Won-Keun Kim, Costanza Pellegrini, Clemens Eckel, Matthias Renker, Christina Grothusen, Yeong-Hoon Choi, Efstratios I Charitos, Charlotte Duesmann, Johannes Blumenstein, Tobias Rheude, Samuel Sossalla, Michael Joner, Helge Möllmann
{"title":"1-Year Outcomes of Transcatheter Aortic Valve Replacement Using a Self-Expanding vs Balloon-Expandable Transcatheter Aortic Valve.","authors":"Won-Keun Kim, Costanza Pellegrini, Clemens Eckel, Matthias Renker, Christina Grothusen, Yeong-Hoon Choi, Efstratios I Charitos, Charlotte Duesmann, Johannes Blumenstein, Tobias Rheude, Samuel Sossalla, Michael Joner, Helge Möllmann","doi":"10.1016/j.jcin.2024.09.042","DOIUrl":"10.1016/j.jcin.2024.09.042","url":null,"abstract":"<p><strong>Background: </strong>Mid-term comparative data for the self-expanding ACURATE neo2 transcatheter heart valve and the balloon-expandable SAPIEN 3 Ultra are lacking.</p><p><strong>Objectives: </strong>The aim of this study was to compare 1-year outcomes after transcatheter aortic valve replacement of these 2 valves.</p><p><strong>Methods: </strong>A total of 2,106 patients from 3 centers (neo2, n = 1,166; Ultra, n = 940) undergoing transfemoral transcatheter aortic valve replacement were analyzed retrospectively. The primary endpoint was the composite of all-cause mortality, stroke, and rehospitalization at 1 year. Secondary endpoints were the individual components of the primary endpoint at 1 year. To adjust for baseline differences, nearest neighbor propensity score matching was used.</p><p><strong>Results: </strong>After matching (702 pairs), baseline characteristics were similar between groups. Device success was more common in the neo2 group (87.5% vs 82.3%; P = 0.007), irrespective of matching. DP mean after the procedure was higher for Ultra (13 mm Hg [Q1-Q3: 10-15 mm Hg] vs 8 mm Hg [Q1-Q3: 6-11] mm Hg; P < 0.001). Rates of paravalvular leakage, device embolization, and multiple valve implantations were more common in the neo2 arm, whereas major cardiac structural complications and major vascular complications occurred more frequently in the Ultra group. All other in-hospital complication rates were similar between the 2 groups. At 1 year, the cumulative incidence of the primary endpoint (14.1% for neo2 vs 14.5% for Ultra; P = 0.819) was similar between the groups. Likewise, the individual components showed no difference between the groups.</p><p><strong>Conclusions: </strong>Despite differing immediate results, the outcomes at 1 year, including the composite of all-cause mortality, stroke, or hospitalization, were similar for neo2 and Ultra transcatheter heart valves.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"32-40"},"PeriodicalIF":11.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682003","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}
Iván Gómez-Blázquez, Felipe Díez-Delhoyo, Julio García-Tejada, Ignacio Fernández-Herrero, Nicolás Maneiro-Melón, Rafael Salguero-Bodes, Fernando Sarnago-Cebada
{"title":"Left Ventricular Embolization During TAVR for Pure Aortic Regurgitation: Arterio-Arterial Loop as a Bailout Technique.","authors":"Iván Gómez-Blázquez, Felipe Díez-Delhoyo, Julio García-Tejada, Ignacio Fernández-Herrero, Nicolás Maneiro-Melón, Rafael Salguero-Bodes, Fernando Sarnago-Cebada","doi":"10.1016/j.jcin.2024.09.022","DOIUrl":"10.1016/j.jcin.2024.09.022","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"120-122"},"PeriodicalIF":11.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620819","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}
Sahar Samimi, Taha Hatab, Chloe Kharsa, Safi U Khan, Rody G Bou Chaaya, Fatima Qamar, Joe Aoun, Syed Zaid, Nadeen Faza, Marvin D Atkins, Stephen H Little, William A Zoghbi, Michael J Reardon, Neal S Kleiman, Sachin S Goel
{"title":"Meta-Analysis of Dedicated vs Off-Label Transcatheter Devices for Native Aortic Regurgitation.","authors":"Sahar Samimi, Taha Hatab, Chloe Kharsa, Safi U Khan, Rody G Bou Chaaya, Fatima Qamar, Joe Aoun, Syed Zaid, Nadeen Faza, Marvin D Atkins, Stephen H Little, William A Zoghbi, Michael J Reardon, Neal S Kleiman, Sachin S Goel","doi":"10.1016/j.jcin.2024.08.042","DOIUrl":"10.1016/j.jcin.2024.08.042","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) for high surgical risk patients with severe native aortic regurgitation (AR) presents unique challenges. Dedicated devices such as the JenaValve (JenaValve Technology) and J-Valve (JC Medical Inc) show promising results in addressing these challenges.</p><p><strong>Objectives: </strong>This study compares the safety and efficacy of dedicated vs off-label devices among high surgical risk patients with pure native AR.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials through July 11, 2024, for studies on TAVR among patients with pure severe native AR. The primary endpoint was 30-day all-cause mortality. Secondary endpoints were device success, residual AR ≥ moderate, valve embolization/migration, pacemaker implantation, reintervention, and all-cause mortality at 1 year. Summary estimates were constructed using a random effects model.</p><p><strong>Results: </strong>A total of 34 studies encompassing 2,162 patients (mean age 75.4 ± 0.2 years, 42.8% women) were included in the meta-analysis. Patients undergoing TAVR with dedicated devices had a lower all-cause 30-day mortality rate (3% vs 9%; P < 0.01) and higher device success (93% vs 82%; P < 0.01) compared with off-label devices. The risk of AR ≥ moderate (2% vs 5%; P = 0.03), valve embolization/migration (2% vs 8%; P < 0.01), pacemaker implantation (11% vs 20%; P < 0.01), and reintervention (4% vs 10%; P < 0.01) at 30 days and all-cause mortality at 1 year (6% vs 24%; P < 0.01) were lower in the dedicated device group.</p><p><strong>Conclusions: </strong>Dedicated TAVR devices for native AR show superior device success and reduced mortality, residual AR, and reintervention rates compared with off-label devices. These findings support the use of dedicated devices as a safer alternative for high-risk patients.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"44-57"},"PeriodicalIF":11.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682010","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}
