Journal of interventional cardiology最新文献

{"title":"The Impact of Kidney Function on the Slow-Flow/No-Reflow Phenomenon in Patients Treated with Primary Percutaneous Coronary Intervention: Registry Analysis","authors":"Lidija Savic,&nbsp;Igor Mrdovic,&nbsp;Milika Asanin,&nbsp;Sanja Stankovic,&nbsp;Ratko Lasica,&nbsp;Gordana Krljanac,&nbsp;Dubravka Rajic,&nbsp;Damjan Simic","doi":"10.1155/2022/5815274","DOIUrl":"10.1155/2022/5815274","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The objective of this study is to analyze the impact of declining kidney function on the occurrence of the slow-flow/no-reflow phenomenon in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI (pPCI), as well as the analysis of the prognostic impact of the slow-flow/no-reflow phenomenon on short- and long-term mortality in these patients. <i>Methods</i>. We analyzed 3,115 consecutive patients. A value of the glomerular filtration rate (eGFR) at the time of admission of eGFR &lt;90 ml/min/m² was considered a low baseline eGFR. The follow-up period was 8 years. <i>Results</i>. The slow-flow/no-reflow phenomenon through the IRA was registered in 146 (4.7%) patients. Estimated GFR of &lt;90 ml/min/m² was an independent predictor for the occurrence of the slow-flow/no-reflow phenomenon (OR 2.91, 95% CI 1.25–3.95, <i>p</i> &lt; 0.001), and the risk for the occurrence of the slow-flow/no-reflow phenomenon increased with the decline of the kidney function: eGFR 60–89 ml/min/m²: OR 1.94 (95% CI 1.22–3.07, <i>p</i> = 0.005), eGFR 45–59 ml/min/m²: OR 2.55 (95% CI 1.55–4.94, <i>p</i> &lt; 0.001), eGFR 30–44 ml/min/m²: OR 2.77 (95% CI 1.43–5.25, <i>p</i> &lt; 0.001), eGFR 15–29 ml/min/m²: OR 5.84 (95% CI 2.84–8.01, <i>p</i> &lt; 0.001). The slow-flow/no-reflow phenomenon was a strong independent predictor of short- and long-term all-cause mortality: 30-day mortality (HR 2.62, 95% CI 1.78–3.57, <i>p</i> &lt; 0.001) and 8-year mortality (HR 2.09, 95% CI 1.49–2.09, <i>p</i> &lt; 0.001). <i>Conclusion</i>. Reduced baseline kidney function was an independent predictor for the occurrence of the slow-flow/no-reflow phenomenon, and its prognostic impact started with the mildest decrease in eGFR (below 90 ml/min/m²) and increased with its further decline. The slow-flow/no-reflow phenomenon was a strong independent predictor of mortality in the short- and long-term follow-up of the analyzed patients.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10399004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the Angle of the Left Subclavian Artery and Procedural Time for Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome","authors":"Masatsugu Miyagawa,&nbsp;Daisuke Fukamachi,&nbsp;Katsunori Fukumoto,&nbsp;Masaki Monden,&nbsp;Kurara Takahashi,&nbsp;Shohei Migita,&nbsp;Saki Mizobuchi,&nbsp;Yudai Tanaka,&nbsp;Akihito Ogaku,&nbsp;Yutaka Koyama,&nbsp;Hidesato Fujito,&nbsp;Riku Arai,&nbsp;Norio Takei,&nbsp;Keisuke Kojima,&nbsp;Korehito Iida,&nbsp;Nobuhiro Murata,&nbsp;Yasuo Okumura","doi":"10.1155/2022/3249745","DOIUrl":"10.1155/2022/3249745","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The effect of left subclavian artery tortuosity during percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) remains unclear. <i>Methods</i>. Of 245 ACS patients (from November 2019 and May 2021), 79 who underwent PCI via a left radial approach (LRA) were included. We measured the angle of the left subclavian artery in the coronal view on CT imaging as an indicator of the tortuosity and investigated the association between that angle and the clinical variables and procedural time. <i>Results</i>. Patients with a left subclavian artery angle of a median of &lt;70 degrees (severe tortuosity) were older (75.4 ± 11.7 vs. 62.9 ± 12.3 years, <i>P</i> &lt; 0.001) and had a higher prevalence of female sex (42.1% vs. 14.6%, <i>P</i> = 0.007), hypertension (94.7% vs. 75.6%, <i>P</i> = 0.02), and subclavian artery calcification (73.7% vs. 34.2%, <i>P</i> &lt; 0.001) than those with that ≥70 degrees. The left subclavian artery angle correlated negatively with the sheath cannulation to the first balloon time (<i>ρ</i> = −0.51, <i>P</i> &lt; 0.001) and total procedural time (<i>ρ</i> = −0.32, <i>P</i> = 0.004). A multiple linear regression analysis revealed that the natural log transformation of the sheath insertion to first balloon time was associated with a subclavian artery angle of &lt;70 degrees (<i>β</i> = 0.45, <i>P</i> &lt; 0.001). <i>Conclusion</i>. Our study showed that lower left subclavian artery angles as a marker of the tortuosity via the LRA were strongly associated with a longer sheath insertion to balloon time and subsequent entire procedure time during the PCI.