Cardiovascular Revascularization Medicine最新文献

{"title":"Editorial: \"Cherchez la femme\": To include her, not to blame her.","authors":"Biljana Parapid, Stéphane Manzo-Silberman, Mirvat Alasnag","doi":"10.1016/j.carrev.2026.10.008","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.10.008","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197154","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":"Short-frame, self-expanding, fully recapturable transcatheter aortic valve replacement device in pure aortic regurgitation: Procedural performance and 30-day outcomes.","authors":"Hui Yan, Yunyao Li, Weiguo Wan, Haihan Liao, Sheng Cao, Hongning Song, Xiaoya Zhou, Hong Jiang, Bing Huang","doi":"10.1016/j.carrev.2026.10.006","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.10.006","url":null,"abstract":"<p><strong>Background: </strong>Achieving stable anchoring and effective sealing remains the principal limitation of transcatheter aortic valve replacement (TAVR) in patients with pure native aortic regurgitation (PNAR). A short-frame, fully recapturable self-expanding valve may expand the procedural margin by enabling iterative repositioning and implantation depth optimisation in non-calcified anatomy.</p><p><strong>Methods: </strong>We analysed 13 consecutive patients with symptomatic moderate-to-severe or severe PNAR who underwent transfemoral TAVR with the ScienCrown® (Lepu Medical, Beijing, China) system. The primary endpoint was technical success at exit from the procedure room according to VARC-3 criteria. Secondary endpoints included device success and early safety at 30 days.</p><p><strong>Results: </strong>Technical success was achieved in all patients (13/13, 100%), and device success at 30 days was also achieved in all patients (13/13, 100%). The 30-day early safety endpoint was met in 12 patients (92.3%). The mean prosthesis size was 27.62 ± 1.26 mm, with a mean prosthesis diameter oversizing relative to the average annular diameter of 12.90 ± 3.54%; no balloon predilatation was performed. The mean number of deployment attempts was 1.62 ± 0.77. All procedures were completed without valve embolisation/migration, coronary obstruction, second-valve implantation, or emergency surgery. One patient (7.69%) developed complete atrioventricular block on postoperative day 3 and underwent permanent pacemaker implantation; no additional pacemaker implantations occurred through 30 days. Predischarge diffusion-weighted magnetic resonance imaging demonstrated no new acute cerebral infarction. At 30 days, there were no deaths, strokes or transient ischaemic attacks, myocardial infarction, life-threatening/major bleeding, major vascular complications, endocarditis, or valve-related reinterventions. Mean transvalvular gradients were 7.67 ± 5.20 mmHg, and all patients had improved or stable NYHA functional class with no moderate or severe residual aortic regurgitation.</p><p><strong>Conclusions: </strong>In this exploratory single-centre series, transfemoral TAVR using a short-frame, fully recapturable self-expanding valve achieved 100% technical success and favourable early safety and haemodynamic performance in selected patients with PNAR. Prospective multicentre studies with longer follow-up and appropriate comparator groups are warranted.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185294","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":"Rationale and design of a randomized controlled trial to evaluate thrombus modification efficacy of sustained mechanical aspiration thrombectomy in patients with ST Elevation Myocardial Infarction: The CAPTURE AMI study.","authors":"Afik D Snir, Rafail A Kotronias, Angelicarosa Cascone, Stefano Andreaggi, Asad Shabbir, Jeremy P Langrish, Adrian P Banning, Giovanni-Luigi De Maria","doi":"10.1016/j.carrev.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.10.002","url":null,"abstract":"<p><strong>Background: </strong>Distal myocardial perfusion remains impaired in up to half of patients after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI), partly through the distal embolization of thrombus and plaque debris. Reduction of thrombus burden prior to PCI in STEMI has been associated with improved markers of perfusion. However, traditional manual syringe aspiration thrombectomy has demonstrated inconsistent efficacy of thrombus extraction in prior studies. Sustained mechanical aspiration thrombectomy may achieve more reliable coronary thrombus extraction, with promising early results in non-randomized analyses thus far.</p><p><strong>Objectives: </strong>CAPTURE AMI (ClinicalTrials.gov; NCT07687576) will test whether sustained mechanical aspiration thrombectomy reduces pre-stent thrombus burden compared with standalone PCI in patients with highly thrombotic STEMI.