Structural Heart最新文献

Impact of Baseline Anteroposterior Mitral Annular Dimensions on Clinical Outcomes after MitraClip for Secondary Mitral Regurgitation 二尖瓣前后环基线尺寸对二尖瓣夹闭治疗继发性二尖瓣返流后临床结果的影响

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2025.100460

Jason H. Rogers MD , Thomas W. Smith MD , Jeroen J. Bax MD, PhD , Federico M. Asch MD , D. Scott Lim MD , Ningyan Wong MBBS , Janani Aiyer MS , William T. Abraham MD , JoAnn Lindenfeld MD , Michael J. Mack MD , Gregg W. Stone MD , Steven F. Bolling MD

{"title":"Impact of Baseline Anteroposterior Mitral Annular Dimensions on Clinical Outcomes after MitraClip for Secondary Mitral Regurgitation","authors":"Jason H. Rogers MD , Thomas W. Smith MD , Jeroen J. Bax MD, PhD , Federico M. Asch MD , D. Scott Lim MD , Ningyan Wong MBBS , Janani Aiyer MS , William T. Abraham MD , JoAnn Lindenfeld MD , Michael J. Mack MD , Gregg W. Stone MD , Steven F. Bolling MD","doi":"10.1016/j.shj.2025.100460","DOIUrl":"10.1016/j.shj.2025.100460","url":null,"abstract":"<div><h3>Background</h3><div>In the randomized Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT; <span><span>NCT01626079</span><svg><path></path></svg></span>) trial, mitral transcatheter edge-to-edge repair (M-TEER) improved clinical outcomes in patients with severe secondary mitral regurgitation (MR). A prior post hoc analysis from the COAPT trial showed that increasing anteroposterior mitral annular diameter (APMAD) was the sole independent echocardiographic predictor of the composite endpoint of death or heart failure hospitalizations (HFH) at 2 years. Given the relationship between the mitral annulus and leaflets, we examined the association of baseline APMAD with long-term clinical outcomes.</div></div><div><h3>Methods</h3><div>COAPT patients (n = 575) were stratified into tertiles by baseline APMAD as follows: small APMAD, medium APMAD, and large APMAD. APMAD was measured in the anteroposterior direction from the parasternal long-axis view at end-diastole and in the intercommissural direction from the apical two-chamber view.</div></div><div><h3>Results</h3><div>Patients with larger baseline APMAD were more often male and had fewer comorbidities, larger ventricles, and larger mitral orifice areas. At 2 years, there were no significant differences in MR severity and the composite endpoint of death or HFH in patients treated with M-TEER by baseline APMAD. In patients treated with guideline-directed medical therapy (GDMT) alone, there were no significant differences in MR severity, but the composite endpoint of death or HFH was higher in patients with the largest baseline APMADs. The treatment effect of M-TEER was consistent among APMAD tertiles (<em>p</em><sub>interaction</sub> = 0.87).</div></div><div><h3>Conclusions</h3><div>APMAD was a predictor of adverse outcomes in patients treated with GDMT alone. M-TEER reduced MR severity and the risk of death or HFH regardless of baseline APMAD compared with GDMT alone.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 6","pages":"Article 100460"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Aortic Valve Replacement Versus Conservative Management: A Meta-Analysis of Randomized Controlled Trials 早期主动脉瓣置换术与保守治疗：随机对照试验的荟萃分析

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2025.100461

Tayyab Shah MD , Yousuf Shah MD , Alexandra J. Lansky MD , Jay Giri MD, MPH , Alexander Fanaroff MD, MHS , Ashwin Nathan MD, MS

引用次数: 0

Quality of Life After Mitral Transcatheter Edge-to-Edge Repair According to Baseline Tricuspid Regurgitation 基于基线三尖瓣返流的二尖瓣边缘修复术后的生活质量

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2024.100408

Collin J. Brooks MD , Neal Duggal MD , Milan Seth MS , Megan S. Joseph MD , Devraj Sukul MD, MSc , Stan J. Chetcuti MD , Gorav Ailawadi MD , Himanshu Patel MD , P. Michael Grossman MD , Raed Alnajjar MD , Andrew W. Harris MD