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10349157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Use of Pulmonary Vasodilators in Patients with Fontan Physiology","authors":"Thomas Glenn,&nbsp;Nicole Duster,&nbsp;Jerry Dwek,&nbsp;Jose Silva-Sepulveda,&nbsp;Howaida G. El-Said","doi":"10.1155/2022/7602793","DOIUrl":"10.1155/2022/7602793","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Fontan-associated liver disease is a well-known sequela following the Fontan procedure for patients living with single-ventricle heart disease. Pulmonary vasodilators, such as phosphodiesterase type 5 inhibitors, have emerged as a potential therapeutic option for lowering central venous pressures by reducing pulmonary vascular resistance. <i>Method</i>. We performed a single-center retrospective review of Fontan patients who were placed on pulmonary vasodilator therapy with prehemodynamic and posthemodynamic, MR elastography, and histologic assessments. <i>Results</i>. A total of 125 patients with Fontan circulation underwent surveillance with cardiac catheterization during the review period. Fifty-three (42%) patients who did not have increased end-diastolic pressures at the time of cardiac catheterization were started on phosphodiesterase type 5 inhibitor therapy. Nine patients (17%) underwent posttherapy follow-up catheterization. The mean Fontan pressure decreased from 15.4 ± 3.3 mmHg to 13.3 ± 2.5 mmHg (<i>p</i> = 0.026), after initiation of pulmonary vasodilatory therapy. There was no change in end-diastolic pressure, transpulmonary gradient, wedge pressure, pulmonary vascular resistance, cardiac index, or saturation. Eleven patients (21%) underwent pretherapy MR elastography testing with posttherapy follow-up MR elastography. We found no improvement in liver stiffness score following the application of pulmonary vasodilators. Three patients underwent pretherapy and posttherapy liver biopsies, with variable histological changes observed within the hepatic parenchyma. <i>Conclusions</i>. These data demonstrate indeterminate results for the selective use of pulmonary vasodilators but highlight the need for large prospective randomized control trials of pulmonary vasodilator therapies to fully assess the benefit of such therapies in Fontan-associated liver disease.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9671729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40723076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Impella CP versus VA-ECMO in Patients Undergoing Complex High-Risk Indicated PCI","authors":"Deborah M.F. van den Buijs,&nbsp;Adriaan Wilgenhof,&nbsp;Paul Knaapen,&nbsp;Carlo Zivelonghi,&nbsp;Tom Meijers,&nbsp;Paul Vermeersch,&nbsp;Fatih Arslan,&nbsp;Niels Verouden,&nbsp;Alex Nap,&nbsp;Krischan Sjauw,&nbsp;Floris S. van den Brink","doi":"10.1155/2022/8167011","DOIUrl":"10.1155/2022/8167011","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. To compare two different forms of mechanical circulatory support (MCS) in patients with complex high-risk indicated PCI (CHIP): the Impella CP system and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). <i>Background</i>. To prevent hemodynamic instability in CHIP, various MCS systems are available. However, comparable data on different forms of MCS are not at hand. <i>Methods</i>. In this multicenter observational study, we retrospectively evaluated all CHIP procedures with the support of an Impella CP or VA-ECMO, who were declined surgery by the heart team. Major adverse cardiac events (MACE), mortality at discharge, and 30-day mortality were evaluated. <i>Results</i>. A total of 41 patients were included, of which 27 patients were supported with Impella CP and 14 patients with VA-ECMO. Baseline characteristics were well-balanced in both groups. No significant difference in periprocedural hemodynamic instability was observed between both groups (3.7% vs. 14.3%; <i>p</i> = 0.22). The composite outcome of MACE showed no significant difference (30.7% vs. 21.4%; <i>p</i> = 0.59). Bleeding complications were higher in the Impella CP group, but showed no significant difference (22.2% vs. 7.1%; <i>p</i> = 0.22) and occurred more at the non-Impella access site. In-hospital mortality was 7.4% in the Impella CP group versus 14.3% in the VA-ECMO group and showed no significant difference (<i>p</i> = 0.48). 