were evaluated according to the Valve Academic Research Consortium-3 criteria.RESULTSThe median age was 81 years (Q1-Q3: 77.0-83.9 years) with a median Society of Thoracic Surgeons Risk Score of 3.1% (Q1-Q3: 2.1%-5.9%). Technical success was achieved in 98% (n = 42 of 43). One patient was converted to open surgery. The median aortic gradient was 5.0 mm Hg (Q1-Q3: 4.0-7.0 mm Hg), and no patient had moderate or greater paravalvular regurgitation (88% [n = 37 of 42] with none or trace paravalvular regurgitation). At 30 days, major vascular complications and stroke each occurred in 1 (2.3%) patient, 2 (4.7%) patients had died, and permanent pacemaker implantation was needed in 4.9% (n = 2 of 41). Overall, early safety at 30 days was achieved in 82% (n = 27 of 33) of patients.CONCLUSIONSTreatment of AS patients with this novel transfemoral THV system is safe and effective. The JVT offers an excellent alternative to established transcatheter aortic valve replacement prostheses for patients with AS.","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"45 1","pages":"60-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining TAVR Risk Stratification: The Role of Complex Vascular Anatomy and Aortic Tortuosity.","authors":"Ahmad Hayek,Pierre Lantelme,Brahim Harbaoui","doi":"10.1016/j.jcin.2024.10.051","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.051","url":null,"abstract":"","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"19 1","pages":"134"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of the Dry-Pericardium Transcatheter Aortic Valve: 2-Year Outcomes of the Pivotal Study.","authors":"Yong Peng,Lin Bai,Zhenfei Fang,Yujie Zhou,Yan Wang,Shaoliang Chen,Xu Meng,Jianan Wang,Yuan Feng,Mao Chen,","doi":"10.1016/j.jcin.2024.10.030","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.030","url":null,"abstract":"","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"23 1","pages":"135-137"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Native Leaflet Calcification: A Culprit for TAVR Degeneration?","authors":"Danny Dvir","doi":"10.1016/j.jcin.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.11.014","url":null,"abstract":"","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"20 1","pages":"86-88"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thou Shalt Not Go Femoral!: Benefits of the Radial Artery for Transcatheter Aortic Valve Replacement.","authors":"Giuseppe Biondi-Zoccai,Arturo Giordano,Nicola Corcione","doi":"10.1016/j.jcin.2024.10.050","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.050","url":null,"abstract":"","PeriodicalId":14666,"journal":{"name":"JACC: Cardiovascular Interventions","volume":"150 1","pages":"2933-2935"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}