Structural Heart最新文献

{"title":"The Federal Budget and Structural Heart Disease Innovations","authors":"Anthony DeMaria MD","doi":"10.1016/j.shj.2025.100444","DOIUrl":"10.1016/j.shj.2025.100444","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100444"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829095","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}

{"title":"Bilobed Left Atrial Appendage Closure Using Two Different Types of Occlusion Devices","authors":"Joshua Campbell MD , Jorge Castellanos MD","doi":"10.1016/j.shj.2024.100373","DOIUrl":"10.1016/j.shj.2024.100373","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100373"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829096","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}

{"title":"Aortic Valve and Left Ventricular Outflow Tract Calcium Distribution and Conduction Outcomes After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis","authors":"Princess Neila Litkouhi BMed, MD ,&nbsp;Karan Rao BMed, MPH, MD ,&nbsp;Alexandra Baer BSN, MSHM ,&nbsp;Peter S. Hansen MBBS, PhD ,&nbsp;Ravinay Bhindi MBBS, MSc, PhD","doi":"10.1016/j.shj.2024.100389","DOIUrl":"10.1016/j.shj.2024.100389","url":null,"abstract":"<div><div>Permanent pacemaker implantation (PPMI) is an important complication following transcatheter aortic valve replacement (TAVR). The influence of valvular and subvalvular calcium and its distribution between aortic leaflets on the risk of PPMI following TAVR remains unclear. We performed a systematic review of the aortic valve complex (AVC) calcium by leaflet, left ventricular outflow tract (LVOT) calcium by leaflet, total AVC calcium, total LVOT calcium, and mitral annular calcium and its association with post-TAVR atrioventricular block, left bundle branch block, and new PPMI. The search strategy included five databases identifying 893 articles. A total of 34 studies with 11,528 patients were included for qualitative analysis, and seven studies totaling 1056 patients were suitable for quantitative analysis. On meta-analysis, left coronary cusp calcium and right coronary cusp calcium were significant predictors of PPMI, while noncoronary cusp (NCC) calcium was not predictive (left coronary cusp: mean difference: 21.05 mm³, 95% CI: 5.92-36.19, <em>p</em> ​&lt; ​0.001; right coronary cusp: mean difference: 46.02 mm³, 95% CI: 1.84-90.21, <em>p</em> ​= ​0.04, and NCC: mean difference: 0.19 mm³, 95% CI: −0.32 to 0.50, <em>p</em> ​= ​0.10). On qualitative review, LVOT calcium in the NCC region was the leaflet most commonly predictive of post-TAVR conduction outcomes. Total AVC, total LVOT calcium, and mitral annular calcium had no convincing association with post-TAVR conduction outcomes. The distribution of calcium rather than its total volume was associated with post-TAVR conduction abnormalities. Heterogeneity in methodology and implantation techniques between studies limits the clinical significance of these findings.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100389"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828717","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}

{"title":"First-In-Human Experience of the New Fully Repositionable IMPERIA Delivery System to Implant the ALLEGRA Transcatheter Heart Valve in Patients With Severe Calcific Aortic Stenosis or Degenerated Surgical Bioprosthesis: Thirty-Day Results of the EMPIRE I Study","authors":"José Antonio Baz MD ,&nbsp;Christof Burgdorf MD ,&nbsp;Christian Frerker MD ,&nbsp;Ignacio Cruz González MD ,&nbsp;Joan Antoni Gômez MD ,&nbsp;Joseph Graham MD ,&nbsp;José Maria Hernândez MD ,&nbsp;Pilar Jimenez MD ,&nbsp;Claire B. Ren MD ,&nbsp;Ernest Spitzer MD ,&nbsp;Pim Tonino MD ,&nbsp;Pieter Vriesendorp MD ,&nbsp;Nicolas van Mieghem MD ,&nbsp;Samuel Copt PhD ,&nbsp;Anders Jönsson MD ,&nbsp;Keith G. Oldroyd MD ,&nbsp;Nicolas Doll MD","doi":"10.1016/j.shj.2024.100391","DOIUrl":"10.1016/j.shj.2024.100391","url":null,"abstract":"<div><h3>Background</h3><div>The ALLEGRA (Biosensors International) transcatheter heart valve is a self-expanding supra-annular bovine pericardial aortic valve. A new delivery system (IMPERIA™, Biosensors International) has been designed which allows the valve to be fully resheathed and repositioned in situ. The aim of this premarket study was to assess the safety and efficacy of transcatheter aortic valve implantation using the combination of the CE (Conformite Europeenne) marked ALLEGRA valve and the new IMPERIA delivery system.</div></div><div><h3>Methods</h3><div>One hundred thirty-seven patients were enrolled in 11 centers from January to November 2023. There were 30 roll-in patients, 91 in the intention-to-treat (ITT) population and 16 with degenerated surgical aortic bioprostheses. The primary outcome was device success according to the Valve Academic Research Consortium-2 from discharge up to 7 days in the ITT cohort.</div></div><div><h3>Results</h3><div>Implantation of the ALLEGRA valve was successful in 136 patients (99.3%). There were no device embolizations and no patient required a second valve. Device success was achieved in 91.9% of the ITT cohort. At 30 days, all-cause mortality was 2.2% in the native aortic stenosis (AS) cohort and 0% in the valve-in-valve cohort. New pacemaker implantation was required in 12.4% (17/137). There was no patient prosthesis mismatch (PPM) in the 121 patients with native AS and moderate PPM in 2/16 valve-in-valve patients.</div></div><div><h3>Conclusions</h3><div>This study confirms the safety and efficacy of transcatheter aortic valve implantation using the IMPERIA delivery system to implant the CE marked ALLEGRA transcatheter heart valve in patients with severe calcific native AS or a degenerated surgical aortic bioprostheses.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100391"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828759","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}