30-Day mortality showed no significant difference (7.4% vs. 21.4%; <i>p</i> = 0.09). <i>Conclusions</i>. In patients with CHIP, there were no significant differences in hemodynamic instability and overall MACE between VA-ECMO or Impella CP device as mechanical circulatory support. Based on this study, the choice of either VA-ECMO or Impella CP does not alter the outcome.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40723077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenchymal Stem Cell-Derived Extracellular Vesicles Therapy for Pulmonary Hypertension: A Comprehensive Review of Preclinical Studies","authors":"Ji-Hong Xu,&nbsp;Jia-Ping Liang,&nbsp;Chu-Jun Zhu,&nbsp;Yu-Jun Lian","doi":"10.1155/2022/5451947","DOIUrl":"10.1155/2022/5451947","url":null,"abstract":"<div>\u0000 <p>Pulmonary hypertension (PH) is a type of clinical pathophysiological syndrome characterized by a progressive increase in pulmonary vascular resistance and subsequent progressive failure of the right heart function, and is a common complication of many diseases. Mesenchymal stem cells (MSCs) autonomously home to sites damaged by disease, repair damaged tissues, and participate in the regulation of systemic inflammation and immune responses, which have good clinical application prospects. Extracellular vesicles (EVs), such as exosomes and microvesicles, participate in various biological activities by regulating intercellular communication. Exosomes secreted into the extracellular environment also affect the host immune system. MSC-derived extracellular vesicles (MSC-EVs), as a mediator in the paracrine processes of MSCs, carry biologically active substances such as proteins, lipids, mRNA, and micro-RNA. MSC-EVs therapies, safer than cell-based treatments, have been shown to be effective in modulating macrophages to support anti-inflammatory phenotypes, which are strongly related to histological and functional benefits in preclinical models of pulmonary hypertension. The main effects of active substances and their potential medical value have attracted wide attention from researchers. This article reviews the role and relevant mechanisms of MSC-EVs in the treatment of pulmonary hypertension in recent studies and provides a basis for their future clinical applications.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40703303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a Clinical Predictive Model of Left Atrial and Left Atrial Appendage Thrombi in Patients with Nonvalvular Atrial Fibrillation","authors":"Lei Yin,&nbsp;Changjian He,&nbsp;Huixin Zheng,&nbsp;Jianshuai Ma,&nbsp;Jinting Liu,&nbsp;Xiaohong Zhang,&nbsp;Ruiqin Xie","doi":"10.1155/2022/7806027","DOIUrl":"10.1155/2022/7806027","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The purpose of this study was to investigate the risk factors of left atrial (LA) or left atrial appendage (LAA) thrombi in patients with nonvalvular atrial fibrillation (NVAF) and to establish and validate relevant predictive models. It might improve thromboembolic risk stratification in patients with NVAF. <i>Methods</i>. This study retrospectively included 1210 consecutive patients with NVAF undergoing transesophageal echocardiography (TEE), of whom 139 patients had thrombi in LA or in LAA. Through literature review and the ten events per variable (10EPV) principle, 13 variables were finally identified for inclusion in multivariate analysis. Models were constructed by multivariate logistic stepwise regression and least absolute shrinkage and selection operator (lasso) regression. <i>Results</i>. After logistic regression, five variables (AF type, age, B-type natriuretic peptide, <i>E</i>/<i>e</i>’ ratio, and left atrial diameter) were finally screened out as model 1. After Lasso regression, AF type, age, gender, B-type natriuretic peptide, E/e’ ratio, left atrial diameter, and left ventricular ejection fraction were finally screened as model 2. After comparing the two models, the simpler model 1 was finally selected. The area under the ROC curve (AUC) of the model 1 was 0.865 (95% CI: 0.838–0.892), the Hosmer–Lemeshow test = 0.898, and the AUC = 0.861 after internal validation. The clinical decision curve showed that the new clinical prediction model could achieve a net clinical benefit when the expected threshold was between 0 and 0.6. <i>Conclusion</i>. This study constructed a new clinical prediction model of LA or LAA thrombi, with a higher discriminative degree than the CHADS2 and CHA2DS2-VASc scoring systems (AUC: 0.865 vs. 0.643; AUC: 0.865 vs 0.652).