Journal of the Society for Cardiovascular Angiography & Interventions最新文献

{"title":"Inflow-to-Outflow Stent Frame Expansion, Ellipticity, and Decoupling in Evolut TAVR: Implications for Mid-term Hemodynamic Performance","authors":"Rishi Puri MD, PhD ,&nbsp;Julianne Spencer PhD ,&nbsp;Didier Tchétché MD ,&nbsp;Nicolas M. Van Mieghem MD, PhD ,&nbsp;John K. Forrest MD ,&nbsp;Michael J. Reardon MD ,&nbsp;Jorge Zhingre Sanchez PhD ,&nbsp;Andres Caballero PhD ,&nbsp;Philipp Blanke MD ,&nbsp;Jonathon A. Leipsic MD ,&nbsp;Paul Sorajja MD ,&nbsp;G. Michael Deeb MD ,&nbsp;Shinichi Fukuhara MD ,&nbsp;Lindsay M. Lucas MSc ,&nbsp;Taofik Oyekunle MSc ,&nbsp;Gilbert H.L. Tang MD, MSc, MBA","doi":"10.1016/j.jscai.2024.102448","DOIUrl":"10.1016/j.jscai.2024.102448","url":null,"abstract":"<div><h3>Background</h3><div>The native aortic annulus for self-expanding transcatheter aortic valve replacement (TAVR) has variable ellipticity. A noncircular and underexpanded transcatheter aortic valve (TAV) may impact hemodynamic performance. This study aimed to quantify Evolut TAV (Medtronic) frame ellipticity and expansion 30 days post-TAVR and evaluate their impact on 1-year hypoattenuating leaflet thickening and 4-year hemodynamics.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated 184 patients from the Evolut Low Risk substudy with high-quality computed tomography images. Frame ellipticity ratio and percent expansion were quantified at each frame node level 30 days after TAVR. Variables associated with frame deformation, 1-year hypoattenuating leaflet thickening, and 4-year hemodynamics were identified.</div></div><div><h3>Results</h3><div>Mean Evolut frame ellipticity was highest at the inflow (1.18 ± 0.08) and lowest at the functional leaflet region (1.05 ± 0.03) and frame outflow (1.04 ± 0.03). Frame expansion was lowest at the inflow (83.8% ± 4.9%) and highest at the functional leaflet region (97.8% ± 1.7%). TAV frame circularity and expansion significantly increased from the annular level to the leaflet region (<em>P</em> &lt; .001). Mean gradient, effective orifice area, and paravalvular regurgitation at 4 years were not affected by Evolut TAV's relative noncircularity and underexpansion at the frame inflow. Frame underexpansion at the leaflet region, however, was associated with a smaller effective orifice area at 4 years.</div></div><div><h3>Conclusions</h3><div>Evolut frame deformation at the inflow did not affect the circularity and expansion of the stent at the functional leaflet region. Mid-term (4-year) Evolut hemodynamic performance does not appear to be impacted by frame inflow geometry.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 1","pages":"Article 102448"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170025","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":"Understanding Right Heart Flow: Implications for Interatrial Shunt Device Therapy in Heart Failure","authors":"Raviteja Guddeti MD ,&nbsp;Pankaj Garg MD ,&nbsp;Dean J. Kereiakes MD ,&nbsp;João L. Cavalcante MD ,&nbsp;Marcus Carlsson MD, PhD ,&nbsp;Santiago Garcia MD","doi":"10.1016/j.jscai.2024.102439","DOIUrl":"10.1016/j.jscai.2024.102439","url":null,"abstract":"<div><div>Elevation in left atrial pressure with subsequent pulmonary congestion is central to the pathology of heart failure. Interatrial shunts have emerged as a potential therapeutic strategy in patients with heart failure, especially those with diastolic dysfunction. These devices decrease left atrial pressure by shunting blood into the right atrium. Normal right heart flow is characterized by a predominant vortex formation in the right atrium, which then enters the right ventricle as a direct flow that preserves kinetic energy and right ventricular work efficiency. Examining the abnormal right heart blood flow patterns in naturally occurring interatrial shunts using 4-dimensional flow magnetic resonance imaging can improve our understanding of the effects of various interatrial shunt devices currently being investigated for heart failure management.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 1","pages":"Article 102439"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168867","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":"Carotid Artery Stenting","authors":"Jun Li MD ,&nbsp;Dmitriy N. Feldman MD ,&nbsp;Andrew J. Klein MD ,&nbsp;Mahmoud B. Malas MD, MHS, RPVI ,&nbsp;D. Christopher Metzger MD ,&nbsp;Sahil A. Parikh MD ,&nbsp;Gary S. Roubin MD, PhD ,&nbsp;Peter A. Soukas MD ,&nbsp;Shirling Tsai MD ,&nbsp;William A. Gray MD ,&nbsp;Members of the SCAI 2024 Think Tank Peripheral Consortium,&nbsp;Cody Bliss PhD ,&nbsp;Kevin Brounstein ,&nbsp;Fely Canorea-Vega MD ,&nbsp;Richard Dean ,&nbsp;Gina Donnelly ,&nbsp;Lindsay Farrel ,&nbsp;Shane Gleason ,&nbsp;Chris Hughes ,&nbsp;Michael Kohler ,&nbsp;Jennifer Williams","doi":"10.1016/j.jscai.2024.102435","DOIUrl":"10.1016/j.jscai.2024.102435","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102435"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980891","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":"Can Contrast Injections Cause or Propagate Coronary Injuries? Insights From Vessel and Guiding Catheter Hemodynamics","authors":"Daniel Chamié MD, PhD ,&nbsp;Rahul Bahl MBBS ,&nbsp;Julio Maia MD ,&nbsp;Mauro Echavarria-Pinto MD ,&nbsp;Suraya Gafore MBBS ,&nbsp;Amr Saleh MD ,&nbsp;Ecaterina Cristea MD ,&nbsp;Henry Seligman MBBS ,&nbsp;Rodrigo M. Joaquim MD ,&nbsp;Fausto Feres MD, PhD ,&nbsp;Sayan Sen MD ,&nbsp;Rasha Al-Lamee MBBS ,&nbsp;Marinella Centemero MD, PhD ,&nbsp;Christopher Baker MD, PhD ,&nbsp;Tom Johnson MD ,&nbsp;Matthew J. Shun-Shin BM, BCh, PhD ,&nbsp;Alexandra J. Lansky MD ,&nbsp;Ricardo Petraco MD, PhD","doi":"10.1016/j.jscai.2024.102396","DOIUrl":"10.1016/j.jscai.2024.102396","url":null,"abstract":"<div><h3>Background</h3><div>The mechanistic association between the hydraulic forces generated during contrast injection and the risk of coronary injury is poorly understood. In this study, we sought to evaluate whether contrast injections increase intracoronary pressures beyond resting levels and estimate the risk of hydraulic propagation of coronary dissections.</div></div><div><h3>Methods</h3><div>This is a prospective, single-arm, multicenter study that included patients with nonculprit, non−flow-limiting coronaries. A continuous 60-second pressure recording was taken at 5 predetermined locations during contrast injections: distal, mid, and proximal vessel, catheter tip, and inside the catheter. The primary end point was the change in intracoronary peak pressure between resting and injections in each location.</div></div><div><h3>Results</h3><div>A total of 269 pressure recordings (58 vessels; 52 patients) were analyzed. Injections led to a small increase in peak pressure in the distal (mean difference, +4.5 mm Hg; 95% CI, 1.5-7.4), mid (mean difference, +4.1 mm Hg; 95% CI, 1.4-6.9), and proximal (mean difference, +5.1 mm Hg; 95% CI, 2.5-7.7) vessel locations, and much higher increases at the catheter tip (mean difference, +11.7 mm Hg; 95% CI, 5.8-17.7) and inside the catheter (mean difference, +77.5 mm Hg; 95% CI, 64.5-90.4). Compared to the distal vessel, pressure changes were only significant at the catheter tip (+10 mm Hg; <em>P</em> &lt; .01) and inside the catheter (+79.1 mm Hg; <em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>Contrast injections lead to negligible changes in intracoronary pressures beyond the catheter tip. Although it is sensible to minimize injections when coronary dissections are close to the catheter, it is unlikely that they would cause injuries beyond the catheter tip.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102396"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980889","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":"De Novo Atherosclerotic Renal Artery Stenosis Covered Stent Treatment for Resistant Hypertension (ARTISAN) Results","authors":"Douglas E. Drachman MD ,&nbsp;D. Christopher Metzger MD ,&nbsp;Ashit Jain MD ,&nbsp;Ravish Sachar MD ,&nbsp;Amr El-Sayed Abbas MD ,&nbsp;Kenneth Rosenfield MD ,&nbsp;Gary M. Ansel MD","doi":"10.1016/j.jscai.2024.102400","DOIUrl":"10.1016/j.jscai.2024.102400","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerotic renal artery stenosis (ARAS) may provoke hypertension and/or impaired kidney function. Some patients develop uncontrolled hypertension and deteriorating kidney function despite optimal medical therapy. In these patients, endovascular treatment is an important therapeutic option. ARTISAN was a prospective, open-label, single-arm, multicenter clinical trial to evaluate the safety and effectiveness of the iCast RX covered stent both functionally for reestablishing renal artery flow, and clinically for controlling resistant hypertension.</div></div><div><h3>Methods</h3><div>Patients considered for enrollment had average systolic blood pressure (SBP) ≥155 mm Hg despite taking 3 antihypertensive medications. Prior to enrollment and covered stent placement, angiographic confirmation of ARAS ≥80% with physiologic significance was required. Clinical assessments were performed at 30 days, 9 months, and annually through 36 months. Covered stent safety and efficacy were based on 9-month coprimary end points, including primary vessel patency and SBP improvement at 9 months. Secondary outcomes included target lesion revascularization, major adverse events, and secondary patency.