JACC. Cardiovascular interventions最新文献

{"title":"Same-Day Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement","authors":"Quentin Fischer MD ,&nbsp;Marina Urena MD, PhD ,&nbsp;Guillem Muntané-Carol MD, PhD ,&nbsp;Alberto Alperi MD, PhD ,&nbsp;Luis Nombela-Franco MD, PhD ,&nbsp;Gabriela Veiga MD, PhD ,&nbsp;Ander Regueiro MD, PhD ,&nbsp;Gaspard Suc MD ,&nbsp;Rafael Romaguera MD ,&nbsp;Pablo Avanzas MD, PhD ,&nbsp;Gabriela Tirado-Conte MD ,&nbsp;Jose M. de la Torre Hernandez MD, PhD ,&nbsp;Pedro Cepas-Guillén MD, PhD ,&nbsp;Mélanie Côté MSc ,&nbsp;François Philippon MD ,&nbsp;Josep Rodés-Cabau MD, PhD","doi":"10.1016/j.jcin.2025.05.041","DOIUrl":"10.1016/j.jcin.2025.05.041","url":null,"abstract":"<div><h3>Background</h3><div>The development of conduction disturbances leading to permanent pacemaker implantation (PPI) remains the main complication of transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Objectives</h3><div>The aim of this study was to determine the impact of same-day PPI in patients developing persistent complete or high-degree atrio-ventricular block (CHB/HAVB) during TAVR.</div></div><div><h3>Methods</h3><div>This was a multicenter study including consecutive patients without prior pacemaker and developing procedural persistent CHB/HAVB. Baseline, procedural, and follow-up clinical and pacing interrogation data were prospectively collected in a dedicated database.</div></div><div><h3>Results</h3><div>A total of 584 consecutive patients (mean age: 81 ± 8 years, 50% of women) were included; 157 (26.9%) had same-day PPI (SDP), and 427 (73.1%) were observed to assess for potential conduction recovery (n-SDP). In the n-SDP group, 376 patients (88%) finally received a PPI at a median of 3 [1-4] days following TAVR. There were no differences in periprocedural complications between groups, including pacemaker pocket hematomas, and the hospitalization length was shorter in the SDP group (5 [2-7] days vs 8[4-9] days; <em>P</em> &lt; 0.001). At 1-month follow-up, the median percentage of ventricular pacing (SDP: 96% (22%-99%), n-SDP: 90% (10%-99%); <em>P</em> = 0.203) and pacemaker dependency rate (SDP: 56%, n-SDP: 50%; <em>P</em> = 0.277) were similar in both groups.</div></div><div><h3>Conclusions</h3><div>In patients developing procedural persistent CHB/HAVB during TAVR, SDP was safe and associated with a shorter hospitalization length and a very high pacing burden at 30 days. These results, along with the very low rate of conduction recovery in the n-SDP group, would support SDP as a reasonable strategy in these patients.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 14","pages":"Pages 1776-1785"},"PeriodicalIF":11.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722452","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":"Finishing the Job","authors":"Georgi Fram MD,&nbsp;Hussayn Alrayes DO,&nbsp;Leo Kar Lok Lai MD,&nbsp;John Dawdy MD,&nbsp;Bryan Zweig MD,&nbsp;Sachin Parikh MD,&nbsp;James Alter RT(R)(CT),&nbsp;Pedro Engel Gonzalez MD,&nbsp;Pedro Villablanca MD,&nbsp;Brian O’Neill MD,&nbsp;James Lee MD,&nbsp;Tiberio Frisoli MD","doi":"10.1016/j.jcin.2025.03.009","DOIUrl":"10.1016/j.jcin.2025.03.009","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 14","pages":"Pages 1804-1805"},"PeriodicalIF":11.