Journal of Invasive Cardiology最新文献

{"title":"Very late mechanical mitral valve prosthesis dehiscence.","authors":"Shashwat Joshi, Shivam Goel, Saurabh Kumar Gupta, Sivasubramanian Ramakrishnan, Sourabh Agstam","doi":"10.25270/jic/26.00103","DOIUrl":"10.25270/jic/26.00103","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More than a pretty image: envisioning the use of coronary computed tomography angiography to plan percutaneous coronary interventional procedures.","authors":"George W Vetrovec","doi":"10.25270/jic/26.00193","DOIUrl":"https://doi.org/10.25270/jic/26.00193","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":"38 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in reverse remodeling after transcatheter aortic valve replacement in low-flow aortic stenosis.","authors":"Eileen Galvani, Oludamilola Akinmolayemi, Philippe Pibarot, Sébastien Hecht, Roya Anahita Mousavi, Yash Prakash, Esha Vaish, Samin K Sharma, Annapoorna S Kini, Marie-Annick Clavel, Stamatios Lerakis","doi":"10.25270/jic/26.00117","DOIUrl":"10.25270/jic/26.00117","url":null,"abstract":"<p><strong>Objectives: </strong>Sex-specific differences in left ventricular (LV) remodeling after transcatheter aortic valve replacement (TAVR) in low-flow aortic stenosis (LFAS) remain incompletely defined, and the influence of LFAS subtype on remodeling by sex is uncertain. The authors sought to characterize post-TAVR remodeling in LFAS by sex and subtype and identify predictors of remodeling.</p><p><strong>Methods: </strong>This retrospective cohort study included 488 patients with LFAS (303 men, 185 women) who underwent TAVR. Smoothed conditional mean curves assessed longitudinal changes in LV mass index (LVMi), relative wall thickness (RWT), and LV ejection fraction (LVEF) through 18 months. Linear mixed models identified predictors of remodeling.</p><p><strong>Results: </strong>Women more often had paradoxical low-flow low-gradient (pLFLG) AS (58.4% vs 43.6%, P = .001), whereas men more often had classical low-flow low-gradient AS (31.4% vs 13.5%, P < .001). At 1 year, both sexes showed significant improvement in LVMi, RWT, and LVEF. Men demonstrated sustained improvement in LVEF and LVMi during follow-up, whereas women showed earlier improvement followed by decline beginning around 12 months. Predictors also differed: lower LVMi after TAVR was associated with White race and less severe baseline mitral regurgitation in men, and with pLFLG subtype in women.</p><p><strong>Conclusions: </strong>Reverse remodeling after TAVR occurred in both sexes, but trajectories and predictors were sex-specific.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary computed tomography angiography to guide percutaneous coronary intervention: proceedings from the 1st CCTA-guided PCI summit in the United States.","authors":"Pedro E P Carvalho, João L Cavalcante, Carlos Collet, Jonathon Leipsic, Omar K Khalique, Victor Cheng, John Lesser, Bavana V Rangan, Emmanouil S Brilakis, Yader Sandoval","doi":"10.25270/jic/26.00085","DOIUrl":"10.25270/jic/26.00085","url":null,"abstract":"<p><p>Coronary computed tomography angiography (CCTA) can be used beyond diagnostic purposes to support the preprocedural planning of percutaneous coronary intervention (PCI). Advances in scanner technology, software platforms, and physiology- and plaque-based visualization tools have expanded the role of CCTA-guided PCI. CCTA provides detailed assessment of coronary anatomy, plaque and calcium morphology, lesion length, vessel size, and noninvasive physiology, offering opportunities to anticipate procedural complexity, optimize resource utilization, and individualize PCI strategy. Emerging data, including randomized studies in chronic total occlusions and ongoing multicenter trials, support the feasibility and potential clinical value of this approach. In April 2024, the first CCTA-guided PCI summit in the United States convened interventional cardiologists and cardiac imagers, as well as industry stakeholders, to discuss the evidence, technical considerations, clinical applications, and unmet needs related to CCTA-guided PCI. This manuscript summarizes the key discussions and conclusions specific to this meeting, with a focus on the transition of CCTA from a diagnostic to a therapeutic planning tool, emerging artificial intelligence applications, its complementary role with intravascular imaging, and opportunities to enhance procedural planning and decision-making. While early experience is promising, broader adoption will require broader educational efforts, access to purpose-built visualization software tools designed for interventional cardiologists, multidisciplinary collaboration, and additional randomized and real-world studies to define its impact on clinical outcomes and procedural efficiency.