Cardiovascular Revascularization Medicine最新文献

{"title":"Transcatheter aortic valve replacement in small aortic annuli: A propensity-matched comparison between intra-annular self-expanding valves and balloon-expandable valves.","authors":"Danial Ahmad, Michel Pompeu Sá, Dustin Kliner, Derek Serna-Gallegos, Catalin Toma, Amber Makani, David West, Yisi Wang, Floyd Thoma, Takuya Ogami, Irsa Hasan, Ibrahim Sultan","doi":"10.1016/j.carrev.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Specific transcatheter aortic valve replacement (TAVR) valve superiority is not established in the small aortic annulus (SAA) population. We sought to compare clinical and echocardiographic characteristics between patients with a SAA who underwent TAVR with either intra-annular self-expanding valves (SEV) or balloon-expandable valves (BEV).</p><p><strong>Methods: </strong>This was an observational, retrospective analysis (2013-2023). SAA was defined as an aortic annulus diameter < 23 mm (maximum) and annulus area ≤ 430 mm². Unmatched and propensity-score matched (PSM) populations were compared.</p><p><strong>Results: </strong>We identified 663 patients with SAA who underwent TAVR with SEV (n = 106) or BEV (n = 557). The PSM cohort (96 pairs) was predominantly female (90.6 % and 87.5 %) with a median age of 82.5 and 81.0 years. No statistically significant differences were observed in VARC-3 outcomes (periprocedural mortality, technical success, device success, clinical efficacy). Higher rates of residual mean gradients >20 mmHg were seen in the BEV group at 30 days (SEV 2.1 % vs BEV 21.9 %, P < 0.001) as well as lower median values of indexed effective orifice area (SEV 0.9 vs 0.6 cm²/m²). Severe PPM was also more common in the BEV group (SEV 5.2 % vs BEV 21.9 %, P = 0.002). At 2 years, differences in the rates of all-cause death (SE 11.9 % vs BE 17.1 %, P_log-rank = 0.6794) and stroke (SEV 3.4 % vs BEV 10.2 %, P = 0.7055) were not statistically significant.</p><p><strong>Conclusions: </strong>Intra-annular SEV presented better hemodynamics compared to BEV; however, survival and incidence of stroke were comparable between the groups at 2 years. Potential risk of nonstructural valve deterioration with BEV needs further investigation with longer follow-up.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081332","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: understanding drug coated balloon treatment - not quite that simple.","authors":"Bruno Scheller, Simone Fezzi","doi":"10.1016/j.carrev.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.013","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086878","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: Side ports and stopcocks, not sheath size: flow determinants in reperfusion circuits.","authors":"Sumit R Kumar, Ian C Gilchrist","doi":"10.1016/j.carrev.2025.04.036","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.036","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057270","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":"Characteristics and outcomes of Black patients with wild type transthyretin cardiac amyloidosis.","authors":"Jason Z Li, Meredith M Njus, Connor P Oates, Tania A Vora, Ajay Kadakkal, Nana Afari-Armah, Rachel M Barish, Farooq H Sheikh","doi":"10.1016/j.carrev.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>The clinical characteristics and outcomes of Black patients with wild type transthyretin cardiac amyloidosis (ATTRwt-CA) are not well described in the literature.</p><p><strong>Methods: </strong>We conducted a single center retrospective cohort study of 186 patients with cardiac amyloidosis, of which 62 had ATTRwt-CA, diagnosed at our institution between 2/2010 and 4/2023. We compared clinical, laboratory, electrocardiographic, and echocardiographic characteristics between Black and non-Black ATTRwt-CA patients. Our primary outcome of interest was all cause mortality.</p><p><strong>Results: </strong>Of the 62 patients with ATTRwt-CA, 19 patients self-identified as Black. Black ATTRwt-CA patients had higher rates of chronic kidney disease (63.2 % vs 23.3 %; p = 0.002), lower glomerular filtration rate (50.8 ± 18.0 vs 63.3 ± 18.4; p = 0.019), and lower rates of carpal tunnel syndrome (36.8 % vs 67.4 %; p = 0.024). There were no significant differences in disease stage (p = 0.058), frequency of NYHA III or IV symptoms (35.3 % vs 35.5 %; p = 0.990), or LVEF (41.2 ± 17.1 vs 49.1 ± 13.2; p = 0.074) at the time of CA diagnosis. Black ATTRwt-CA patients demonstrated higher rates of mortality on both univariate (HR: 5.52; CI 2.05-14.81; p = 0.001) and multivariate (HR: 4.85; CI 1.53-15.41; p = 0.007) Cox regression analysis.</p><p><strong>Conclusion: </strong>Black patients with ATTRwt-CA demonstrate phenotypic differences and worse survival compared to non-Black patients. The reasons underlying this survival difference warrant further investigation.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081331","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":"Beyond the guidelines: expert perspectives on the management of AMI-related cardiogenic shock from the cardiovascular research technologies (CRT) 2025 meeting.","authors":"Lior Lupu, Gregg W Stone, Lindsey Cilia, Holger Thiele, Ramesh Daggubati, Dean J Kereiakes, Tanveer Rab, Michael J Rinaldi, George W Vetrovec, Ron Waksman","doi":"10.1016/j.carrev.