Leo Kar Lok Lai MBChB, Hussayn Alrayes DO, Georgi Fram MD, James C. Lee MD, Ahmad Jabri MD, Joiven Nyongbella MD, Bryan Zweig MD, Brian P. O’Neill MD, Tiberio M. Frisoli MD, Pedro Engel Gonzalez MD, William W. O’Neill MD, Pedro A. Villablanca MD
{"title":"Beyond Limits in Alternative Access","authors":"Leo Kar Lok Lai MBChB, Hussayn Alrayes DO, Georgi Fram MD, James C. Lee MD, Ahmad Jabri MD, Joiven Nyongbella MD, Bryan Zweig MD, Brian P. O’Neill MD, Tiberio M. Frisoli MD, Pedro Engel Gonzalez MD, William W. O’Neill MD, Pedro A. Villablanca MD","doi":"10.1016/j.jcin.2025.05.035","DOIUrl":"10.1016/j.jcin.2025.05.035","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 19","pages":"Pages 2418-2420"},"PeriodicalIF":11.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278051","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}
Toby Rogers MD, PhD , Jaffar M. Khan BM BCh, PhD , Roger Laham MD , Vasilis C. Babaliaros MD , Adam B. Greenbaum MD , Lowell F. Satler MD , Azeem Latib MD , Jeremy D. Rier MD , James E. Harvey MD , J. Bradley Oldemeyer MD , Jamie M. McCabe MD , Jeremiah P. Depta MD , Jason R. Foerst MD , David V. Daniels MD , George A. Petrossian MD , Newell B. Robinson MD , William B. Chung MD , Isida Byku MD , Andrea Scotti MD , Justin A. Strote MD , Robert J. Lederman MD
{"title":"Electrosurgical Leaflet Modification to Prevent Coronary Obstruction During Transcatheter Aortic Valve Replacement in Failing Native and Bioprosthetic Valves","authors":"Toby Rogers MD, PhD , Jaffar M. Khan BM BCh, PhD , Roger Laham MD , Vasilis C. Babaliaros MD , Adam B. Greenbaum MD , Lowell F. Satler MD , Azeem Latib MD , Jeremy D. Rier MD , James E. Harvey MD , J. Bradley Oldemeyer MD , Jamie M. McCabe MD , Jeremiah P. Depta MD , Jason R. Foerst MD , David V. Daniels MD , George A. Petrossian MD , Newell B. Robinson MD , William B. Chung MD , Isida Byku MD , Andrea Scotti MD , Justin A. Strote MD , Robert J. Lederman MD","doi":"10.1016/j.jcin.2025.07.032","DOIUrl":"10.1016/j.jcin.2025.07.032","url":null,"abstract":"<div><h3>Background</h3><div>In patients with high-risk anatomy, transcatheter aortic valve replacement (TAVR) risks coronary obstruction which is associated with high morbidity and mortality. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) is effective at preventing coronary obstruction.</div></div><div><h3>Objectives</h3><div>The authors sought to test the safety and effectiveness of TELLTALE (Transmural Electrosurgery LeafLet Traversal And Laceration Equipment), the first dedicated transcatheter electrosurgery leaflet modification system.</div></div><div><h3>Methods</h3><div>The TELLTALE trial (<span><span>NCT05666713</span><svg><path></path></svg></span>) enrolled participants with high or prohibitive surgical risk undergoing TAVR for native aortic stenosis or bioprosthetic valve failure and in whom computed tomography core laboratory confirmed high risk of coronary obstruction. The primary efficacy endpoint was technical success in the catheterization lab and the primary safety endpoint was inpatient safety.</div></div><div><h3>Results</h3><div>A total of ninety participants (age 79 [75-82] years, 66% [59/90] female, 30 native aortic stenosis, 60 bioprosthetic valve failure) were enrolled at 11 centers in the United States. High risk of coronary obstruction was confirmed by computed tomography (coronary height 8.2 [6.3-10.8] mm, valve-to-coronary distance 3.4 [2.7-3.7] mm, valve-to-sinotubular-junction distance 1.2 [0.7-1.7] mm). Leaflet modification was easy and reliable with median 1 traversal and laceration attempt per participant. The primary efficacy endpoint was met in 100% (95% CI: 95%-100%) of participants. The primary safety endpoint was met in 96% (95% CI: 88%-99%) of participants, including zero mortality, 3 strokes (1 disabling, 2 nondisabling), and 1 coronary obstruction from transcatheter heart valve commissural suture pos-malalignment. At 30 days, there was zero mortality and zero delayed coronary obstruction.</div></div><div><h3>Conclusions</h3><div>Electrosurgical leaflet modification using the TELLTALE system is safe and effective in patients undergoing TAVR for native aortic stenosis or bioprosthetic valve failure at high risk of coronary obstruction.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 19","pages":"Pages 2355-2368"},"PeriodicalIF":11.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278405","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}
