Cardiovascular Revascularization Medicine最新文献

{"title":"Editorial: Beyond the valve: Silent coronary artery disease in TAVR patients","authors":"Basel Ramlawi , Dimitrios E. Magouliotis , Massimo Baudo","doi":"10.1016/j.carrev.2025.07.015","DOIUrl":"10.1016/j.carrev.2025.07.015","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 68-70"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838257","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: The relationship between implantation depth, oversizing, distribution of radial strength and conduction disturbances","authors":"Stefan Toggweiler","doi":"10.1016/j.carrev.2025.08.007","DOIUrl":"10.1016/j.carrev.2025.08.007","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"79 ","pages":"Pages 52-53"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859778","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 tricuspid valve replacement and valve-in-valve in patient with unusually calcified tricuspid valve.","authors":"Deven R Rajagopal, James P Stewart, Vinod H Thourani, Pradeep K Yadav","doi":"10.1016/j.carrev.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.014","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259622","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":"A Bayesian meta-analysis of transcatheter versus surgical aortic valve replacement in patients with small aortic annulus.","authors":"Vinícius Martins Rodrigues Oliveira, Maria Elisa Passos Nishikubo, Ana Gabrielly Oliveira Antunes, Lucas M Barbosa, Pedro Antônio de Sousa, Lucca Lopes, Ludimilla Pereira Tartuce, Daniela do Carmo Rassi, Humberto Graner Moreira","doi":"10.1016/j.carrev.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.011","url":null,"abstract":"<p><strong>Background: </strong>Small aortic annulus (SAA) is associated to suboptimal results after aortic valve replacement. The optimal treatment for aortic disease in SAA remains unclear.</p><p><strong>Methods: </strong>We conducted a systematic review and Bayesian random-effects meta-analysis to compare transcatheter (TAVR) versus surgical aortic valve replacement (SAVR) in patients with small aortic annulus. A comprehensive search of PubMed, Scopus, and Cochrane Library was performed through May 2024. Binary outcomes were synthesized using a binomial-normal hierarchical model to estimate posterior distributions of log odds ratios (log OR) and corresponding 95 % credible intervals (CrIs). Posterior probabilities of treatment effects were calculated to assess the certainty of benefit or harm. All statistical analyses were performed using R version 4.5.0.</p><p><strong>Results: </strong>Nine studies comprising 2548 patients (50.9 % TAVR) were included. TAVR was associated with reduced risk of severe patient-prosthesis mismatch (OR 0.47; 95 % CrI 0.31-0.72; posterior probability of benefit 99.8 %) and moderate mismatch (OR 0.56; 95 % CrI 0.40-0.79; posterior probability 99.7 %). In contrast, SAVR was associated with lower risk of moderate/severe aortic regurgitation (OR 4.74; 95 % CrI 2.43-9.27; posterior probability of harm with TAVR 98.1 %) and permanent pacemaker implantation (OR 2.66; 95 % CrI 1.69-4.20; posterior probability of harm with TAVR 98.5 %). No meaningful differences were observed for stroke at 30 days (OR 1.51; 95 % CrI 0.69-3.36) or all-cause mortality at 1 year (OR 0.78; 95 % CrI 0.51-1.17).</p><p><strong>Conclusions: </strong>TAVR is superior to SAVR regarding severe and moderate PPM in SAA patients. SAVR is associated with lower risk of aortic regurgitation and new pacemaker implant, with no significant differences in mortality and stroke.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207936","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":"Disparities in access, utilization, and outcomes of percutaneous coronary intervention in Hispanics compared to non-Hispanic Whites in the United States: A comprehensive review.","authors":"Eric C H Leung, James C Blankenship, Carolina Ponce Orellana, Deirdre Hill, Bharath Yarlagadda","doi":"10.1016/j.carrev.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.008","url":null,"abstract":"<p><strong>Background: </strong>Ischemic heart disease is the leading cause of cardiovascular mortality in the United States, with percutaneous coronary intervention (PCI) being one of the definitive treatments. Historically, data suggested Hispanics, when compared to non-Hispanic Whites, suffer worse acute coronary syndrome mortality rates. Therefore, we conducted a comprehensive literature review to summarize factors influencing PCI outcomes in this population.</p><p><strong>Methods: </strong>In accordance with PRISMA guidelines for systematic reviews, we performed a literature search encompassing PCI for any indication with Hispanic-specific outcomes using the PubMed database through April 2025 yielding 69 studies. Authors independently screened search results and resolved discrepancies through consensus. Meta-analysis was performed where ever feasible using random effects models due to expected study heterogeneity.