Cardiovascular Revascularization Medicine最新文献

{"title":"A novel functional index, aortic-valve-coefficient, for assessing aortic-stenosis in patients undergoing TAVR: A prospective-pilot study","authors":"Shreyash M. Manegaonkar ,&nbsp;Rishi Sukhija ,&nbsp;Mohamed A. Effat ,&nbsp;Marepalli Rao ,&nbsp;Rupak K. Banerjee","doi":"10.1016/j.carrev.2024.08.006","DOIUrl":"10.1016/j.carrev.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Evaluating the severity of aortic stenosis (AS) can be challenging, particularly in patients with low-gradient (LG, Δp &lt; 40 mmHg) AS. <em>Objective:</em> This study aims to improve the accuracy of assessing severity of AS using a novel functional index- Aortic Valve Coefficient (AVC). The AVC is defined as ratio of mean transvalvular pressure-drop (Δp) to the proximal dynamic pressure (1/2 × blood density × <span><math><msubsup><mi>V</mi><mi>LVOT</mi><mn>2</mn></msubsup></math></span>; V_LVOT: left ventricular outflow tract peak velocity). <em>Hypothesis:</em> AVC, developed from fundamental fluid dynamic principles, is a better index for accessing AS severity as it incorporates square of V_LVOT and downstream pressure recovery.</div></div><div><h3>Methods</h3><div>This pilot prospective study enrolled 47 patients undergoing TAVR for AS. Using cardiac-catheterization-measured Δp and echocardiography-Doppler-derived V_LVOT, AVC was evaluated. Pre- and post-TAVR pressure-velocity measurements were obtained, resulting in a dataset with 78 data points, including 32 data points specifically linked to LG AS. Linear regression analysis was performed to correlate AVC with Δp, V_LVOT and aortic-valve-area. Welch 2-sample <em>t</em>-test was carried out to compare the means of AVC against aortic-valve-area.</div></div><div><h3>Results</h3><div>Moderate correlation (<em>r</em> = 0.85) was observed between AVC and aortic-valve-area indicating AVC could be a prospective index. However, correlation decreased (<em>r</em> = 0.75) in LG AS patients, indicating increased discordancy. Comparing AVC and aortic-valve-area in LG AS patients with left ventricular ejection fraction (LVEF) &lt; 50 % and LVEF ≥50 %, <em>t</em>-test showed that AVC values are significantly different (<em>p</em> &lt; 0.05) as compared to aortic-valve-area (<em>p</em> = 0.48).</div></div><div><h3>Conclusion</h3><div>AVC, a novel index, has the potential to improve assessment of AS severity and clinical decision making for treating patients with AS.</div></div><div><h3>Condensed abstract</h3><div>Complex hemodynamics, such as paradoxical “low-flow low-gradient (LG)” Aortic stenosis (AS) can be difficult to diagnose. Currently, mean transvalvular pressure-drop and flow-derived aortic-valve-area assess AS severity. Aortic valve coefficient (AVC) is a novel index which combines both pressure-drop and flow measurements to assess the severity of AS. A total of 47 patients (72 data points) were studied undergoing TAVR. In LG AS patients, <em>t</em>-test comparing left ventricular ejection fraction (LVEF) &lt; 50 % and LVEF ≥50 % showed that AVC are significantly different (<em>p</em> &lt; 0.05) as compared to aortic-valve-area (<em>p</em> = 0.48). Therefore, AVC could be a better index.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 14-20"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113444","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 optimal intervention for in-stent restenosis: Unravelling Ariadne's thread","authors":"Kyriakos Dimitriadis,&nbsp;Aggelos Papanikolaou,&nbsp;Nikolaos Pyrpyris,&nbsp;Konstantinos Tsioufis","doi":"10.1016/j.carrev.2024.12.019","DOIUrl":"10.1016/j.carrev.2024.12.019","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 83-84"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933062","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 balloon valvuloplasty outcome according to calcium distribution and valve geometry – The ABCD study","authors":"Gianni Dall'Ara ,&nbsp;Sara Piciucchi ,&nbsp;Carolina Moretti ,&nbsp;Caterina Cavazza ,&nbsp;Miriam Compagnone ,&nbsp;Giuseppe Guerrieri ,&nbsp;Simone Grotti ,&nbsp;Daniela Spartà ,&nbsp;Roberto Carletti ,&nbsp;Elisabetta Fabbri ,&nbsp;Emanuela Giampalma ,&nbsp;Andrea Santarelli ,&nbsp;Filippo Ottani ,&nbsp;Marco Balducelli ,&nbsp;Francesco Saia ,&nbsp;Fabio Felice Tarantino ,&nbsp;Marcello Galvani","doi":"10.1016/j.carrev.2024.08.004","DOIUrl":"10.1016/j.carrev.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><div>There is little data on the outcome of balloon aortic valvuloplasty (BAV) in relation to valve dimensions and calcification patterns. The procedure is not standardized, particularly the choice of balloon size.