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013683","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":"“Bridging to Plug” for an A3-Scallop Prolapse With Deficient Posterior Leaflet","authors":"Joyce Shek MBChB ,&nbsp;Martin C.K. Wong MBBS ,&nbsp;Vyanne H.T. Chan MBBS ,&nbsp;Fuk Kei Fong MBBS ,&nbsp;Geri L.N. Wong MBChB ,&nbsp;Kevin K.H. Kam MBChB ,&nbsp;Alex P.W. Lee MD ,&nbsp;Kent C.Y. So MBChB","doi":"10.1016/j.jcin.2025.05.020","DOIUrl":"10.1016/j.jcin.2025.05.020","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 14","pages":"Pages 1817-1819"},"PeriodicalIF":11.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600442","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 Mechanisms in Aortic Stenosis and Following Transcatheter Aortic Valve Replacement","authors":"Antonin Trimaille MD, PhD,&nbsp;Sandy Hmadeh PhD,&nbsp;Benjamin Marchandot MD,&nbsp;Valérie Schini-Kerth PhD,&nbsp;Olivier Morel MD, PhD","doi":"10.1016/j.jcin.2025.03.037","DOIUrl":"10.1016/j.jcin.2025.03.037","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 14","pages":"Page 1831"},"PeriodicalIF":11.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720927","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":"The WOLVERINE Technique: Wire Landmark-Guided Orientation Controlled Leaflet-Resection to Prevent Left-Ventricular Outflow-Tract Obstruction Using Endoscopic-Scissors in TMVR Procedures.","authors":"Leo Kar Lok Lai, Hussayn Alrayes, Georgi Fram, John Dawdy, James C Lee, Brian P O'Neill, Tiberio M Frisoli, Pedro Engel Gonzalez, William W O'Neill, Pedro A Villablanca","doi":"10.1016/j.jcin.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.jcin.2025.06.014","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":""},"PeriodicalIF":11.7,"publicationDate":"2025-07-17","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":"Novel Percutaneous Septectomy for Left Atrial Myxoma","authors":"Barbara A. Danek MD ,&nbsp;Joseph Park MD ,&nbsp;David Elison MD ,&nbsp;Christine J. Chung MD ,&nbsp;G. Burkhard Mackensen MD, PhD ,&nbsp;James M. McCabe MD","doi":"10.1016/j.jcin.2025.04.030","DOIUrl":"10.1016/j.jcin.2025.04.030","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1699-1701"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325739","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":"Vessel Patency After Femoropopliteal Drug-Coated Balloon Therapy in Patients on Hemodialysis","authors":"Yasutaka Yamauchi MD, PhD ,&nbsp;Mitsuyoshi Takahara MD, PhD ,&nbsp;Yoshimitsu Soga MD, PhD ,&nbsp;Osamu Iida MD, PhD ,&nbsp;Akiko Tanaka MD ,&nbsp;Kazuki Tobita MD ,&nbsp;Daizo Kawasaki MD, PhD ,&nbsp;Masahiko Fujihara MD ,&nbsp;Amane Kozuki MD, PhD ,&nbsp;Akira Miyamoto MD, PhD","doi":"10.1016/j.jcin.2025.05.001","DOIUrl":"10.1016/j.jcin.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Drug-coated balloons (DCBs) are widely used as a core treatment for femoropopliteal lesions, but no largescale prospective studies have evaluated DCB in hemodialysis (HD) patients.</div></div><div><h3>Objectives</h3><div>The authors sought to clarify restenosis risk and associated factors after DCB therapy for symptomatic femoropopliteal artery disease in patients on HD.</div></div><div><h3>Methods</h3><div>We analyzed the database of a multicenter prospective study that registered patients undergoing DCB treatment (either Lutonix or IN.PACT Admiral) from March 2018 to December 2019. Of the 3,165 registered lesions, 991 lesions were in patients on HD. The primary outcome was freedom from restenosis.