American Journal of Cardiology最新文献

{"title":"Site-Level Variation and Factors Associated With an Outpatient Intravenous Diuretic Strategy for Worsening Heart Failure","authors":"Hubert B. Haywood MD, MBA , Lisa A. Kaltenbach MS , Uchechukwu Ikeaba MS , Gregg C. Fonarow MD , Karen Chiswell PhD , Veraprapas Kittipibul MD , Muhammad Shahzeb Khan MD, MSc , Megha Gupta BA , Best Uchehara MD, MBA , Bradley G. Hammill DrPH , Javed Butler MD, MPH, MBA , Adrian F. Hernandez MD, MHS , G. Michael Felker MD, MHS , Stephen J. Greene MD","doi":"10.1016/j.amjcard.2025.03.041","DOIUrl":"10.1016/j.amjcard.2025.03.041","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 3-5"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes Stratified by Time to ST-Segment Elevation Myocardial Infarction Presentation","authors":"Yosuke Kakimoto MD ,&nbsp;Ko Yamamoto MD ,&nbsp;Masahiro Natsuaki MD ,&nbsp;Goro Yoshioka MD ,&nbsp;Yuhei Goriki MD ,&nbsp;Kohei Kamishita MD ,&nbsp;Kensuke Yokoi MD ,&nbsp;Atsushi Kawaguchi PhD ,&nbsp;Mitsuhiro Shimomura MD ,&nbsp;Keiki Yoshida MD ,&nbsp;Shinjo Sonoda MD ,&nbsp;Koichi Node MD ,&nbsp;SAGA-ACS registry investigators","doi":"10.1016/j.amjcard.2025.03.043","DOIUrl":"10.1016/j.amjcard.2025.03.043","url":null,"abstract":"<div><div>There were few data on the clinical characteristics of ST-segment elevation myocardial infarction (STEMI) patients with late presentation (long symptom onset to door [hospital arrival] time). Among 719 consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) in the SAGA-ACS registry, we compared baseline characteristics and clinical outcomes between patients with early presentation (symptom onset to door time &lt;2.3 hours) and late presentation (≥2.3 hours). The cut-off point of 2.3 hours was the median value for the present study population. The median onset to door time was 1.3 hours in the early presentation group, and 4.8 hours in the late presentation group. Door to balloon time was not different between the groups (62.0 minutes vs 60.5 minutes). Late night to early morning onset (OR, 2.03; 95% CI, 1.45 to 2.85), age ≥75 years (OR, 1.56; 95% CI, 1.09 to 2.22), and women (OR, 1.49; 95% CI, 1.03 to 2.16) were independently associated with the late presentation, while culprit lesions in right coronary artery (RCA) was inversely associated the late presentation (OR, 0.62; 95% CI, 0.46 to 0.85). During the median 2.7 years follow-up, the cumulative incidence of all-cause death was numerically, but not statistically, higher in the late presentation group than in the early presentation group (16.3% vs 11.6% at 3 years, HR, 1.42; 95% CI, 0.97 to 2.07; p = 0.07). In conclusion, among patients with STEMI who underwent PCI, late night to early morning onset, advanced age, women, and culprit lesions in non-RCA were strongly associated with the late presentation. Strategies for minimizing symptom onset to door time should be targeted especially in these patients.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 57-63"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Peripheral Arterial Disease on Clinical Outcomes of Patients Undergoing Complex vs Noncomplex Percutaneous Coronary Intervention","authors":"Michael Gao MD,&nbsp;Angelo Oliva MD,&nbsp;Raman Sharma MD,&nbsp;Frank Kalaba MD,&nbsp;Samantha Sartori PhD,&nbsp;Serdar Farhan MD,&nbsp;Kenneth Smith MPH,&nbsp;Birgit Vogel MD,&nbsp;Prakash Krishnan MD,&nbsp;George Dangas MD, PhD,&nbsp;Roxana Mehran MD,&nbsp;Annapoorna Kini MD,&nbsp;Samin Sharma MD","doi":"10.1016/j.amjcard.2025.03.037","DOIUrl":"10.1016/j.amjcard.2025.03.037","url":null,"abstract":"<div><div>Peripheral arterial disease (PAD) often predicts poor outcomes in patients undergoing percutaneous coronary intervention (PCI). Here we examine the impact of PAD in patients receiving complex PCI (CPCI) and noncomplex PCI. Patients undergoing PCI at the Mount Sinai Hospital between 2012 