Cardiovascular Revascularization Medicine最新文献

{"title":"TAVR vs. SAVR for severe aortic stenosis in the low and intermediate surgical risk population: An updated meta-analysis, meta-regression, and trial sequential analysis","authors":"Mrinal Murali Krishna ,&nbsp;Meghna Joseph ,&nbsp;Chidubem Ezenna ,&nbsp;Vinicius Pereira ,&nbsp;Raiza Rossi ,&nbsp;Zafer Akman ,&nbsp;Muni Rubens ,&nbsp;Vaikom S. Mahadevan ,&nbsp;Michael G. Nanna ,&nbsp;Andrew M. Goldsweig","doi":"10.1016/j.carrev.2025.05.021","DOIUrl":"10.1016/j.carrev.2025.05.021","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend transcatheter aortic valve replacement<span> (TAVR) or surgical aortic valve replacement (SAVR) for patients of age &gt; 65 years. The relative risks and benefits of TAVR vs. SAVR in low and intermediate surgical risk remain incompletely described.</span></div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Scopus, and Cochrane Central databases identified randomized controlled trials (RCTs) comparing clinical outcomes of TAVR vs. SAVR in low and intermediate surgical risk.</div></div><div><h3>Results</h3><div>Ten RCTs (9239 patients, TAVR 50.8 %) were included. TAVR was associated with lower rates of all-cause death or stroke at 30-day (rate ratio [RR] 0.70; 95%CI 0.55–0.89; <em>p</em> = 0.003; I² = 26 %) and 1-year (RR 0.77; 95%CI 0.60–0.98; <em>p</em> = 0.033; I²<span><span> = 54 %) follow-up. Bleeding complications, new-onset atrial fibrillation (AF), </span>acute kidney injury<span><span> (AKI), and severe patient-prosthesis mismatch (PPM) were lower with TAVR at 30 days and 1-year. Permanent pacemaker implantation, aortic valve reintervention, major vascular complications, and </span>paravalvular leak<span> (PVL) were significantly higher with TAVR at 30-day and 1-year follow-ups. Rates of all-cause death, stroke, MI, endocarditis, and rehospitalization were comparable between the groups at 30-day and 1-year follow-up.</span></span></span></div></div><div><h3>Conclusion</h3><div>In patients with severe AS<span> and low to intermediate surgical risk, TAVR is associated with reduced rates of all-cause death or stroke, bleeding, new-onset AF, AKI, and severe PPM compared to SAVR. However, despite these short-term benefits, higher rates of permanent pacemaker implantation, PVL, and reintervention raise significant concerns about the long-term safety of TAVR, particularly for younger, lower-risk patients.</span></div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 78-89"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162912","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 edge-to-edge repair for the management of secondary mitral regurgitation – CRT 2025 Beyond the Guidelines","authors":"Dan Haberman ,&nbsp;Michael J. Reardon ,&nbsp;Gregg W. Stone ,&nbsp;Chet Rihal ,&nbsp;Tiziana Claudia Aranzulla ,&nbsp;Nidhi Madan ,&nbsp;Wojtek Wojakowski ,&nbsp;Mark J. Reisman ,&nbsp;Lior Lupu ,&nbsp;Abhishek Chaturvedi ,&nbsp;Ron Waksman","doi":"10.1016/j.carrev.2025.08.003","DOIUrl":"10.1016/j.carrev.2025.08.003","url":null,"abstract":"<div><div>Secondary mitral regurgitation (SMR) remains a prevalent and challenging complication in patients with heart failure (HF), associated with poor prognosis despite optimal guideline-directed medical therapy (GDMT) and cardiac resynchronization therapy. Current American and European guidelines recommend GDMT as first-line therapy, with transcatheter edge-to-edge repair (TEER) reserved for severe symptomatic SMR patients who remain refractory. However, both guidelines preceded the reporting of pivotal randomized controlled trials (RESHAPE-HF2, MATTERHORN, and EFFORT) and emerging evidence in new clinical scenarios. At the 2025 Cardiovascular Research Technologies (CRT) conference, the session “Beyond the Guidelines” convened an expert panel to address existing gaps and evolving indications. Discussions highlighted unresolved questions regarding TEER in moderate SMR, asymptomatic patients, atrial functional MR, cardiogenic shock, and as a bridge in end-stage HF. Panel consensus emphasized the need for dedicated randomized trials in these subgroups and consideration of broader TEER use based on registry and observational data demonstrating procedural safety and clinical benefit. This review summarizes current evidence, knowledge gaps, and expert perspectives to inform future guideline development and optimize management of SMR across the spectrum of HF.