</div></div><div><h3>Results</h3><div>The HD group was younger (72 ± 9 years vs 76 ± 9 years) and had a higher frequency of diabetes (76.5% [557/728 patients]) vs 60.8% [1,081/1,779 patients]). The prevalence of chronic limb-threatening ischemia was 52.2% (444/850 patients) vs 22.1% (437/1,977 patients). Lutonix was used in 30.6% (688/991 lesions) vs 21.3% (462/2,174 lesions), and IN.PACT Admiral was used in 69.4% (303/991 lesions) vs 78.7% (1,712/2,174 lesions). After propensity-score matching, the 1- and 3-year rates of freedom from restenosis in the HD and non-HD groups were 82.2% (95% CI: 79.0%-85.3%) vs 85.8% (83.0%-88.7%) at 1 year and 61.9% (57.7%-66.1%) vs 66.3% (62.2%-70.4%) at 3 years, respectively. In the HD group, restenosis occurred in 363 lesions during a median follow-up of 16.2 months (Q1-Q3: 7.2-35.5 months). Factors independently associated with restenosis risk in the HD group were no below-the-knee runoff, history of endovascular therapy, popliteal lesion, severe calcification, use of Lutonix, and severe dissection.</div></div><div><h3>Conclusions</h3><div>DCB endovascular therapy is a reasonable treatment for femoropopliteal lesions in patients on HD.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1660-1670"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632521","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":"Aortic Tortuosity as a Predictor of Surgical Bailout and Adverse Outcomes in TAVR","authors":"Thomas Lohse MD,&nbsp;Ahmad Hayek MD, MSc,&nbsp;Brahim Harbaoui MD, PhD","doi":"10.1016/j.jcin.2025.01.447","DOIUrl":"10.1016/j.jcin.2025.01.447","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Page 1717"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991044","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":"Prognostic Value of Microvascular Function in Takotsubo Syndrome","authors":"Rob Eerdekens MD, MSc ,&nbsp;Mohamed El Farissi MD, PhD ,&nbsp;Giovanni Luigi De Maria MD, PhD ,&nbsp;Aviel Shetrit MD ,&nbsp;Robert Sykes MBChB, MSc ,&nbsp;Christina Ekenbäck MD, PhD ,&nbsp;Jonas Persson MD, PhD ,&nbsp;Jonas Spaak MD, PhD ,&nbsp;Liam S. Couch MBBS, PhD ,&nbsp;Fernando Alfonso MD, PhD ,&nbsp;Fernando Rivero MD, PhD ,&nbsp;Nieves Gonzalo MD, PhD ,&nbsp;Javier Escaned MD, PhD ,&nbsp;Iván J. Núñez Gil MD, PhD ,&nbsp;Oscar Vedia Cruz MD ,&nbsp;Reut Amar Shamir MD ,&nbsp;Ophir Freund MD ,&nbsp;Marc Vanderheyden MD ,&nbsp;Marta Belmonte MD ,&nbsp;Emanuele Barbato MD, PhD ,&nbsp;Frederik M. Zimmermann MD, PhD","doi":"10.1016/j.jcin.2025.05.028","DOIUrl":"10.1016/j.jcin.2025.05.028","url":null,"abstract":"<div><h3>Background</h3><div>Coronary microvascular dysfunction appears to play a major role in the pathogenesis of Takotsubo syndrome (TTS). However, the prognostic value of microvascular function measured in the acute phase of TTS is unclear.</div></div><div><h3>Objectives</h3><div>This study sought to assess the prognostic value of microvascular function measured invasively in the acute phase of TTS.</div></div><div><h3>Methods</h3><div>In a collaborative, pooled analysis of individual patient data from 9 prospective TTS cohorts, invasive assessment of coronary microvascular function was performed, including the index of microcirculatory resistance (IMR), coronary flow reserve, and microvascular resistance reserve. The primary endpoint was all-cause mortality. Secondary endpoints included major adverse cardiac and cerebrovascular events (MACCE) defined as the composite of all-cause death, recurrence of TTS, stroke, transient ischemic attack, or myocardial infarction.