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.005","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081296","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":"Beyond the guidelines: Forging a new chapter in medical education at CRT 2025.","authors":"Ron Waksman","doi":"10.1016/j.carrev.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.004","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095492","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":"Hemocompatibility related complications in Impella 5+ patients treated with Bivalirudin and dual antiplatelet therapy: a SHEAR score evaluation.","authors":"Marta Bandini, Serena Querio, Elena Utzeri, Astrid Cardinale, Giulia Maj, Andrea Audo, Federico Pappalardo","doi":"10.1016/j.carrev.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>The surgical Impella 5.0 and 5.5 (5+) provide greater and more durable hemodynamic support than Impella CP in patients with cardiogenic shock. The concomitant need for DAPT on top of systemic anticoagulation might increase the risk for hemocompatibility-related adverse events.</p><p><strong>Methods: </strong>13 patients who underwent primary PCI and Impella 5+ support and were treated with DAPT and Bivalirudin. We evaluated adverse events (AEs) and hemocompatibility-related complications according to the SHEAR score.</p><p><strong>Results: </strong>Median duration of Impella 5+ support was 14 ± 32 days. At baseline, all patients had risk for bleeding because of DAPT (SHEAR A); moreover, 2 patients suffered from thrombocytopenia. None presented risk factors for thrombosis. The highest total SHEAR score was 6 in 2 patients, three patients had a total SHEAR score of 3, three patients had a total SHEAR score of 2, 5 patients had a total SHEAR score of 1. Both bleeding and thrombotic events were most frequent within the first 48 h of support, and bleeding events had a greater role in determining the hemocompatibilty score. No patient suffered from clinically relevant hemocompatibility-related adverse events.</p><p><strong>Conclusions: </strong>In conclusion, we report a low rate of thrombotic and hemorrhagic events in a cohort of AMI-CS patients requiring Impella 5+ support and treated with bivalirudin and DAPT, according to the SHEAR score classification. This is further confirmed by the ability of the SHEAR score to add multiple events that can occur during prolonged support. Further studies are urgently needed to confirm this new approach in tMCS.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054669","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: Left atrial appendage closure experience; getting to the heart of the matter.","authors":"Richard K Shepard, Kenneth A Ellenbogen","doi":"10.1016/j.carrev.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.002","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021916","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: Cardiac amyloidosis: To prevent arrhythmia, treat before it's too late.","authors":"Chidubem Ezenna, Gregory Valania, Andrew M Goldsweig","doi":"10.1016/j.carrev.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.05.001","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020534","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":"Predictors of permanent pacemaker implantation after TAVI with Navitor transcatheter heart valve.","authors":"Matteo Casenghi, Sara Corradetti, Stefano Rigattieri, Francesca Giovannelli, Marta Belmonte, Marco Redivo, Carlo Terrone, Daniele Barzetti, Antonella Tommasino, Eric Wyffels, Emanuele Gallinoro, Raffaella Mistrulli, Pasquale Paolisso, Andrea Berni, Marc Vanderheyden, Emanuele Barbato","doi":"10.1016/j.carrev.2025.04.039","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.039","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to identify predictors of permanent pacemaker implantation (PPI) within 30 days after transcatheter aortic valve implantation (TAVI) using the Navitor™ (Abbott Chicago, IL, USA) transcatheter heart valve (THV).</p><p><strong>Methods and results: </strong>This retrospective two-center study included 173 patients with severe aortic stenosis undergoing transfemoral TAVI with Navitor™ THV. Patients with prior pacemaker implantation and valve-in-valve procedures were excluded. Mean age was 81.5 ± 5.0 years, and 54 patients (31 %) required PPI; they were more often male (57 % vs. 37 %, p = 0.01), had higher left ventricular ejection fraction (55.3 ± 9.0 vs. 52.4 ± 9.2, p = 0.049), and higher rates of COPD (30 % vs. 16 %, p = 0.017) and pre-existing right bundle branch block (RBBB; 17 % vs. 0.8 %, p < 0.001). Procedural factors associated with PPI included greater annulus-to-THV oversizing (13.6 % ± 3.4 vs. 12.5 % ± 3.1, p = 0.041), implantation depth > 4 mm (75.9 % vs. 52.1 %, p = 0.002), and 29 mm valve size use (46.3 % vs. 26.9 %, p = 0.010). At multivariable analysis, COPD (OR 2.4, p = 0.049), pre-existing RBBB (OR 34.4, p = 0.001), annulus-to-THV oversizing (OR 1.2, p = 0.002), and implantation depth > 4 mm (OR 3.2, p = 0.007) were independent predictors of PPI. ROC analysis (AUC 0.58) identified an optimal cut-off of 15 % annulus-to-THV oversizing for predicting PPI.</p><p><strong>Conclusions: </strong>Annulus-to-THV oversizing emerges as a novel independent predictor for PPI after TAVI with Navitor™ THV.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051038","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}