Leo Kar Lok Lai MD, Hussayn Alrayes DO, Georgi Fram MD, John Dawdy MD, James C. Lee MD, Brian P. O’Neill MD, Tiberio M. Frisoli MD, Pedro Engel Gonzalez MD, William W. O’Neill MD, Pedro A. Villablanca MD
{"title":"The WOLVERINE Technique","authors":"Leo Kar Lok Lai MD, Hussayn Alrayes DO, Georgi Fram MD, John Dawdy MD, James C. Lee MD, Brian P. O’Neill MD, Tiberio M. Frisoli MD, Pedro Engel Gonzalez MD, William W. O’Neill MD, Pedro A. Villablanca MD","doi":"10.1016/j.jcin.2025.06.014","DOIUrl":"10.1016/j.jcin.2025.06.014","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 19","pages":"Pages 2408-2410"},"PeriodicalIF":11.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698576","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":"Open for Business Next Year?","authors":"Andrew M. Goldsweig MD, MS , Mohamed Doma MD","doi":"10.1016/j.jcin.2025.08.025","DOIUrl":"10.1016/j.jcin.2025.08.025","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 19","pages":"Pages 2335-2337"},"PeriodicalIF":11.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278401","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}
Ho Young Hwang MD, PhD , Daixin Ding PhD , Jeehoon Kang MD , Pengcheng Sun PhD , Suk Ho Sohn MD, PhD , Shengxian Tu PhD , Bon-Kwon Koo MD, PhD
{"title":"Association Between Angiography-Derived Murray Law–Based Quantitative Flow Ratio and 1-Year Coronary Artery Bypass Graft Patency","authors":"Ho Young Hwang MD, PhD , Daixin Ding PhD , Jeehoon Kang MD , Pengcheng Sun PhD , Suk Ho Sohn MD, PhD , Shengxian Tu PhD , Bon-Kwon Koo MD, PhD","doi":"10.1016/j.jcin.2025.08.027","DOIUrl":"10.1016/j.jcin.2025.08.027","url":null,"abstract":"<div><h3>Background</h3><div>Studies evaluating the impact of functional significance of coronary artery stenosis-based decision-making on results after coronary artery bypass grafting (CABG) are limited.</div></div><div><h3>Objectives</h3><div>This study was conducted to evaluate the predictive value of preoperative angiography-derived Murray law–based quantitative flow ratio (μFR) of target native coronary arteries on 1-year graft patency following CABG.</div></div><div><h3>Methods</h3><div>A total of 809 patients who underwent isolated off-pump CABG for 3-vessel disease and 1-year graft evaluation were retrospectively enrolled. Preoperative μFR data were obtained for all feasible target vessels. Multivariable analyses were conducted using generalized linear mixed-effects models. The minimal <em>P</em> value approach was used to determine the optimal cutoff value of the μFR that predicting graft patency.</div></div><div><h3>Results</h3><div>The mean age of the study population was 65.9 ± 9.0 years. A total of 2,324 distal anastomoses were included in the analysis. Early and 1-year graft occlusion rates were 0.8% (19 of 2,324 anastomoses; 95% CI: 0.5-1.3 anastomoses) and 5.1% (118 of 2,324 anastomoses; 95% CI: 4.2-6.1 anastomoses), respectively. Multivariable analysis demonstrated that μFR was significantly associated with 1-year graft patency (OR [95% CI]: 0.847 [0.731-0.982]; <em>P</em> = 0.03), but not with early graft patency (0.941 [0.746-1.186]; <em>P</em> = 0.60). The minimal <em>P</em> value approach identified μFR values between 0.75 and 0.78 having the strongest discriminative power, with the lowest <em>P</em> value at a μFR of 0.77.</div></div><div><h3>Conclusions</h3><div>The functional significance of coronary artery stenosis of target vessels, as measured by μFR, is associated with 1-year graft patency after off-pump CABG with an optimal cutoff value of 0.77 (Association Between ΜFR and CABG Outcomes; <span><span>NCT06844721</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 19","pages":"Pages 2326-2334"},"PeriodicalIF":11.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278403","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}
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