</p><p><strong>Results/data: </strong>Hispanics experience acute myocardial infarction more frequently and are more likely to present urgently or emergently than Whites. Hispanic ethnicity correlates with delayed door-to-balloon and catheterization laboratory activation times. Additionally, Hispanics are disproportionately admitted to low procedure volume hospitals with disparities in hospital quality resulting in inferior PCI outcomes. High Medicaid and uninsured rates in Hispanics reflect cost-prohibitive healthcare access limitations, resulting in a trend towards lower rates of resvascularization and procedural differences like stent utilization. However, in-hospital and long-term outcomes between Hispanic and White populations undergoing PCI are similar.</p><p><strong>Conclusion(s): </strong>This review uncovers an incongruity between profound disparities in access and utilization of PCI, driven by socio-economic determinants, and comparable in-hospital and mortality outcomes between Hispanics and Whites. Consequently, it highlights the need for increased research to improve patient outcomes and reduce health disparities.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226196","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":"Utilization patterns in catheter-directed therapies in intermediate- and high-risk pulmonary embolism: A nationwide analysis.","authors":"Chukwuemeka Umeh, Gagan Kaur, Iman Richie, Melanie Yoshihara, Rakesh Gupta","doi":"10.1016/j.carrev.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.009","url":null,"abstract":"<p><strong>Background: </strong>Catheter-based therapies (CBT), including both catheter-directed thrombolysis (CT) and mechanical thrombectomy (MT), are current treatments for intermediate- and high-risk pulmonary embolism (PE). Although the safety and efficacy of CT and MT have previously been explored, limited studies have investigated utilization patterns. This study aims to examine the trends and correlations between CT and MT use and various clinical patient factors.</p><p><strong>Methods: </strong>Retrospective cohort analysis of data from the 2017 to 2021 National Inpatient Sample (NIS), the largest publicly available database of hospitalized patients in the United States, focusing on adult patients admitted with a diagnosis of pulmonary embolism. Using demographic and clinical variables extracted from the NIS, we evaluated the factors that affect the use of CT and MT.</p><p><strong>Results: </strong>1,983,074 cases of pulmonary embolism were identified in patients 18 years and above. 63,205 received CBT (3.19 %), of which 23,930 (37.86 %) received MT, 36,470 (57.7 %) received CT, and 2805 (4.43 %) received both. The proportion of CBT that was MT increased from 14.1 % in 2017 to 68.7 % in 2021, while the proportion of CT decreased from 85.9 % in 2017 to 31.3 % in 2021. In the multivariate analysis, patients 65 years and older (aOR 1.07, p < 0.001) and those with saddle pulmonary embolism (aOR 1.29, p < 0.001) and sicker patients, such as those with acute kidney injury (aOR 1.305, 95 % CI 1.255-1.356, p < 0.001) and acute myocardial infarction (aOR 1.298, 95 % CI 1.232-1.367, p < 0.001), were more likely to receive MT than CT. However, in 2021, when MT became the main CBT, MT was no longer associated with older or sicker patients. In addition, compared to rural hospitals, patients in urban non-teaching hospitals (aOR 1.317, 95 % CI 1.191-1.456, p < 0.001) and urban teaching hospitals (aOR 2.024, 95 % CI 1.843-2.223, p < 0.001) were more likely to receive MT than CT. Furthermore, patients in medium-sized (aOR 1.078, 95 % CI 1.022-1.136, p = 0.005) or large-sized hospitals (aOR 1.516, 95 % CI 1.445-1.590, p < 0.001) were more likely to receive MT than CT compared to those in small-sized hospitals.</p><p><strong>Conclusion: </strong>MT became the primary form of CBT in patients with pulmonary embolism in 2021, although its use in this condition remains low. Before 2021, MT was mainly used for sicker patients and those with co-morbidities, but that changed when it became the predominant CBT.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182368","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":"Comment on Steinke et al.: Long-term outcomes of coronary angiography in patients with and without diabetes.","authors":"Parth Aphale, Himanshu Shekhar, Shashank Dokania","doi":"10.1016/j.carrev.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.010","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179148","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":"Intracardiac echocardiography via the transesophageal route versus transesophageal echocardiography for guiding left atrial appendage occlusion.","authors":"Giulia Laterra, Giorgio Sacchetta, Giombattista Barrano, Claudia Artale, Silvia Motta, Paolo Mazzone, Giovanni Ruscica, Serena Costa, Marco Barbanti, Marco Contarini","doi":"10.1016/j.carrev.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.006","url":null,"abstract":"<p><strong>Objectives: </strong>This study sought to compare intracardiac echocardiography (ICE) probe via the esophageal route (TE-ICE) and transesophageal echocardiography (TEE) guidance for the LAAO procedure.