JTCVS structural and endovascular最新文献

{"title":"The necessity for surgeons to embrace transcatheter tricuspid valve therapy.","authors":"John N Rachko, Ella Malynowski, Gilbert H L Tang","doi":"10.1016/j.xjse.2026.100143","DOIUrl":"10.1016/j.xjse.2026.100143","url":null,"abstract":"","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100143"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful explant and replacement of transcatheter Tendyne mitral valve.","authors":"Nataliya Bahatyrevich, Guy Elgar, Gagan D Singh, Jason H Rogers, Jorge Catrip","doi":"10.1016/j.xjse.2026.100144","DOIUrl":"10.1016/j.xjse.2026.100144","url":null,"abstract":"","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100144"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning for predicting transvalvular gradient outcomes for patients undergoing transcatheter aortic valve replacement for native aortic stenosis.","authors":"Wenyuan Song, Dhruv Polsani, Taylor Sirset-Becker, Luis René Mata Quinonez, Pradeep Yadav, Vinod Thourani, Lakshmi Prasad Dasi","doi":"10.1016/j.xjse.2026.100142","DOIUrl":"10.1016/j.xjse.2026.100142","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a deep learning-based predictive model for preprocedurally predicting post-transcatheter aortic valve replacement (TAVR) gradient waveform using pre-TAVR echocardiographic information only for candidates for both balloon-expandable and self-expandable THV in a TAVR procedure.</p><p><strong>Methods: </strong>A total of 69 patients (mean age 81 ± 9.04 years, 58% female) receiving Edwards SAPIEN 3 and 77 patients (mean age 85 ± 8.56 years, 43% female) receiving Medtronic Evolut were included for pressure gradient collection. Two deep machine learning models were trained on the cohorts, respectively, each using the paired pre/postprocedural gradient waveform.</p><p><strong>Results: </strong>The SAPIEN model demonstrated an average accuracy of 84% on point-by-point agreement between predicted and clinically measured post-TAVR gradient waveform and an average prediction error of 2.1 and 5 mm Hg in mean and peak gradient, specifically. This group of metrics were reported as 87%, 1.4 mm Hg, and 3.1 mm Hg for the Evolut model. Bland-Altman analyses on both cohorts showed >90% agreement between clinical measurement and prediction for both mean and peak gradients. The SAPIEN model was additionally validated on a prospective cohort (n = 33) with average prediction error of 2.2 and 4.8 mm Hg for mean and peak gradient.</p><p><strong>Conclusions: </strong>A deep machine learning rationale was introduced to infer the full post-TAVR pressure gradient pattern directly from the preprocedural one obtainable through Doppler echocardiogram. It helps guide decision-making for the prevention of various post-TAVR complications. Further studies are necessary to investigate the gradient change of other valve types under specific deployment scenarios in a lifetime timespan.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100142"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute left ventricular unloading in chronic ovine biventricular failure with functional tricuspid regurgitation.","authors":"Magda Piekarska, Manikantam Gaddam, Marcin Malinowski, Tomasz Jaźwiec, Austin Goodyke, Boguslaw Gaweda, Manuel Rausch, Tomasz Timek","doi":"10.1016/j.xjse.2026.100140","DOIUrl":"10.1016/j.xjse.2026.100140","url":null,"abstract":"<p><strong>Objectives: </strong>Right ventricular failure and functional tricuspid regurgitation are associated with left ventricular assist device implantation. We set out to investigate the effect of acute left ventricular unloading on right ventricular subvalvular geometry in the setting of ovine biventricular heart failure with functional tricuspid regurgitation.</p><p><strong>Methods: </strong>Seven adult Dorset male sheep underwent left thoracotomy and pacemaker implantation and were paced until the development of biventricular dysfunction and functional tricuspid regurgitation. Subsequently, animals underwent sternotomy and cardiopulmonary bypass for implantation of sonomicrometry crystals around the tricuspid annulus, on each papillary muscle tip, and on the right ventricular epicardium. After weaning from cardiopulmonary bypass, a continuous-flow left ventricular assist device was implanted. Simultaneous hemodynamic, sonomicrometry, and echocardiographic data were acquired before and after full left ventricular unloading.</p><p><strong>Results: </strong>Pacing resulted in a significant increase in left ventricular end-diastolic dimension, tricuspid annular size, and tricuspid and mitral regurgitation. There was a significant reduction in left ventricular ejection fraction (60% ± 6% vs 34% ± 11%, <i>P</i> = .002) and right ventricular fractional area contraction (56% ± 8% vs 38% ± 12%, <i>P</i> = .001). During left ventricular unloading, inter-papillary muscle distances and papillary muscle area increased without changes in the distance of each papillary muscle tip to tricuspid annular plane. The septal region of the tricuspid annulus tended to increase during unloading. Tricuspid regurgitation did not change during left ventricular assist device unloading.