</p><p><strong>Methods: </strong>In this investigator-initiated, single-center randomized controlled trial, 60 patients undergoing primary PCI with TIMI thrombus grade ≥ 4 will be randomized 1:1 to optical coherence tomography (OCT) guided PCI alone, or to sustained mechanical aspiration using the CAT-RX (Penumbra) Aspiration System followed by OCT-guided PCI. The primary endpoint is the absolute change in thrombus burden between two paired pre-PCI OCT runs, measured offline by blinded readers. Exploratory endpoints include pre-PCI thrombus volume, thrombus area and flow area, post-PCI in-stent thromboatheroma and flow volumes, final stent expansion and apposition on OCT, indices of coronary microvascular physiology and major adverse cardiac and cerebrovascular events over 6-month follow-up.</p><p><strong>Conclusions: </strong>CAPTURE AMI will provide randomized, imaging- and physiology-based evidence on the thrombus-modifying efficacy of sustained mechanical aspiration thrombectomy in STEMI.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185220","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":"The patient's complaint (with apologies to Portnoy).","authors":"Spencer B King","doi":"10.1016/j.carrev.2026.10.005","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.10.005","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197117","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":"Prognostic impact of coronary artery ectasia after acute coronary syndrome: A systematic review and meta-analysis.","authors":"Ahmed Elmorsy Mohamed, Mustafa Abomohsen, Ahmed Farid Gadelmawla, Rana S Sayed, Bryan Cogar, Jeffrey Sparling, George Chrysant, Moshe Gunsburg, Khaldoon Alaswad, Emmanouil S Brilakis, Michael Megaly","doi":"10.1016/j.carrev.2026.10.003","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.10.003","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery ectasia (CAE) is associated with abnormal coronary flow, thrombus formation, and impaired reperfusion, but its prognostic significance after acute coronary syndrome (ACS) remains uncertain.</p><p><strong>Objectives: </strong>To evaluate clinical outcomes among patients with versus without CAE presenting with ACS.</p><p><strong>Methods: </strong>PubMed/MEDLINE and Scopus were searched from inception to April 2026 for studies comparing ACS patients with versus without CAE. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp adjustment. Subgroup, leave-one-out, and Bayesian random-effects analyses were performed to assess robustness.</p><p><strong>Results: </strong>Twelve observational studies comprising 13,540 patients were analyzed, including 1177 with CAE and 12,363 without CAE. Follow-up ranged from in-hospital assessment to 120 months. CAE was associated with a higher risk of recurrent myocardial infarction (RR, 1.96; 95% CI, 1.16-3.32; P = 0.022; I² = 61.1%), corresponding to an estimated absolute excess of 58.6 events per 1000 patients and a descriptive number needed to harm of 17. For stroke, the prespecified Hartung-Knapp analysis yielded an RR of 2.40 (95% CI, 1.59-3.61), whereas conventional random-effects inference, used as the basis of interpretation, yielded an RR of 2.40 (95% CI, 1.08-5.31; P = 0.031). This estimate was based on 3 studies and was model-sensitive. CAE was not significantly associated with all-cause mortality, in-hospital mortality, cardiac death, repeat revascularization, or MACE. Stent thrombosis was not pooled because only 2 studies provided estimable stent-exposed comparisons. Bayesian analyses supported the recurrent myocardial infarction finding.</p><p><strong>Conclusions: </strong>Among patients presenting with ACS, CAE identifies a higher-risk ischemic phenotype, with the most consistent association observed for recurrent myocardial infarction. Prospective studies are needed to define CAE-specific risk stratification and treatment strategies.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208099","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":"Editorial: Off-label use of microaxial left ventricular assist devices is associated with higher mortality despite use in younger patients with fewer comorbidities.","authors":"Niku Thapa, Aliza Ahmed, Navin Ramlal, Sarah Aftab Ahmad, Nauman Khalid","doi":"10.1016/j.carrev.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.10.001","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185267","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":"Association between advanced chronic kidney disease and left-sided transcatheter heart valve re-intervention.","authors":"Beni Rai Verma, Cheng Zhang, Abhinav Sood, Abdullah Al Qaraghuli, Maximilien Andrew Wilkey, Asa Phichaphop, Vaishnavi Sawant, Jason Galo, Ori Waksman, Edward Ha, Sevket Ozturk, Yama Thakkar, Itsik Ben-Dor, Lowell Satler, Anita Sadeghpour, Ron Waksman, Toby Rogers","doi":"10.1016/j.carrev.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.09.011","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding whether advanced chronic kidney disease (ACKD) serves as an independent risk factor for shorter time to valve re-intervention remains limited.