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closure of symptomatic mitral paravalvular leak following recent transcatheter mitral valve-in-ring.","authors":"Matthew Atienza, Ahmad Alkhalil, Neda Dianati Maleki, Jonathan Price, Daniel Montellese, Puja Parikh","doi":"10.25270/jic/26.00050","DOIUrl":"10.25270/jic/26.00050","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison between visual, robotic, and intracoronary imaging lesion length assessment during robotic-assisted percutaneous coronary intervention.","authors":"James Leung, John French, James Xu, Kathryn Wales, Hashim Kachwalla, Krishna Kaddapu, Sarah Fares, Viet Dang, Tamer Badie, Christian Mussap, Rohan Rajaratnam, Dominic Leung, Sidney Lo, Craig Juergens","doi":"10.25270/jic/26.00208","DOIUrl":"https://doi.org/10.25270/jic/26.00208","url":null,"abstract":"<p><strong>Objectives: </strong>Inaccurate lesion length assessment can lead to adverse clinical outcomes after percutaneous coronary intervention (PCI). Robotic-assisted PCI (R-PCI) may provide more accurate lesion assessment. The authors aimed to compare the accuracy of visual, robotic, and intracoronary imaging-derived lesion length assessment.</p><p><strong>Methods: </strong>Sixty-three patients (69 lesions) who underwent R-PCI using the CorPath GRX (Siemens Healthineers) system were analyzed. The operator provided a visual estimate of lesion length, which was compared to the measurement using the robotic system. In cases in which intracoronary imaging (ICI) was performed (n=21), the visual and robotic estimates were compared against the ICI measurements, which were considered the gold standard.</p><p><strong>Results: </strong>The median visual length measurement was 23.0 mm (IQR: 18.0-28.0) and the median robotic visual length measurement was 24.0 mm (IQR: 18.7-33.0 mm). In only 10.1% of lesions did the visual and robotic estimates agree. In 66.7% of the lesions, the visual estimate was shorter than the robotic measurement, whereas the visual estimate was longer than the robotic measurement in 23.2% of lesions. Using a threshold of greater than 5 mm too long/short, 22 lesions (32%) were inaccurately measured. Both visual (r=0.82) and robotic (r=0.97) estimates had good correlation with ICI measurements; however, this difference in correlation was statistically significant (P = .004). Visual assessment consistently underestimated lesion length compared with ICI (mean difference -4.2 ± 6.9 mm).</p><p><strong>Conclusions: </strong>Visual assessment of lesion length often underestimates true lesion length. R-PCI may provide more accurate and reproducible lesion measurements, with better correlation and agreement with ICI measurements than visual estimation.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAFE-SEAL: a bail-out technique for percutaneous femoral closure after failed hybrid closure.","authors":"Marco Angelillis, Leonardo Misuraca, Paolo Calabria, Cristina Giannini, Paolo Spontoni, Laura Stazzoni, Alessandro Sticchi, Giulia Costa, Marco De Carlo","doi":"10.25270/jic/26.00137","DOIUrl":"https://doi.org/10.25270/jic/26.00137","url":null,"abstract":"<p><strong>Objectives: </strong>Failure of the plug-based component during hybrid suture- and plug-based femoral closure may result in persistent bleeding when guidewire access is lost, leaving limited percutaneous bailout options. The authors describe a novel percutaneous bailout strategy designed to achieve hemostasis in this high-risk scenario.</p><p><strong>Methods: </strong>The first clinical application of the SAFE-SEAL (Suture-Assisted Femoral Emergency SEALing) technique was performed in a patient undergoing transfemoral transcatheter aortic valve implantation. Following failure of the plug-based closure component and persistent bleeding despite balloon tamponade, a bioresorbable extravascular sealant was advanced over retained suture limbs from a previously deployed suture-based closure device and positioned at the arterial wall using a knot pusher.</p><p><strong>Results: </strong>Complete hemostasis was achieved without additional vascular access or endovascular intervention, as confirmed angiographically. No residual bleeding or flow limitation was observed.</p><p><strong>Conclusions: </strong>The SAFE-SEAL technique may represent a practical and reproducible bailout option for femoral access-site bleeding after hybrid closure failure, warranting further evaluation in additional cases.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic valve replacement in patients with small aortic annuli: a systematic review and network meta-analysis.","authors":"Juan Guido Chiabrando, Marco Lombardi, Edoardo Elia, Claudio Laudani, Giovanni Occhipinti, Ander Regueiro, Andrea Audo, Giulia Maj, Carlos Giuliani, Salvatore Garibaldi, Josep Rodés-Cabau, Philippe Pibarot, Rocco Vergallo, Italo Porto, Nicolas M Van Mieghem, Giuseppe Patti, Gioel Gabrio Secco","doi":"10.25270/jic/26.00198","DOIUrl":"https://doi.org/10.25270/jic/26.00198","url":null,"abstract":"<p><strong>Objectives: </strong>Up to 40% of patients with aortic stenosis undergoing valve replacement have a small annulus, a key determinant of valve hemodynamics, durability, and clinical outcomes. Surgical and transcatheter approaches have been reported to be determined by prosthesis design, considering the operative mortality and morbidity risk. The authors sought to evaluate surgical and transcatheter strategies in patients with small aortic annuli.