and 2022 were stratified by the presence of CPCI and PAD. The primary outcome was major adverse cardiovascular events (MACE), a composite of death, myocardial infarction, target vessel revascularization, or stroke within 1 year; secondary endpoints included bleeding events. An adjusted Cox proportional hazard method was used to evaluate risks of each outcome within each subgroup. Among 20,376 patients, 8,200 (40.2%) had CPCI and 1,959 (9.6%) had PAD. PAD patients were older and more likely to be female and have risk factors such as diabetes and smoking and were more commonly discharged with anticoagulants. 1-year risk of MACE was significantly higher for patients with PAD in both CPCI (19.6% vs 14.4%, adj. hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.08 to 1.58, p = 0.006) and no-CPCI strata (13.9% vs 9.2%, adj. HR 1.35, 95% CI 1.12 to 1.64, p = 0.002; p-interaction = 0.349). Bleeding events were also more frequent in PAD patients for CPCI (8.5% vs 5.5%, adj. HR 1.40, 95% CI 1.07 to 1.84, p = 0.014) and no-CPCI (7.1% vs 4.3%, adj. HR 1.52, 95% CI 1.18 to 1.96, p = 0.001; p-interaction = 0.608). In conclusion, presence of PAD is associated with a significantly increased risk of MACE and bleeding after PCI, regardless of procedural complexity.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 76-83"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Clinically Significant Ventricular Arrhythmias in Patients on Home Inotrope Infusion in the Contemporary Era","authors":"Seth Fakess DO ,&nbsp;Gregory A. Panza PhD ,&nbsp;Ayesha Shaik MBBS ,&nbsp;Ina Lico DO ,&nbsp;Aneesh Tolat MD","doi":"10.1016/j.amjcard.2025.03.042","DOIUrl":"10.1016/j.amjcard.2025.03.042","url":null,"abstract":"<div><div>Approximately 6.2 million Americans live with heart failure (HF). Inotropic support is often used as bridge therapy and palliation. The incidence of events attributed to hemodynamically significant ventricular arrhythmias (VA) on current medical therapy is not well established. Establish incidence rates of clinically meaningful VA events (syncope, defibrillator therapy, sustained VA's or cardiac arrest) in the contemporary era. Consecutive charts were reviewed of patients with end-stage HF who received home inotrope therapy. ICD interrogations and history of presentation with an event in the electronic medical record were also reviewed. About 438 consecutive patients aged 68.0 ± 13.7yr (72.4% Male) were included in the analysis. Patients were on milrinone (<em>n</em> = 353) or dobutamine (<em>n</em> = 85) over 9.3 ± 11.6 months. Incidence of VA events for the overall sample was 5.66 events per 100 person-months (95% CI = 4.97 to 6.44). Patients on Milrinone (<em>n</em> = 353) had a VA event rate of 6.04 events per 100 person-months, while on Dobutamine (<em>n</em> = 85) the VA event rate was 3.79 events per 100 person-months. Incidence rate for patients with nonischemic cardiomyopathy was significantly greater than those with ischemic cardiomyopathy [difference = 2.54 events per 100-person months (95% CI = −1.09 to 3.99; p <em>&lt;</em>0.001)]. Incidence rate for patients on antiarrhythmics was significantly greater than those not on antiarrhythmics [difference=5.65 events per 100-person months (95% CI = 3.71 to 7.59; p &lt;0.001)]. In this contemporary evaluation of significant VA events in patients receiving home inotropes, overall event rates were low (∼6 per 100 person-months) in the current era. Event rates were higher in patients on Milrinone, with nonischemic cardiomyopathy or taking antiarrhythmic medications</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 50-54"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulation vs No Anticoagulation for Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Graft: A Meta-Analysis","authors":"Mariam Shariff MBBS ,&nbsp;Ashish Kumar MD ,&nbsp;Gabor Bagameri MD ,&nbsp;Narayan G. Kowlgi