</div></div><div><h3>Results</h3><div>Sixty-eight of the planned 138 subjects were enrolled. Primary patency was seen in 94.3% of subject lesions; the mean SBP reduction was 15.7 mm Hg. The functional and clinical end points met prespecified performance goals of 70% primary patency (<em>P</em> &lt; .0001) and ≥10 mm Hg SBP decrease (<em>P</em> = .0192), respectively, at 9 months. Six subjects (8.8%) experienced 7 major adverse events within 36 months. The clinically driven target lesion revascularization rate was 7.3% at 36 months.</div></div><div><h3>Conclusions</h3><div>The high primary patency and improvement in SBP, persisting through 36 months, suggest that the iCast RX covered stent is safe and effective for the treatment of appropriately selected patients with ARAS.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102400"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980895","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":"Efficacy of Zwolle Score in Predicting Outcomes of Patients With ST-Segment Elevation Myocardial Infarction","authors":"Akshay Machanahalli Balakrishna MD ,&nbsp;Khansa Ahmad MD ,&nbsp;Melvin G. Joice MD ,&nbsp;Alexander G. Truesdell MD ,&nbsp;Syed Tanveer Rab MD ,&nbsp;Jinnette Dawn Abbott MD ,&nbsp;Saraschandra Vallabhajosyula MD, MSc","doi":"10.1016/j.jscai.2024.102389","DOIUrl":"10.1016/j.jscai.2024.102389","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102389"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980896","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 Randomized Trial of Cardiac Catheterization With Fasting Versus Liberal Oral Intake: The CALORI Trial","authors":"Brian K. Mitchell MD ,&nbsp;Anna Tomdio MD ,&nbsp;Muhammad S. Pir MD ,&nbsp;Suraj K. Mishra MD ,&nbsp;Pradeep Dayanand MD ,&nbsp;Guillaume Bonnet MD, PhD ,&nbsp;Maria C. Alu MS ,&nbsp;Zachary M. Gertz MD","doi":"10.1016/j.jscai.2024.102291","DOIUrl":"10.1016/j.jscai.2024.102291","url":null,"abstract":"<div><h3>Background</h3><div>Routine preprocedural fasting before cardiac catheterization remains common practice, despite a lack of robust evidence to support this practice. We investigated the impact of a liberal nonfasting strategy vs a standardized nil per os (NPO) regimen prior to cardiac catheterization.</div></div><div><h3>Methods</h3><div>Adult inpatients undergoing elective or urgent cardiac catheterization were randomized (1:1 ratio) to either NPO past midnight or ad libitum intake of liquids and solids (without dietary constraints) until immediately prior to the procedure. Only patients at high risk of aspiration or undergoing complex interventions were excluded. The primary end point was preprocedural patient-reported well-being scores (scaled 0-5, with 0 signifying absence of ailment and 5 the most extreme form), for variables including hunger, fatigue, anxiety, and nausea. A composite score summed the individual scores for hunger and fatigue. Other end points were periprocedural adverse events including emesis, aspiration, or intubation, in addition to postprocedural satisfaction.</div></div><div><h3>Results</h3><div>A total of 198 patients (65% male and 42% Black) were included in the final analysis. There were no differences in baseline characteristics between groups. Time from most recent oral intake (liquid or solid) to the start of the procedure averaged 148 minutes for the nonfasting group and 970 minutes for the NPO strategy (<em>P</em> &lt; .001). The composite preprocedural well-being score was significantly better in the nonfasting arm (2.4 ± 2.4 nonfasting vs 6.0 ± 2.5 NPO; <em>P</em> &lt; .001), as were the individual components of hunger (0.9 ± 1.5 vs 3.7 ± 1.5; <em>P</em> &lt; .001), fatigue (1.5 ± 1.6 vs 2.3 ± 1.8; <em>P</em> &lt; .001), and nausea (0.1 ± 0.5 vs 0.5 ±1.2; <em>P</em> = .006). There were no significant differences in adverse events between groups. Overall postprocedural satisfaction scores were significantly better in the nonfasting vs NPO group (0.3 ± 0.7 vs 1.0 ± 1.3, respectively; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>In this single-center randomized trial, a liberal nonfasting strategy prior to cardiac catheterization significantly improved patient well-being and satisfaction without compromising safety. Given the findings of this and other studies, routine fasting prior to cardiac catheterization should be reconsidered.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102291"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980888","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":"Three-Dimensional Rotational Angiography to Guide Cardiac Catheterization in Critical Infants Below 5kg of Body Weight","authors":"Chenise N. Lucas MSc,&nbsp;Martijn G. Slieker PhD,&nbsp;Mirella M.C. Molenschot MD,&nbsp;Hans M.P.J. Breur PhD,&nbsp;Gregor J. Krings PhD","doi":"10.1016/j.jscai.2024.102391","DOIUrl":"10.1016/j.jscai.2024.102391","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional rotational angiography (3DRA) is a promising advancement to guide cardiac catheterizations. It is used with restraint in critically ill infants with congenital heart disease (CHD) due to the lack of research conducted within this patient group.