</div></div><div><h3>Methods</h3><div>This retrospective multicenter study focused on BAV efficacy and safety by analyzing the relationship between balloon size, annulus geometry (i.e., diameters, perimeter, and area), and calcification patterns (total burden and calcium distribution over each individual leaflet). From March 2018 to March 2023, all consecutive patients who underwent clinically indicated BAV and ECG-gated multidetector computed tomography of the aorta were included, except those with a bicuspid valve. Calcium score was calculated on contrast-enhanced images based on a luminal attenuation threshold of +100 HU.</div></div><div><h3>Results</h3><div>One hundred and fifteen patients were included. Procedural success was 82.6 %. The balloon-to-annulus ratio (BAR) relative to diameter, perimeter, and area was higher in patients with successful BAV. Patients with unsuccessful BAV had a significantly higher aortic valve calcium burden. The complication rate was 4.3 % and there was no association with valve geometry or calcium burden. A trend towards a reduced complication rate was found as calcium asymmetry increased. BAR minimum annulus diameter was the best parameter in predicting procedural success, with a cut-off at 0.85.</div></div><div><h3>Conclusions</h3><div>BAV efficacy is correlated directly with balloon size in relation to annulus dimension and inversely with total calcium burden. The minimum diameter of the valve may be adopted as a reference for balloon sizing.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 21-27"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009703","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":"Contemporary risk models for transcatheter aortic valve replacement: A narrative review","authors":"Nicholas Chan ,&nbsp;Ankit Agrawal ,&nbsp;Aro Daniela Arockiam ,&nbsp;Muhammad Majid ,&nbsp;Elio Haroun ,&nbsp;Aaisha Shah ,&nbsp;Rishi Puri ,&nbsp;Brian Griffin ,&nbsp;Tom Kai Ming Wang","doi":"10.1016/j.carrev.2025.02.011","DOIUrl":"10.1016/j.carrev.2025.02.011","url":null,"abstract":"<div><div>Aortic stenosis (AS) is the most common form of valvular heart disease in older adults requiring intervention. Severe symptomatic AS, if left untreated, is typically associated with a poor prognosis. Over the past two decades, there have been significant advances in the field of transcatheter aortic valve replacement (TAVR), leading to its emergence as an alternative to the well-established surgical aortic valve replacement (SAVR) for treating severe AS. Multiple randomized clinical trials have demonstrated comparable efficacy and safety outcomes of TAVR vs SAVR in high, intermediate, and low-risk surgical candidates. In the process, multiple risk scores, both traditional surgical and TAVR-specific, have been developed to better risk stratify patients as well as guide periprocedural management and patient counseling. This review aims to discuss the currently available risk models for risk prediction in TAVR patients, highlighting their strengths, limitations, and applicability to different patient populations.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 71-79"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626471","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 impact of stress testing to guide PCI in patients with chronic coronary disease","authors":"Garry W. Hamilton ,&nbsp;Anoop N. Koshy ,&nbsp;Diem Dinh ,&nbsp;Angela Brennan ,&nbsp;Julian Yeoh ,&nbsp;Matias B. Yudi ,&nbsp;Mark Horrigan ,&nbsp;Christopher M. Reid ,&nbsp;Dion Stub ,&nbsp;William Chan ,&nbsp;Ernesto Oqueli ,&nbsp;Melanie Freeman ,&nbsp;Chin Hiew ,&nbsp;Andrew Ajani ,&nbsp;Omar Farouque ,&nbsp;David J. Clark","doi":"10.1016/j.carrev.2024.08.010","DOIUrl":"10.1016/j.carrev.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines and international appropriate use criteria increasingly endorse non-invasive stress testing to evaluate patients with suspected chronic coronary disease (CCD). We sought to review the real-world utilisation of non-invasive stress testing and investigate whether their use prior to PCI associates with outcomes in patients with CCD.</div></div><div><h3>Methods</h3><div>Consecutive patients from a multicentre registry who underwent PCI for CCD between 2006 and 2018 were included. Clinical characteristics and outcomes were stratified according to whether stress testing was performed prior to PCI (stress vs no-stress groups). The primary outcome was 3-year all-cause mortality.</div></div><div><h3>Results</h3><div>Among the 8251 patients included, 4970 (60.2 %) underwent pre-PCI stress testing and this proportion increased over time (p-for-trend&lt;0.001). The stress group had a lower prevalence of prior revascularization, myocardial infarction, or heart failure, and a lower incidence of triple vessel disease, in stent re-stenosis, and ACC/AHA class B2/C lesions (all <em>p</em> &lt; 0.001). When comparing post-procedural outcomes, the stress group had lower rates of arrhythmia (1.5 % vs 2.6 %, <em>p</em> = 0.001), new heart failure (0.2 % vs 0.8 %, p = 0.001), renal impairment, and a shorter length of stay (1.6 vs 2.1 days, <em>p</em> &lt; 0.001). Mortality at 3-years was lower in those undergoing PCI following stress testing (5.8 % vs 8.8 %, p &lt; 0.001). After adjusting for key clinical variables, stress guided revascularization was associated with a significantly lower risk of 3-year mortality (adjusted Hazard Ratio 0.77, 95 % CI 0.64–0.92).