JACC. Cardiovascular interventions最新文献

{"title":"Surgical Mitral Valve Repair vs Replacement After Failed Mitral Transcatheter Edge-to-Edge Repair","authors":"Mateo Marin-Cuartas MD ,&nbsp;Jagdip Kang MD ,&nbsp;Thilo Noack MD ,&nbsp;Manuela de la Cuesta MD ,&nbsp;Markus Krane MD ,&nbsp;Volkmar Falk MD ,&nbsp;Lenard Conradi MD ,&nbsp;Christian Hagl MD ,&nbsp;Maurizio Taramasso MD, PhD ,&nbsp;Tom C. Nguyen MD ,&nbsp;D. Scott Lim MD ,&nbsp;Gorav Ailawadi MD ,&nbsp;Michael J. Mack MD ,&nbsp;Robert L. Smith MD ,&nbsp;Anita W. Asgar MD ,&nbsp;Kendra J. Grubb MD, MHA ,&nbsp;Luigi Pirelli MD ,&nbsp;Paolo Denti MD ,&nbsp;Thomas Modine MD, PhD, MBA ,&nbsp;Michael J. Reardon MD ,&nbsp;Rebecca T. Hahn MD","doi":"10.1016/j.jcin.2025.02.008","DOIUrl":"10.1016/j.jcin.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>The impact of mitral valve (MV) surgery type after failed mitral transcatheter edge-to-edge repair (M-TEER) has not been well studied.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare the outcomes of MV repair vs replacement after failed M-TEER.</div></div><div><h3>Methods</h3><div>From 2009 to 2020, a total of 332 patients across 34 centers from the CUTTING-EDGE registry underwent MV surgery after M-TEER. Outcomes were compared between MV repair and replacement. Primary outcomes included 30-day mortality and 1-year survival after MV surgery.</div></div><div><h3>Results</h3><div>Among enrolled patients (mean age 73.8 ± 10.1 years, median Society of Thoracic Surgeons Predicted Risk of Mortality 3.9% [Q1-Q3: 2.2%-6.8%]), 25 (7.5%) underwent repair and 307 (92.5%) underwent replacement. The replacement group had a significantly higher rate of comorbidities, including atrial fibrillation, prior cardiac surgery, more secondary mitral regurgitation, and more devices implanted at index M-TEER (<em>P</em> &lt; 0.05 for all). Replacement patients showed a trend toward higher 30-day mortality (17.7% [52 of 294] vs 4.0% [1 of 25]; <em>P</em> = 0.094). The observed-to-expected ratio of 30-day mortality was 3.6 (95% CI: 1.9-5.3) overall, 3.8 (95% CI: 2.1-5.5) in the replacement group, and 1.7 (95% CI: 0.7-3.3) in the repair group. Replacement patients had higher 1-year mortality (33.3% [65 of 195] vs 10.5% [2 of 19]; <em>P</em> = 0.041). Significantly lower survival rates were observed after replacement at 2 years (<em>P</em> = 0.033) and persisted in the risk-adjusted Cox regression analysis (HR for replacement: 4.24; 95% CI: 1.04-17.31; <em>P</em> = 0.044).</div></div><div><h3>Conclusions</h3><div>MV surgery after failed M-TEER is a high-risk procedure associated with higher than expected 30-day mortality, with higher mortality associated with MV replacement. Compared with repair, replacement is associated with higher 1-year mortality and a lower 2-year survival.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 912-923"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828710","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":"Understanding 30-Day Out-of-Hospital Mortality After Mitral TEER","authors":"Vera Fortmeier MD,&nbsp;Tanja K. Rudolph MD","doi":"10.1016/j.jcin.2025.02.005","DOIUrl":"10.1016/j.jcin.2025.02.005","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 895-897"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673897","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":"Guidewire Friction Following Super High-Pressure Balloon Percutaneous Coronary Intervention","authors":"Laura Novelli MD,&nbsp;Jose Antonio Sorolla Romero MD,&nbsp;José Luis Diez Gil MD, PhD,&nbsp;Ignacio Amat-Santos MD, PhD,&nbsp;Emmanouil S. Brilakis MD, PhD,&nbsp;Jorge Sanz-Sanchez MD, PhD","doi":"10.1016/j.jcin.2024.12.020","DOIUrl":"10.1016/j.jcin.2024.12.020","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 956-957"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476514","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 Repair in Posterior, Anterior, and Bileaflet Mitral Valve Disease","authors":"Saibal Kar MD ,&nbsp;Matthew J. Price MD ,&nbsp;M. Andrew Morse MD ,&nbsp;Michael J. Rinaldi MD ,&nbsp;Paul Mahoney MD ,&nbsp;Paolo Denti MD ,&nbsp;Federico M. Asch MD ,&nbsp;Jose L. Zamorano MD ,&nbsp;Janani Aiyer MS ,&nbsp;Rong Huang MS ,&nbsp;Francesco Maisano MD ,&nbsp;Ralph Stephan von Bardeleben MD, PhD ,&nbsp;Evelio Rodriguez MD","doi":"10.1016/j.jcin.2024.12.023","DOIUrl":"10.1016/j.jcin.2024.12.023","url":null,"abstract":"<div><h3>Background</h3><div>Treating anterior and bileaflet mitral valve disease in patients with primary or degenerative mitral regurgitation (DMR) is considered more challenging than posterior leaflet repair.