</div></div><div><h3>Methods</h3><div>Data of all infants with CHD and a body weight &lt;5 kg who underwent cardiac catheterization with the use of 3DRA between November 2011 and April 2021 were retrospectively analyzed. Primary outcome measures were 3DRA-related periprocedural deaths or major adverse events (MAEs). Secondary outcome measures were 3DRA-related minor adverse events (MiAEs), the amount of radiation exposure and contrast agent, and whether 3DRA led to important new findings. The case-based workflow of 3DRA in vulnerable infants is explained.</div></div><div><h3>Results</h3><div>Eighty-six patients underwent 109 cardiac catheterizations in which 132 3DRA scans were performed. Median age and weight were 50.0 days (IQR, 20.0-98.5) and 3.8 kg (IQR, 3.2-4.5). There were no periprocedural deaths or MiAEs, and only 2 MAEs occurred, both concerning ventricular fibrillation. The median radiation exposure was 160.0 cGy⋅cm² (IQR, 81.3-257.5), of which 28.0 cGy⋅cm² (IQR, 19.4-43.0) was derived from 3DRA. The mean amount of contrast agent used was 4.8 ± 1.6 mL/kg. In 70.6%, 3DRA imaging led to important new findings. Multivariate binary logistic regression analysis showed the presence of comorbidity to be associated with a lower odds of receiving a 3DRA-derived radiation dose ≥15 cGy⋅cm² (<em>P</em> = .01). Additionally, the interval between surgery and cardiac catheterization was significantly associated with higher odds of a contrast dye consumption ≥6 mL/kg (<em>P</em> = .046).</div></div><div><h3>Conclusions</h3><div>3DRA proved to be safe in vulnerable infants with CHD weighing &lt;5 kg, enabling visualization of anatomical substrates often invisible in conventional angiography. However, when an advanced computed tomography scanner is available, the diagnostic purposes for 3DRA are few. The greatest benefit of 3DRA usage is interventional guidance (3D roadmap).</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102391"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980383","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":"Continuous Mechanical Suction Use During Chronic Total Occlusion Revascularization","authors":"Paul Gilbert MD ,&nbsp;Taral Patel MD ,&nbsp;Ankur Gupta MD","doi":"10.1016/j.jscai.2024.102392","DOIUrl":"10.1016/j.jscai.2024.102392","url":null,"abstract":"<div><div>Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is high risk compared to non-CTO PCI. Iatrogenic coronary artery hematoma formation is a common occurrence during CTO PCI, impairing true lumen visualization. We describe the use of a continuous mechanical suction (CMS) device in 2 applications in which it was used for successful subintimal hematoma decompression and distal vessel re-entry. Additionally, we briefly review CMS utilization within the published literature. CMS use during CTO may be a viable technique in future revascularization attempts.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102392"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980892","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":"Strategic Management of Valve Infolding in Evolut TAVR Procedures: Enhancing Outcomes and Ensuring Patient Safety","authors":"Rajendra Shah MBBS ,&nbsp;Olayiwola Bolaji MD, MSc ,&nbsp;Yasemin Bahar MD ,&nbsp;Renu Sah MBBS ,&nbsp;Anderson Chukwuka Ariaga MD ,&nbsp;Timir K. Paul MD ,&nbsp;Rajeev L. Narayan MD ,&nbsp;M. Chadi Alraies MD","doi":"10.1016/j.jscai.2024.102394","DOIUrl":"10.1016/j.jscai.2024.102394","url":null,"abstract":"<div><div>Transcatheter aortic valve repair (TAVR) presents a minimally invasive alternative to traditional surgical valve replacement, albeit not without its own set of complications. A rare complication is the infolding of the self-expanding valve, which can precipitate cardiac arrest. The estimated incidence rate of this complication stands at 1.6%. The management of this complication hinges on either balloon dilation or valve replacement. This article discusses a case involving a 78-year-old man with symptomatic severe aortic valve stenosis. Following TAVR, the patient experienced asystole due to valve infolding, highlighting the need for heightened vigilance and refined intervention strategies in the management of TAVR complications.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 12","pages":"Article 102394"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980067","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}