</p><p><strong>Objectives: </strong>This study investigates the prognostic association between ACKD and transcatheter heart valve re-intervention (THVr) in patients with left-sided bioprosthetic valves.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients who underwent THVr between November 2011 and March 2025 following prior surgical or transcatheter bioprosthetic aortic or mitral valve replacement. Patients with estimated glomerular filtration rate (eGFR) ≤45 ml/min/1.73 m² at the time of re-intervention were categorized as having ACKD and were compared to those without ACKD.</p><p><strong>Results: </strong>Among 271 THVr patients (mean age 74 ± 10 years, 57.2% males, 77.0% Caucasians), 241 underwent aortic and 30 underwent mitral valve re-intervention. ACKD was identified in 27 patients (10%). ACKD patients were younger (68.8 vs. 74.8 years, p = 0.003), more frequently African American (51.9% vs 13.9%, p < 0.01), had higher rates of prior myocardial infarction (31.6% vs 12.2%, p = 0.033), and higher Society of Thoracic Surgeons (STS) score (8.8 vs 5.5, p = 0.032). ACKD patients had a significantly shorter time to THVr (7.4 vs 10.1 years, p = 0.012). Interval decline in eGFR was independently associated with shorter time to THVr. In-hospital outcomes were similar between groups, including mortality (0% vs 0.8%; p = 1), blood transfusion (18.5% vs 10.7%, p = 0.21), any bleeding (7.4% vs 5.7%, p = 0.7), or stroke (3.7% vs 0.8%, p = 0.27).</p><p><strong>Conclusion: </strong>ACKD patients undergoing THVr tend to be younger and have advanced co-morbidities. The interval decline in their eGFR may be associated with accelerated time to THVr. These observational findings are hypothesis generating, suggesting a need for enhanced surveillance for early detection of valve deterioration.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128903","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":"Serum biomarkers in structural deterioration of surgical bioprosthetic aortic valves: A systematic review and meta-analysis.","authors":"Zeyad Kholeif, Mohamed Doma, Rana Rashwan, Ahmed Elmorsy Mohamed, Ahmed E Ali, Merna Abouelenein, Ameer Awashra, Andrew Goldsweig, Mackram Eleid, Gabor Bagameri, Tim Leiner, Bas Kietselaer","doi":"10.1016/j.carrev.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.09.007","url":null,"abstract":"<p><strong>Background: </strong>Patients with surgically implanted bioprosthetic aortic valves remain at risk of structural valve deterioration (SVD), a progressive process that may compromise durability and clinical outcomes. In this study, we aimed to assess serum biomarkers in patients with versus without SVD following surgical aortic valve replacement (SAVR).</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science were systematically searched from inception through September 9, 2026 for studies comparing serum biomarkers in patients with versus without SVD following SAVR with a bioprosthetic aortic valve. Random-effects models were used to calculate pooled mean differences (MDs) with 95% confidence intervals (CIs). PROSPERO registration: CRD420250655746.</p><p><strong>Results: </strong>Four studies with 819 patients (193 [23.6%] with SVD) were included. Patients with SVD had higher serum levels of low-density lipoprotein (LDL) (MD 0.23 mmol/L; 95% CI 0.05-0.41; p<0.01) compared to patients without SVD. Additionally, oxidized LDL levels (MD 3.86 U/L; 95% CI 1.14-6.58; p<0.01) as well as the concentration of small dense LDL-C (MD 0.14 mmol/L; 95% CI 0.03-0.25; p<0.01) were higher among patients with SVD. Furthermore, ApoB/ApoA-1 ratio was higher among SVD patients (MD 0.07; 95% CI 0.03-0.11; p<0.01) compared to patients without SVD. However, there were no significant differences between the groups in levels of triglycerides, high-density lipoprotein (HDL), creatinine, and fasting glucose.</p><p><strong>Conclusions: </strong>In patients with surgically implanted bioprosthetic aortic valves, higher serum LDL, oxidized LDL, small dense LDL-C, and ApoB/ApoA-I ratio were associated with SVD. Given the small observational evidence base, these findings are hypothesis-generating and require validation before these biomarkers can be used for prediction or clinical decision-making.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116702","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":"From 2290 matched points to 20 vessels: Interpreting agreement between FFRCT and FFRangio.","authors":"Teruhiko Imamura","doi":"10.1016/j.carrev.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.09.012","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116677","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":"Editorial: Paclitaxel or sirolimus for in-stent restenosis? What a cross-trial comparison teaches the American operators.","authors":"Bernardo Cortese, Rahul Kurup","doi":"10.1016/j.carrev.2026.09.013","DOIUrl":"https://doi.org/10.1016/j.carrev.2026.09.013","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116705","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}