{"title":"Acute Valve Syndrome in Aortic Stenosis","authors":"Philippe Généreux MD ,&nbsp;Patricia A. Pellikka MD ,&nbsp;Brian R. Lindman MD, MSCI ,&nbsp;Philippe Pibarot DVM, PhD ,&nbsp;Santiago Garcia MD ,&nbsp;Konstantinos P. Koulogiannis MD ,&nbsp;Evelio Rodriguez MD ,&nbsp;Vinod H. Thourani MD ,&nbsp;Michael Dobbles MS ,&nbsp;Gennaro Giustino MD ,&nbsp;Rahul P. Sharma MBBS ,&nbsp;David J. Cohen MD, MSc ,&nbsp;Allan Schwartz MD ,&nbsp;Martin B. Leon MD ,&nbsp;Linda D. Gillam MD, MPH","doi":"10.1016/j.shj.2024.100377","DOIUrl":"10.1016/j.shj.2024.100377","url":null,"abstract":"<div><h3>Background</h3><div>To describe the impact of clinical presentation among patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR).</div></div><div><h3>Methods</h3><div>We analyzed a real-world dataset including patients from 29 US hospitals (egnite Database, egnite). Patients over 18 years old with moderate or greater AS undergoing AVR were included. Patients were classified into 3 groups according to the acuity and severity of clinical presentation prior to AVR: (i) asymptomatic, (ii) progressive signs and symptoms (progressive valve syndrome [PVS]), and (iii) acute or advanced signs and symptoms (acute valve syndrome [AVS]). Mortality and heart failure hospitalization after AVR were examined with Kaplan-Meier estimates, with results compared using the log-rank test.</div></div><div><h3>Results</h3><div>Among 2,009,607 patients in our database, 17,838 underwent AVR (78.6% transcatheter AVR, 21.4% surgical AVR). Age was 76.5 ± 9.7 years, and 40.2% were female. Prior to AVR, 2504 (14.0%) were asymptomatic, 6116 (34.3%) presented with PVS, and 9218 (51.7%) presented with AVS. At 2 years, the estimated rate of mortality for asymptomatic, PVS, and AVS were 5.8% (4.6%-7.0%), 7.6% (6.7%-8.4%), and 17.5% (16.5%-18.5%), respectively, and the estimated rate of hospitalization with heart failure for asymptomatic, PVS, and AVS were 11.1% (9.5%-12.6%), 19.0% (17.8%-20.2%), and 41.5% (40.2%-42.8%), respectively. After adjustment, patients presenting with AVS had increased risk of mortality after AVR (hazard ratio, 2.2; 95% CI, 1.8-2.6).</div></div><div><h3>Conclusions</h3><div>From a large, real-world database of patients undergoing AVR for AS, most patients presented with AVS, which was associated with an increased risk of mortality and heart failure hospitalization.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100377"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828760","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}

{"title":"Evolving Standards in Prosthetic Heart Valve Assessment With Cardiovascular Imaging: Key Changes in the 2024 American Society of Echocardiography Guidelines","authors":"Fraser Graham MD ,&nbsp;Stephen Dobbin MD ,&nbsp;Maala Sooriyakanthan RDMS ,&nbsp;Wendy Tsang MD, SM","doi":"10.1016/j.shj.2024.100372","DOIUrl":"10.1016/j.shj.2024.100372","url":null,"abstract":"<div><div>The American Society of Echocardiography recommendations published in 2024 for evaluating prosthetic heart valve (PHV) function with cardiovascular imaging include new recommendations for the use of cardiac magnetic resonance imaging, cardiac computed tomography, and cardiac positron emission tomography. Additionally, they now provide normative echocardiographic values for right-sided PHVs and transcatheter heart valves in native valves and when used for valve-in-valve procedures. Furthermore, the recommendations include definitions to improve the recognition and classification of prosthetic heart valve dysfunction. The aim of this review is to summarize these key changes compared to the 2009 update and to include useful tables and figures to aid the reader in assessment of PHV function.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100372"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828718","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}

