JACC. Cardiovascular interventions最新文献

{"title":"Initial Experience and Bench Validation of the CLEVE Prosthetic Leaflet Modification Procedure During Aortic and Mitral Valve-in-Valve Procedures","authors":"Amar Krishnaswamy MD ,&nbsp;David Meier MD ,&nbsp;Serge Harb MD ,&nbsp;Hacina Gill BSc ,&nbsp;Julien Delarive MD ,&nbsp;Althea Lai BSc ,&nbsp;Geoffrey Payne MSc, PhD ,&nbsp;James Yun MD ,&nbsp;Rhonda Miyasaka MD ,&nbsp;Stephanie Sellers MSc, PhD ,&nbsp;Samir R. Kapadia MD","doi":"10.1016/j.jcin.2024.11.037","DOIUrl":"10.1016/j.jcin.2024.11.037","url":null,"abstract":"<div><h3>Background</h3><div>Some patients with failing surgical aortic or mitral valves are anatomically unsuitable for typical valve-in-valve procedures due to threatened coronary artery or left ventricular outflow tract obstruction, respectively.</div></div><div><h3>Objectives</h3><div>The authors assessed the clinical and benchtop efficacy of the novel CLEVE (CLEveland Valve Electrosurgery) leaflet modification technique in patients with the previous concerns.</div></div><div><h3>Methods</h3><div>Eight patients with degenerated aortic valve replacement (AVR) and 6 patients with mitral valve replacement (MVR) at high risk for obstruction of left main coronary artery (AVR) or left ventricular outflow tract (MVR) were treated. The threatening prosthetic leaflet was punctured using electrosurgical techniques and dilated progressively, followed by deployment of a balloon-expandable valve into the modified leaflet. Benchtop analyses were performed using the same techniques to assess the response of the surgical leaflet ex vivo.</div></div><div><h3>Results</h3><div>Successful leaflet clearance was achieved in all without evidence of ostial coronary artery obstruction (AVR) or left ventricular outflow tract obstruction (MVR). One patient experienced left main trunk obstruction due to suspected embolization of material that was treated percutaneously (patient expired due to further complications). No other complications at 30 days. On the benchtop, the procedure demonstrated complete clearance of the threatening leaflet, with detachment from one of the surgical posts in the AVR model and splitting across the leaflet edge in the MVR model.</div></div><div><h3>Conclusions</h3><div>Patients with a degenerated surgical valve who are unsuitable for a valve-in-valve replacement due to anatomic concerns regarding displacement of the index prosthetic leaflet can be successfully treated after using the CLEVE method of leaflet modification. Further studies of the procedure should be considered.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 767-781"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682627","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":"Mortality in Infarct-Related Cardiogenic Shock Without Cardiac Arrest","authors":"Jacob Eifer Møller MD, DMSC ,&nbsp;Holger Thiele MD ,&nbsp;Rasmus Paulin Beske MD,&nbsp;Jan Belohlavek MD,&nbsp;Petr Ostadal PD, PhD,&nbsp;Marcus Flather MD,&nbsp;Jose P.S. Henriques MD,&nbsp;Melchior Seyfarth MD,&nbsp;Steffen Massberg MD,&nbsp;Uwe Zeymer MD ,&nbsp;Christian Hassager MD, DMSC","doi":"10.1016/j.jcin.2024.12.005","DOIUrl":"10.1016/j.jcin.2024.12.005","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 818-819"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364720","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":"Intravascular Ultrasound for Guiding Venus-P-Valve Deployment","authors":"Karol A. Sadowski MS ,&nbsp;Gary S. Mintz MD ,&nbsp;Olgierd Woźniak MD ,&nbsp;Ewa Warchoł-Celińska MD ,&nbsp;Elżbieta K. Biernacka MD ,&nbsp;Magda Lipczyńska MD ,&nbsp;Piotr Hoffman MD ,&nbsp;Lars Søndergaard MD ,&nbsp;Marcin Demkow MD ,&nbsp;Łukasz Kalińczuk MD","doi":"10.1016/j.jcin.2024.10.053","DOIUrl":"10.1016/j.jcin.2024.10.053","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 804-807"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872118","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":"SGLT2 Inhibition in Aortic Stenosis","authors":"Brian R. Lindman MD, MSc ,&nbsp;Bassim El-Sabawi MD","doi":"10.1016/j.jcin.2024.12.025","DOIUrl":"10.1016/j.jcin.2024.12.025","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 749-751"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476567","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":"Diabetic Status and Thrombogenicity","authors":"Sungsoo Cho MD, PhD ,&nbsp;Moonki Jung MD, PhD ,&nbsp;Jong-Hwa Ahn MD, PhD ,&nbsp;Min Gyu Kang MD, PhD ,&nbsp;Jae Seok Bae MD ,&nbsp;Jin-Sin Koh MD, PhD ,&nbsp;Seok-Jae Hwang MD, PhD ,&nbsp;Hwi Seung Kim MD ,&nbsp;Sang-Wook Kim MD, PhD ,&nbsp;Jin-Yong Hwang MD, PhD ,&nbsp;Young-Hoon Jeong MD, PhD","doi":"10.1016/j.jcin.2024.12.002","DOIUrl":"10.1016/j.jcin.