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008530","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":"Anxiety during transcatheter aortic valve replacement under local anesthesia - the ART-VR trial","authors":"Sraman Chatterjee ,&nbsp;Joris Ooms ,&nbsp;Marjo de Ronde ,&nbsp;Stefan van Gorsel ,&nbsp;Antonio Maarten Mattace-Raso ,&nbsp;Jeannette Goudzwaard ,&nbsp;Francesco Mattace-Raso ,&nbsp;Isabella Kardys ,&nbsp;Rutger-Jan Nuis ,&nbsp;Joost Daemen ,&nbsp;Nicolas Van Mieghem","doi":"10.1016/j.carrev.2025.05.015","DOIUrl":"10.1016/j.carrev.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>The use of local anesthesia during transcatheter aortic valve replacement (TAVR) could result in patient discomfort. Application of immersive virtual reality (VR) during TAVR might distract the patient and enhance the overall experience.</div></div><div><h3>Objective</h3><div>To evaluate the effect of an immersive VR environment on periprocedural anxiety and patient discomfort, compared to standard of care in patients undergoing transfemoral (TF) TAVR under local anesthesia.</div></div><div><h3>Methods</h3><div>In this single-center, randomized controlled pilot study, patients were randomized to either VR immersion during TAVR or standard of care. The intervention was a VR headset to create 3D experiences during percutaneous transfemoral TAVR. The main outcome was patient-reported procedural anxiety assessed directly after the procedure on a visual analog scale (VAS). Secondary outcomes were procedural satisfaction, pain, and change in anxiety. Personality scores were obtained at baseline to explore associations between personality types and relevant outcomes.</div></div><div><h3>Results</h3><div>A total of 75 patients (VR = 37, control = 38) were included between September 2021 and January 2023. The median age was 79 (25th–75th: 75–84) years and 32 patients (43 %) were female. Overall procedural anxiety VAS was 1.0 (0.0–3.0) and satisfaction was 9.0 (8.0–10.0). There was no difference in procedural anxiety between VR and control (VAS: 1.0 [25th–75th: 0.0–3.0] versus 1.0 [25th–75th: 0.0–3.0], <em>p</em> = 0.59). Procedural satisfaction, pain perception and change in anxiety were not affected by VR use.</div></div><div><h3>Conclusion</h3><div>Patients undergoing TF-TAVR under local anesthesia experienced mild procedural anxiety and high satisfaction levels. Procedural VR use did not affect procedural anxiety or pain perception.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 71-77"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112287","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 in-hospital early mortality following valve-in-valve transcatheter aortic valve replacement","authors":"Yong-Hao Yeo ,&nbsp;Ghee-Kheng Lim ,&nbsp;Xuan-Ci Mee ,&nbsp;Qi-Xuan Ang ,&nbsp;Min Choon Tan","doi":"10.1016/j.carrev.2025.01.013","DOIUrl":"10.1016/j.carrev.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div><span>There is an increasing preference of utilizing valve-in-valve transcatheter aortic valve replacement (ViV TAVR) after </span>bioprosthetic valve failure. However, updated large-scale analysis investigating early-mortality after the patients underwent ViV TAVR is limited.</div></div><div><h3>Objective</h3><div>This study aimed to assess in-hospital early mortality and analyze the factors associated with in-hospital early mortality among patients who underwent ViV TAVR.</div></div><div><h3>Methods</h3><div>Using the all-payer, nationally representative National Readmission Database, our study included patients aged 18 years or older who had ViV TAVR between 2017 and 2020. We categorized the cohort into two groups depending on the occurrence of in-hospital early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of in-hospital early mortality after ViV TAVR and further analyzed the significant factors associated with it.</div></div><div><h3>Results</h3><div>After adjustment, a total of 11,009 patients who had ViV TAVR were included in this study. 