</div></div><div><h3>Objectives</h3><div>The aim of this analysis was to evaluate the impact of anterior, posterior, or bileaflet disease on outcomes following mitral transcatheter edge-to-edge repair (M-TEER) in the EXPANDed studies.</div></div><div><h3>Methods</h3><div>EXPANDed is a pooled, patient-level analysis of subjects undergoing M-TEER with the MitraClip G3 or G4 system as part of the contemporary EXPAND and EXPAND G4 studies. Subjects with DMR were categorized according to echocardiography core laboratory–assessed prolapse or flail location into posterior (prolapse or flail at P1, P2, and/or P3), anterior (prolapse or flail at A1, A2, and/or A3) or bileaflet disease (prolapse or flail at any combination of A1, A2, and A3 and P1, P2, and P3). Key outcomes assessed included procedural outcomes, 30-day major adverse events, and 1-year mitral regurgitation (MR) severity.</div></div><div><h3>Results</h3><div>Of 2,205 subjects in EXPANDed, 556 had echocardiography core laboratory–assessed DMR and prolapse or flail location. A total of 389 had posterior, 106 had anterior, and 61 had bileaflet disease. All groups experienced low device and procedure times with high procedural success rates (defined as discharge MR ≤2+). Thirty-day major adverse events rates were low across all groups (posterior, 4.4% [17 of 388]; anterior, 3.8% [4 of 105]; bileaflet, 6.6% [4 of 61]; <em>P</em> = 0.65). Through 1 year, all groups showed a significant reduction in MR severity from baseline (MR ≤1+ posterior, 82% [179 of 219]; anterior, 93% [53 of 57]; bileaflet, 97% [28 of 29]).</div></div><div><h3>Conclusions</h3><div>Results from the EXPANDed studies demonstrate that subjects with DMR treated with M-TEER experienced significant improvements in outcomes, regardless of the location of prolapse or flail.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 898-908"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567178","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":"IVUS-Guided PCI Optimization in Patients With Post-PCI FFR <0.90","authors":"Tara Neleman PhD ,&nbsp;Annemieke C. Ziedses des Plantes BSc ,&nbsp;Alessandra Scoccia MD,&nbsp;Frederik T.W. Groenland MD,&nbsp;Laurens J.C. van Zandvoort MD, PhD,&nbsp;Paul Cummins CCRN,&nbsp;Eric Boersma PhD,&nbsp;Wijnand K. den Dekker MD, PhD,&nbsp;Roberto Diletti MD, PhD,&nbsp;Jeroen Wilschut MD,&nbsp;Nicolas M. Van Mieghem MD, PhD,&nbsp;Joost Daemen MD, PhD","doi":"10.1016/j.jcin.2024.12.021","DOIUrl":"10.1016/j.jcin.2024.12.021","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 958-960"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476523","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":"From Cath Lab to C-Suite","authors":"Mohamad Alkhouli MD, MBA (Deputy Editor, JACC: Cardiovascular Interventions)","doi":"10.1016/j.jcin.2025.03.004","DOIUrl":"10.1016/j.jcin.2025.03.004","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 961-962"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742912","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":"Beyond Rescue","authors":"Sabine Bleiziffer MD","doi":"10.1016/j.jcin.2025.03.006","DOIUrl":"10.1016/j.jcin.2025.03.006","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 924-926"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828711","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":"Fish and CHIP","authors":"Jonathan X. Fang MBBS ,&nbsp;Zaid Al Jebaje MD ,&nbsp;Khaldoon Alaswad MD ,&nbsp;Gennaro Giustino MD ,&nbsp;James C. Lee MD ,&nbsp;Brian P. O’Neill MD ,&nbsp;Pedro Engel Gonzalez MD ,&nbsp;Tiberio M. Frisoli MD ,&nbsp;Hussayn