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>A heightened prothrombotic environment, combined with premature and more aggressive atherosclerosis, contributes to the elevated cardiovascular risk in patients with diabetes mellitus (DM).</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate the association between DM status and thrombogenicity and their prognostic implications in patients with significant coronary artery disease.</div></div><div><h3>Methods</h3><div>A total of 2,501 patients with coronary artery disease undergoing percutaneous coronary intervention, with on-admission glycated hemoglobin and thrombogenicity indexes (measured by thromboelastography). Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death, myocardial infarction, or stroke within 4-year follow-up.</div></div><div><h3>Results</h3><div>Patients with DM (n = 970 [38.8%]) demonstrated significantly higher platelet-fibrin clot strength (PFCS), as indicated by maximal amplitude (median [Q1-Q3]: 67.1 [62.2-72.2] mm vs. 65.5 [61.0-70.4] mm; <em>P</em> &lt; 0.001), and reduced fibrinolytic activity, measured by lysis at 30 minutes (median [Q1-Q3]: 0.1% [0.0%-1.0%] vs. 0.2% [0.0%-1.3%]; <em>P</em> = 0.003), compared to patients without DM. PFCS level was closely related with diabetic status, showing a positive relationship with glycated hemoglobin level up to 7.0% and then reaching a plateau. In a multivariable analysis, high PFCS phenotype defined as maximal amplitude ≥68 mm (HR: 1.39; 95% CI: 1.07-1.81; <em>P</em> = 0.015) and DM phenotype (HR: 1.38; 95% CI: 1.05-1.79; <em>P</em> = 0.018) were independently associated with MACE occurrence. The presence of diabetic phenotype and high PFCS exhibited an additive effect on MACE occurrence (HR: 2.49; 95% CI: 1.77-3.51; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In percutaneous coronary intervention–treated patients, diabetic status and clot-strength value were significantly correlated. High clot-strength phenotype increased the risk for MACE, irrespective of diabetic phenotype. (Gyeongsang National University Hospital Registry [GNUH]; <span><span>NCT04650529</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 720-733"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682926","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":"Full Issue PDF","authors":"","doi":"10.1016/S1936-8798(25)00781-2","DOIUrl":"10.1016/S1936-8798(25)00781-2","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages I-CXXXV"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679459","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":"Transcatheter Aortic Valve Replacement for Pure Aortic Regurgitation","authors":"Matti Adam MD,&nbsp;Hendrik Wienemann MD","doi":"10.1016/j.jcin.2024.12.029","DOIUrl":"10.1016/j.jcin.2024.12.029","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 765-766"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682626","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":"Different Mechanical Circulatory Support Strategies for Infarct-Related Cardiogenic Shock","authors":"Hans-Josef Feistritzer MD, PhD ,&nbsp;Uwe Zeymer MD ,&nbsp;Taoufik Ouarrak MSc ,&nbsp;Ibrahim Akin MD ,&nbsp;Tienush Rassaf MD ,&nbsp;Ralf Lehmann MD ,&nbsp;Ingo Eitel MD ,&nbsp;Tim Seidler MD ,&nbsp;Carsten Skurk MD ,&nbsp;Peter Clemmensen MD ,&nbsp;Ingo Voigt MD ,&nbsp;Melchior Seyfarth MD ,&nbsp;Axel Linke MD ,&nbsp;Eike Tigges MD ,&nbsp;Christian Jung MD ,&nbsp;Philipp Lauten MD ,&nbsp;Janine Pöss MD ,&nbsp;Steffen Schneider PhD ,&nbsp;Steffen Desch MD ,&nbsp;Anne Freund MD ,&nbsp;Holger Thiele MD","doi":"10.1016/j.jcin.2024.12.010","DOIUrl":"10.1016/j.jcin.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Mechanical circulatory support (MCS) devices are frequently used in patients with acute myocardial infarction complicated by cardiogenic shock. In clinical practice, escalation of MCS device therapy is performed in a significant proportion of patients aiming to improve hemodynamic status.</div></div><div><h3>Objectives</h3><div>The aim of this study was to analyze outcomes of different MCS device strategies in the ECLS-SHOCK (Extracorporeal Life Support in Cardiogenic Shock) trial.</div></div><div><h3>Methods</h3><div>The present subanalysis from the ECLS-SHOCK trial analyzed outcomes of patients treated with upfront extracorporeal life support (ECLS) only, bailout MCS, and escalated MCS therapy. The primary outcome was 30-day all-cause mortality.