329 (3.0 %) had in-hospital early mortality and 10,680 (97.0 %) without. There was a decreasing trend in in-hospital early mortality from 3.3 % in 2017 to 1.0 % in 2020, but it was insignificant (<em>p</em><span> = 0.71). In multivariable analysis, the independent factors associated with in-hospital early mortality were chronic liver disease (adjusted odds ratio [aOR]: 3.62; 95 % confidence interval [CI]: 1.96–6.71, </span><em>p</em><span> &lt; 0.01), coagulation disorder (aOR: 1.77; CI: 1.16–2.68, p &lt; 0.01) and pulmonary hypertension (aOR: 1.78; CI: 1.18–2.68, p &lt; 0.01). Among patients who died during early readmission following ViV TAVR, the most common cardiac cause and non-cardiac cause of readmission were heart failure (15.4 %) and infection (23.1 %), respectively.</span></div></div><div><h3>Conclusion</h3><div>The in-hospital early mortality following ViV TAVR was low at 3.0 %. The independent factors associated with in-hospital early mortality post-procedurally were chronic liver disease, coagulation disorder, and pulmonary hypertension.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 18-23"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371307","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-term outcomes of transcatheter aortic valve implantation in patients with concomitant mitral or tricuspid regurgitation","authors":"Shafaqat Ali ,&nbsp;Irisha Badu ,&nbsp;Manoj Kumar ,&nbsp;Thannon Alsaeed ,&nbsp;Lalitsiri Atti ,&nbsp;Faryal Farooq ,&nbsp;Sanchit Duhan ,&nbsp;Bijeta Keisham ,&nbsp;Pramod Kumar Ponna ,&nbsp;Vijaywant Brar ,&nbsp;Pratik Agrawal ,&nbsp;Mabruka Alfaidi ,&nbsp;Yasmin S. Hamirani ,&nbsp;Tarek Helmy ,&nbsp;Timir K. Paul","doi":"10.1016/j.carrev.2025.02.008","DOIUrl":"10.1016/j.carrev.2025.02.008","url":null,"abstract":"<div><div><span>Mitral regurgitation<span><span><span> (MR) or tricuspid regurgitation<span> (TR) is often an indicator of poor prognosis in patients with aortic stenosis (AS). Our study aims to compare </span></span>transcatheter aortic valve implantation (TAVI) outcomes in patients with and without concomitant MR or isolated TR. Using the national readmission database (2016–2020), we identified patients with severe AS undergoing TAVI. We used multivariable regression for adjusted analysis and the </span>Propensity Score Matching (PSM) model. Among 315,163 hospitalizations for TAVI, 14,577 (4.6 %) had concomitant MR, while 3859 (1.2 %) had isolated TR. On PSM, TAVI in concomitant MR was associated with higher acute CHF (50.1 % vs 43.7 %, </span></span><em>p</em><span>-value &lt; 0.001), mechanical circulatory support (MCS) need (1.5 % vs 0.9 %, </span><em>p</em><span>-value: 0.001), acute myocardial infarction (5.6 % vs. 4.3 %, </span><em>p</em>-value &lt; 0.001) and net adverse events (61.5 % vs. 59.2 %, <em>p</em>-value: 0.002) while the mortality difference was not significant (<em>p</em> &gt; 0.05). Higher total costs ($58,104 vs $55,183, <em>p</em>-value &lt; 0.001), 90- (22.8 % vs. 21.2 %), and 180-day readmission rates (32.1 % vs. 29.4 %) were also observed [<em>p</em><span>-value &lt; 0.05]. Similarly, TAVI in the presence of isolated TR was associated with higher cardiogenic shock (3.2 % vs. 1.8 %, </span><em>p</em>: 0.004) and MCS need (1.5 % vs 0.7 %, <em>p</em>: 0.009). TAVI with coexisting TR showed higher rates of 30-day (13.4 % vs. 11.2 %), 90-day (26 % vs. 21.2 %), and 180-day (34.3 % vs 29.1 %) readmission rates [<em>p</em> &lt; 0.05]. A higher median length of stay (3 vs. 2 days) and total cost ($60,376 vs. $55,183) [<em>p</em>-value &lt; 0.001] were also observed. TAVI in concomitant MR or TR was associated with higher periprocedural adverse events, increased healthcare burden &amp; readmission rates.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 31-40"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568503","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 and prognosis of progression of aortic valve stenosis in patients hospitalized with heart failure with mildly reduced ejection fraction","authors":"Noah Abel ,&nbsp;Michael Behnes ,&nbsp;Alexander Schmitt ,&nbsp;Marielen Reinhardt ,&nbsp;Felix Lau ,&nbsp;Kathrin Weidner ,&nbsp;Mohamed Ayoub ,&nbsp;Kambis Mashayekhi ,&nbsp;Thomas Bertsch ,&nbsp;Ibrahim Akin ,&nbsp;Tobias Schupp","doi":"10.1016/j.carrev.2025.05.028","DOIUrl":"10.1016/j.carrev.2025.05.028","url":null,"abstract":"<div><h3>Background</h3><div>Although aortic valve stenosis (AS) is a recognized predictor of outcomes in heart failure (HF), limited data is available concerning predictors for and the prognostic value of progressive AS in patients with HF with mildly reduced ejection fraction (HFmrEF).