</p><p><strong>Background: </strong>Intraprocedural imaging guidance is recommended for all LAAO procedures. Currently, both femoral-ICE-guided and TEE-guided LAAO demonstrated similar outcomes. TE-ICE may serve as a potential alternative imaging modality in LAAO. This approach avoids general anesthesia and its potential complications, while maintaining a favorable learning curve, as it is highly similar to standard transesophageal echocardiography, with whose imaging operators are generally more familiar.</p><p><strong>Methods: </strong>A pooled analysis of the FLXiEST and DIONISIO registries was conducted. For the purposes of this study, TE-ICE patients were compared to TEE patients. All TE-ICE procedures were performed using a 2D ICE catheter introduced via the transesophageal route. One-to-one propensity score matching was applied to compare the TE-ICE technique with the gold standard TEE in guiding LAAO. Technical success and procedural success were defined as the primary outcomes of the study.</p><p><strong>Results: </strong>A total of 282 patients were included in the present study. After adjustment for clinical and echocardiographic characteristics, 99 matched-pair treated with LAAO using TE-ICE and TEE were compared. The technical success did not differ between TE-ICE and TEE patients (98 % vs 96 %; p = 0.6827). The procedural success, defined as technical success in the absence of in- hospital device or procedure-related clinical events, was comparable between the two groups (93 % vs 92 %; p = 0.7673). No statistically significant differences were found for all procedural complications assessed: death, stroke, TIA, pericardial effusion, device embolization, systemic arteria embolization and major bleeding.</p><p><strong>Conclusions: </strong>The present pooled analysis of the DIONISO and the FLXiEST demonstrated that LAAO procedure guidance can be performed with equivalent outcomes using either TE-ICE and TEE. Indeed, the use of TE-ICE technique could be particularly advantageous in high-volume centers to reduce the need for anesthesia, especially in fragile and elderly patients. This approach offers significant organizational benefits by potentially eliminating the requirement for an anesthesiologist in the cath lab, thereby streamlining workflow and improving resource allocation.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151314","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 occlusion, antiplatelets and anticoagulants.","authors":"David Hildick-Smith","doi":"10.1016/j.carrev.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.007","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151257","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":"Impact of flow on outcomes in patients with left ventricular systolic dysfunction undergoing TAVR.","authors":"Besir Besir, Shivabalan Kathavarayan Ramu, Maryam Muhammad Ali Majeed-Saidan, Judah Rajendran, James J Y Yun, Rishi Puri, Grant W Reed, Amar Krishnaswamy, Rhonda Miyasaka, Serge C Harb, Samir R Kapadia","doi":"10.1016/j.carrev.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.09.005","url":null,"abstract":"<p><strong>Background: </strong>TAVR is associated with better outcomes for patients with classical low-flow low-gradient aortic stenosis (C-LFLG AS) and normal-flow low-gradient (NFLG AS) compared to medical management. Left ventricular ejection fraction (LVEF) predicts mortality in patients undergoing TAVR. However, the outcomes based on flow in patients with lower LVEF undergoing TAVR remain unclear.</p><p><strong>Objectives: </strong>This study explored the outcomes of patients with reduced LVEF undergoing TAVR with C-LFLG AS and NFLG AS. It also explored the hemodynamic changes post-TAVR in these populations and identified factors determining their outcomes.</p><p><strong>Methods: </strong>In this retrospective, single-center study involving 305 patients with severe AS, patients were classified into 2 groups: 1) C-LFLG AS, AV mean gradient (MG) <40 mmHg, stroke volume index (SVI) <35 mL/m², LVEF <50 %; 2) Low LVEF NFLG AS: MG <40 mmHg, SVI ≥35 mL/m², LVEF <50 %. Binary logistic regression was used to assess the determinants of C-LFLG AS and NFLG AS. Cox regression was used to determine the clinical outcomes.</p><p><strong>Results: </strong>Of 2600 patients undergoing TAVR, low LVEF patients meeting the inclusion criteria were 305. NFLG AS was less common (18 %). Patients in the C-LFLG AS had similar mortality (hazard ratio (HR) = 1.07, 95 % confidence interval (CI) 0.64-1.80), and heart failure rehospitalization (HR = 1.31, CI 0.69-2.48) rates 3 years post-TAVR, compared to patients with low LVEF NFLG AS. End-stage renal disease was associated with NFLG AS, whereas diabetes predicted C-LFLG AS.</p><p><strong>Conclusions: </strong>Mortality after TAVR was similar in patients with low-gradient severe AS and LV systolic dysfunction regardless of flow.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092717","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}