</div></div><div><h3>Results</h3><div>Upfront ECLS only, bailout MCS, and escalated MCS therapy were used in 165 (78.9%), 54 (26.0%), and 27 (12.9%) patients, respectively. Thirty-day all-cause mortality was 44.8% (95% CI: 37.1%-52.8%), 61.1% (95% CI: 46.9%-74.1%), and 55.6% (95% CI: 35.3%-74.5%) in the upfront ECLS, bailout MCS, and escalated MCS group (<em>P</em> = 0.09). Need for renal replacement therapy was higher in the bailout MCS (35.2%; 95% CI: 22.7%-49.4%) than in upfront ECLS (7.3%; 95% CI: 3.8%-12.4%) and escalated MCS (14.8%; 95% CI: 4.2%-33.8%) (<em>P</em> &lt; 0.001). Moderate or severe bleeding complications were similar in the upfront ECLS (25.5%; 95% CI: 19.0%-32.8%), bailout MCS (22.2%; 95% CI: 12.0%-35.6%), and escalated MCS (22.2%; 95% CI: 8.6%-42.3%) group (<em>P</em> = 0.86).</div></div><div><h3>Conclusions</h3><div>Bailout and escalated MCS therapy is associated with numerically higher 30-day mortality compared with upfront ECLS use only. Bailout MCS use is also associated with higher need for renal replacement therapy. (Extracorporeal Life Support in Cardiogenic Shock [ECLS-SHOCK]; <span><span>NCT03637205</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 691-701"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682919","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 Novel Self-Centering Aortic Valve Crossing Catheter for Transcatheter Aortic Valve Replacement","authors":"Mackram F. Eleid MD,&nbsp;Rajiv Gulati MD, PhD,&nbsp;Brandon J. Tefft PhD,&nbsp;Roger McGowan PhD,&nbsp;Douglas Pennington PhD,&nbsp;Daniel B. Spoon MD,&nbsp;Kevin L. Greason MD,&nbsp;Guy S. Reeder MD,&nbsp;Gurpreet S. Sandhu MD, PhD","doi":"10.1016/j.jcin.2024.11.039","DOIUrl":"10.1016/j.jcin.2024.11.039","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 820-821"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476497","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":"Effect of Sodium-Glucose Cotransporter-2 Inhibitors on the Progression of Aortic Stenosis","authors":"Tayyab Shah MD ,&nbsp;Zhiyuan Zhang MD, MPH ,&nbsp;Haashim Shah BA ,&nbsp;Alexander C. Fanaroff MD, MHS ,&nbsp;Ashwin S. Nathan MD, MS ,&nbsp;Helen Parise ScD ,&nbsp;John Lutz MA ,&nbsp;Lissa Sugeng MD, MPH ,&nbsp;Lavanya Bellumkonda MD ,&nbsp;Björn Redfors MD, PhD ,&nbsp;Elmir Omerovic MD, PhD ,&nbsp;Mark C. Petrie MD ,&nbsp;Amit N. Vora MD, MPH ,&nbsp;Paul N. Fiorilli MD ,&nbsp;Taisei Kobayashi MD ,&nbsp;Yousif Ahmad MD, PhD ,&nbsp;John K. Forrest MD ,&nbsp;Jay S. Giri MD, MPH ,&nbsp;Howard C. Herrmann MD ,&nbsp;Alexandra J. Lansky MD","doi":"10.1016/j.jcin.2024.11.036","DOIUrl":"10.1016/j.jcin.2024.11.036","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) is the leading cause of valvular heart disease-related morbidity and mortality, but there are no medical treatments to slow its progression. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have pleiotropic effects which could be disease modifying in AS.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to determine if SGLT2i usage is associated with slower progression of AS.</div></div><div><h3>Methods</h3><div>A target trial emulation comparing the effect of the initiation of SGLT2i compared with no SGLT2i in patients with nonsevere AS was performed using retrospective electronic medical record data from the Yale New Haven Health System from January 2016 to September 2022. Patients with native aortic valve sclerosis or nonsevere AS with at least 12 months of echocardiographic follow-up were included. Patients were excluded if they had an estimated glomerular filtration rate &lt;30 mL/min/1.73 m² or had initiated SGLT2i &gt;1 year before the index echocardiogram. The prespecified primary outcome was progression to severe AS.</div></div><div><h3>Results</h3><div>A total of 458 patients prescribed SGLT2i and 11,240 patients never prescribed SGLT2i were included. Patients were on SGLT2i for a median of 0.9 years. Patients on SGLT2i were younger and had higher rates of diabetes and chronic kidney disease. Patients on SGLT2i were more likely to have ejection fraction ≤40%. There were no differences between groups in baseline AS severity (66% sclerosis, 23% mild stenosis, and 11% moderate in overall cohort). Patients ever prescribed SGLT2i were less likely to progress to severe AS (HR: 0.61; 95% CI: 0.39-0.94; <em>P</em> = 0.03) with a progressively lower risk among patients on SGLT2i for &gt;3, 6, and 12 months (HR: 0.54, 0.48, and 0.27, respectively).</div></div><div><h3>Conclusions</h3><div>This retrospective, multicenter, observational study suggests that SGLT2i may slow the progression of nonsevere AS.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 6","pages":"Pages 738-748"},"PeriodicalIF":11.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476507","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}