</div></div><div><h3>Methods</h3><div>From 2016 to 2022, consecutive patients hospitalized with HFmrEF at one institution were retrospectively included. AS progression was assessed during follow-up echocardiography and patients with and without progression were compared regarding the primary endpoint long-term all-cause mortality at 30 months (median follow-up) using Kaplan-Meier and Cox regression analyses. Key secondary endpoint was rehospitalization for worsening HF. Predictors of AS progression were investigated using logistic regression analyses.</div></div><div><h3>Results</h3><div>From 603 included patients hospitalized with HFmrEF, progressive AS was observed in 55 patients, which was associated with an increased risk of long-term all-cause mortality (HR = 1.697; 95 % CI 1.094–2.633; <em>p</em> = 0.018), but not with HF-related rehospitalization (<em>p</em> = 0.585). The association with long-term all-cause mortality was still evident after multivariable adjustment (<em>p</em> = 0.044). Independent predictors of AS progression were older age at baseline (HR = 1.033; 95 % CI 1.001–1.065; <em>p</em> = 0.042; per year increase), diabetes mellitus (HR = 1.851; 95 % CI 1.019–3.363; <em>p</em> = 0.043) and baseline AS severity (mild AS: HR = 3.923; 95 % CI = 1.605–9.588; <em>p</em> = 0.003, moderate AS: HR = 6.122; 95 % CI 2.587–14.488; <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>AS progression in HFmrEF patients is independently associated with impaired long-term survival.</div><div>clinicaltrials.gov identifier: <span><span>NCT05603390</span><svg><path></path></svg></span>, ethical approval code: 2022-818 (Medical Ethics Committee II of the Medical Faculty Mannheim, University of Heidelberg, Germany).</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 90-97"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235587","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":"Should STEMI be retired?","authors":"Spencer B. King III","doi":"10.1016/j.carrev.2025.09.003","DOIUrl":"10.1016/j.carrev.2025.09.003","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 126-127"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058752","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 disease in patients undergoing transcatheter aortic valve replacement","authors":"Max B. Sayers ,&nbsp;Krishnaraj Rathod ,&nbsp;Mohammed Akhtar ,&nbsp;Asha Pavithran ,&nbsp;Michael Michail ,&nbsp;Vincenzo Tufaro ,&nbsp;Sumanto Mukhopadhyay ,&nbsp;Thomas A. Treibel ,&nbsp;Simon Kennon ,&nbsp;Mick Ozkor ,&nbsp;Andreas Baumbach ,&nbsp;Daniel Jones ,&nbsp;Anthony Mathur ,&nbsp;Michael J. Mullen ,&nbsp;Kush P. Patel","doi":"10.1016/j.carrev.2025.05.010","DOIUrl":"10.1016/j.carrev.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div><span>The prognostic impact of coronary artery disease<span> (CAD) in patients with severe aortic stenosis<span> (AS) undergoing transcatheter aortic valve replacement (TAVR) remains unclear. We assessed the impact of CAD on TAVR procedural safety and long-term </span></span></span>adverse outcomes<span> by stratifying patients according to CAD burden.</span></div></div><div><h3>Methods</h3><div>This single-centre, retrospective study stratified patients into low-, intermediate- and high-burden according to angiographic severity and location. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular (CV) death, myocardial infarction (MI), hospitalization for heart failure (HHF) and major adverse coronary events (MACE).</div></div><div><h3>Results</h3><div>Of 1803 consecutive patients, low-, intermediate- and high-coronary burden was identified in 1281 (71 %), 382 (21 %) and 140 (8 %) patients, respectively. There were no differences in procedural outcomes or in-hospital mortality between groups. At a median follow-up of 4.8 (3.7–6.1) years, the incidence of all-cause mortality was 49 % vs 54 % vs 62 %, respectively. After adjusting for age and comorbidities, high-burden CAD was associated with all-cause mortality (HR: 1.35, 95 % CI 1.07–1.70, <em>P</em> = 0.011), CV-mortality (HR: 1.54, 95 % CI 1.07–2.17, <em>P</em> = 0.02) and MACE (adjusted HR 1.63, 95 % CI 1.23–2.15, <em>P</em> = 0.001), but not HHF (HR: 1.43, 95 % CI: 0.96–2.13, <em>P</em> = 0.082). Both intermediate- (HR 2.87, CI 1.83–4.50, <em>P</em> &lt; 0.001) and high-burden groups (HR 2.69, 95 % CI 1.38–5.25, <em>P</em> = 0.004) were associated with MI.