MBBS ,&nbsp;Abhishekh Deshmukh MBBS ,&nbsp;John Stulak MD","doi":"10.1016/j.amjcard.2025.03.036","DOIUrl":"10.1016/j.amjcard.2025.03.036","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 16-17"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Aortic-Valve Replacement in Patients With Asymptomatic Severe Aortic Stenosis With Preserved Left Ventricular Systolic Function: A Systematic Review and Meta-Analysis","authors":"Vinicius Bittar de Pontes ,&nbsp;Mariana R.C. Clemente ,&nbsp;Thierry Trevisan ,&nbsp;Sebastian Jaramillo ,&nbsp;Mauricio Ferreira Boneli ,&nbsp;Nicole Felix MD ,&nbsp;Laura G.S. Gameiro MD ,&nbsp;Philippe Garot MD ,&nbsp;Wilton F. Gomes MD","doi":"10.1016/j.amjcard.2025.03.039","DOIUrl":"10.1016/j.amjcard.2025.03.039","url":null,"abstract":"<div><div>Current guidelines recommend routine clinical surveillance for patients with asymptomatic severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF). However, the role of early aortic valve replacement (AVR) as compared with conservative treatment in these patients remains unclear. We systematically searched PubMed, Embase and Cochrane databases to identify studies comparing early AVR versus conservative treatment in asymptomatic patients with severe AS and preserved LVEF. All statistical analyses were performed using R software version 4.3.1 with a random-effects model. Seven studies comprising 2,531 patients with asymptomatic severe AS and preserved LVEF were included, of whom 1,234 (49%) underwent AVR. Median follow-up time was 49.3 months. Early AVR was associated with significantly lower incidence of all-cause (HR 0.51; 95% CI 0.31 to 0.83) and cardiac mortality (RR 0.51; 95% CI 0.30 to 0.89). There were no significant differences between early AVR and conservative treatment in terms of sudden death, hospitalization for cardiovascular (CV) causes, stroke, or myocardial infarction (MI). However, upon a subanalysis of randomized controlled trials (RCTs) only, patients undergoing early AVR had lower rates of hospitalization for CV causes (RR 0.41; 95% CI 0.27 to 0.63) and stroke (RR 0.62; 95% CI 0.40 to 0.95), with no difference in terms of all-cause mortality, sudden death, MI, or cardiac death. In this meta-analysis, early AVR was associated with reduced rates of all-cause and cardiac mortality, while yielding similar rates of stroke, hospitalization for CV causes, MI, or sudden death in the overall cohort analysis as compared with conservative treatment.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"248 ","pages":"Pages 73-79"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Right Ventricular Function Parameters can Identify Short-Term Nonresponders to Transcatheter Edge-to-Edge Repair for Mitral Regurgitation","authors":"Raffaella Mistrulli ,&nbsp;Tatyana Storozhenko ,&nbsp;Arthur Iturriagagoitia ,&nbsp;Sara Corradetti ,&nbsp;Michele Mattia Viscusi ,&nbsp;Dimitri Buytaert ,&nbsp;Thabo Mahendiran ,&nbsp;Elayne Kelen de Oliveira ,&nbsp;Lucio Addeo ,&nbsp;Emanuele Barbato ,&nbsp;Jerrold Spapen ,&nbsp;Jozef Bartunek ,&nbsp;Marc Vanderheyden ,&nbsp;Guy Van Camp ,&nbsp;Martin Penicka","doi":"10.1016/j.amjcard.2025.03.034","DOIUrl":"10.1016/j.amjcard.2025.03.034","url":null,"abstract":"<div><div>Mitral regurgitation (MR) is a common valvular disease associated with poor prognosis. Percutaneous mitral valve repair (PMVR) combined with guideline-directed medical therapy has shown prognostic benefits, yet a substantial proportion of patients experience major adverse cardiovascular events (MACE), including death and heart failure hospitalization, within the first year. Identifying short-term nonresponders remains a clinical priority. This study evaluated the prognostic value of advanced right ventricular (RV) function parameters in predicting MACE following PMVR using the MitraClip system. A total of 60 consecutive patients with symptomatic severe MR