</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40703302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four-Year Outcomes of Left Main Percutaneous Coronary Intervention with a Bioresorbable Scaffold in the Circumflex Ostium","authors":"Andrejs Erglis,&nbsp;Inga Narbute,&nbsp;Dace Sondore,&nbsp;Sanda Jegere,&nbsp;Indulis Kumsars,&nbsp;Andis Dombrovskis,&nbsp;Karlis Grikis,&nbsp;Ieva Briede,&nbsp;Kristine Dombrovska,&nbsp;Karlis Trusinskis,&nbsp;Alona Grave,&nbsp;Martins Erglis,&nbsp;Martins Kalejs,&nbsp;Peteris Stradins,&nbsp;Uldis Strazdins","doi":"10.1155/2022/7934868","DOIUrl":"10.1155/2022/7934868","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. The study aimed to investigate the long-term outcomes of a double stent scaffold strategy in patients with left main (LM) bifurcation lesions involving the ostium of the left circumflex artery (LCX), utilizing a drug-eluting stent (DES) in the LM extending into the left anterior descending artery (LAD) and a bioresorbable vascular scaffold (BVS) in the LCX ostium. <i>Background</i>. The high occurrence of in-stent restenosis of the LCX ostium is the major limitation of percutaneous coronary intervention (PCI) for LM lesions with a two-stent strategy. <i>Methods</i>. This was a single-center, prospective, single-arm study of 46 consecutively enrolled patients with a stable coronary artery disease and significant unprotected LM distal bifurcation disease. Patients underwent imaging-guided PCI using DES in the LM-LAD and BVS in the LCX using a T-stent or mini-crush technique. The primary outcome at four years was the composite of death, myocardial infarction, stroke, and target lesion revascularization (TLR). <i>Results</i>. At four years, the primary outcome was identified in 9 patients (19.6%). All events were TLRs except one myocardial infarction due to BVS thrombosis. Seven of the eight TLRs were a result of side branch BVS restenosis. Univariate predictors of the 4-year outcome were higher LDL cholesterol and BVS size ≤2.5 mm. On multivariate analysis, LCX lesion preparation with a cutting balloon and post-procedure use of intravascular ultrasound for optimization were found to be independent protective factors of MACE. <i>Conclusions</i>. In selected patients with LM distal bifurcation disease, an imaging-guided double stent scaffold strategy with DES in the LM and BVS in the LCX ostium was technically successful in all patients and was reasonably safe and effective for four years.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40477366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of TAVR Approach and Other Baseline Factors on the Incidence of Acute Kidney Injury: A Systematic Review and Meta-Analysis","authors":"Hossam Alzu’bi,&nbsp;Anan Abu Rmilah,&nbsp;Ikram-UI Haq,&nbsp;Babikir Kheiri,&nbsp;Ahmad Al-abdouh,&nbsp;Bashar Hasan,&nbsp;Omar Elsekaily,&nbsp;Suhaib Jaber,&nbsp;Ibraheem Qaisi,&nbsp;Asil Yagmour,&nbsp;Hamada Dajani,&nbsp;Azza Ahmed,&nbsp; Ahmed elhag,&nbsp;Kianoush Kashani,&nbsp;Abhishek Deshmukh","doi":"10.1155/2022/3380605","DOIUrl":"10.1155/2022/3380605","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Acute kidney injury (AKI) is a well-known complication following a transcatheter aortic valve replacement (TAVR) and is associated with higher morbidity and mortality. <i>Objective</i>. We aim to compare the risk of developing AKI after transfemoral (TF), transapical (TA), and transaortic (TAo) approaches following TAVR. <i>Methods</i>. We searched Medline and EMBASE databases from January 2009 to January 2021. We included studies that evaluated the risk of AKI based on different TAVR approaches. After extracting each study’s data, we calculated the risk ratio and 95% confidence intervals using RevMan software 5.4. Publication bias was assessed by the forest plot. <i>Results</i>. Thirty-six (36) studies, consisting of 70,406 patients undergoing TAVR were included. Thirty-five studies compared TF to TA, and only seven investigations compared TF to TAo. AKI was documented in 4,857 out of 50,395 (9.6%) patients that underwent TF TAVR compared to 3,155 out of 19,721 (16%) patients who underwent TA-TAVR, with a risk ratio of 0.49 (95% CI, 0.36–0.66; p &lt; 0.00001). Likewise, 273 patients developed AKI out of the 1,840 patients (14.8%) that underwent TF-TAVR in contrast to 67 patients out of the 421 patients (15.9%) that underwent TAo-TAVR, with a risk ratio of 0.51 (95% CI, 0.27–0.98; <i>p</i> = 0.04). There was no significant risk when we compared TA to TAo approaches, with a risk ratio of 0.89 (95% CI, 0.29–2.75; <i>p</i> = 0.84). <i>Conclusion</i>. The risk of post-TAVR AKI is significantly lower in patients who underwent TF-TAVR than those who underwent TA-TAVR or TAo-TAVR.