</p><p><strong>Conclusions: </strong>Left ventricular unloading in an ovine model of biventricular failure with tricuspid regurgitation was associated with increased inter-papillary distances and papillary muscle area most likely due to septal shift. These geometric alterations in subvalvular geometry may contribute to valvular insufficiency and right ventricular failure over time.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100140"},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter aortic valve canting creates cusp-specific thrombogenic microenvironments through altered sinus hemodynamics.","authors":"Thangam Natarajan, Jae Hyun Kim, Christian Salgado, Akshita Jha, Cole A Baker, Stephanie L Sellers, Joseph E Aslan, Monica T Hinds, Ajit P Yoganathan, Lakshmi Prasad Dasi","doi":"10.1016/j.xjse.2026.100139","DOIUrl":"10.1016/j.xjse.2026.100139","url":null,"abstract":"<p><strong>Objectives: </strong>Transcatheter aortic valve replacement has transformed the management of aortic stenosis; however, leaflet thrombosis and hypoattenuated leaflet thickening remain major clinical concerns. Flow disturbances from valve canting may alter local hemodynamics and promote thrombogenic conditions. We investigated how modest valve canting alters cusp-specific sinus flow and washout, and promotes thrombogenic microenvironments associated with leaflet thrombosis using particle image velocimetry, a physiologic blood loop, and tissue analysis.</p><p><strong>Methods: </strong>A patient-derived aortic root model was used to evaluate the hemodynamic and thrombogenic effects of valve canting at -10° (anti-curvature), 0° (neutral), and +10° (along-curvature). Velocimetry quantified sinus flow and washout characteristics, and whole-blood loop experiments enabled histologic assessment of leaflet-associated thrombus.</p><p><strong>Results: </strong>Canting redistributed systolic jet orientation and sinus recirculation in a direction-dependent manner while preserving global hemodynamics. The most spatially constrained cusp showed the greatest stasis and the slowest washout. In the right coronary cusp, anticurvature canting increased regions within the sinus with velocity less than 0.05 m/s to 92% versus 43% in neutral and 10% in along-curvature deployments, and prolonged neo-sinus (T₉₀) washout to 4.7 versus 2.9 and 1.8 cycles. Histology localized surface-adherent thrombus to poorly washed regions, most prominently on the right coronary cusp leaflet in anticurvature deployments. Left and noncoronary cusp responses shifted with tilt direction, indicating redistribution rather than uniform worsening of thrombogenic conditions.</p><p><strong>Conclusions: </strong>Modest noncoaxial deployment creates sinus-resolved thrombogenic microenvironments that are not captured by global measures such as transvalvular gradient or effective orifice area; therefore, it is a modifiable determinant of post-transcatheter aortic valve replacement leaflet thrombosis risk and a potential contributor to hypoattenuated leaflet thickening.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100139"},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes, survival, mortality, and major adverse events in aortic valve replacement surgeries in Africa: A systematic review and meta-analysis.","authors":"Victory Bassey Effiom, Victor Oluwafemi Femi-Lawal, Atharv Vivek Oak, Oluwasegun John Oyesola, Fatma Kamal Ahmed, Samuel Ghislain Junior Fodop, Michael James Anayo, Achanga Bill-Smith Anyinkeng, Jonas Paul Ibekwe, Kolawole Victor Olalekan, Samuel Mesfin Girma, Daniel Brabi, Ahmet Kilic","doi":"10.1016/j.xjse.2026.100131","DOIUrl":"https://doi.org/10.1016/j.xjse.2026.100131","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic valve replacement (AVR) is the definitive treatment for severe aortic valve disease, yet outcome data from Africa remain scarce. This systematic review and meta-analysis assessed survival, mortality, and major adverse events after AVR across Africa.</p><p><strong>Methods: </strong>Adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched PubMed, Embase, and Web of Science for studies reporting AVR outcomes in African populations, covering randomized trials, cohort studies, case series, and case reports. Subgroup analyses were conducted by AVR modality: surgical aortic valve replacement (SAVR), minimally invasive surgery (MICS), and transcatheter aortic valve implantation. Study quality was assessed using the Cochrane Risk of Bias tool 2 and the Newcastle-Ottawa Scale. Outcomes included survival, mortality, echocardiographic improvements, and valve- or procedure-related complications.