undergoing PMVR were analyzed. Echocardiographic assessments were performed at baseline, postprocedure before discharge, and at 6-month follow-up. Parameters included tricuspid annular plane systolic excursion (TAPSE) normalized to pulmonary artery systolic pressure (TAPSE/PASP), right ventricular end-diastolic area (TAPSE/RVAD), and end-systolic area (TAPSE/RVAS), along with RV myocardial work indices. During the first year, 35% of patients experienced MACE. At baseline, those who developed MACE had significantly higher creatinine, troponin T, NT-proBNP levels, larger right heart dimensions, and lower TAPSE (all p &lt;0.05), while other clinical, imaging, and procedural characteristics were similar. In multivariate analysis, TAPSE/PASP, TAPSE/RVAS, and TAPSE/RVAD were independent predictors of MACE (all p &lt;0.05), with AUC values ranging from 0.80 to 0.85, indicating strong predictive capacity. Throughout follow-up, these indices remained significantly lower in patients with MACE, while RV myocardial work parameters had lower predictive accuracy (AUC&lt;0.60). In conclusion, a comprehensive RV assessment, particularly TAPSE-based indices, can help identify patients at higher risk of adverse outcomes after PMVR, whereas RV myocardial work indices appear less reliable.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 13-20"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Aortic Valve Replacement With a Fully Retrievable Self-Expanding Dry-Tissue Valve: First-in-Man Study","authors":"Zhengang Zhao MD ,&nbsp;Yong Peng MD ,&nbsp;Fei Chen MD ,&nbsp;Esteban Villegas MD ,&nbsp;Adolfo Lopez Campanher MD ,&nbsp;Zhongkai Zhu MD ,&nbsp;Xi Li MD ,&nbsp;Xin Wei MD ,&nbsp;Jiafu Wei MD ,&nbsp;Scott Lim MD ,&nbsp;Jorge Baccaro MD ,&nbsp;Yuan Feng MD ,&nbsp;Mao Chen MD, PhD","doi":"10.1016/j.amjcard.2025.03.032","DOIUrl":"10.1016/j.amjcard.2025.03.032","url":null,"abstract":"<div><div>Contemporary self-expanding transcatheter aortic valve replacement (TAVR) devices are retrievable and repositionable at partial release, however, valve migration may occur during final release. The Venus-PowerX Valve is a novel self-expanding dry-tissue TAVR device which is retrievable at 100% full deployment. This first-in-man study sought to evaluate the feasibility and safety of the new TAVR device. The clinical outcomes and adverse events were assessed and reported according to the Valve Academic Research Consortium-3 criteria. A total of 25 patients with severe aortic stenosis (75.3 ± 5.3 years, 48.0% male, 52.0% bicuspid aortic valve) were enrolled. Acute technical success was achieved in 25 (100%) patients. Valve recapture at 100% full deployment was attempted in 2 patients due to suboptimal position or inappropriate valve size, and was successful in both. No patient required a second valve. At 30 days, device success was achieved in 88.0%. The reasons for unachieved device success included residual gradient (4.0%), moderate paravalvular leak (PVL, 4.0%) and VARC type 2 bleeding (4.0%). New permanent pacemaker was required in 5 (20.0%) patients. At 1-year follow-up, overall survival rate was 96.0%, there was no stroke, myocardial infarction, or cardiovascular rehospitalization. Mean aortic valve gradient improved significantly from 56.0 ± 17.9 mmHg to 11.6 ± 6.0 mmHg, and effective orifice area improved from 0.6 ± 0.2 cm² to 1.8 ± 0.4 cm²; 79.1% had none or trivial PVL. In conclusion, the novel fully retrievable Venus-PowerX Valve could enable highly predictable TAVR device positioning and produce satisfactory hemodynamic and clinical outcomes in both bicuspid and tricuspid aortic valve stenosis.