</p><p><strong>Methods: </strong>The authors systematically reviewed and synthesized evidence of 20 studies including 8843 patients. Primary outcomes included all-cause death and severe patient-prosthesis mismatch (PPM). Secondary outcomes included hemodynamic structural and non-structural valve dysfunction, postprocedural hemodynamics (indexed effective orifice area [iEOA] and mean transvalvular gradients), and major clinical events.</p><p><strong>Results: </strong>Compared with supra-annular self-expanding valves (SAV), intra-annular devices and surgical aortic valve replacement (SAVR) were associated with higher risks of severe PPM (P < .05) without differences in 1-year mortality (P > .05). Balloon-expandable valves were associated with increased hemodynamic structural dysfunction (risk ratio [RR], 4.44; 95% CI, 2.08-9.45), smaller iEOA (mean difference [MD], -0.18 cm²/m²; 95% CI, -0.24 - -0.11), and higher gradients (MD 4.72 mm Hg; 95% CI, 3.52-5.92). SAVR showed the worst hemodynamics, but lower risk of paravalvular leak (RR, 0.12; 95% CI; 0.03-0.54), pacemaker implantation (RR, 0.43; 95% CI; 0.20-0.94) and major vascular complications (RR, 0.20; 95% CI, 0.08-0.47). Stroke, major bleeding, and heart failure hospitalization events were similar among groups.</p><p><strong>Conclusions: </strong>In patients with small annuli, SAV showed superior hemodynamic profile and the lowest risk of dysfunction. These differences did not translate into a lower incidence of hard clinical outcomes at 1-year follow-up.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Halfway rotablation to improve wire bias in a severely calcified and angulated proximal left anterior descending artery lesion.","authors":"Kwok-Ho Yau, Justin Ka-Ho Wong, John Cheong-Hin Chan","doi":"10.25270/jic/26.00313","DOIUrl":"https://doi.org/10.25270/jic/26.00313","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic therapy and device healing after left atrial appendage occlusion with WATCHMAN FLX Pro: a single-center real-world cohort study.","authors":"Maedeh Zokaei Nikoo, Rafey Feroze, Luis Augusto Palma Dallan, Yusef Saeed, Alexander Cove, Abdullah Altorbag, Andreas A Towers, Syed R Nabi, Harsh Amin, Sabin Lama, Christopher Mishreky, Kareem Fanous, Justin M Dunn, Vinicius Esteves, Steven J Filby","doi":"10.25270/jic/26.00212","DOIUrl":"https://doi.org/10.25270/jic/26.00212","url":null,"abstract":"<p><strong>Objectives: </strong>The authors sought to determine whether discharge antithrombotic regimen (dual antiplatelet therapy [DAPT] vs low-dose direct oral anticoagulant [DOAC] monotherapy) is independently associated with computed tomography (CT)-detected high-grade hypoattenuated thickening (HAT), an imaging correlate of device-related thrombus, and with early clinical outcomes following WATCHMAN FLX Pro (Boston Scientific) implantation.</p><p><strong>Methods: </strong>A single-center retrospective analysis of 427 consecutive patients undergoing attempted WATCHMAN FLX Pro implantation (July 2024-October 2025) was conducted. After excluding 10 patients with screen failure and 17 on alternative antithrombotic regimens, 400 patients (263 DAPT, 137 low-dose DOAC) were included. The primary endpoint was high-grade HAT on 4-month surveillance cardiac CT. Secondary endpoints were appendage patency, peridevice leak (PDL), incomplete neoendocardial coverage, and 180-day clinical outcomes.</p><p><strong>Results: </strong>Surveillance CT was performed in 322 of 400 patients (80.5%). High-grade HAT occurred in 12/213 patients on DAPT (5.6%) vs 1/109 patients on DOAC (0.9%; P = .046); 92.3% of high-grade HAT cases were in the DAPT group. DAPT remained independently associated with high-grade HAT on multivariable analysis (adjusted odds ratio, 7.43; 95% CI, 1.01-54.44; P = .048). Appendage patency, PDL, and incomplete neoendocardial coverage were similar between groups. Through 180 days, stroke, bleeding, and mortality did not differ significantly by regimen.</p><p><strong>Conclusions: </strong>In this real-world WATCHMAN FLX Pro cohort, low-dose DOAC monotherapy was associated with a markedly lower risk of CT-detected high-grade HAT than DAPT, without an observed increase in bleeding or stroke. Anticoagulation during the early post-implant healing period may mitigate thrombus formation more effectively than antiplatelet therapy. Randomized trials are needed to confirm these findings.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}