</div></div><div><h3>Conclusions</h3><div>In patients with CCD, PCI guided by non-invasive stress testing is increasingly utilized and associated with improved survival. Further studies are necessary to investigate whether this results from differences in patient characteristics, optimized patient selection, or refined choice of target vessel.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 45-51"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037295","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 percutaneous left atrial appendage occlusion on the severity of ischemic stroke","authors":"Ahmed Maraey ,&nbsp;Hadeer Elsharnoby ,&nbsp;Mona Mahmoud ,&nbsp;Paul Chacko ,&nbsp;George V. Moukarbel","doi":"10.1016/j.carrev.2024.12.007","DOIUrl":"10.1016/j.carrev.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous left atrial appendage occlusion (pLAAO) presents an alternative to anticoagulation (AC) for stroke prophylaxis in atrial fibrillation (Afib) patients with high bleeding risk. pLAAO was associated with lower rates of disabling stroke which was mainly attributed to the reduction of hemorrhagic stroke (HS). Little is known about the impact of pLAAO on the severity of ischemic strokes which we sought to study.</div></div><div><h3>Methods</h3><div>The study is a retrospective analysis of the National Readmission Database for the years 2016–2020. All 6-month readmissions with IS after pLAAO admissions were identified. The control group comprised patients with Afib on AC who were admitted for IS. Patients with intracranial hemorrhage or those who underwent surgical LAAO were excluded. A propensity score matching system was utilized to match both groups. Treatment effects were presented as percentages and odds ratio (OR) with 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>A total of 342 observations in each group were matched (weighted estimate: 583 in the pLAAO group and 663 in the control group). pLAAO group was associated with a decreased risk of fatal stroke (5.1 % vs. 10.0 %, OR: 0.48, 95 % CI [0.26–0.88], <em>P</em> = 0.018), and a decreased risk of non-fatal severe stroke (50.5 % vs. 59.6 %, OR: 0.69, 95 % CI [0.50–0.96], <em>P</em> = 0.029) at 6 months follow-up.</div></div><div><h3>Conclusion</h3><div>Compared with patients on AC, patients with pLAAO admitted with ischemic strokes are less likely to have severe and fatal stroke. Further studies are needed to validate our findings.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 81-82"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899155","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":"30-Day unplanned readmission rates, causes and outcomes of patients hospitalized for acute coronary syndrome based on the trial participation status","authors":"Andrija Matetic ,&nbsp;Adrian Kuchtaruk ,&nbsp;Zbigniew Siudak ,&nbsp;Waqas Ullah ,&nbsp;Ayman Elbadawi ,&nbsp;Islam Y. Elgendy ,&nbsp;Sarah Zaman ,&nbsp;Vijay Bang ,&nbsp;Sarita Rao ,&nbsp;Rodrigo Bagur ,&nbsp;Mamas A. Mamas","doi":"10.1016/j.carrev.2024.07.023","DOIUrl":"10.1016/j.carrev.2024.07.023","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the association between index trial participation status and 30-day unplanned readmission rates, causes, and outcomes in acute coronary syndrome (ACS) patients.</div></div><div><h3>Methods</h3><div>The <em>National Readmission Database</em> was analysed for all index hospitalizations with a principal diagnosis of ACS between October 2015 to November 2019, stratified by index trial participation status (<em>International Classification of Diseases – 10th edition code: Z00.6</em>). The 30-day unplanned readmission rates, causes and outcomes were analysed, including the assessment of factors associated with readmission. Multivariable regression analyses were reported as adjusted odds ratios (aOR) with 95 % confidence intervals (95 % CI). All analyses were weighted and utilized hierarchical multi-level organization.