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 29-34"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Combined Electrocardiographic and Imaging Predictive Risk Model for New Permanent Pacemaker After Transcatheter Aortic Valve Implantation: The RITMO Score","authors":"Giulia Costa ,&nbsp;Marco Angelillis ,&nbsp;Cristina Giannini ,&nbsp;Matteo Mazzola ,&nbsp;Chiara Primerano ,&nbsp;Giulia Brandi ,&nbsp;Paolo Spontoni ,&nbsp;Laura Stazzoni ,&nbsp;Anna Sonia Petronio ,&nbsp;Marco De Carlo","doi":"10.1016/j.amjcard.2025.03.028","DOIUrl":"10.1016/j.amjcard.2025.03.028","url":null,"abstract":"<div><div>Currently, permanent pacemaker implantation (PPMI) is the most common complication of transcatheter aortic valve implantation (TAVI). The aim of this analysis is to develop a simple and effective risk prediction model for PPMI within 30 days of TAVI. Data from 370 patients who underwent TAVI with the self-expanding valve between February 2015 and June 2022 at our center were collected in the development cohort (DC). A risk score was developed based on baseline anatomical and electrocardiographic characteristics, including the estimation of aortic calcium load (ACL) using both the Agatston score and calcium volume. A validation cohort (VC) of 234 patients was used to test the score. Seventy-two patients (19.5%) underwent PPMI in DC. Preprocedural right bundle branch block (RBBB), membranous septum length (MSL) &lt;5 mm, and severe ACL were significant predictors of PPMI. The Agatston score showed higher agreement with PPMI compared to calcium volume (<em>K</em> = 0.89; 95% CI 0.84 to 0.93 vs <em>K</em> = 0.71; 95% CI 0.64 to 0.79, respectively). Pre-existing RBBB, MSL, and Agatston score have been combined into a simple score, called RITMO (theoretical range from −1 to 4 points). We applied the score to the VC and find that a high score (&gt;1) had an OR&gt;6 to predict PPMI after TAVI. In patients undergoing TAVI with a self-expanding valve, baseline RBBB, shorter MSL, and higher ACL evaluated using the Agatston method were predictive of 30-day PPMI. In conclusion, the RITMO score represents a simple tool for risk stratification, with implications for procedural planning and patient counseling.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"248 ","pages":"Pages 1-9"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Intraprocedural Complications During Transcatheter Aortic Valve Implantation Requiring Emergent Cardiac Surgery: An Updated Systematic Review","authors":"Giuseppe Verolino MD ,&nbsp;Michele Di Mauro MD, PhD ,&nbsp;Dario Calderone MD ,&nbsp;Roberto Lorusso MD, PhD","doi":"10.1016/j.amjcard.2025.03.031","DOIUrl":"10.1016/j.amjcard.2025.03.031","url":null,"abstract":"<div><div>Transcatheter aortic valve implantation (TAVI) is an established treatment for patients &gt;75 years old with severe aortic stenosis. From the technique's beginnings in the early 2000s, over 20 years of experience in the TAVI procedure have allowed its wide diffusion with optimal procedural results. Intraprocedural complications during TAVI are yet a fearful scenario, sometimes requiring emergent open-heart surgery (EOHS) that is burdened by high intraoperative mortality (50% at 30 days). Furthermore, also when a surgical treatment is not needed, intraprocedural complications have a challenging management and a critical impact on patients’ prognosis. The volume of procedures in the last 10 years has been observed to increase substantially, with an incidence of major intraprocedural complications of around 1%. However, the features and specific incidence for each complication have not been revised recently. This work aims to update the knowledge about major intraprocedural complications during TAVI, considering the increased operators' experience and recent device developments. An updated point of view on major intraprocedural complications could suggest a need for change in the TAVI paradigm, promoting TAVI programs even in centers without on-site cardiac surgery.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"247 ","pages":"Pages 21-28"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}