</div></div><div><h3>Results</h3><div>A total of 166 patients with TTS were included, in whom 130 (78%) had the typical (apical) TTS variant and 36 (22%) had an atypical variant. During a median follow-up of 20.6 [4.3-60.0] months, all-cause mortality occurred in 17 patients (10.2%) and MACCE in 29 patients (17.5%). IMR, coronary flow reserve, and microvascular resistance reserve were associated with all-cause mortality. After adjustment for baseline differences, IMR was the only independent predictor of both all-cause mortality (aHR: 3.9; 95% CI: 1.39-10.88; <em>P</em> = 0.010; c-statistic 0.817; 95% CI: 0.711-0.923) and MACCE (aHR: 2.6; 95% CI: 1.17-5.67; <em>P</em> = 0.018; c-statistic 0.719; 95% CI: 0.612-0.826).</div></div><div><h3>Conclusions</h3><div>In this pooled analysis of individual patient data from 9 prospective TTS cohorts, microvascular dysfunction measured in the acute phase was associated with all-cause mortality. In particular, an elevated microvascular resistance, as assessed by IMR, was the only independent predictor of both mortality and MACCE.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1646-1656"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136656","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":"Randomized Comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in Serial Disease","authors":"Matthew E. Li Kam Wa MBBS ,&nbsp;Saad M. Ezad MBBCh ,&nbsp;Bhavik Modi PhD ,&nbsp;Ozan M. Demir PhD ,&nbsp;Jonathan Hinton MD ,&nbsp;Howard Ellis BSc ,&nbsp;Kalpa De Silva PhD ,&nbsp;Ankur Gulati MD ,&nbsp;Ranil De Silva PhD ,&nbsp;Peter O’Kane MD ,&nbsp;Abdel Douiri PhD ,&nbsp;Damien Collison MD ,&nbsp;Nick Curzen PhD ,&nbsp;Carlos Collet PhD ,&nbsp;Divaka Perera MD","doi":"10.1016/j.jcin.2025.05.033","DOIUrl":"10.1016/j.jcin.2025.05.033","url":null,"abstract":"<div><h3>Background</h3><div>Fractional flow reserve (FFR) and the instantaneous wave-free ratio (iFR) identify arteries that benefit from percutaneous coronary intervention (PCI). FFR or iFR gradients on pullback are often used to predict the physiological result (FFR_Δ or iFR_Δ), but this approach is unvalidated.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare the accuracy of FFR_Δ, iFR_Δ and FFR_calc (a mathematical solution incorporating interaction between lesions) for predicting post-PCI physiology in serial or diffuse disease.</div></div><div><h3>Methods</h3><div>Patients with a focal target lesion and either a second focal lesion or a diffusely diseased segment in the same vessel were randomized to FFR- vs iFR-guided PCI (<span><span>ISRCTN18106869</span><svg><path></path></svg></span>). FFR and iFR pullbacks were performed, with operators blinded to one modality. Following target lesion PCI, FFR and iFR were remeasured. The primary outcome was the error in predicted post-PCI physiology compared with actual values.</div></div><div><h3>Results</h3><div>A total of 87 patients were randomized to FFR (n = 45) or iFR (n = 42). Median FFR and iFR were 0.70 (Q1-Q3: 0.62 to 0.78) and 0.81 (Q1-Q3: 0.68 to 0.90) at baseline and 0.82 (Q1-Q3: 0.74 to 0.87) and 0.89 (Q1-Q3: 0.83 to 0.93) after target lesion PCI. The predictive errors were 12% (6% to 17%) for FFR_Δ, 4% (0% to 9%; <em>P</em> &lt; 0.001) for iFR_Δ, and −5% (−18% to 8%; <em>P</em> = 0.427) for FFR_calc. Significant residual disease was missed in 36% of cases with FFR_Δ, 34% with iFR_Δ, and 14% with FFR_calc.</div></div><div><h3>Conclusions</h3><div>FFR and iFR pullback gradients overestimate the benefit of target lesion PCI and can miss residual ischemia in one-third of patients. FFR or iFR should be routinely repeated post-PCI in serial disease.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1617-1627"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632522","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}