{"title":"Flow Status-Based Predicted Prosthesis-Patient Mismatch in Patients Undergoing Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve","authors":"Daijiro Tomii MD ,&nbsp;Dik Heg PhD ,&nbsp;Masaaki Nakase MD ,&nbsp;Daryoush Samim MD ,&nbsp;Jonas Lanz MD, MSc ,&nbsp;Fabien Praz MD ,&nbsp;Stefan Stortecky MD, MPH ,&nbsp;David Reineke MD ,&nbsp;Stephan Windecker MD ,&nbsp;Thomas Pilgrim MD, MSc","doi":"10.1016/j.shj.2024.100379","DOIUrl":"10.1016/j.shj.2024.100379","url":null,"abstract":"<div><h3>Background</h3><div>Effective orifice area (EOA) is flow dependent. However, established methods for the assessment of predicted prosthesis-patient mismatch (PPM) do not consider flow status and therefore may underestimate the rate and impact of PPM in patients with abnormal flow status. This study aimed to investigate the clinical impact of flow status-based predicted PPM in patients undergoing transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Methods</h3><div>Patients undergoing TAVR in a prospective TAVR registry were stratified by the presence of moderate or severe PPM (EOA index to body surface area [EOAi]: 0.65-0.85 or ≤0.65 and 0.55-0.70 or ≤0.55 cm²/m² if obese). PPM was defined according to echocardiographically measured EOAi (measured PPM) or predicted or flow status-based predicted EOAi. Predicted EOAs were based on reference values of EOA for each valve generation and size (predicted PPM_THV) or native aortic annulus dimension (predicted PPM_CT).</div></div><div><h3>Results</h3><div>Among 1510 patients included (August 2007-June 2022), rates of moderate or severe PPM differed according to method of assessment: 27.0 and 8.7% according to measured PPM, 11.3 and 1.2% according to predicted PPM_THV, 12.0 and 0.1% according to PPM_CT, 21.6 and 0.2% according to flow status-based predicted PPM_THV, and 25.1 and 0.4% according to flow status-based predicted PPM_CT. Five-year mortality was comparable in patients with and without flow status-based predicted PPM defined by either method. These results were consistent when patients were stratified by flow status.</div></div><div><h3>Conclusions</h3><div>Rates of PPM differ considerably when flow status is considered. There was no consistent signal of increased risk of adverse events up to 5 years in patients with flow status-based predicted PPM.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>https://www.clinicaltrials.gov</span><svg><path></path></svg></span>. <span><span>NCT01368250</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100379"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828758","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}

{"title":"Glimpse Into the Hemodynamic Performance of Myval Series vs Sapien 3 Ultra Resilia","authors":"Akihiro Tobe MD ,&nbsp;Yoshinobu Onuma PhD ,&nbsp;Osama Soliman PhD ,&nbsp;Andreas Baumbach PhD ,&nbsp;Patrick W. Serruys PhD","doi":"10.1016/j.shj.2024.100394","DOIUrl":"10.1016/j.shj.2024.100394","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100394"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828719","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}

{"title":"Aims & Scope","authors":"","doi":"10.1016/S2474-8706(25)00040-5","DOIUrl":"10.1016/S2474-8706(25)00040-5","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 4","pages":"Article 100448"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828756","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}

{"title":"Transcatheter Closure of Complex Multifenestrated Atrial Septal Defect Using Three Septal Occluders: Is Three Too Many?","authors":"Hussam Al Hennawi MD ,&nbsp;Appa Bandi MD ,&nbsp;Ahmad Abulshamat MD ,&nbsp;Shaurya Srivastava DO ,&nbsp;Mohammed Qintar MD, MSc","doi":"10.1016/j.shj.2024.100355","DOIUrl":"10.1016/j.shj.2024.100355","url":null,"abstract":"<div><div>Atrial septal defects (ASDs) are a common form of adult congenital heart disease, with surgical or transcatheter closure being the mainstay of treatment in patients with hemodynamic or clinical complications. Transcatheter repair of secundum ASD is safe and effective. Complex secundum ASDs with multifenestrated defects pose a unique challenge to transcatheter repair. We report a successful but complex transcatheter closure of an ASD using three overlapping Amplazter devices.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 3","pages":"Article 100355"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}