</p><p><strong>Results: </strong>Of 2547 studies screened, 21 studies involving 1303 patients across 6 African countries were included; 15 (71.4%) studies were from Egypt. Mean age was 60.4 years; 43.3% were female. Aortic stenosis (70.4%) and regurgitation (64.0%) predominated. Modalities included SAVR (45.1%), minimally invasive surgery (27.8%), and transcatheter aortic valve implantation (27.1%). Technical success rate was high (97.5%-100%). Complications included arrhythmias (16.0%), postoperative bleeding (15.0%), paravalvular leak (5.0%), pacemaker requirement (6.0%), stroke (5.0%), and myocardial infarction (3.0%). Reoperation rate was 4.4%. Thirty-day mortality was 5.0% (95% CI. 3.1%-8.1%), with 1-year and 5-year survival of 93.2% and 91.0%, respectively.</p><p><strong>Conclusions: </strong>AVR outcomes in Africa show favorable success and survival rate although below optimal benchmarks despite resource constraints. However, results are not generalizable continent-wide, given the heavy geographic skew. Complications including arrhythmias and postoperative bleeding necessitate enhanced perioperative protocols.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100131"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct-access, balloon-expandable mitral valve replacement under fibrillatory arrest in extensive mitral annular calcification.","authors":"John Wheeler, Gilbert Tang, Dimosthenis Pandis, Ahmed El-Eshmawi","doi":"10.1016/j.xjse.2026.100130","DOIUrl":"https://doi.org/10.1016/j.xjse.2026.100130","url":null,"abstract":"","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"11 ","pages":"100130"},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissection dimensions differ: Global variability in ascending aortic size challenges universal surgical thresholds.","authors":"Nimrat Grewal, Nora Bacour, Mohammad Zafar, Simran Grewal, Mohammed Idhrees, Bashi Velayudhan, Julia Dumfarth, Simone Gasser, John Elefteriades","doi":"10.1016/j.xjse.2026.100124","DOIUrl":"10.1016/j.xjse.2026.100124","url":null,"abstract":"<p><strong>Background: </strong>Current surgical thresholds for ascending aortic replacement are derived from Western, male-predominant populations. Whether these thresholds apply across diverse ethnic and geographic groups remains uncertain. We evaluated global and sex-specific variability in ascending aortic dimensions at the time of acute type A aortic dissection (ATAAD).</p><p><strong>Methods: </strong>We retrospectively analyzed 1388 surgically treated ATAAD patients from 4 international cohorts: Netherlands (n = 500), United States (n = 382), Austria (n = 435), and India (n = 71). Ascending aortic diameters were measured on preoperative contrast-enhanced computed tomography scans. Multivariable linear regression adjusted for age, sex, body surface area, hypertension, and diabetes.</p><p><strong>Results: </strong>Age at dissection differed markedly by region, with Indian patients presenting more than a decade earlier than Western cohorts (48.5 years vs ∼63 years). Women presented later than men (68 years vs 59 years; <i>P</i> < .001) but had smaller ascending aortic diameters (mean, 46.0 ± 9.8 mm vs 48.4 ± 10.6 mm; <i>P</i> < .001). Country of origin independently predicted aortic size; compared with Dutch patients, Indian (B = +7.09 mm; <i>P</i> < .001), American (B = +3.11 mm; <i>P</i> < .001), and Austrian (B = +2.42 mm; <i>P</i> < .001) cohorts had larger diameters. Only 19.5% dissected at diameters ≥55 mm, while 39.7% presented between 45 and 54 mm. Because acute dissection may transiently enlarge the aortic lumen, measured diameters likely overestimate predissection size.</p><p><strong>Conclusions: </strong>Ascending aortic dimensions at ATAAD vary substantially by sex and geographic origin. Most dissections occur below current surgical thresholds, indicating that absolute diameter alone inadequately defines risk. These findings challenge the universality of fixed cut-offs and support the need for population- and sex-specific approaches to aortic risk assessment.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"10 ","pages":"100124"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148268021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of cardiac surgery after transcatheter aortic valve replacement: Short-term clinical outcomes at a high-volume center.","authors":"Marco Tagliafierro, Ali Fatehi Hassanabad, Jonathan Nickles, Riley Sevensky, Arnar Geirsson, Isaac George, Hiroo Takayama, Michael Argenziano, Luigi Pirelli","doi":"10.1016/j.xjse.2026.100128","DOIUrl":"10.1016/j.xjse.2026.100128","url":null,"abstract":"<p><strong>Background: </strong>The growing adoption of transcatheter aortic valve replacement (TAVR) in younger and lower-risk patients has increased the number of patients with other cardiac diseases requiring surgical intervention. Such surgeries pose unique technical challenges due to the presence of the TAVR, often requiring explantation. Despite increasing clinical relevance, outcomes of these operations remain poorly characterized. We sought to assess the incidence, indications, and short-term results of cardiac surgery following TAVR at a high-volume institution.