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic Therapy Duration after Patent Foramen Ovale Closure for Stroke Prevention: Impact on Long-Term Outcome","authors":"Joelle Kefer,&nbsp;Karlien Carbonez,&nbsp;Sophie Pierard,&nbsp;François-Pierre Mouthuy,&nbsp;Andre Peeters,&nbsp;Cedric Hermans,&nbsp;Catherine Lambert,&nbsp;Christophe DeMeester,&nbsp;Thierry Sluysmans,&nbsp;Agnes Pasquet","doi":"10.1155/2022/6559447","DOIUrl":"10.1155/2022/6559447","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The optimal duration of antithrombotic therapy (ATT) after patent foramen ovale (PFO) closure remains under debate. This study sought to compare the clinical outcome of patients receiving antithrombotic agents for a short (6 months) versus extended (&gt;6 months) period after the procedure. <i>Methods</i>. This was a retrospective cohort study using a propensity score matching analysis on 259 consecutive patients (131 males, 43 ± 10 years) undergoing PFO closure due to cryptogenic stroke, with complete follow-up (median duration of 10 [4–13] years). The outcome was compared between patients receiving short-term (Group short, <i>N</i> = 88) versus extended ATT (Group long, <i>N</i> = 171). <i>Results</i>. The PFO closure device was successfully implanted in all cases, with 3% of minor complications. After propensity score matching, there were no differences between Groups short and long in the rate of stroke (0.3 vs. 0.4% patient-year, <i>p</i> = 1.00), bleeding (2 vs. 2% patient-year, <i>p</i> = 0.17), and device thrombosis (0.3 vs. 0.1% patient-year; <i>p</i> = 0.60). Univariate analysis showed that short-term ATT was not associated with an increased risk of recurrent stroke (HR: 1.271 [95% CI: 0.247–6.551], <i>p</i> = 0.775) or prosthesis thrombus (HR: 0.50 [95% CI: 0.070–3.548], <i>p</i> = 0.72). Kaplan–Meier analysis revealed similar overall survival in Group short and long (100 vs. 99 ± 1%, respectively; <i>p</i> = 0.25). <i>Conclusions</i>. Short-term (6 months) ATT after PFO closure did not impair the clinical outcome, with a preserved low rate of recurrent stroke (0.3% patient-year) and device thrombosis (0.2% patient-year) at 10-year follow-up.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon-Expandable TAVR Bioprostheses: Area or Perimeter Sizing? A Prospective Pilot Study","authors":"Jonathan Halim,&nbsp;Peter den Heijer,&nbsp;Jeroen Vos,&nbsp;Bas E. Schölzel,&nbsp;Martijn Meuwissen,&nbsp;Ben van den Branden,&nbsp;Andreas Baumbach,&nbsp;Alexander J. J. Ijsselmuiden","doi":"10.1155/2022/3139476","DOIUrl":"10.1155/2022/3139476","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. In TAVR, area sizing is used for balloon-expandable (BE) valves, whereas self-expanding valves are sized to annulus perimeter. For BE valves, this seems illogical: these frames force a circular shape even on an ellipsoid annulus. This can potentially lead to relative undersizing when area sizing is being applied. We developed a perimeter-based sizing algorithm to evaluate the safety and feasibility of perimeter sizing for the Myval BE valve. <i>Methods</i>. In this prospective single-center study, 60 patients with severe aortic stenosis treated with the Myval BE valve were included. Perimeter sizing was used with limited oversizing of 3.7% ± 1.3% compared to the annulus perimeter. After TAVR, clinical outcomes were evaluated at 30 days and 1 year. An echocardiographic follow-up took place at 30 days. <i>Results</i>. At 30 days, the need for PPI and stroke occurred in 2% and 3% of the patients, respectively. Moreover, cardiac death and moderate-severe PVL were absent. At 1-year, cardiac death and stroke were observed in 3% and 8% of the patients, respectively. In 33.3% of the patients, a larger valve size was implanted compared to the valve size calculated by area sizing. <i>Conclusions</i>. Perimeter sizing with the Myval BE valve leads to substantial use of larger valve sizes and favorable clinical outcomes, with low PPI and the absence of significant PVL. A randomized controlled trial is being planned to prove the superiority of this alternative sizing method.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9596236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40448764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}