{"title":"Prosthesis-Patient Mismatch in Young and Low-Risk Patients After Newer Generation Balloon-Expandable Transcatheter Aortic Valve Replacement","authors":"Kazuki Suruga MD , Vivek Patel MS , Takashi Nagasaka MD , Yuchao Guo MD , Prateek Madaan MD , Ofir Koren MD , Dhairya Patel MPH , Izabela Harutyunyan MSN , Aakriti Gupta MD , Tarun Chakravarty MD , Wen Cheng MD , Hasan Jilaihawi MD , Mamoo Nakamura MD , Raj R. Makkar MD","doi":"10.1016/j.jcin.2025.05.003","DOIUrl":"10.1016/j.jcin.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>The clinical impact of prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is not well known in young and low-risk patients.</div></div><div><h3>Objectives</h3><div>The aim of this single-center study was to evaluate the incidence, predictors, and long-term impact of PPM in young and low-risk patients with severe native aortic stenosis (AS) following TAVR.</div></div><div><h3>Methods</h3><div>From August 2015 to December 2022, a total of 3,549 patients underwent TAVR with newer generation balloon-expandable valves. Among them, 512 patients with severe native AS who were younger than 75 years and had Society of Thoracic Surgeons scores <4% were included. All-cause and cardiovascular mortality or heart failure hospitalization during follow-up period were compared between the PPM and non-PPM groups. PPM was defined according to the Valve Academic Research Consortium-3 criteria.</div></div><div><h3>Results</h3><div>PPM was observed in 200 of 512 patients (39.0%), with moderate and severe PPM in 162 of 512 (31.6%) and 38 of 512 (7.4%), respectively. Younger age, female sex, larger body surface area, no balloon postdilation, and smaller annular area were independent predictors of PPM. Over a median follow-up duration of 1,034 days (Q1-Q3: 550-1,567 days), compared with the non-PPM group, the PPM group had significantly higher all-cause mortality (HR: 2.55; 95% CI: 1.3-5.0; <em>P</em> = 0.007), cardiovascular mortality (HR: 2.81; 95% CI: 1.1-7.5; <em>P</em> = 0.04), and heart failure hospitalization (HR: 4.43; 95% CI: 2.0-9.9; <em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>PPM is associated with worse clinical outcomes in young and low-risk patients with AS after TAVR, even with newer generation balloon-expandable valves.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 12","pages":"Pages 1512-1523"},"PeriodicalIF":11.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365472","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}
Gennaro Giustino MD , Konstantinos Koulogiannis MD , Lawrence Blitz MD , Benjamin van Boxtel MD , Barry Cohen MD , Pedro Villablanca MD , Linda Gillam MD , John Brown III MD , Robert Kipperman MD , Philippe Genereux MD
{"title":"First-in-Human Percutaneous Transseptal Retrieval of Embolized Transcatheter Valve in the Left Ventricle","authors":"Gennaro Giustino MD , Konstantinos Koulogiannis MD , Lawrence Blitz MD , Benjamin van Boxtel MD , Barry Cohen MD , Pedro Villablanca MD , Linda Gillam MD , John Brown III MD , Robert Kipperman MD , Philippe Genereux MD","doi":"10.1016/j.jcin.2025.03.011","DOIUrl":"10.1016/j.jcin.2025.03.011","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 12","pages":"Pages 1591-1594"},"PeriodicalIF":11.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010242","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":"How Does the TAVR Universe Best Expand?","authors":"Sachin S. Goel MD , Michael J. Reardon MD","doi":"10.1016/j.jcin.2025.03.035","DOIUrl":"10.1016/j.jcin.2025.03.035","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 12","pages":"Pages 1569-1570"},"PeriodicalIF":11.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365349","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}
Stefano Cannata MD , Ibrahim Sultan MD , Nicolas Van Mieghem MD , Arturo Giordano MD , Ole De Backer MD , Johnathan Byrne MD , Didier Tchetche MD , Sergio Buccheri MD , Luis Nombela-Franco MD , Rui Campante Teles MD, PhD , Marco Barbanti MD , Emanuele Barbato MD , Ignacio Amat Santos MD , Daniel J. Blackman MD , Francesco Maisano MD , Roberto Lorusso MD, PhD , Ketty La Spina MD , Antonella Millin MD , Dustin E. Kliner MD , Mark van den Dorpel MD , Azeem Latib MD