Dan Haberman, Lior Lupu, Ilan Merdler, Kalyan R Chitturi, Itsik Ben-Dor, Lowell F Satler, Ron Waksman, Toby Rogers
{"title":"UNICORN With a Self-Expanding Valve to Treat a Degenerated Balloon-Expandable Valve.","authors":"Dan Haberman, Lior Lupu, Ilan Merdler, Kalyan R Chitturi, Itsik Ben-Dor, Lowell F Satler, Ron Waksman, Toby Rogers","doi":"10.1016/j.jcin.2024.09.048","DOIUrl":"10.1016/j.jcin.2024.09.048","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":"123-125"},"PeriodicalIF":11.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682013","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}
Giuseppe Tarantini, Gilbert H L Tang, Thomas Pilgrim, Won-K Kim, Adam Greenbaum, Fausto Castriota, John G Webb, Luis Nombela Franco, Ole De Backer, Tau Hartikainen, Pablo Codner, Ofir Koren, Vivek Patel, David Meier, Daijiro Tomii, Hiroki A Ueyama, José Gildardo Paredes-Vázquez, Federico Arturi, Ran Kornowski, Raj R Makkar, Francesco Cardaioli, Luca Nai Fovino
{"title":"Clinical Characteristics and Outcomes of Patients Undergoing 3 Aortic Valve Interventions: The THIRD Multicenter Registry.","authors":"Giuseppe Tarantini, Gilbert H L Tang, Thomas Pilgrim, Won-K Kim, Adam Greenbaum, Fausto Castriota, John G Webb, Luis Nombela Franco, Ole De Backer, Tau Hartikainen, Pablo Codner, Ofir Koren, Vivek Patel, David Meier, Daijiro Tomii, Hiroki A Ueyama, José Gildardo Paredes-Vázquez, Federico Arturi, Ran Kornowski, Raj R Makkar, Francesco Cardaioli, Luca Nai Fovino","doi":"10.1016/j.jcin.2024.10.037","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.037","url":null,"abstract":"<p><strong>Background: </strong>Lifetime treatment of aortic valve disease is a matter of increasing debate. Although the risks of a second aortic valve intervention are recognized, little attention has been given to the challenges of a third.</p><p><strong>Objectives: </strong>This study delves into the clinical characteristics, indications, and outcomes of patients undergoing 3 aortic valve interventions.</p><p><strong>Methods: </strong>The THIRD (THree aortIc Reinterventions for valve Disease) registry is a retrospective multicenter, international study of patients who underwent a third procedure on the aortic valve, either surgically or transcatheter-based. Patients undergoing 2 aortic procedures during the same hospital admission were excluded. Baseline characteristics, timing, and mode of bioprosthetic failure, sequence of the procedures, and clinical outcomes were adjudicated according to the Valve Academic Research Consortium criteria.</p><p><strong>Results: </strong>A total of 51 patients from 11 centers were enrolled in this study. Median follow-up time was 565 (314-1,560) days. Eighteen patients (35%) underwent surgical aortic valve replacement (SAVR), and 33 of 51 patients (65%) underwent transcatheter aortic valve replacement (TAVR) as the third intervention. Mean age was 69 ± 14 years, 20 of 51 patients (39%) were female. STS score was 5.0% (Q1-Q3: 3.3%-7.0%). In all TAVR cases, the indication for the first intervention was severe aortic stenosis, as was the indication in 31 of 45 (69%) of SAVR cases (33% bicuspid). The most prevalent procedure sequence was SAVR-SAVR-TAVR (19/51, 37%), followed by SAVR-SAVR-SAVR (10/51, 20%) and SAVR-TAVR-TAVR (10/51, 20%). TAVR-TAVR-TAVR was performed in 4 of 51 cases (8%). The primary indications for a third intervention included structural valve deterioration (SVD) (39/51, 76%), non-SVD (8/51, 16%), and endocarditis (2/51, 4%). Excluding patients with a mechanical prosthesis, predictors of SAVR as third intervention included a lower STS score (OR: 0.58; 95% CI: 0.34-0.98; P = 0.04) and the presence of moderate or severe prosthesis-patient mismatch (OR: 44.8; 95% CI: 2.41-122.00; P = 0.01). Thirty-day device success was 85% for TAVR and 94% for SAVR.</p><p><strong>Conclusions: </strong>In the THIRD registry, SVD emerged as the predominant indication for a third aortic valve procedure. The most frequent procedure sequence was SAVR-SAVR-TAVR, whereas TAVR-TAVR-TAVR was less common. Although the short-term outcomes in our selected cohort were favorable, further investigation is needed.</p>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 1","pages":"103-115"},"PeriodicalIF":11.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005604","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":"Bioresorbable Vascular Scaffolds Journey: A New Brick Into a Still Dismantled Wall.","authors":"Salvatore Brugaletta, Giovanni Occhipinti","doi":"10.1016/j.jcin.2024.10.054","DOIUrl":"https://doi.org/10.1016/j.jcin.2024.10.054","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 1","pages":"28-31"},"PeriodicalIF":11.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005586","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}