</p><p><strong>Methods: </strong>This was a retrospective single-center analysis of patients undergoing any cardiac surgery post-TAVR between 2015 and 2024. Primary endpoints were perioperative all-cause mortality and stroke; secondary endpoints included cardiopulmonary bypass and cross-clamp times, as well as in-hospital and 30-day outcomes.</p><p><strong>Results: </strong>Among 10,898 surgeries, 61 (0.5%) involved patients with prior TAVR (median age, 72 years; 59% male), including 85% with hypertension, 28% with diabetes, 43% with chronic lung disease, and 15% with cerebrovascular disease. The median time between TAVR and surgery was 20 months, and 57% of the surgeries were urgent or emergent/salvage procedures. Major indications included TAVR dysfunction (28%), infective endocarditis (26%), and aortic pathology (13%). Common procedures were TAVR explant and surgical aortic valve replacement (n = 49), mitral surgery (n = 19), aortic root/arch surgery (n = 12), and multivessel coronary artery bypass grafting (n = 5). The median aortic cross-clamp and cardiopulmonary bypass times were 121 minutes and 160 minutes, respectively. The mortality rate was 13%. Other outcomes included stroke (3%), prolonged ventilation (31%), tracheostomy (7%), de novo dialysis (8%), need for postoperative blood products (61%), cardiac reintervention (10%), discharge to rehabilitation facility (34%), and readmission (13%).</p><p><strong>Conclusions: </strong>Cardiac surgery post-TAVR is uncommon and associated with significant morbidity and mortality. Prosthesis dysfunction and endocarditis are the leading indications, and TAVR explant remains a common although highly morbid intervention.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"10 ","pages":"100128"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo surgical aortic valve replacement versus valve-in-valve transcatheter aortic valve replacement with balloon valve fracture: Short-term clinical outcomes.","authors":"Rahul Kanade, Marco Tagliafierro, Isao Anzai, Fady Soliman, William M Mitchell, Darina Kirilina, Paul Kurlansky, Rebecca T Hahn, Susheel Kodali, Tamim M Nazif, Torsten P Vahl, Arnar Geirsson, Michael Argenziano, Isaac George, Luigi Pirelli","doi":"10.1016/j.xjse.2026.100127","DOIUrl":"10.1016/j.xjse.2026.100127","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate short-term outcomes of redo surgical aortic valve replacement (SAVR) versus valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) with bioprosthetic valve fracture (ViVBVF) in patients with bioprosthetic structural valve deterioration undergoing reintervention.</p><p><strong>Methods: </strong>This retrospective single-center study was conducted between 2015 and 2025. Data were obtained from institutional registries. A total of 128 consecutive patients met the inclusion criteria (75 with redo-SAVR and 53 with ViVBVF). Patients requiring concomitant cardiac procedures, mechanical valves, or unsuitable anatomy for ViV were excluded. The primary endpoints were 30-day mortality, stroke, and readmission; secondary endpoints included echocardiographic changes and postoperative complications. Overlap propensity score weighting to adjust baseline differences was performed.</p><p><strong>Results: </strong>Compared to the redo-SAVR patients, the ViVBVF patients were older and had a higher predicted risk of mortality. The rates of 30-day mortality, stroke, and readmission were similar in the 2 groups. ViVBVF achieved significantly greater reductions in mean gradient (-26.0 mm Hg vs -17.4 mm Hg; <i>P =</i>.003), peak gradient (-39.2 mm Hg vs -23.3 mm Hg; <i>P =</i>.004), and peak velocity. After matching, 30-day mortality was higher after redo-SAVR (8.9% vs 0%; <i>P</i> < .001). The ViVBVF group showed a greater reduction in peak velocity but more frequent pacemaker implantation.</p><p><strong>Conclusions: </strong>In patients with bioprosthetic valves requiring reintervention, ViVBVF offers greater gradient reduction, with a perioperative safety advantage suggested in the adjusted analysis.</p>","PeriodicalId":520968,"journal":{"name":"JTCVS structural and endovascular","volume":"10 ","pages":"100127"},"PeriodicalIF":0.0,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148268044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}