{"title":"Transcatheter Aortic Valve Replacement With Intra-Annular Self-Expanding or Balloon-Expandable Valves","authors":"Stefano Cannata MD , Ibrahim Sultan MD , Nicolas Van Mieghem MD , Arturo Giordano MD , Ole De Backer MD , Johnathan Byrne MD , Didier Tchetche MD , Sergio Buccheri MD , Luis Nombela-Franco MD , Rui Campante Teles MD, PhD , Marco Barbanti MD , Emanuele Barbato MD , Ignacio Amat Santos MD , Daniel J. Blackman MD , Francesco Maisano MD , Roberto Lorusso MD, PhD , Ketty La Spina MD , Antonella Millin MD , Dustin E. Kliner MD , Mark van den Dorpel MD , Azeem Latib MD","doi":"10.1016/j.jcin.2025.03.015","DOIUrl":"10.1016/j.jcin.2025.03.015","url":null,"abstract":"<div><h3>Background</h3><div>No comparative data exist with the self-expanding Navitor (NAV) and the balloon-expandable SAPIEN 3 Ultra (ULTRA) transcatheter heart valves (THVs).</div></div><div><h3>Objectives</h3><div>This study sought to investigate the 1-year outcomes of transcatheter aortic valve replacement using the intra-annular NAV and the ULTRA THVs.</div></div><div><h3>Methods</h3><div>The NAVULTRA (Navitor and SAPIEN 3 Ultra) registry included consecutive patients who underwent transfemoral transcatheter aortic valve replacement at 16 centers with NAV or ULTRA between November 2018 and April 2024. Propensity score matching was used for adjustment. The primary outcomes of interest were all-cause death and the composite of all-cause death, disabling stroke, and hospitalization for heart failure at 1 year.</div></div><div><h3>Results</h3><div>The overall study cohort included 3,878 patients treated with NAV (n = 1,746) or ULTRA (n = 2,176). The propensity score–matched population resulted in 1,363 pairs. At 1 year, the rate of death from any cause was 9.7% with NAV and 9.9% with ULTRA (adjusted <em>P</em> = 0.585). Similarly, there were no significant differences in primary composite outcome (13.6% in the NAV group and 12.6% in the ULTRA group; adjusted <em>P</em> = 0.218). The rate of new permanent pacemaker implantation (20.6% vs 10.6%; adjusted <em>P</em> < 0.01) and heart failure rehospitalization (4.6% vs 2.8%; adjusted <em>P</em> < 0.05) was higher in NAV group. At 1 year, the use of NAV was associated with higher rates of mild paravalvular leak (OR: 1.53; 95% CI: 1.01 to 2.33; adjusted <em>P</em> < 0.05) but lower mean transprosthetic gradients compared with ULTRA (mean change:−3.90, 95% CI: −4.47 to −3.34; adjusted <em>P</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>Both intra-annular THVs were associated with similar 1-year clinical outcomes; however, differences were observed in secondary clinical endpoints and valve hemodynamic performance.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 12","pages":"Pages 1557-1568"},"PeriodicalIF":11.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997295","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}
Henning Guthoff MD, Mohamed Abdel-Wahab MD, Won-Keun Kim MD, Jasmin Shamekhi MD, Helge Möllmann MD, Nicolas M. Van Mieghem MD, PhD, Stefan Toggweiler MD, Tobias Rheude MD, Tobias Zeus MD, Tanja K. Rudolph MD, Victor Mauri MD, IMPPACT TAVR Investigators
{"title":"Clinical Impact of Balloon-Expandable vs Self-Expanding TAVR in Small Aortic Annuli","authors":"Henning Guthoff MD, Mohamed Abdel-Wahab MD, Won-Keun Kim MD, Jasmin Shamekhi MD, Helge Möllmann MD, Nicolas M. Van Mieghem MD, PhD, Stefan Toggweiler MD, Tobias Rheude MD, Tobias Zeus MD, Tanja K. Rudolph MD, Victor Mauri MD, IMPPACT TAVR Investigators","doi":"10.1016/j.jcin.2025.03.020","DOIUrl":"10.1016/j.jcin.2025.03.020","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 12","pages":"Pages 1611-1613"},"PeriodicalIF":11.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965933","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}