</div></div><div><h3>Results</h3><div>A total of 2,066,328 cases with a principal diagnosis of ACS were included in the study, of which there were 4061 trial participants (0.2 %) and 189,240 (9.2 %) cases experienced unplanned 30-day readmission. Rates of unplanned 30-day readmission were similar between trial participants and non-participants (9.8 % vs. 9.2 %, <em>p</em> = 0.16). Consistently, after multivariable adjustment, there was no significant association between trial participation and unplanned 30-day readmissions (aOR 0.96, 95 % CI 0.86–1.07, <em>p</em> = 0.45). Compared with trial participants, the majority of readmissions in non-participants were related to cardiovascular conditions (55.2 % vs. 46.7 %, <em>p</em> = 0.005, respectively). There was no significant difference in all-cause mortality (5.5 % vs. 4.6 %, <em>p</em> = 0.368, respectively), but trial participants were more likely to develop major bleeding (3.5 % vs. 2.1 %, <em>p</em> = 0.044), ischemic stroke (4.0 % vs. 2.1 %, <em>p</em> = 0.008) and haemorrhagic stroke (2.0 % vs. 0.6 %, <em>p</em> &lt; 0.001) at readmissions.</div></div><div><h3>Conclusion</h3><div>Overall rates of unplanned 30-day readmissions after ACS are similar between trial participants and non-participants, but non-participation in trials was associated with a higher likelihood of cardiovascular readmission.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"74 ","pages":"Pages 57-63"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850968","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":"Immediate transcatheter aortic valve replacement versus temporizing balloon aortic valvuloplasty in severe aortic stenosis: A systematic review and meta-analysis immediate TAVR vs. temporizing BAV.","authors":"Mohamed Doma, Wilbert Huang, Sarai Hernandez, Syeda Rubab Fatima, Shanmukh Lingamsetty, Mangesh Kritya, Maya Hemdanieh, Zahra Naji, Douglas Mesadri Gewehr, Felipe Villa Martignoni, Andrew M Goldsweig","doi":"10.1016/j.carrev.2025.04.019","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.019","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is a first-line therapy for severe aortic stenosis (AS). In patients with contraindications to immediate TAVR, temporizing balloon aortic valvuloplasty (BAV) may be performed to stabilize patients prior to TAVR. The relative efficacy and safety of TAVR with or without temporizing BAV remains inadequately described.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases for studies comparing TAVR with and without temporizing BAV in patients with severe AS. Random-effects models were used to calculate pooled odds, risk ratios (RRs) and mean differences with 95 % confidence intervals (CIs).</p><p><strong>Results: </strong>Nine studies (59,205 patients: 95.7 % immediate TAVR, 4.3 % BAV + TAVR) met inclusion criteria. Mean age was 82.9 ± 6.6 years old, and 45.9 % were males. Patients in the TAVR group were a mean difference of 1 year younger with no difference in gender distribution between groups. Direct TAVR was associated with a lower risk of 30-day all-cause mortality than BAV + TAVR (RR = 0.62; 95 % CI 0.41 to 0.93; p = 0.02). There were no significant differences in risks of post-procedural pacemaker implantation, myocardial infarction, cardiac tamponade, major vascular complications, ischemic stroke, major bleeding, 2+ or greater aortic regurgitation grade or acute kidney injury.</p><p><strong>Conclusion: </strong>While immediate TAVR was associated with slightly lower short-term mortality compared to BAV + TAVR in patients with severe AS, other binary endpoints were equivalent. This potential mortality difference should be considered when offering BAV + TAVR in patients with contraindications to immediate TAVR. Randomized studies are required to confirm these results.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989710","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: Will the kidneys kill atherectomy? Comparing intravascular lithotripsy and atherectomy.","authors":"Neal S Kleiman","doi":"10.1016/j.carrev.2025.04.028","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.028","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041469","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":"Complete fracture and retrieval of the delivery system of GORE cardioform atrial septal defect occluder during transcatheter closure.","authors":"Akihito Tanaka, Kenji Furusawa, Yoshiyuki Tokuda, Masato Mutsuga, Toyoaki Murohara","doi":"10.1016/j.carrev.2025.04.034","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.034","url":null,"abstract":"<p><p>The Gore® Cardioform ASD Occluder (GCA) was recently introduced for the transcatheter closure of atrial septal defects in clinical practice. Properly aligning the GCA device with the atrial septum is sometimes challenging, and the tip of the device delivery system is sometimes hand-shaped for better alignment. In this report, we present a complete fracture of GCA delivery system during deployment when using the bending technique. This phenomenon should be considered when using this device.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055977","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}