{"title":"Quality of Life After Mitral Transcatheter Edge-to-Edge Repair According to Baseline Tricuspid Regurgitation","authors":"Collin J. Brooks MD , Neal Duggal MD , Milan Seth MS , Megan S. Joseph MD , Devraj Sukul MD, MSc , Stan J. Chetcuti MD , Gorav Ailawadi MD , Himanshu Patel MD , P. Michael Grossman MD , Raed Alnajjar MD , Andrew W. Harris MD","doi":"10.1016/j.shj.2024.100408","DOIUrl":"10.1016/j.shj.2024.100408","url":null,"abstract":"<div><h3>Background</h3><div>There is a high prevalence of significant tricuspid regurgitation (TR) in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER). Significant TR is associated with poor prognosis and affects decision-making between M-TEER and concomitant mitral and tricuspid valve surgery. Improved quality of life (QoL) is an important metric for patients.</div></div><div><h3>Methods</h3><div>We analyzed data from 1838 patients undergoing M-TEER included in a multicenter statewide registry from 2015 to 2023. QoL was assessed using baseline and 30-day Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. Patients were classified as no/mild TR or moderate/severe TR, and changes in KCCQ scores were compared. The primary outcome was an adjusted analysis consisting of survival to 30 days with a ≥15-point improvement in KCCQ score.</div></div><div><h3>Results</h3><div>Complete endpoint data were available for 1421 patients (77.3%). On average, patients undergoing M-TEER experienced large improvements in QoL, regardless of baseline TR group. Thirty-day mortality for patients with moderate/severe TR was higher than for those with no/mild TR (42 [4.1%] vs. 16 [2.0%], respectively, <em>p</em> = 0.018). The majority of patients survived to 30 days with ΔKCCQ ≥15 (63.8% for no/mild TR vs. 59.6% for moderate/severe TR, <em>p</em> = 0.120). Patients with moderate/severe TR exhibited no difference in the primary adjusted outcome (adjusted odds ratio: 0.851, <em>p</em> = 0.177).</div></div><div><h3>Conclusions</h3><div>The majority of patients experience a large improvement in QoL after M-TEER, regardless of baseline TR severity. Further research should explore a staged approach of M-TEER followed by tricuspid valve intervention as needed compared to concomitant mitral/tricuspid valve surgery.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 6","pages":"Article 100408"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is a Preprocedure Transesophageal Echocardiogram Always Necessary Prior to Mitral Valve Transcatheter Edge-to-Edge Repair? 经食管超声心动图在二尖瓣边缘修补术前是否一定要进行？

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2025.100445

Thomas W. Smith MD , Mark Reisman MD

引用次数: 0

Aims & Scope 目标及范围

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/S2474-8706(25)00242-8

引用次数: 0

Passing the Baton 传递接力棒

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2025.100644

Anthony DeMaria MD

引用次数: 0

Transcatheter Aortic Valve Replacement for Native Aortic Regurgitation: If You Can't Be With the Valve You Love, Love the Valve You're With 经导管主动脉瓣置换术治疗先天性主动脉瓣返流：如果你不能和你喜欢的瓣膜在一起，那就爱你喜欢的瓣膜

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2024.100371

Amar Krishnaswamy MD , Mark Reisman MD

引用次数: 0

The Prognostic Value of Frailty in a Transcatheter Mitral Valve-in-Valve Cohort 虚弱在经导管二尖瓣中瓣膜队列中的预后价值

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2025.100462

Vinesh Appadurai MBBS , Chen Chen MD , Charles J. Davidson MD , James D. Flaherty MD , S. Christopher Malaisrie MD , Zhiying Meng MS , Abigail S. Baldridge MS, DrPH , Patrick McCarthy MD , James D. Thomas MD , Jyothy Puthumana MD , Akhil Narang MD

引用次数: 0

Novel Technique Employing Transcatheter Balloon-Expandable Valves in Pure Aortic Regurgitation: A Proof-of-Concept Study 采用经导管球囊膨胀阀治疗单纯主动脉反流的新技术：一项概念验证研究

IF 1.4

Structural Heart Pub Date : 2025-06-01 DOI: 10.1016/j.shj.2025.100443

Mi Chen MD, PhD , Jonathan M. Michel MD , Barbara E. Stähli MD , Thomas S. Gilhofer MD , Martin O. Schmiady MD , Felix C. Tanner MD , Albert Markus Kasel MD

{"title":"Novel Technique Employing Transcatheter Balloon-Expandable Valves in Pure Aortic Regurgitation: A Proof-of-Concept Study","authors":"Mi Chen MD, PhD , Jonathan M. Michel MD , Barbara E. Stähli MD , Thomas S. Gilhofer MD , Martin O. Schmiady MD , Felix C. Tanner MD , Albert Markus Kasel MD","doi":"10.1016/j.shj.2025.100443","DOIUrl":"10.1016/j.shj.2025.100443","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to evaluate the hypothesis that employing the “flare the outflow” technique might allow anchoring of transcatheter balloon-expandable valves (BEVs) in patients with pure aortic regurgitation.</div></div><div><h3>Methods</h3><div>This was a single-center, 6-patient, consecutive, retrospective observational cohort. Inoperable patients with pure AR were included to perform transcatheter aortic valve implantation. The technique involved deploying BEVs with 2-mm oversizing and “flare the outflow” technique. Computed tomography scans were obtained at baseline and after implantation.</div></div><div><h3>Results</h3><div>BEVs with the flared outflow were successfully implanted in all patients. All patients were discharged without device migration and none or trace paravalvular leak. At 1-year follow-up, no deaths, valve dysfunction, or reinterventions were observed. Among the 5 patients out of 6 who underwent follow-up computed tomography scans, findings confirmed the overexpanded outflow of the BEVs compared to the annulus, indicated by mean (24.5 vs. 23.3 mm, <em>p</em> = 0.02) and minimal diameters (24.6 vs. 22.2 mm, <em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>The utilization of BEVs incorporating the “flare the outflow” technique demonstrated feasibility and effectiveness in inoperable patients with pure AR. Further studies are required to determine the durability and lifetime management associated with this technique.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 6","pages":"Article 100443"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Repeat Interventions After Transcatheter Aortic Valve Replacement: Considerations for Lifetime Management—The First Cut Is the Deepest 经导管主动脉瓣置换术后的重复干预：对终身管理的考虑-第一次切口最深

IF 1.4

Structural Heart Pub Date : 2025-05-01 DOI: 10.1016/j.shj.2025.100426

Sachin S. Goel MD , Benjamin Z. Galper MD, MPH

引用次数: 0