Alrayes DO ,&nbsp;Leo Kar Lok Lai MBChB ,&nbsp;Dee Dee Wang MD ,&nbsp;William W. O’Neill MD ,&nbsp;Pedro A. Villablanca MD, MSc","doi":"10.1016/j.jcin.2025.01.009","DOIUrl":"10.1016/j.jcin.2025.01.009","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 942-945"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828704","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":"Physiological Disease Pattern as Assessed by Pull Back Pressure Gradient Index in Vessels With FFR/iFR Discordance","authors":"Pruthvi C. Revaiah MD, DM ,&nbsp;Tsung-Ying Tsai MD ,&nbsp;Albert Chinhenzva MSc, MPH ,&nbsp;Kotaro Miyashita MD ,&nbsp;Akihiro Tobe MD ,&nbsp;Asahi Oshima MD ,&nbsp;Gonçalo Ferraz-Costa MD ,&nbsp;Scot Garg MD, PhD ,&nbsp;Simone Biscaglia MD ,&nbsp;Manesh Patel MD ,&nbsp;Carlos Collet MD, PhD ,&nbsp;Takashi Akasaka MD ,&nbsp;Javier Escaned MD, PhD ,&nbsp;Yoshinobu Onuma MD, PhD ,&nbsp;Patrick W. Serruys MD, PhD","doi":"10.1016/j.jcin.2024.12.017","DOIUrl":"10.1016/j.jcin.2024.12.017","url":null,"abstract":"<div><h3>Background</h3><div>Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are discordant in approximately 20% of cases, and it is unclear whether this is influenced by the physiological pattern of coronary artery disease (CAD). The pull back pressure gradient index (PPGi) can objectively characterize the physiological pattern of CADs.</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate whether PPGi differed in discordant groups (FFR+/iFR− vs FFR−/iFR+).</div></div><div><h3>Methods</h3><div>The study enrolled 355 patients (390 vessels) with chronic coronary syndrome who had ≥1 epicardial coronary artery lesion with 40% to 90% diameter stenosis by visual assessment on invasive coronary angiography and had analyzable FFR, iFR, and PPGi derived from quantitative flow ratio. Cutoffs for hemodynamic significance were FFR ≤0.80 and iFR ≤0.89. Vessels were classified as FFR+/iFR+ (n = 103 [26.4%]), FFR−/iFR+ (n = 27 [6.9%]), FFR+/iFR− (n = 38 [9.7%]), and FFR−/iFR− (n = 222 [57%]) groups.</div></div><div><h3>Results</h3><div>Median FFR, iFR, and quantitative flow ratio were 0.84 (Q1-Q3: 0.77-0.90), 0.92 (Q1-Q3: 0.88-0.97), and 0.83 (Q1-Q3: 0.73-0.90), respectively. FFR disagreed with iFR in 16.7% of cases (65 of 390). The median PPGi was 0.75 (Q1-Q3: 0.67-0.85). The physiological pattern of CAD was classified according to the PPGi as predominantly physiologically focal (PPGi ≥0.75) in 209 of 390 vessels (53.6%) or diffuse (PPGi &lt; 0.75) in 181 of 390 vessels (46.4%). The median PPGi was significantly lower in FFR−/iFR+ vs FFR+/iFR− vessels (0.65 [Q1-Q3: 0.60-0.69] vs 0.82 [Q1-Q3: 0.75-0.85]; <em>P</em> &lt; 0.001). Predominantly physiologically focal disease was significantly associated with FFR+/iFR− (76.3% [29 of 38]), while predominantly physiologically diffuse disease was significantly associated with FFR−/iFR+ (96.3% [26 of 27] [<em>P</em> &lt; 0.001] for pattern of CAD between FFR+/iFR− and FFR−/iFR+ groups).</div></div><div><h3>Conclusions</h3><div>The physiological pattern of CAD is an important influencing factor in FFR/iFR discordance. (Radiographic Imaging Validation and Evaluation for Angio iFR [REVEAL iFR]; <span><span>NCT03857503</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 823-834"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476529","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":"Residual Mitral Regurgitation Predicts Survival Independent of Mitral Valve Pressure Gradient Following Transcatheter Edge-to-Edge Repair","authors":"Dennis Rottländer MD,&nbsp;Jörg Hausleiter MD,&nbsp;Thomas Schmitz MD,&nbsp;Alexander Bufe MD,&nbsp;Melchior Seyfarth MD,&nbsp;Ralph Stephan von Bardeleben MD,&nbsp;Harald Beucher MD,&nbsp;Taoufik Ouarrak MSc,&nbsp;Steffen Schneider PhD,&nbsp;Peter Boekstegers MD,&nbsp;the MITRA-PRO Investigators","doi":"10.1016/j.jcin.2025.01.420","DOIUrl":"10.1016/j.jcin.2025.01.420","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 7","pages":"Pages 950-952"},"PeriodicalIF":11.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567173","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}