</div></div><div><h3>Conclusions</h3><div><span>Increasing CAD burden does not impact TAVR procedural safety and therefore revascularization should not be a pre-requisite before TAVR. High CAD burden is associated with long-term </span>adverse events. This group would benefit from future studies addressing CAD management in TAVR patients.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 61-67"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095496","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 SAPIEN M3 system for transcatheter mitral valve replacement: A new era begins","authors":"Michail Penteris ,&nbsp;Konstantinos Lampropoulos","doi":"10.1016/j.carrev.2025.06.034","DOIUrl":"10.1016/j.carrev.2025.06.034","url":null,"abstract":"<div><div>Mitral regurgitation<span><span><span> (MR) remains a prevalent and undertreated valvular heart disease, particularly in patients at prohibitive surgical risk. While mitral transcatheter edge-to-edge repair (M-TEER) offers a less invasive alternative, anatomical limitations and incomplete MR reduction in some patients have fueled the development of transcatheter </span>mitral valve replacement (TMVR) technologies. The SAPIEN M3 system (Edwards Lifesciences, Irvine, CA, USA) introduces a novel, fully percutaneous TMVR approach utilizing a two-component system: a self-expanding </span>nitinol dock that encircles the subvalvular apparatus and a balloon-expandable SAPIEN 3 valve adapted for the mitral position. This design minimizes the risk of left ventricular outflow tract (LVOT) obstruction and enables stable, anatomy-independent anchoring without requiring annular calcification. Early feasibility studies have shown high technical success rates (&gt;85 %), effective MR reduction, and a favorable safety profile in high-risk patients. The ongoing ENCIRCLE trial and a planned European post-market study aim to further evaluate the system's safety, durability, and long-term outcomes. Despite promising early results, challenges remain, including procedural complexity, the potential for LVOT obstruction, and limited long-term durability data.</span></div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 120-125"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561521","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":"Combined mitral and tricuspid TEER with a single TriClip steerable guide catheter: A single-center study","authors":"Georgios E. Papadopoulos,&nbsp;Ilias Ninios,&nbsp;Sotirios Evangelou,&nbsp;Andreas Ioannides,&nbsp;Vlasis Ninios","doi":"10.1016/j.carrev.2025.04.033","DOIUrl":"10.1016/j.carrev.2025.04.033","url":null,"abstract":"<div><h3>Background</h3><div>Combined M- and T- TEER typically involves two separate systems, complicating logistics and increasing procedural risks. This study aims to evaluate the safety and efficacy of combined mitral (M-TEER) and tricuspid (T-TEER) transcatheter edge-to-edge repair using a single TriClip® steerable guide catheter (SGC).</div></div><div><h3>Methods</h3><div>Patients with moderate-to-severe (3+) or severe (4+) degenerative (DMR) or functional (FMR) mitral regurgitation<span> and massive/torrential or severe functional tricuspid regurgitation (TR), classified as New York Heart Association (NYHA) class III or IV, who underwent combined M- and T- TEER with the same TriClip SGC between January 2022 and December 2024, were included. The primary objectives included procedural outcomes, MR and TR severity reduction, and NYHA class improvement.</span></div></div><div><h3>Results</h3><div>Among 42 patients (64 % female; median age: 77 years [IQR: 9]), the implantation success rate was 100 %, with mean device and procedure times of 39.2 ± 6.9 and 71.2 ± 9.6 min, respectively. There were no in-hospital or 30-day major adverse events (MAEs), except for 2 patients (4.8 %) with tricuspid single leaflet device attachment (SLDA), and 1 patient (2.4 %) who underwent atrial septal defect (ASD) closure. Over a median follow-up period of 0.91 years, 3 (7.1 %) patients were hospitalized for heart failure, with zero mortality. At 1-year follow-up, all patients achieved NYHA class ≤II, along with MR ≤2+ and 34 (81 %) patients had only trivial/mild TR.</div></div><div><h3>Conclusions</h3><div>Combined M-TEER and T-TEER using the same TriClip SGC demonstrated favorable safety and efficacy, along with significant functional and echocardiographic improvements.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 98-103"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022274","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}